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Found 290 results
  1. News Article
    NHS England has announced the first details of its ‘Leadership Competency Framework’, and revealed it will be launched this September. The LCF will underpin the annual appraisal of NHS board directors and, in turn, adherence to the revamped Fit and Proper Person Test. NHSE also revealed that leaders, including senior clinicians, who hold “significant roles” but are not board members may be subject to the FPPT in the near future. The new FPPT framework said the LCF would contain “six competency domains which should be incorporated into all senior leader job descriptions and recruitment processes”. Read full story Source: HSJ, 3 August 2023
  2. Content Article
    The Fit and Proper Person Test (FPPT) Framework has been developed by NHS England in response to recommendations made by Tom Kark KC in his 2019 review of the FPPT (the Kark Revew). This framework introduces a means of retaining information relating to testing the requirements of the FPPT for individual directors, a set of standard competencies for all board directors, a new way of completing references with additional content whenever a director leaves an NHS board, and extension of the applicability to some other organisations, including NHS England and the CQC. It will help prevent directors who have been involved in or enabled serious misconduct or mismanagement from joining a new NHS organisation.
  3. Content Article
    Authors conducted a before and after, retrospective, observational study using anonymised, routinely collected, patient-level data from a single English NHS ED between April 2018 and December 2019. The primary outcomes of interest were the proportion of admitted patients, that is, the admission rate, the length of stay in the ED and ambulance handover times. They used interrupted time series models to study and estimate the impact of removing the 4-hour access standard.
  4. News Article
    Three intensive care units for children are not meeting standards for co-located services, a national report has found. Royal Stoke University Hospital, Royal Brompton Hospital in London and Freeman Hospital in Newcastle, which all have “level three” paediatric intensive care beds for the most seriously ill patients, do not offer specialised paediatric surgery, according to a report from NHS England’s Getting it Right First Time (GIRFT) programme. The report, released in April, said specialised paediatric surgery “should be co-located on the same site” as a paediatric intensive care unit with level three beds and be “immediately available” to meet quality standards set by the Paediatric Intensive Care Society. The report also found the units do not offer services such as trauma, neurosurgery and bone marrow transplantation, which it says is a reflection of the variability and “the poor alignment” of specialised paediatric services at PICUs. Read full story (paywalled) Source: HSJ, 23 May 2022
  5. News Article
    The trust at the centre of a maternity scandal insists it has been providing immediate anaesthetic cover for obstetric emergencies, contrary to an NHS England report suggesting it had not and had been potentially breaching safety standards. Health Education England – now part of NHSE – visited William Harvey Hospital in March and was told senior doctors in training who were covering obstetrics could also be covering the cath lab – which deals with patients who have had a heart attack, and could receive trauma, paediatric emergency and cardiac arrest calls. This suggested the trust was in conflict with Royal College guidelines which state an anaesthetist should always be “immediately available” for obstetrics. East Kent Hospitals University Foundation Trust, which runs the hospital, originally told HSJ its rota had very recently been changed and that an anaesthetist with primary responsibility for maternity could leave any other work to attend to a maternity emergency immediately. However, it has since said it has been the case for a long time that an anaesthetist is available to return to maternity in case of an emergency. Read full story (paywalled) Source: HSJ, 17 June 2023
  6. News Article
    A trust at the centre of a maternity scandal has been failing to meet Royal College standards in one of its maternity units, HSJ can reveal. The duty anaesthetist for the maternity unit at the William Harvey Hospital in Ashford has also had to cover the hospital’s primary percutaneous coronary intervention suite. This could mean no anaesthetist is available to carry out an emergency Caesarean if they are needed to treat a heart attack patient. This goes against Royal College of Anaesthetists’ guidelines, which say a duty anaesthetist must be “immediately available for the obstetric unit 24/7”. The guidelines add that where the duty anaesthetist has other responsibilities – because, for example, they work at a smaller maternity unit where the workload does not justify them being there exclusively – then “these should be of a nature that would allow the activity to be immediately delayed or interrupted should obstetric work arise”. The William Harvey unit is East Kent Hospitals University Foundation Trust’s major birth centre. The trust has around 6,500 births a year – the majority at the WHH – and was heavily criticised for poor maternity care in a report by Bill Kirkup last year. Read full story Source: HSJ. 17 July 2023
  7. News Article
    The Government is consulting on a draft code of practice which will ensure health and care staff, including GPs, receive training on learning disabilities and autism ‘appropriate to their role’. Since July last year, all CQC-registered health and social care providers including GP practices in England have been required to provide training for their staff in learning disability and autism, including how to interact with autistic people and people who have a learning disability. The legal requirement was introduced by the Health and Care Act 2022, but the Government has now launched a consultation on the Oliver McGowan Code of Practice, which outlines how providers can meet the new requirement. The BMA’s GP Committee last month said that the Act does not specify a training package or course for staff and that the CQC ‘cannot tell practices specifically how to meet their legal requirements in relation to training’. The Government’s draft code says that CQC-registered providers must ensure that all staff, regardless of role or level of seniority, have ‘the right attitude and skills to support people with a learning disability and autistic people’ and will need to demonstrate to the CQC how their training meets or exceeds the standards set out in the code. Read full story Source: Pulse, 29 June 2023
  8. News Article
    A new patient safety chief should be appointed in each of the four UK nations to oversee health and social care and tackle the currently “fragmented and complex” system, experts have urged. The Professional Standards Authority for Health and Social Care (the body that oversees the 10 statutory bodies that regulate health and social care professionals in the UK, including the General Medical Council) has called for what it described as a radical rethink to improve safety in care. In a report published last week, it recommended the appointment of an independent health and social care safety commissioner (or equivalent) for each UK country. These commissioners would identify current and potential risks across the whole health and social care system, it said, and instigate necessary action across organisations. Read full story (paywalled) Source: BMJ, 6 September 2022 Related reading Working together to achieve safer care for all: a blog by Alan Clamp (chief executive of the Professional Standards Authority) Joining up a fragmented landscape: Reflections on the PSA report ‘Safer care for all’ (a blog from Patient Safety Learning
  9. News Article
    Some of the country’s leading acute hospitals are not meeting a key NHS standard for mental health support in emergency departments, HSJ research suggests, with some regions faring better than others. Latest official estimates indicate that more than a third of EDs (36 per cent) are not yet meeting ‘core 24’ standards for psychiatric liaison – which requires a minimum of 1.5 full-time equivalent consultants and 11 mental health practitioners. The long-term plan target is for 70 per cent of acute trust emergency departments to have the optimum ‘core 24’ standard service by 2023-24. The NHS appears to be on track to hit this, with significant progress made, despite the pandemic. Annabel Price, chair of the Royal College of Psychiatrists’ liaison faculty, said tackling the workforce crisis with a fully funded plan would “prove instrumental in boosting recruitment across all acute trusts”. Read full story (paywalled) Source: HSJ, 23 August 2022
  10. News Article
    Trust boards should start scrutinising performance against new indicators set out by NHS England this month as part of a national push to iron out unwarranted variation in performance on key sepsis blood tests, according to an NHSE report. Blood cultures are the primary test for detecting blood stream infections, determining what causes them, and directing the best antimicrobial treatment to deal with them. However, it is too often seen as part of a box-ticking exercise, according to a report published by NHSE yesterday. Improving performance on this important pathway should be integrated into existing trust governance structures for sepsis, antimicrobial stewardship, and infection control “to help secure a ‘board to ward’ focus on improvement,” the report says. It says there is too much variation in how blood cultures are taken prior to analysis and sets out two targets for trusts to use to standardise their collection. The first is ensuring clinicians collect two bottles of blood, each containing at least 20ml for culturing. The more blood collected, the higher the rate of detecting bloodstream infections. Blood culture bottles “are frequently underfilled”. The second is ensuring blood cultures are loaded into an analyser as fast as possible, within a maximum of four hours, because delaying analysis reduces the volume of viable microorganisms that can be detected. Read full story (paywalled) Source: HSJ, 1 July 2022
  11. News Article
    Concerned healthcare workers in Illinois and Indiana are calling on The Joint Commission to add a safe staffing standard to its accreditation process. Yolanda Stewart, a patient care technician at Northwestern Memorial Hospital, once injured her back so badly on the job that she couldn’t work for six months. But when she talks about that time, she doesn’t mention her own pain. Instead, she talks about the patient she’d been trying to help, recalling his extreme discomfort. Because the unit was short-staffed, Stewart lifted and turned the patient on her own. The move helped the patient but cost Stewart. Many healthcare workers have similar stories, she says, adding, “Working short-staffed is a safety issue for workers and patients.” In fact, reports show that lack of staff in hospitals leads to higher patient infection and death rates. Covid-19 has greatly worsened the healthcare staffing shortage, with 1 in 5 hospital employees — from environmental services workers to nurses — leaving the field. Hospitals have grappled with staffing issues since before the pandemic, but Covid-19 highlighted the challenges — and exacerbated them. Now, concerned healthcare workers throughout Illinois and Indiana are sounding the alarm. They’re calling on The Joint Commission — the third-party agency that accredits 22,000 US healthcare organisations — to add a safe staffing standard to its accreditation process, similar to student-to-teacher ratio requirements that many states have. “We have all kinds of rules to make sure that hospitals are safe: We make sure that healthcare workers wash their hands before procedures, that they wear gloves and protective equipment, that bed sheets are changed between patients. Yet there are no statewide regulations about hospital staffing levels,” said Service Employees International Union (SEIU) Healthcare Illinois President Greg Kelley at a demonstration in early June. Read full story Source: Chicago Health, 8 June 2022
  12. News Article
    The Care Quality Commission (CQC) has issued a trust with a warning notice following an inspection that found wards did not have enough staff to care for patients. Staff at York hospital told inspectors they were not able to interact with individual patients and cater to their needs, with one saying: “We have to choose, do we turn, check, and make sure all patients are not soiled, or do we fully wash ten? Some of these patients haven’t been washed for two to three days.” York and Scarborough Teaching Hospitals CEO Simon Morritt said: “Many of the issues raised by the CQC were known to us, and reflect the extreme pressures facing the trust, the demands of covid and associated staff absence, and the well-documented recruitment challenges. The report demonstrates that, when faced with these pressures, it is not always possible to give the standard of care we would want for all of our patients all of the time.” The CQC said there were “significant safety concerns about fundamental standards of patient care” at the hospital. “The service didn’t have enough nursing staff with the right skills, training and experience to keep patients safe and to provide the right care and treatment,” said Sarah Dronsfield, the CQC’s head of hospital inspection. “It was disappointing that managers didn’t regularly review the situation and change the staffing arrangements to accommodate this.” Read full story (paywalled) Source: HSJ, 9 June 2022
  13. News Article
    All the NHS’s 1.5m staff in England should tackle discrimination against disadvantaged groups, not just bosses and specialist diversity teams, a major review has concluded. NHS trusts will need fewer equality, diversity and inclusion (EDI) teams if action against discrimination does become “the responsibility of all”, according to the report. The review of NHS leadership said the health service should adopt a different approach to equality issues in order to overcome the widely recognised disadvantages faced by certain groups of its own staff, which include lower pay and chances of promotion among Black and ethnic minority doctors compared with white medics and low BAME representation in senior managerial ranks. The inquiry, undertaken by Genl Sir Gordon Messenger and Dame Linda Pollard, was commissioned last year by Sajid Javid, the health secretary. The report concluded that: “Most critically, we advocate a step-change in the way the principles of equality, diversity and inclusion are embedded as the personal responsibility of every leader and every member of staff. “Although good practice is by no means rare, there is widespread evidence of considerable inequity in experience and opportunity for those with protected characteristics, of which we would call out race and disability as the most starkly disadvantaged. “The only way to tackle this effectively is to mainstream it as the responsibility of all, to demand from everyone awareness of its realities and to sanction those that don’t meet expectations.” Read full story Source: The Guardian, 8 June 2022
  14. News Article
    A government review of health and care leadership has recommended a single set of ‘core leadership and management standards’ for NHS managers. The report by General Sir Gordon Messenger and Dame Linda Pollard calls for “consistent management standards delivered through accredited training”, according to a government statement this morning. The full document has yet to be published but the statement summarises the findings and says an “institutional inadequacy” has formed in the way leadership and management is trained and developed in the NHS. It says the report has produced seven recommendations, which have all been accepted in full by the health and social care secretary Sajid Javid, who said they must be taken forward “urgently”. Among them is a call for a more “effective and consistent” appraisal system to reduce variation in how performance is managed. This is after the review concluded a greater focus was needed on “how people have behaved [and] not just what they have achieved”. The recommendations do not include any registration system for NHS managers, despite calls from some over many years for more regulation of the roles, nor appear to include specific reform of the “fit and proper person” test, which has been discredited and under review. Read full story (paywalled) Source: HSJ, 8 June 2022
  15. News Article
    The US Joint Commission will hold a safety briefing with healthcare organisations at the start of every accreditation survey starting in 2023, the organisation has said. Site surveyors and staff members preselected by the healthcare organisation will conduct an informal, five-minute briefing to discuss any potential safety concerns — such as fires, an active shooter scenario or other emergencies — and how surveyors should react if safety plans are implemented while they are on site. The change takes effect 1 January 2023 and applies to all accreditation surveys performed by the organisation. Read full story Source: Becker's Hospital Review, 13 December 2022
  16. News Article
    People concerned about the safety of patients often compare health care to aviation. Why, they ask, can’t hospitals learn from medical errors the way airlines learn from plane crashes? That’s the rationale behind calls to create a 'National Patient Safety Board,' an independent federal agency that would be loosely modelled after the US National Transportation Safety Board (NTSB), which is credited with increasing the safety of skies, railways, and highways by investigating why accidents occur and recommending steps to avoid future mishaps. But as worker shortages strain the US healthcare system, heightening concerns about unsafe care, one proposal to create such a board has some patient safety advocates fearing that it wouldn’t provide the transparency and accountability they believe is necessary to drive improvement. One major reason: the power of the hospital industry. The board would need permission from health care organisations to probe safety events and could not identify any healthcare provider or setting in its reports. That differs from the NTSB, which can subpoena both witnesses and evidence, and publish detailed accident reports that list locations and companies. A related measure under review by a presidential advisory council would create such a board by executive order. Its details have not been made public. Learning about safety concerns at specific facilities remains difficult. While transportation crashes are public spectacles that make news, creating demand for public accountability, medical errors often remain confidential, sometimes even ordered into silence by court settlements. Meaningful and timely information for consumers can be challenging to find. However, patient advocates said, unsafe providers should not be shielded from reputational consequences. Read full story Source: CNN, 30 May 2023 Related reading on the hub: Blog - It is time for a National Patient Safety Board: Pittsburgh Regional Health Initiative
  17. News Article
    Every time a mistake is made in a healthcare setting, there can be serious repercussions. Patients may suffer lifetime injuries or even pay the ultimate price for someone else's mistake. Hospitals may wind up paying the price literally — financially and legally — and suffer costly public reputation troubles in the aftermath. Increased patient loads combined with the workforce shortage and often decreasing financial resources have created "chaos" in hospitals, said Doug Salvador MD, chief quality officer at Baystate Health in Springfield, Mass. Safety watchdog organizations, including The Joint Commission and The Leapfrog Group, have reported the result of that chaos: soaring cases of preventable medical errors. The solution, he and several other sources who spoke with Becker's said, is to create standard operating procedures in every department, at every step of the patient journey. These SOPs are more than lists of guidelines; they require strict adherence and limited room for error thanks to built-in cross-check points. And, when instituted properly, they highlight system flaws in real time by creating what Dr. Salvador called "situational awareness." Situational awareness, he added, keeps front-line healthcare professionals on top of their safety game. Read full story Source: Becker's Healthcare, 9 May 2023
  18. News Article
    The Nursing and Midwifery Council (NMC) has withdrawn its accreditation of the midwifery programme at a Kent university due to fears over quality and safety. The regulator highlighted concerns that Canterbury Christ Church University students were not gaining the expertise needed to deliver safe, effective and kind care. An NMC director said the decision was made in the “best interests of women, babies, and families”. The university said the decision had “devastating consequences” for their student midwives. “Our absolute priority is the wellbeing of our students and staff, and ensuring that our students can continue to complete their studies and begin their future careers, to be the high quality, much needed midwives that this region needs,” a university spokesperson said. Sam Foster, NMC executive director of professional practice, said while the decision would impact students and the local workforce, the regulator's role was to uphold the high standards that “women and families have the right to expect”. Read full story Source: BBC News, 4 May 2023
  19. Content Article
    Sedation for therapeutic and investigative procedures in healthcare is extensively and increasingly used. In 2013 the Academy of Medical Royal Colleges (the Academy) published Safe sedation practice for healthcare procedures: Standards and guidance (this updated and replaced earlier guidance). The guidance recommended core knowledge, skills and competencies required for the safe delivery of effective sedation. It also highlighted that safety will be enhanced by the provision of achievable standards, along with the availability of appropriate facilities and monitoring used under good organisational governance of staffing, equipment, education and practice. However, despite this, avoidable morbidity and mortality continue to occur. Service reviews by the Royal College of Anaesthetists’ (RCoA’s) Anaesthesia Clinical Services Accreditation (ACSA) programme suggest that the recommendations in the 2013 guidance have not been fully acted upon by many hospitals. Therefore, this update summarises the recommendations to provide regulators with a set of standards against which to inspect facilities providing sedation and to ensure that safety standards are being met.
  20. Content Article
    In this BMJ opinion piece, Scarlett McNally discusses the revised National Safety Standards for Invasive Procedures (NatSSIP2). The original NatSSIPs were designed to prevent “never events”—yet more than 300 occurrences of wrong site surgery, retained objects after procedure, or wrong implant insertion still occur yearly in the UK.  NatSSIP2 brings in safety science and human factors, with expectations for organisations including standardisation, harmonisation, training, and audit. "The biggest danger is if the new standards sit on the shelf. With their benefits for patient safety and teamworking, we must accept the repetitive elements and consistently apply these new standards, every time, in every department", writes Scarlett.
  21. Content Article
    Lilian Chiwera is an independent surgical site infection (SSI) surveillance and prevention (SSISP) expert with experience setting up and coordinating a very successful SSI surveillance service at Guys & St Thomas’ NHS Foundation Trust from 2009–2022. Lilian shares the work she and her colleagues are doing around a surgical site infections patient safety initiative and explains why she wants to establish an annual Surgical Site Infections Prevention Day.
  22. Content Article
    The original National Safety Standards for Invasive Procedures (NatSSIPs) were published in 2015. Understanding of how to deliver safe care in a complex and pressurised system is evolving. These revised standards (NatSSIPs2) are intended to share the learning and best practice to support multidisciplinary teams and organisations to deliver safer care.
  23. Content Article
    Nicole McCarthy tells us about the Royal College of Psychiatrists' Quality Network for Inpatient Working Age Mental Health Services (QNWA), how it supports and engages mental health inpatient wards in a process of quality improvement, its accreditation and developmental processes and how you can become a member.
  24. Content Article
    As global trade and the Internet keep on growing it has become much easier for people to pass goods off as genuine. Counterfeiting in medicine products is becoming more prevalent and countries are now adopting systems to protect the legitimate supply of products to protect the industry and importantly the patients. Systems are already operating in America and Germany and the EU has formulated a directive for all European countries to adopt a system that protects all European citizens. The False Medicine Directive (FMD) registration database tracks all medicines from the manufacturer through to the patient in a unified way across the whole of Europe. Across the EU those who manufacture, sell or dispense medicines must comply with new track and trace regulations. Find out more from the FMD plus website.
  25. Content Article
    In this blog, Patient Safety Learning’s Chief Executive Helen Hughes reflects on some of the key patient safety issues and developments over the past 12 months and looks ahead to 2023.
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