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Content ArticleThis joint report by the APPG on Baby Loss and the APPG on Maternity is a culmination of over 100 submissions to an open call for evidence from staff, service users and organisations, on the maternity staffing crisis. It paints a picture of a service that is at breaking point and staff that are over-worked, burnt out and stressed.
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Content ArticleThe workforce is healthcare’s most precious resource. Hospitals and health systems are committed to supporting mental well-being and improving access to behavioural health screenings, referrals and treatment when the workforce needs it. This new American Hosptial Association guide, Suicide Prevention: Evidence-Informed Interventions for the Health Care Workforce, identifies three drivers of suicide: stigma, limited access to behavioural health resources and treatment, and job-related stressors. The guide offers a curated list of 12 evidence-informed interventions that hospitals and health systems can implement to reduce the risk of suicide among healthcare workers. Hospitals and health systems should choose the interventions and metrics that work for their organisation based on their own needs and available resources to customise a pathway to suicide prevention for their employees.
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Content ArticleDespite the constant pressures and chronic shortages, the number of nurses leaving the NHS had flatlined over recent years. Now our analysis of new data shows there has been a large increase in nurses leaving the NHS, and that this trend is being driven by younger workers. The last year's data (June 2021 - June 2022) saw a 25% increase in the number of NHS nurses leaving their role, with an additional 7,000 leaving compared to the previous year. The largest increase in numbers leaving was seen among the younger nurses, two thirds of leavers were under 45 years of age. In this article, Jonathon Holmes explores why there is a sudden increase in vacancies.
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News Article
‘Exploited’ foreign doctors worry about risk to UK patients
Patient-Safety-Learning posted a news article in News
Doctors recruited from some of the world's poorest countries to work in UK hospitals say they're being exploited - and believe they're so overworked they fear putting patients' health at risk. A BBC investigation has found evidence that doctors from Nigeria are being recruited by a British healthcare company and expected to work in private hospitals under conditions not allowed in the National Health Service. The British Medical Association (BMA) has described the situation as "shocking" and says the sector needs to be brought in line with NHS working practices. Dr Jenny Vaughan of the Doctors Association UK said, "This is a slave-type work with… excess hours, the like of which we thought had been gone 30 years ago. It is not acceptable for patients for patient-safety reasons. It is not acceptable for doctors. " Read full story Source: BBC News, 11 October 2022 -
News Article
Social care ‘on its knees’ as vacancies hit record high
Patient Safety Learning posted a news article in News
Social care services face an “absolute crisis” over record vacancies as unfilled jobs have risen by more than 50% in a year, a new analysis reveals. New data on social care workers shows at least 165,000 vacancies across adult social care providers at the end of 2021-22. This is the highest on record according to the charity Skills for Care, which has collected the data since 2012. Leading think tanks have warned the figures to point to the “absolute crisis” facing social care with the “system on its knees”. At the same time the demand for care has risen, highlighting that social care is facing a complex challenge with recruitment and retention which will be impacting on the lives of people who need social care. The annual report by Skills for Care predicts social care services will need an extra 480,000 workers by 2035 to meet the demand but could be set to lose 430,000 staff to retirement over the next decade. Simon Bottery, senior fellow at The King’s Fund, said the report was evidence “of the absolute crisis social care faces when trying to recruit staff, a crisis that has profound consequences for people needing care”. He added: “A key reason for that is pay, which continues to lag behind other sectors including retail and hospitality, as well as similar roles in the NHS. Our recent analysis found that nearly 400,000 care workers would be better paid to work in most supermarkets." Read full story Source: The Independent, 11 October 2022 -
Content ArticleThis report from Skills for Care provides a comprehensive analysis of the adult social care workforce in England and the characteristics of the 1.50 million people working in it. Topics covered include recent trends in workforce supply and demand, employment information, recruitment and retention, demographics, pay, qualification rates and future workforce forecasts.
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News ArticleNHS trusts may be forced to cancel appointments and limit visiting times in a Covid and flu “twindemic” this winter, health leaders have warned. Fears have been raised the viruses could strip back the workforce and further increase demand for services during an already busy period. It comes amid rising Covid infections in the UK. Around 1.3 million tested positive in late September, according to the latest figures, which was a 25% increase on the week before. The UK is also concerned there could be a bad flu season this year, with lower immunity across the population due to reduced exposure in the Covid pandemic. NHS leaders have warned that this background could make winter even more difficult for the health service. “I make no bones about this: we know it’s going to be a pressurised time for trusts over the next four months if not longer,” Saffron Cordery from NHS Providers, which represents trusts in England, told The Independent. The interim chief executive added: “We’re worried about Covid and we’re worried about flu.” Ms Cordery said these joint pressures – which could increase demand, strip back workforces and introduce the need for greater infection control measures – could have a knock-on effect on services. “We need to anticipate that there may well be cancellations for either outpatient appointments or routine procedures or operations, because there could be staff shortages or rising demand in emergency care – that means that those routine appointments cannot take place as quickly as we’d like,” she said. Read full story Source: The Independent, 8 October 2022
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News Article
Four of UK’s top countries for nurse recruitment on WHO ‘red list’
Patient Safety Learning posted a news article in News
Three of the top seven countries from which the UK recruits overseas nurses are on the World Health Organization’s (WHO) ‘red list’ where active recruitment should not be used. Nigeria, Ghana and Nepal are the third, fifth and seventh highest respectively in the list of countries that provided the largest number of overseas staff joining the Nursing and Midwifery Council (NMC) register between April 2021 and March 2022. All three were on the red list during this period, which is derived by the WHO and identifies countries facing the most pressing health workforce shortages, meaning they should not be targeted for systematic recruitment by international employers. Nepal has since moved off the red list following of a government-to-government agreement between the Department of Health and Social Care (DHSC) and the Government of Nepal in the summer. But the agreement has raised concerns among health leaders, including those reported in The Observer which suggested Nepali recruitment agencies carried out abusive practices, such as charging illegal fees. Royal College of Nursing general secretary and chief executive Pat Cullen said the “overreliance” on international recruitment showed that the government had “no grip on the nursing workforce crisis”. “It’s deeply concerning that four ‘red list’ countries appear amongst the top 20 most recruited from countries,” she said. “This approach is unsustainable. Ministers must invest in growing the domestic nursing workforce. “They need to give nursing staff the pay rise they deserve to retain experienced nurses and attract new people to the profession.” Read full story Source: Nursing Times, 4 October 2022 -
Content ArticleIn this blog for The House, Jeremy Hunt MP outlines how tackling long-term challenges in the health system will improve staff morale. While celebrating some short-term measures announced by the new Health Secretary Thérèse Coffey, he argues that longer term reforms are needed to "break the cycle of long waits, burned-out staff and declining standards." The key priority he outlines is workforce reform, including workforce projections and investment in training new healthcare workers for the future. He suggests that this will also encourage NHS staff to remain in their roles by restoring trust and confidence.
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Content ArticleThis article in the Manchester Evening News details the experience of Amy, whose daughter Harper was stillborn following failings in Amy's care. After being induced, Amy was left on her own in a room at the Royal Oldham Hospital's maternity unit overnight, without any monitoring. She had raised concerns about her baby's reduced movements but was denied additional checks. When Amy was finally checked in the morning, Harper had no heartbeat. An internal investigation conducted by The Royal Oldham Hospital found that if Amy had received appropriate monitoring, CTG abnormalities would have been noticed. This would have led to an escalation in her care, earlier delivery and Harper is likely to have been born alive.
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Content ArticleThis longitudinal study in BMJ Quality & Safety aimed to examine the impact of nursing team size and composition on inpatient hospital mortality. The authors found that registered nurse staffing and seniority levels were associated with patient mortality. The lack of association for healthcare support workers and agency nurses indicates they are not effective substitutes for registered nurses who regularly work on the ward.
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Content ArticleCommunity Diagnostic Centres (CDCs) can relieve pressure on NHS acute services and bring diagnostic services closer to patients. This resource by the Chartered Institute of Ergonomics & Human Factors (CIEHF) explores ten principles for including systems thinking in the design of the diagnostic workforce and CDC services.
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News Article
Record number of NHS staff hand in resignation
Patient Safety Learning posted a news article in News
The latest NHS workforce figures have shown that a record number of staff voluntarily resigned from their jobs during the first quarter of this financial year. According to the data, almost 35,000 NHS workers resigned voluntarily, which was up from 28,105 during the same period in 2021, and 19,380 in 2020. It is also higher than in any equivalent first quarter over the last 10 years. The most common reason for leaving during quarter one of 2021-22 was ‘work-life balance’, with almost 7,000 NHS workers citing this as their reason for leaving their jobs. Close to 2,000 NHS workers also left in the same period in search of a ‘better reward package’, with almost 1,000 reporting ‘incompatible working relationships’. In it unclear from the NHS digital data whether they left the NHS altogether. Read full story (paywalled) Source: HSJ, 3 October 2022 -
Content ArticleThe National Association for Healthcare Quality® (NAHQ) has conducted research on the advancement of the quality and safety agenda and has published the results in a new workforce report. NAHQ’s Healthcare Quality and Safety Report answers the question: “Is today’s healthcare workforce doing the work that will advance clinical priorities of quality, safety, equity, value, and system sustainability?”
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News Article
‘Perilous’ shortage of homecare workers leaves patients trapped in hospitals
Patient Safety Learning posted a news article in News
A “perilous” shortage of homecare workers is the biggest reason thousands of people are languishing longer in hospital than needed, driving up waiting lists and making people sicker, figures reveal. Almost one in four people unable to be discharged – sometimes for weeks – were trapped in hospital because they were waiting for home care, as agencies hand back contracts because staff are quitting owing to low pay, leaving 15% of jobs vacant. A fifth of people unable to be discharged were also waiting for short-term rehabilitation and 15% were waiting for a bed in a care home, according to analysis of data obtained using freedom of information requests and public records by Nuffield Trust and the Health Foundation. It estimated that in April this year, one in six patients were in hospital because of delayed discharge, and the discharge of patients with a hospital stay of more than three weeks was delayed by 14 days on average. “People are ending up in hospital for malnutrition and dehydration, problems which, even if you supported people a little bit at home, would stop,” said Jane Townson, the director of the Homecare Association. “More providers are having to turn down work than usual and some are having to hand back people because they can’t do it.” Read full story Source: The Guardian, 3 October 2022 -
News Article
Record number of nurses quitting the NHS
Patient Safety Learning posted a news article in News
Record numbers of nurses are quitting the NHS in England, figures show. More than 40,000 have walked away from the NHS in the past year - one in nine of the workforce, an analysis by the Nuffield Trust think tank for the BBC revealed. It said many of these were often highly skilled and knowledgeable nurses with years more of work left to give. And the high number of leavers is nearly cancelling out the rise in new joiners that has been seen. There were just 4,000 more joiners than leavers in the year to the end of June. But a Department of Health and Social Care spokesman said progress was being made and the government was already halfway to meeting its target to increase the numbers of nurses working in the NHS in England during this Parliament by 50,000. He said a workforce strategy would be published soon, setting out how the NHS will continue to recruit and retain nurses in the coming years. Read full story Source: BBC News, 30 September 2022 -
Content ArticleNursing is the single largest profession in the NHS, but it suffers from substantial staffing shortages. This analysis from Billy Palmer and Lucina Rolewicz for the Nuffield Trust reflects on the rate at which the health service is losing nurses, and considers the reasons why.
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Content ArticleNursing education has long utilised simulation in different forms to teach the principles and skills of nursing care, from anatomical models to computer-based learning. This chapter from Patient Safety and Quality: An Evidence-Based Handbook for Nurses looks at simulation training as a strategy to prevent healthcare errors. It explores the value of human patient simulation in nursing education programs.
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Content ArticleIn this blog, Jeremy Hunt MP, Founder of Patient Safety Watch, argues against introducing more targets for GPs. The new Health Secretary, Therese Coffey MP, plans to introduce a target to ensure that all patients see their GP within two weeks. The blog highlights two issues with this approach: Setting a new target won’t make it a reality Having too many targets result is a system that depersonalises patients, deprofessionalises frontline staff and means it is difficult for health services to prioritise It then proposes that the health system should learn from the UK education system's approach to regulatory oversight, which is aimed at driving up standards, rather than achieving grades.
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Content ArticleMost of the contact that people have with the NHS is with general practice: there are an estimated 300 million appointments each year. These services provide the first step in diagnosing and treating most patients’ health conditions. Due to changes in the data, trends in general practice staff are limited to 2015 at the earliest. The data do not include staff working in prisons, army bases, educational establishments, specialist care centres including drug rehabilitation centres and walk-in centres. From July 2019, primary care networks (PCNs) will offer services to patients and employ new specialist staff such as clinical pharmacists, social prescribing link workers, physiotherapists, physician associates and paramedics. NHS Digital has started to publish information on the PCN workforce, but the data does not presently cover all PCNs. Based on the PCN data that is available, the Nuffield Trust has estimated the number of certain primary care staff groups employed by PCNs across England,.
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News Article
NHS trusts in England offered extra funding to recruit overseas nurses
Patient Safety Learning posted a news article in News
Health service trusts in England are to be given additional funding to recruit nurses from overseas amid record staff shortages and increased demands. For nurses recruited between 1 January and 31 March 2023, trusts will be able to claim £7,000 per overseas nurse from NHS England. This is up to £4,000 higher than the financial support on offer during 2021-22. The move was unveiled by NHS Employers on its website last week and confirmed to Nursing Times by NHS England. NHS Employers said the additional funding reflected the rising costs of flights, accommodation and preparation costs for the nursing and midwifery objective structured clinical examination (OSCE). The OSCE forms part two of the Nursing and Midwifery Council’s test of competence and is a practical exam in which overseas nurses and midwives are tested on their clinical and communication skills. Responding to the move, Unison’s head of health, Sara Gorton, said: “Extra cash to tackle the chronic staffing shortages in the NHS is essential.” She warned that, until NHS staff vacancies ware addressed, there “will be a need for overseas recruitment”. “But it has to be done in the best interests of the individual workers,” she added. Ms Gorton highlighted ongoing concerns about unethical recruitment of nurses from overseas and the poor treatment many report facing. “Sadly, overseas nurses are still being exploited by unscrupulous care and health employers,” she said. “This is no way to treat those who come to offer the UK their help.” Read full story (paywalled) Source: Nursing Times, 27 September 2022 -
Content ArticleThe Francis Inquiries in 2010 and 2013 highlighted nurse staffing as a patient safety factor contributing to the care failings identified at Mid Staffordshire NHS Trust. The reports and government response led to the development of national ‘safe staffing’ policy. This two-year study by the University of Southampton and Bangor University examined the impact of safe staffing policies nationally and explored variation in local responses. The authors concluded that: Policies provided leverage and raised the profile of nursing workforce issues at board level, contributing to a willingness to invest in increasing nursing numbers. However, a lack of assessment of the likely scale of investment (and human resources) required nationally to achieve ‘safe staffing’ led to financial considerations becoming a barrier to achieving the policy vision. External pressures, such as lack of workforce supply and reduced access to temporary staffing, have constrained Trusts’ abilities to fully implement policies aimed at ensuring safe staffing on acute wards.
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Content ArticleThe UK health system is under unprecedented strain. The COVID-19 pandemic exacerbated these pressures, but it did not create them. The Academy of Medical Royal Colleges and its member organisations believe that as a country we are not facing up to the scale of the current challenges and we are not producing any coherent strategy to tackle the problems. Only when we confront these challenges will we be able to begin to fix the NHS. A combination of pressures means that the system is providing care and services which are sub-standard, threaten patient safety and fall below what should be expected in a country with the resources of the United Kingdom. If we do not act with urgency, we risk permanently normalising the unacceptable standards we now witness daily, to the detriment of us all.
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News Article
One in four people could be left without a GP within a decade, doctors claim
Patient Safety Learning posted a news article in News
One in four people could be left without a GP within a decade, medics say. The forecasts from Doctors’ Association UK suggest 16 million people in England could be left without access to a family doctor, amid growing staffing shortages. Today the new Health Secretary is expected to set out plans to boost access to GPs, following warnings that public satisfaction is the lowest on record. Research by the Health Foundation suggests that the NHS will lose up to 8,800 full-time equivalent GPs by 2030 if current trends continue. On Wednesday, Doctors’ Association UK said this could leave one in four people without access to a GP. Dr Lizzie Toberty, GP lead for the Doctors’ Association UK, said the workload of a family doctor now placed “unrealistic demands” on them. She said: “GPs will cut their hours, quit the NHS, or quit the country. We fear patients will suffer the same ‘postcode lottery’ for seeing their GP as many do now with getting an NHS dentist.” Read full story (paywalled) Source: The Telegraph, 21 September 2022 -
Content ArticleThis letter from NHS Confederation to Thérèse Coffey MP, the new Secretary of State for Health and Social Care, sets out what needs to be done to support the delivery of an emergency winter plan for health and social care services. It outlines the views of NHS Confederation members on what will be needed to deliver the ‘ABCD’ highlighted as priorities by the Secretary of State: ambulances, backlogs, care and doctors and dentists.
