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Showing results for tags 'Workforce management'.
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Content ArticleThis brief paper reviews the available published literature on shiftwork and safety that allows the estimation of the relative risk of “accidents” or injuries associated with specific features of shift systems. It discusses three main trends in risk: Risk is higher on the night shift, and to a lesser extent the afternoon shift, than on the morning shift Risk increases over a span of shifts, especially so if they are night shifts Risk increases with increasing shift length over eight hours The authors discuss the fact that some of these trends are not entirely consistent with predictions made based on considerations of the circadian variations in sleep propensity or rated sleepiness, and consider factors relating to sleep that may underlie the observed trends in risk. They also discuss the practical implications of the trends in risk for the design of safer shift systems.
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Content ArticleFatigue refers to the issues that arise from excessive working time or poorly designed shift patterns. It is generally considered to be a decline in mental and/or physical performance that results from prolonged exertion, sleep loss and/or disruption of the internal clock. Fatigue results in slower reactions, reduced ability to process information, memory lapses, absent-mindedness, decreased awareness, lack of attention and underestimation of risk. It can lead to errors and accidents, ill-health and injury, and reduced productivity and is often a root cause of major accidents. This guidance from the Health and Safety Executive (HSE) outlines key information about fatigue and signposts to further resources about managing fatigue at work.
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News Article
NHS faces ‘alarming’ exodus of doctors and dentists, health chiefs warn
Patient Safety Learning posted a news article in News
The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals 4 in 10 are likely to quit over “intolerable” pressures. Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK. In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”. Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone. NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay. Read full story Source: The Guardian, 29 January 2023 -
Content ArticleThis study in the British Journal of Nursing aimed to explore whether fatigue, workload, burnout and the work environment can predict the perceptions of patient safety among critical care nurses in Oman. A cross-sectional predictive design was used on a sample of 270 critical care nurses from the two main hospitals in the country's capital, with a response rate of 90%. The authors found a negative correlation between fatigue and patient safety culture (r= -0.240), which indicates that fatigue has a detrimental effect on nurses' perceptions of safety. There was also a significant relationship between work environment, emotional exhaustion, depersonalisation, personal accomplishment and organisational patient safety culture. Regression analysis showed that fatigue, work environment, emotional exhaustion, depersonalisation and personal accomplishment were predictors for overall patient safety among critical care nurses.
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News Article
NHS ‘haemorrhaging’ senior emergency department nurses
Patient Safety Learning posted a news article in News
Experienced emergency department nurses are “leaving in droves” because they feel unable to do their jobs properly under the current conditions, a doctor has warned. Giving evidence to the Health and Social Care Select Committee yesterday, Dr Adrian Boyle, president of the Royal College of Emergency Medicine, raised concern about nurse retention and morale in emergency departments. “We are haemorrhaging experienced emergency nurses because they are finding it very frustrating" He said: “What I'm also seeing is that a lot of nurses, particularly the experienced nurses, they're almost like the [non-commissioned officers] of the health service, the sergeants who know how to get things done, are leaving in droves.” Dr Boyle added: “We are haemorrhaging experienced emergency nurses because they are finding it very frustrating. “The problem is not because there's too much work but they're unable to do the work that they're trained to do." Read full story Source: Nursing Times, 25 January 2023 -
Content ArticleThe Royal College of Emergency Medicine (RCEM) ‘Wales' Emergency Medicine Workforce Census 2023’ is an in-depth analysis of the state of the Emergency Medicine workforce, providing an insight into the working patterns of clinicians and allowing a forecast to be made around the future workforce needs of Emergency Departments in Wales.
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Content ArticleYou can now watch the recording of the Nuffield Trust event: 'Does the rush for new types NHS staff have a dark side?'
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Content ArticleIn this article for the Byline Times, Consultant David Oliver analyses claims by media and political commentators about spending, waste and inefficiency in healthcare and proposes a ten point plan to restore services to their 2010 level.
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Content ArticleIn this interview for The Guardian, Pat Cullen, General Secretary of Royal College of Nursing (RCN), talks about how RCN members are being forced to use food banks, her frustration with the government and how she learned to be a tough negotiator. She discusses the issues that led to nurses balloting to strike—violence, sexual assault, unsafe staffing levels and pay that has not kept up with inflation—and outlines the difficult realities of being a nurse in the NHS. She also describes the negotiations with the Government, who according to Cullen, refused to discuss nurses' pay.
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Content ArticleIn this article, Richard Murray, Chief Executive of The King's Fund, reflects on what 2023 has in store for the health and care system in England. Acknowledging the intense pressure all services are currently under, he highlights that patients aren't currently receiving the care they need meaning that coping with operational challenges is going to dominate the early part of the year for the health and care sector. He warns of the futility of the Government adding new performance management measures to the sector, and expresses hope that Integrated Care Boards (ICBs) could make a difference by bringing together stakeholders to tackle longer-term problems such as integration, population health and inequalities.
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Content ArticleEven before the Covid-19 pandemic, rural and remote health services in England faced long-standing workforce, financial and capacity issues. This report by the Nuffield Trust explores the impact the pandemic has had on the delivery of rural and remote health services, highlighting the underlying challenges faced by these services. It outlines how the challenges faced are different for rural areas when compared to more urban areas. The authors also discuss how performance could be monitored to signal the risk of any significant service pressures over the coming months.
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Content ArticleIn this article for The Guardian, an anonymous hospital consultant describes the situation in many NHS emergency departments in January 2023—patients ready for medical admission waiting in ambulances in the hospital car park, patients receiving IV antibiotics in chairs in the corridor and staff completely overwhelmed by the workload. The author highlights that accident and emergency departments are now being used for a purpose for which they were not designed—looking after patients who need to be admitted to hospital wards. They describe the implications of this on patient safety and staff wellbeing and argue that the NHS and Government need to call the situation what it is—a crisis—or we will come to accept poor quality care and low patient safety standards as the norm.
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Content ArticleThis BMJ Opinion piece is written by Chris Ham (in a personal capacity)who was chief executive of The King’s Fund from 2010 to 2018. Chris talks about the recent funding announcement to support hospital discharges in order to free up bed space. He highlights a number of key considerations including: the impact on patient involvement in their discharge decisions staff shortages in care homes bed capacity in care homes. Chris questions whether these decisions are 'symbolic policy making' or whether they will actually make a difference to patients.
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News Article
Doctors union plans 72-hour strike
Patient-Safety-Learning posted a news article in News
Junior doctors across England will walk out for 72 hours in March if a ballot for industrial action is successful, the British Medical Association has told ministers. The BMA confirmed the move ahead of the opening of its ballot on Monday (9 January). The union is calling for real terms pay cuts over the past decade to be reversed, claiming the last 15 years have led to a 26 per cent decline in the value of junior doctors’ pay. Robert Laurenson and Vivek Trivedi, co-chairs of the BMA’s junior doctors committee, said: “Pay erosion, exhaustion and despair are forcing junior doctors out of the NHS, pushing waiting lists even higher as patients suffer needlessly.” Read full story (paywalled) Source: HSJ, 8 January 2023 -
Content ArticleThe NHS and social care system in the UK are under immense strain, and this is increasingly causing harm to patients. This is seen in the current crisis in urgent and emergency care, but is present throughout the system. This BMJ article looks at a collaborative document produced by the Royal College of Physicians (RCP), Royal College of Emergency Medicine (RCEM), Royal College of General Practitioners (RCGP), Royal College of Psychiatrists (RCPsych) and the Society for Acute Medicine (SAM). The document highlights key actions and priorities that may help mitigate part of the crisis facing the NHS. As part of these recommendations, the authors call on the UK governments to increase and prioritise investment in primary care, social care, mental health and ambulance services.
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Content ArticleFatigue and sleep deprivation may affect healthcare professionals' skills and communication style and also may affect clinical outcomes. However, there are no current guidelines limiting the volume of deliveries and procedures performed by a single individual, or on the length of time that they can be on call. This Committee Opinion from the American College of Obstetricians and Gynecologists (ACOG) analyses research relating to fatigue and performance in healthcare professionals in order to make recommendations to doctors and managers to improve staff and patient safety.
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Content ArticleThis report commissioned by the NHS Confederation and written by the Centre for Mental Health sets out a vision for what mental health, autism and learning disability services in England should look like in ten years’ time. It brings together research and engagement with a wide range of stakeholders including people who bring personal and professional experience. The report identifies ten interconnecting themes that underpin the vision and three key requirements that would turn the vision into reality.
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Content ArticleThis article for ABC News looks at a study conducted by researchers from the Bond University and other Australian universities about the impact of the 'hero' and 'angel' narratives applied to nurses during the Covid-19 pandemic. They interviewed critical care nurses in the UK, Australia and North America about their perceptions of these terms. The study found that nurses felt the labels devalued their professionalism, created unreasonable expectations, contributed to gender stereotypes and increased burn-out by putting emphasis on showing up for work even when nurses are unwell. The study also highlighted that nurses responded more positively to the terms 'hero' and 'angel' when used by patients, as opposed to governments and the media.
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Content ArticleLetter from Sir David Sloman Chief, Operating Officer NHS England, Professor Sir Stephen Powis, National Medical Director NHS England, and Dame Ruth May, Chief Nursing Officer, to ICBs and Trusts regarding the upcoming ambulance industrial action.
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News Article
Pandemic collaboration ‘no longer exists’ between NHS and private hospitals
Patient Safety Learning posted a news article in News
The collaboration seen between the independent sector and the NHS during the peaks of the pandemic “doesn’t exist any more”, the boss of one of the UK’s largest private hospital companies has said. Mr Justin Ash, chief executive of Spire Healthcare and a member of the government’s recently convened elective recovery task force, whose purpose is to ”focus on how the NHS can [better] utilise independent sector to cut the backlog’.” He told the Westminster Health Forum earlier this week: “In spirit there is collaboration but in practice, it doesn’t exist anymore. There is no more commissioning by trust[s]”. Mr Ash told the conference Spire had previously had administrative teams working at 39 different NHS hospitals examining which NHS patients could be treated at one of its facilities. That number was now three, a decline which he described as “a shame”. He said: “There has to be a mindset change. We have people say ‘you have our nurses and consultants working for you’. “[But] just like patients, nurses and consultants should be able to move around the system [as] one workforce.” Read full story (paywalled) Source: HSJ, 16 December 2022 -
Content ArticleFor decades, western Europe’s national healthcare systems have been widely touted as among the best in the world. But an ageing population, more long-term illnesses, a continuing recruitment and retainment crisis plus post-Covid exhaustion have combined, this winter, to create a perfect healthcare storm that is likely to get worse before it gets better, writes Jon Henley (Berlin), Kate Connolly (Berlin), Sam Jones (Madrid) and Angela Giuffrida (Rome) in this Guardian article.
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Content ArticleOperating rooms are major contributors to a hospital’s carbon footprint due to the large volumes of resources consumed and waste produced. The objective of this study from Sullivan et al., published in the Journal of the American College of Surgeons, was to identify quality improvement initiatives that aimed to reduce environmental impact of the operating room while decreasing costs.
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News Article
Largest nursing strike in NHS history starts
Patient Safety Learning posted a news article in News
Nurses in England, Wales and Northern Ireland have started a nationwide strike in the largest action of its kind in NHS history. Staff will continue to provide "life-preserving" and some urgent care but routine surgery and other planned treatment is likely to be disrupted. The Royal College of Nursing said staff had been given no choice after ministers refused to reopen pay talks. RCN general secretary Pat Cullen has called on the government to "do the decent thing" and resolve the dispute before the year ends. Ms Cullen told BBC Breakfast the strike marked "a tragic day in nursing". "We need to stand up for our health service, we need to find a way of addressing those over seven million people that are sitting on waiting lists, and how are we going to do that? By making sure we have got the nurses to look after our patients, not with 50,000 vacant posts, and with it increasing day by day," she said. Health Minister Maria Caulfield, a former nurse, accepted "it is difficult" living on a nurse's wage, but said that a 19% pay rise "is an unrealistic ask". Under trade union laws, the RCN has to ensure life-preserving care continues during the 12-hour strike. Chemotherapy and kidney dialysis should run as normal, along with intensive and critical care, children's accident and emergency and hospital neonatal units, which look after newborn babies. Read full story Source: BBC News, 15 December 2022 -
Content Article
Roy Lilley eLetter - Helpless (12 December 2022)
Patient-Safety-Learning posted an article in Safe staffing levels
Writer and commentator Roy Lilley writes a daily email about what's happening on the ground in the NHS, and how this relates to policy decisions and guidance. Roy describes his eLetters as "a combination of opinion, my take on issues of the day and a news digest of things that I think are important or interesting." In this email, Roy shares several recent accounts sent to him by doctors and other healthcare professionals working in NHS hospitals. They describe dangerous staff ratios, overcrowding and medication shortages. The common theme is dangerously long working hours that could impact on patient safety. Sign up to receive Roy Lilley's daily eLetter. -
Content ArticleIn the face of record high waiting times for elective care, The King's Fund undertook research to understand the strategies that have been used to reduce waiting times in England and elsewhere in the past 20 years. Elective care waiting lists and waiting times are a product of the fluctuations in and disparities between the demand for and available supply of healthcare. Understanding the root causes of these disparities and taking corrective action to restore balance between demand and supply and optimising the conditions within the health care system is therefore considered key to any strategy to reduce waiting times and sustain them at that level.
