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Showing results for tags 'Workforce management'.
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Content ArticleThe NHS was struggling before Covid-19 and was further severely disrupted by the pandemic. As a result, it is now dealing with a massive backlog in elective care. This blog by Saoirse Mallorie, Senior Analyst at The King's Fund, looks at the causes and state of the backlog and identifies ways to tackle the issue, including increasing workforce and investment, innovation and focusing on prevention.
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Content ArticleThis report provides a snapshot of the NHS Confederation's work over the last year. It outlines how the NHS Confederation has challenged the government for a fair funding settlement for the NHS, pressed ministers for a long-term workforce strategy, urged the government and unions to end the industrial dispute and made the case for more autonomy for healthcare leaders.
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Content ArticleVictoria Vallance, Director of Secondary and Specialist Care, provides an update on the Care Quality Commission (CQC)’s ongoing national maternity inspection programme and offers early insight into the emerging themes, including good practice examples to support wider learning across all trusts.
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Content ArticleIn light of NHS England recently losing an employment tribunal case against a senior black nurse on grounds of race discrimination and whistleblowing, Roger Kline casts light on learnings from the case for NHS board members and HR departments.
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Content ArticleThis Patient Safety Advisory from the Pennsylvania Patient Safety Authority provides an overview of the issues associated with healthcare worker fatigue. It outlines fatigue risk mitigation practices that are being used in healthcare and other industries, including comprehensive fatigue risk management programs.
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Content ArticleThis episode of the Health Service Journal's Health Check podcast features NHS Providers’ new chief executive Sir Julian Hartley, who cautions against creating provider trusts which are extremely large. Sir Julian talks about his fears that leaders could lose touch with the front line. He also answers questions about the role of collaboratives, as well as the shift from competition to system working, the risks of reintroducing a payment by results-style tariff, the importance of the promised long-term NHS workforce plan and the growing voices questioning the future of the NHS model.
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Content ArticleNurses work long hours and play a critical role in keeping patients healthy. Many nurses feel that fatigue “comes with the territory” of such a high-stress, high-impact job. But what’s really at risk when a nurse is fatigued? This blog by US insurance company Nurses Service Organization (NSO) looks at the impact of nurse fatigue on patient and staff safety. It suggests several strategies to address the issue: Designing schedules and organising work to reduce nurse fatigue Developing a fatigue management plan Educating staff on sleep hygiene and the effects of fatigue on nurse health and patient safety Providing opportunities for staff to express concerns about fatigue and taking action to address those concerns Making sure extended shifts have adequate staff support and rest periods
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Content ArticleSentinel Event Alerts from the Joint Commission identify specific types of sentinel event (a patient safety event that results in death, permanent harm or severe temporary harm), describe their common underlying causes and suggest steps to prevent them occurring in the future. This Sentinel Event Alert looks at the well-documented link between health care worker fatigue and adverse events. It looks at: The impact of fatigue Contributing factors to fatigue and risks to patients Actions suggested by The Joint Commission for healthcare organisations
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Content ArticleFatigue in anaesthesia practice is often ignored or accepted as the norm due to persistent, high-intensity work demands and expectations. This document produced by the American Association of Nurse Anesthesiology (AANA) aims to provide guidance to healthcare professionals, healthcare facilities and nurse anaesthesia programs regarding sleep deprivation and fatigue. It provides evidence-based information that promotes fatigue management and work-life balance.
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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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Content ArticleThe 2022 Workforce Race Equality Standard (WRES) report enables organisations to compare their performance with others in their region and those providing similar services, with the aim of encouraging improvement by learning and sharing good practice. It provides a national picture of WRES in practice, to colleagues, organisations and the public on the developments in the workforce race equality agenda The WRES provide detailed analysis to enable employers to understand how their staff experience compares with others in their region and with similar specialism.
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Content ArticleIn this opinion piece for the BMJ, Partha Kar, consultant in diabetes and endocrinology, argues that in spite of extensive research and discussion around the need to tackle race inequalities in the medical workforce, little progress has been made at a system level. He highlights the importance of ensuring the Medical Workforce Race Equality Standard (WRES) Action Plan is implemented effectively, with special attention being paid to tracking GMC referrals and competency reviews that appear to be based on ethnicity.
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News Article
Wales ‘displaying a dangerous and growing reliance’ on agency nurses
Patient-Safety-Learning posted a news article in News
The NHS in Wales could move to a model in which most or all nursing care is outsourced to private companies, if its increasing reliance on agency staff continues, a union report has claimed. According to the Royal College of Nursing, the Welsh health service risks moving to a situation where it no longer directly employs staff to provide patient care. NHS Wales spent between £133m and £140m on agency nursing during 2021-22, based on different freedom of information (FOI) requests and official figures, the RCN’s report suggested. RCN Wales said, “If this trend continues, Wales will move to a situation where NHS Wales no longer directly employs staff to provide patient care and instead moves to a model in which most or all nursing care is outsourced to private companies.” Read more Source: Nursing Times, 4 December 2022 -
News Article
Doctors raise safety fears at Birmingham hospitals
Patient Safety Learning posted a news article in News
Whistleblowers at one of England's worst performing hospital trusts have said a climate of fear among staff is putting patients at risk. Former and current clinicians at University Hospitals Birmingham (UHB) NHS Trust allege they were punished by management for raising safety concerns, a BBC Newsnight investigation found. One insider said the trust was "a bit like the mafia". The trust said it took "patient safety very seriously". It said it had a "high reporting culture of incidents" to ensure accountability and learning. Staff concerns included a dangerous shortage of nurses and a lack of communication leading to some haematology patients dying without receiving treatment. The deaths of 20 patients in the haematology department of the Queen Elizabeth Hospital, which is run by the trust, led to a review in 2017 by consultant Emmanouil Nikolousis. Mr Nikolousis, who left the trust in 2020, told the BBC he was shocked by the failings he found and believes patients' lives could have been saved. A report by Mr Nikolousis criticised a lack of "ownership" of patients and a lack of communication among senior clinicians. In some cases this led to patients dying without having received treatment, he said. "Certainly there should have been different actions done," he said. "They could be saved. Certainly, when you don't have an action done, then you don't really know the outcome." Mr Nikolousis said he felt he had no option but to quit after his findings were ignored and his position was made "untenable". He left the NHS after 18 years. "They were trying, as they did with other colleagues, to completely sort of ruin your career," he said. Read full story Source: BBC News, 1 December 2022 -
News Article
Brexit has worsened shortage of NHS doctors, analysis shows
Patient Safety Learning posted a news article in News
Brexit has worsened the UK’s acute shortage of doctors in key areas of care and led to more than 4,000 European doctors choosing not to work in the NHS, research reveals. The disclosure comes as growing numbers of medics quit in disillusionment at their relentlessly busy working lives in the increasingly overstretched health service. Official figures show the NHS in England alone has vacancies for 10,582 physicians. Britain has 4,285 fewer European doctors than if the rising numbers who were coming before the Brexit vote in 2016 had been maintained since then, according to analysis by the Nuffield Trust. In 2021, a total of 37,035 medics from the EU and European free trade area (EFTA) were working in the UK. However, there would have been 41,320 – or 4,285 more – if the decision to leave the EU had not triggered a “slowdown” in medical recruitment from the EU and the EFTA quartet of Norway, Iceland, Switzerland and Lichtenstein. The dropoff has left four major types of medical specialities that have longstanding doctor shortages – anaesthetics, children, psychiatry, and heart and lung treatment – failing to keep up with a demand for care heightened by Covid and an ageing population. Read full story Source: The Guardian, 27 November 2022 -
News ArticleThe NHS faces the threat of coordinated industrial action lasting several months, with results to be announced within days of strike ballots of ambulance crews and about 300,000 health workers. Junior doctors, paramedics, midwives, porters, cleaners, pharmacy technicians and physiotherapists are being balloted across the NHS. The government now faces the threat of waves of strikes across the public sector, from nurses and firefighters to civil servants and teachers. A ballot of 15,000 ambulance workers in England and Wales closes on Tuesday. The result of the GMB ballot could be announced as early as this week, with the prospect of the first national ambulance strike since the dispute of 1989-90, when police and army vehicles were brought in to transport patients. The RCN said on Saturday that the health secretary Steve Barclay had written to the union asking for officials to “come back to the table” before the planned strikes. RCN chief executive Pat Cullen said any talks needed to focus on the pay deal and that the position of her members was “negotiations or nothing”. Rachel Harrison, GMB public services national secretary, said: “Health service workers have suffered more than a decade of real-terms pay cuts, been on the frontline of a global pandemic and are now in the midst of the worst cost of living crisis in a generation. “This is as much about patient safety as it is about pay. A third of GMB ambulance workers think delays they’ve been involved with have led to the death of a patient.” Read full story Source: The Observer, 27 November 2022
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News Article
Plea to blur line between doctors and nurses amid NHS staff crisis
Patient Safety Learning posted a news article in News
The NHS staffing crisis will be solved only if doctors and nurses get more flexible about their job descriptions and break down barriers between roles, according to Rishi Sunak’s health adviser. Bill Morgan argues that training times for doctors and nurses may have to be reduced, and suggests developing “sub-consultants” and entirely new medical professions, He wants ministers to create an Office for Budget Responsibility-style body to predict future workforce needs. The Treasury has held down the numbers of doctors and nurses Britain trains to prevent “supply-induced demand”, which encourages people to seek appointments that are not needed, Morgan argues. Chronic shortages of qualified staff are the biggest problem facing the health service, which has more than 130,000 vacancies. Morgan acknowledges that this means “some of the government’s key manifesto commitments will not be met”, citing the promise of 6,000 extra GPs. Sunak said this week that the government was “thinking creatively about what new roles and capabilities we need in the healthcare workforce of the future”. He urged the NHS to shed “conventional wisdom”. Read full story (paywalled) Source: The Times, 24 November 2022 -
News Article
NHS ‘needs thousands more staff to meet cost of living crisis demands’
Patient Safety Learning posted a news article in News
NHS therapy services won’t be able to manage increased demand driven by the cost of a living crisis as they are already thousands of therapists short, The Independent has been told. NHS counselling services in England are not meeting therapy access targets due to a shortfall of 2,000 workers, according to sources. The findings come as a poll by the UK Council for Psychotherapy (UKCP) and YouGov, shared with The Independent, found that almost one in two adults felt the cost of living crisis was affecting their mental health. According to the survey of more than 2,000 adults, 25 to 34 years old were most likely to say the cost of the living crisis was impacting their mental health. Adam Jones, policy and public affairs manager for the UKCP, said “I think what we’re concerned about is the fact that already, there is a record level of demand for mental health services. We also know there are record rates of prescription for antidepressant medication as well. We’re concerned the capacity currently is already falling short. “So with the rising demand going forward, we’re concerned that services are going to be stretched, waiting time is going to go up, average number of therapy sessions received is going to go down He warned that although the NHS is focussed on training new therapists, there was already an existing workforce of psychotherapists and counsellors who don’t work in the NHS. “We’d like to see more targeted recruitment of psychotherapists and counsellors who are already trained, and so that most would only require a short adaptive training to be able to work in an NHS context.” Read full story Source: The Independent, 23 November 2022 -
News Article
Menopausal women in NHS England workforce to be offered flexible working
Patient Safety Learning posted a news article in News
Menopausal women working in NHS England will be able to work flexibly should they need to under new guidance. Launching the first national NHS guidance on menopause, the NHS England chief executive, Amanda Pritchard, has called on other employers to follow suit to help “break the stigma”. She said many employees were “silently suffering” and were either too embarrassed to broach the subject or experience a “lack of support” when they did. No one should feel their only option is to “turn their back on their career” over menopausal symptoms, she added. “It’s our responsibility as leaders to ensure this doesn’t happen any longer.” The guidance aims to boost awareness as well as support the introduction of practical measures including flexible working patterns – including lighter duties, fans to make temperatures more comfortable, cooler uniforms and staff training. “Our guidance has been intentionally designed to be transferable to other workplaces too, so I hope organisations and women beyond the NHS can also benefit,” she said. Read full story Source: The Guardian, 23 November 2022 -
News Article
Trust moves away from ‘disturbing’ agency doctor model
Patient Safety Learning posted a news article in News
A major acute trust says it plans to move away from its significant use of agency doctors from overseas, who have been reported to be working on terms and conditions far below their NHS-employed counterparts. East Kent Hospitals University Foundation Trust has a contract with the NES Healthcare agency to supply 47 “resident medical officers (RMO)” across its three main sites to cover trauma and orthopaedics, medical and surgical rotas. HSJ has been told of concerns that RMO's are reporting substantial overworking, and poor terms and conditions, although some of these claims are disputed by NES. East Kent chief medical officer Rebecca Martin has told HSJ: “The well-being of all our colleagues is one of our top priorities and we are working with the agency about how they cover the rota safely". “We are committed to providing a safe workplace environment, where RMOs feel comfortable communicating their feedback and we review working patterns to ensure adequate rest periods between shifts. We are actively working to use substantive staff to fill vacancies, and have already been able to offer some of those positions to current RMOs.” Read full story (paywalled) Source: HSJ, 22 November 2022 -
News Article
BMA chief warns Scotland's GPs are at 'tipping point'
Patient Safety Learning posted a news article in News
GP surgeries across Scotland are at risk of collapsing because of staff shortages and increased demand, a senior doctor has warned. Dr Andrew Buist, chairman of the British Medical Association's (BMA) Scottish GP committee, told the BBC many practices were at "tipping point". More than a third of surveyed surgeries reported at least one GP vacancy – up from just over a quarter last year. About half of the GP surgeries in Scotland took part in the BMA survey. It showed 81% of practices said demand was exceeding capacity - with 42% saying demand substantially exceeded capacity. Dr Buist told BBC Scotland: "I worry that we're reaching a tipping point for some practices. "They lose one or maybe two doctors out of three, and the remaining doctors cannot continue so they return the contract and the practice may cease to exist. "That is a real concern in some parts of Scotland that that is happening and it's going to happen increasingly as the situation develops over this winter." Read full story Source: BBC News, 15 November 2022 -
News Article
Desperate NHS pays up to £2,500 for nursing shifts
Patient Safety Learning posted a news article in News
NHS bosses are increasingly paying premium rates for agency staff to plug holes in rotas, the BBC has found. Spending in this area rose by 20% last year to hit £3bn in England. For many shifts, bosses have been so short-staffed they have been willing to breach the government pay caps for these agency workers, most of whom are doctors and nurses. Separate data supplied by Labour showed some NHS trusts had paid as much as £2,500 to nurses to fill shifts. Out of 60 responses from trusts, 10 reported the most expensive shift cost over £2,000, and for another 13 it was between £1,000-2,000. The BBC spoke to one cancer doctor who was offered work for £130 an hour - well above the cap for his role - and described the fees available as "astonishing" and a reflection of "desperation by management". Chief executive of Colchester hospital, Nick Hulme, says a combination of factors is playing a role, including the need to open extra wards to cope with rising demand, as well as staffing shortages. Some people are even leaving their jobs, only to return later as agency workers. He says while many agency workers do fantastic work on the wards, he would still prefer to be able to use his own staff. "We know that's best for patient care, best for patient experience. Agency staff require more supervision and tasks such as handovers take longer." Read full story Source: BBC News, 11 November 2022 -
News Article
Nurses’ strike: what’s at stake and how will it affect patients?
Patient Safety Learning posted a news article in News
Ministers have offered about 1 million NHS staff in England – everyone bar doctors and dentists – a pay rise of at least £1,400 for 2022-23. That represents a rise of between 4% and 5% for staff covered by the longstanding Agenda for Change negotiating framework. Health unions have rejected the £1,400. They want a rise that would at least match inflation – which is currently 10.1% – while the Royal College of Nursing (RCN) is seeking inflation plus 5%. Without inflation-proof rises, staff will suffer a real-terms cut in their take-home pay, unions say. “Our members will no longer tolerate a financial knife-edge at home and a raw deal at work”, said the RCN general secretary, Pat Cullen. Sara Gorton, head of health at Unison, added: “Inflation has already wiped out this year’s 72p-an-hour increase. The government must put pay right to spare the NHS, its staff and all those relying on its care from a dispute no one wants to see.” The RCN has balloted its members across the UK. The results, published on Wednesday, show that a majority of nurses in most but not all hospitals and other NHS services across the four home nations have rejected the government’s offer and decided to strike in pursuit of better pay. Wes Streeting, the shadow health secretary, has condemned as “unacceptable” the fact that strikes will disrupt services and affect patients’ care. While he has not criticised nurses or any health union, he has blamed ministers for not negotiating with the RCN to try to avert strike action. “I’m concerned, I think lots of people are concerned about the impact of disruption”, he told LBC’s Tonight with Andrew Marr on Monday. “That’s still a disruption to patients, which I think is unacceptable.” If he were the health secretary he would see patients as his “first and foremost” responsibility, he said. “That’s why I think the government have to get a grip on this and get the unions around the table because there is a deal there to be done.” Read full story Source: The Guardian, 9 November 2022 -
News Article
Nurses set to hold biggest-ever strike
Patient Safety Learning posted a news article in News
The biggest ever strike by nurses looks set to go ahead. The Royal College of Nursing is due to unveil the results of its ballot, which ended last week, in the next few days. The final results are being counted but RCN sources say a large majority of nurses have voted in favour of action in a dispute over pay. The RCN had recommended to its 300,000 members that they walk out. If strikes take place, they would affect non-urgent but not emergency care. The vote has involved a series of individual workplace-based ballots across the UK and if nurses do not back action at a local level it is possible some hospitals and services will not be involved. The government had appealed to nurses to "carefully consider" the impact on patients. But Pat Cullen, RCN general secretary and chief executive, said: "Huge numbers of staff - both experienced and newer recruits - are deciding they cannot see a future in a nursing profession that is not valued nor treated fairly. She added: "Our strike action will be as much for patients as it is for nurses. We have their support in doing this." Cabinet minister Oliver Dowden said the government had "well-oiled contingencies in place" for dealing with any strike action by nurses. Speaking on Sky News, Mr Dowden said essential services would be prioritised, "but of course there would be an impact as a result of a strike like that". Read full story Source: BBC News, 6 November 2022
