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Content ArticleThis article in the BMJ highlights a number of recent articles that reflect on the realities facing the health service after the first brutal years of the Covid-19 pandemic. It summarises and links to articles in the BMJ about the elective care backlog, A&E waiting times, remote appointments, Government pressures that stop senior clinicians speaking out about pressures, and the need for credible policy solutions. It also highlights an article outlining how Brexit and the Northern Ireland Protocol have resulted in the UK being denied access to European research funding and meetings.
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Content ArticleThis webpage outlines the role of Medical Examiner Officers (MEOs), who provide the continuity and oversight that the medical examiner service requires to have the maximum benefit. It includes information on training, induction and recruitment, as well as a model job description for an MEO.
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Content Article
Blog - Long Covid: A catalogue of shame (2 November 2022)
Patient-Safety-Learning posted an article in Blogs
In this blog, Roger Kline, Research Fellow at Middlesex University Business School, highlights the lack of support from the Government and NHS that healthcare staff with Long Covid face. He looks at the impact of the Government’s decision to scrap extended sick pay for NHS staff with Long Covid and argues that healthcare workers deserve better support. The blog includes accounts from 31 NHS nurses and midwives with Long Covid; some are having to use annual leave as they cannot work their full hours and some have been threatened with redundancy. Others describe their experiences of phased return to work and applying for the NHS Injury Allowance or ill health early retirement. -
Content ArticleThe number of people on NHS Wales waiting lists for treatment has reached record levels. This problem has worsened since the Covid-19 pandemic, with the average wait time for treatment more than doubling since December 2019. This report by the Welsh Centre for Public Policy identifies five key areas in which policy could be developed to improve outcomes and reduce waiting times. These areas target the underlying factors causing increased waiting times, and are likely to both improve the overall performance of the health system, and to impact outcomes which matter to patients, resulting in a more patient-centred approach: Workforce capacity Digital technology Reimagining primary care Systems collaboration Follow-up care
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Content ArticleNHS Confederation chair Lord Victor Adebowale and chief executive Matthew Taylor wrote to Rt Hon Rishi Sunak MP on his appointment as Prime Minister. Their letter both highlights the critical role of health in driving growth and sets out urgent action needed to help relieve some of the pressures on the NHS this winter, including: support for the NHS workforce urgently bolstering social care capacity protecting the NHS's capital budget supporting communities during the cost of living crisis asserting the government’s commitment to health protection and prevention.
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Content ArticleIn this BMJ feature, journalist Emma Wilkinson looks at how a shortage of health visitors in England is leaving babies and children exposed to safeguarding risks, late diagnosis and other problems. An estimated third of the health visitor workforce has been lost since 2015, and research by the Parent-Infant Foundation suggests that 5000 new health visitors are needed. Families are not getting the minimum recommended number of contacts with health visitors during the first three years of life, and research into the impact of this on children's outcomes is ongoing. Emma speaks to different mothers, including Phillippa Guillou, who had a baby in 2020 and struggled to breastfeed. Philippa felt unsupported and ignored by her local health visiting service, who only saw her once by videocall when her baby was one year old.
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Content ArticleThey play a vital role in society, but workers in adult social care – who are mostly women – are among the lowest paid in the UK and experience poor working conditions. This report by The Health Foundation analyses national survey data from 2017/18 to 2019/20 to understand rates of poverty and deprivation among residential care workers in the UK. It then compares these rates to other sectors including health, retail, hospitality and administration. The analysis demonstrates that: over a quarter of the UK’s residential care workers lived in, or were on the brink of, poverty. Nearly 1 in 10 experienced food insecurity. Around 1 in 8 children of residential care workers were ‘materially deprived’, meaning they may not have access to essential resources such as fresh fruit and vegetables or adequate winter clothing. the prevalence of poverty and deprivation in residential care is similar to hospitality, retail and administration. But residential care workers experienced much higher rates than most workers – and were at least twice as likely to experience poverty and food insecurity than health workers. Their dependent children were nearly four times as likely to experience material deprivation than children of health workers. The report highlights that political and economic conditions have changed since the data they looked at was collected, meaning that the situation is likely to have worsened for many social care workers. The poorest households in the UK are being disproportionately affected by sharp rises in inflation and poverty is set to increase. The report also highlights chronic underfunding in the social care sector, particularly in England, and calls on the new Government to make it a priority to ensure social care workers are paid fairly.
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Content ArticleIn this opinion piece for The BMJ, David Oliver, consultant in geriatrics and acute general medicine, highlights the findings of three recent reports into the growing crisis in social care: Falling short: How far have we come in improving support for unpaid carers in England? (The Nuffield Trust) The state of the adult social care workforce in England 2022 (Skills for Care) The Cost of Caring: Deprivation and Poverty among Residential Care Workers in the UK (The Health Foundation) The reports evidence a lack of support for unpaid carers, growing vacancies in the sector and a high proportion of the residential care workforce living in poverty and food insecurity. David Oliver highlights that in spite of Government promises, there is still no feasible, future-proof plan to protect social care and its staff.
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Content ArticleThis Health and Social Care Select Committee report examines the pressure currently facing general practice, which is leading to low morale, GPs leaving the profession and problems recruiting new GPs. In turn, patients are increasingly dissatisfied with the level of access they receive. The root cause of the situation is that there are not enough GPs to meet the ever-increasing demands on the service, coupled with patients presenting with increasing complexity due to an ageing population. The report outlines the Committee's assessment of the key issues, including the problems with reliance on locum doctors and lack of continuity of care, and outlines what the Government should do to equip general practice for the future.
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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 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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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 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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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 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 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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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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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 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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Content ArticleThis report, from Deloitte, examines how the healthcare workforce is responding to the inexorable rise in demand for healthcare and the challenge of meeting this demand with the right numbers of appropriately skilled staff. It provides actionable insights and evidence-based case solutions to these challenges.
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Content ArticleSocial care in England is at a crossroads. All three major political parties in the 2019 general election have recognised in their manifestos that the social care system is in need of change. So what needs to be done?
