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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.
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Content ArticlePEOPLE FIRST is a CQC resource to help system leaders and service providers.
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Content ArticleIn this blog, Jeremy Hunt MP, Founder of Patient Safety Watch, outlines six priorities for the new Health Secretary, Therese Coffey MP. He argues that these patient safety priorities will help reduce elective and emergency pressures and save money.
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Content ArticleThis Expert Panel evaluation was commissioned by the House of Commons Health and Social Care Committee. It reviews evidence to determine whether the Government’s policy commitments relating to the health and social care workforce in England are appropriate and have been effectively implemented. The Expert Panel consists of members with recognised expertise in research and policy evaluation, complemented by experts with research expertise and practical experience in the health and social care workforce.
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News Article
Burnout in doctors doubles chances of patient safety problems, study finds
Patient Safety Learning posted a news article in News
Doctors suffering from burnout are far more likely to be involved in incidents where patients’ safety is compromised, a global study has found. Burned-out medics are also much more likely to consider quitting, regret choosing medicine as their career, be dissatisfied with their job and receive low satisfaction ratings from patients. The findings, published in the BMJ, have raised fresh concern over the welfare and pressures on doctors in the NHS, given the extensive evidence that many are experiencing stress and exhaustion due to overwork. A joint team of British and Greek researchers analysed 170 previous observational studies of the links between burnout among doctors, their career engagement and quality of patient care. Those papers were based on the views and experience of 239,246 doctors in countries including the US, UK and others in Africa, Asia and elsewhere globally. They found that burned-out medics were twice as likely as their peers to have been involved in patient safety incidents, to show low levels of professionalism and to have been rated poorly by patients for the quality of the care they have provided. Doctors aged 20 to 30 and those working in A&E or intensive care were most likely to have burnout. It was defined as comprising emotional exhaustion, depersonalisation – a “negative, callous” detachment from their job – and a sense of reduced personal accomplishment. Read full story Source: The Guardian, 14 September 2022 -
Content ArticleA systematic review and meta-analysis from Hodkinson et al. examines the association of physician burnout with the career engagement and the quality of patient care globally. A joint team of British and Greek researchers analysed 170 previous observational studies of the links between burnout among doctors, their career engagement and quality of patient care. Those papers were based on the views and experience of 239,246 doctors in countries including the US, UK and others in Africa, Asia and elsewhere globally. This meta-analysis provides compelling evidence that physician burnout is associated with poor function and sustainability of healthcare organisations primarily by contributing to the career disengagement and turnover of physicians and secondarily by reducing the quality of patient care. Healthcare organisations should invest more time and effort in implementing evidence-based strategies to mitigate physician burnout across specialties, and particularly in emergency medicine and for physicians in training or residency. Read accompanying BMJ editorial here.
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Content Article
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Last week the Professional Standards Authority for Health and Social Care (PSA) published a new report, Safer care for all – solutions from professional regulation and beyond, which examines the current state of professional health and care regulation in the UK. In this blog, Patient Safety Learning considers this report from a patient safety perspective. PSA's chief executive, Alan Clamp, has also written a blog for the hub on the report, which can be read here. -
Content Article
In a recent report, the Professional Standards Authority (PSA) for Health and Social Care sets out its view on the biggest challenges affecting the quality and safety of health and social care. In this blog, Alan Clamp, PSA's chief executive, summarises these challenges and the possible solutions. You can also read Patient Safety Learning's reflections on the PSA report here.- Posted
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News Article
Doctors warn Truss over NHS ‘fantasy’
Patient Safety Learning posted a news article in News
Liz Truss has been warned against “fantasy predictions” that the NHS can return to normal without radical change and was told that “unacceptable standards” are being normalised. In a rare political intervention, the professional standards body for the UK’s 220,000 doctors agreed that the NHS was routinely letting down patients. The Academy of Medical Royal Colleges said politicians must be prepared for radical changes to save the health service. Closing smaller hospitals, accepting that routine dentistry cannot be free for everyone and a return of Covid volunteers to allow doctors to treat more patients were all suggested by the head of the academy. The academy released a report that declared the NHS was in crisis, writing: “The system is providing increasing proportions of care or services which are sub-standard, threaten patient safety, and should not be acceptable in a country with the resources that we have in the United Kingdom. If we do not act with urgency, we risk permanently normalising the unacceptable standards we now witness daily.” The report sets out a series of recommendations for reform, including boosting staff numbers, reforming social care and spending more on technology. Helen Stokes-Lampard, the academy’s chairwoman, said patients were facing a “dismal winter” and that politicians must take difficult decisions. “If we don’t make changes it will inevitably deteriorate further,” she said. “The demand isn’t going away, the pressure isn’t going away, which is why the challenge for our government and for our whole society is to confront these issues and have a difficult conversation.” Read full story (paywalled) Source: The Times, 9 September 2022 -
Content ArticleThe NHS Confederation, NHS Providers, the Academy of Medical Royal Colleges, National Voices and the Richmond Group of Charities have penned a joint letter to the new Prime Minister warning that without urgent action on key priorities the NHS risks being trapped in a relentless cycle unable to meet rising patient need and demand. The five organisations, which together represent NHS leaders, clinicians and patients, are calling on the new government to take rapid action to address five key priorities in the short term. These priorities are: Workforce Social care Capital funding The impact of the cost of living crisis and inflation Strengthening the voice of people living with ill health in decision making.
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Content Article“I will deliver on the National Health Service” was as much detail as the new prime minister offered on health policy in her victory speech on Monday. One idea floated during her campaign, that £13bn of new funding earmarked for the NHS should be diverted to social care, might once have won plaudits. But such is the crisis now engulfing hospitals that the moment has passed. Next week, a ballot opens that could see nurses in England and Wales go on strike for the first time. A record 132,139 – or almost 10% of all NHS posts – were vacant in June. This shocking rise in the number of NHS vacancies is a symptom of the government’s dangerous neglect, says the Guardian newspaper in its Editorial.
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News Article
GPs warn of ‘tsunami of demand’ this winter as patient contacts surge 200%
Patient Safety Learning posted a news article in News
GPs have warned of a ‘tsunami of demand’ this winter as patient contacts surged 200% during the pandemic. One of the largest GP providers in the UK, Modality Partnership, told The Independent it received 4.8 million calls from patients in one year alone with around a quarter going unanswered every day. The provider, which covers 500,000 patients across the country, said its practices were now working above “safe levels” with 50 appointments a day per GP, far higher than the 35 advised by the British Medical Association. Speaking with The Independent, Vincent Sai, chief executive and partner at Modality said the new health secretary Therese Coffey must “not point fingers” and “not find a scapegoat” as “every part of the system is under pressure. Every player in the health system is under the cosh.” Dr Sai said: “We believe patient contacts have increased 200 per cent, over the last few years. The expectation is that GP practices have maybe four to five patient contacts per year, but if you just look at just the number of phone calls alone, it’s showing that it’s much more now. “So something is broken somewhere...there’s more work, there are fewer people. People say I can’t get access to my GP and the hypothesis is they’re just lazy and not working, but it’s not the case.” Read full story Source: The Independent, 7 September 2022 -
Content ArticleMedical litigation claim and costs in UK are rising. This study from Lane, Bhome and Somani analysed the 10-year trend in litigation costs for individual clinical specialties in the UK from 2009/10 to 2018/19.The authors concluded that addressing the issue of litigations is complex. Medically there are speciality specific issues that require attention, whilst some general measures are common to all: effective communication, setting realistic targets and maintaining a motivated, adequately staffed workforce. These, alongside legal reforms, may reduce the financial burden of increasing litigation on the NHS.
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News Article
Unfilled consultant posts pose key risk to patient safety - Irish Medical Council
Patient Safety Learning posted a news article in News
Unfilled specialised medical consultant roles and an over-reliance on overworked, internationally trained graduates for non-consultant hospital doctors are among key risks to patient safety identified by the Irish Medical Council. The council, which is the regulatory body for the medical profession, sets out the risks to healthcare for the first time in its workforce intelligence report that breaks down the make-up of the medical register and explains why doctors are leaving the health system. More than a third of all clinically active doctors are on the general register, which is a key risk to patient safety because consultant and specialist roles are not being filled and “a considerable proportion” of non-consultant hospital doctors are required to perform the duties of consultants. The report found that the majority of non-consultant hospital doctors are trained overseas and that the health system overly relied on these doctors who reported being “overworked, undervalued, experiencing discrimination and unable to access specialist training.” “Aside from the individual impact on the doctors, the treatment of international medical graduates has serious implications for patient safety,” the council said. In another risk identified by the regulatory body, more than a quarter of doctors reported working more than 48 hours a week, in breach of the European Working Time Directive. This has further serious implications for patient safety,” the council said. Read full story Source: Irish Times, 1 September 2022 -
Content ArticleThe pandemic has had an enormous impact on health and care services in the UK. In this article, Nuffield Trust fellows Jessica Morris and Sarah Reed take a closer look at access and waiting times before and after the start of the Covid-19 pandemic. They highlight that before the pandemic, pressure on the system was already reducing access to NHS services and making waiting times longer. Covid-19 has made the situation significantly worse due to the need for heightened infection control practices, rising levels of staff sickness and burnout, the cancellation of routine care and redirection of staff. Enabling services to recover will be challenging given these ongoing pressures and real-term budget cuts for the NHS this year. The article examines the impact of the pandemic on waiting times relating to: General practice Elective (planned) care Diagnostic testing Cancer care A&E Ambulance
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Content ArticleScrutiny of NHS chief executive officers (CEOs) has tended to focus on the generally short tenure of their position. The implications of high turnover have been assessed but there has been limited research looking at CEOs who remain in post for long periods, whether in the same organisations or in multiple ones. This study by researchers from the University of Manchester draws on interview data collected in 2019 with 10 long serving CEOs in the English NHS, with an average tenure of 17 years.
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News Article
Ministers to make it easier for foreign nurses and dentists to work in NHS
Patient Safety Learning posted a news article in News
Ministers will introduce legislation as soon as parliament returns on Monday to tackle the NHS’s worsening staffing crisis by making it easier for overseas nurses and dentists to work in the UK. The move is part of a drive by the health secretary, Steve Barclay, to increase overseas recruitment to help plug workforce gaps in health and social care. Barclay believes thousands of extra health professionals will come as a result of new rules making it easier for medical regulators to register those who have qualified abroad. If the change proves successful it will help pave the way for more nurses and dentists coming to work in Britain from countries such as India, Sri Lanka, Kenya, the Philippines and Malaysia. However, critics claim the policy is a stop-gap that is no substitute for ramping up the supply of homegrown staff and risks worsening the lack of health workers in other countries that are struggling with shortages of their own. Read full story Source: The Guardian, 5 September 2022 -
Content ArticleThe NHS often appears to be in a state of permanent crisis. Recently, there've been headlines about long waiting times for ambulances and the huge backlog for routine surgery. Before that, the NHS faced a two-year pandemic which may rear its head again this winter. But the NHS also has a big underlying problem that it has tens of thousands of vacancies for doctors, nurses and other medical workers – and that makes all the other pressures on the NHS even harder to handle. So why does the NHS have a staffing problem? And what can be done to fix it?
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News Article
NHS vacancies in England at ‘staggering’ new high as almost 10% of posts empty
Patient Safety Learning posted a news article in News
The number of posts lying vacant across the NHS in England has reached a “staggering” record high of 132,139 – almost 10% of its planned workforce. The number at the end of June was up sharply from three months earlier when there were 105,855 vacancies, quarterly personnel figures show. NHS leaders said the huge number of empty posts showed why the health service is in a state of deepening crisis, with patients facing long waits for almost every type of care. The previous highest number of vacancies for full-time-equivalent staff was 111,864, recorded at the end of June 2019. The new number represents 9.7% of the NHS’s planned staffing levels – a new high. As recently as March 2021 there were 76,082 vacancies. Danny Mortimer, the chief executive of NHS Employers, said: “These figures paint a bleak picture. A jump in nearly 30,000 staff vacancies – equivalent to the entire staffing of a large NHS hospital – show an alarming trend across the NHS of rising levels of vacancies.” Read full story Source: The Guardian, 1 September 2022 -
Content Article“The National Health Service and the adult social care sector are facing the greatest workforce crisis in their history”, said Parliament’s Health and Social Care Select Committee in July. The aspirations to rebuild services post-Covid, and tackle rising waiting times and other access challenges, are limited by the same challenge: there are simply not enough staff, writes Richard Murray in this article for the Independent.
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Content ArticleThis report by the Institute for Fiscal Studies (IFS) looks at which staff are more likely to leave the NHS acute sector. There is still little analysis available on the reasons why staff leave the NHS, but increasing our understanding of the complex factors that cause people to leave the health service would allow the NHS to develop more effective retention strategies. The report uses the Electronic Staff Record, the monthly payroll of directly employed NHS staff, to analyse the leaving rates of consultants, nurses and midwives, and health-care assistants (HCAs) between 2012 and 2021. The authors highlight that many other factors that influence retention remain unknown, and much more research is needed in this area.
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Content ArticleThis article in The Guardian aims to explain the major pressures the NHS will face in Autumn 2022. It identifies and explores the following threats: Covid Influenza Cost of living crisis Workforce shortages Pay
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Content ArticleThe Government's Race Disparity Unit has published data relating to NHS staff reports of discrimination at work. The charts, tables and commentary on this page cover survey data from 2019, and the data from 2020 is available to download without commentary. 300 NHS organisations took part in the staff survey in 2019, including 229 NHS trusts.
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Content ArticleThis report by The Tony Blair Institute for Global Change sets out an action plan to save the NHS this winter. It highlights the pressures the health service faces, worsened by the Covid-19 pandemic, including a resurgent flu epidemic, the effect of the cost-of-living crisis, the unprecedented elective-care backlog and a depleted and exhausted workforce. The authors call for the Government to immediately: focus leadership minimise demand on the service improve patient flow and efficiency maximise capacity.
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News Article
Minnesota nurses’ strike vote puts safety and conditions in spotlight
Patient-Safety-Learning posted a news article in News
Nurses at 15 hospitals in the Twin Cities area (Minneapolis-St Paul) and Duluth, Minnesota, that are negotiating new union contracts with their respective hospitals have overwhelmingly voted to authorize a strike. A date for the work stoppage has not been set yet by the union, the Minnesota Nurses Association, which represents about 15,000 nurses who voted on the strike authorization, but a 10-day notice must be given ahead of any strike. If a strike is carried out, it would be one of the largest nurses’ strikes in US history. Jayme Wicklund, a registered nurse at the Children’s hospital in St Paul, Minnesota, and member of the negotiating committee, said, “We need more resources to take care of the patients. The hospitals are very focused on wages. We have to be comparable to other places. But that’s all that they focus on. Once you start talking about wages, they don’t want to talk about the other important issues around patient safety or actually, other ways to save money.” Read full story Source: The Guardian (23 August 2022)
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