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Found 596 results
  1. Content Article
    This performance tracker produced by the Institute for Government looks at the state of adult social care in 2023. It highlights that although the Government has provided more funding, the sector may struggle to address unmet need in the face of rising costs and competing priorities. Key findings Spending remains well above pre-pandemic levels The government continues to rely on a model of ‘crisis-cash-repeat’ for the service Without extra funding, reforming the charging model for adult social care in 2023 would have been difficult Cost pressures mean that increased funding might not achieve all the government’s objectives Vacancy rates are falling, but remain high Staff turnover is high in some key roles The size of the workforce recovered somewhat in 2022/23 International recruitment has been crucial in filling vacancies Recruitment and retention are hampered by low pay… as well as poor career progression and lack of training Requests for support increased after a drop in the first year of the pandemic Local authorities have not cleared the assessment backlog More people are providing large amounts of unpaid care The number of people receiving long-term care rose in 2022/23 A decline in people receiving long-term support is unlikely to be because other models are working
  2. Content Article
    That safety is paramount in healthcare goes without saying. There are though variations in patient outcomes between hospitals that cannot be explained by different population characteristics. Based on aggregate staffing data, a number of studies have shown that skill mix can be a factor accounting for these variations – essentially the higher the ratio of unregistered staff to registered staff the greater the incidence of adverse outcomes including mortality rates. Professor Richard Griffin explores this further in his LinkedIn article.
  3. Content Article
    This rapid evidence review and economic analysis makes the business case for investing in the wellbeing of NHS staff. It was written by a team from the University of East Anglia, RAND Europe and the International Public Policy Observatory (IPPO) and includes a narrative review of data on the current state of the mental health and wellbeing of NHS staff. Data shows that nearly half of staff reported feeling unwell as a result of work-related stress in the most recent survey, that sickness absence has increased and that there are high vacancy and turnover rates in some trusts. Research also shows that patient care can be affected by poor healthcare staff wellbeing. 
  4. Event
    until
    The health and care workforce continues to face profound challenges, with severe staff shortages and increasing financial pressures across health and care. While the NHS Long Term Workforce Plan aims to support the NHS’s future needs, it does not cover the social care workforce, resulting in a knock-on effect across the entire health and care system, particularly for those who rely on social care services. To resolve the challenges facing health and care, the sector needs to embrace positive disruption and its potential to change the nature of work and to improve recruitment, retention and the health and wellbeing of the workforce. This event from the King's Fund will explore the changing nature of work and how this can support the health and care system to adapt to future challenges. It will look at the different expectations between those already in the workforce and those joining it, and the challenges and opportunities this presents – whether it’s redesigning job roles, reforming education and training and providing different routes into health and care careers, developing a system that embraces flexible working, creating spaces for digital collaboration, or supporting moves to shift care out of hospital and into the community. Attendees will consider how those working in health and care can be supported to make the most of these opportunities against the backdrop of deep-seated cultural issues in the health and care system. Conference sessions will explore how to support the health and care workforce to succeed in their roles, and how organisations can be more responsive to the needs of people who work in them, whether through redesigning job roles to enable staff to deliver the best possible care, reforming regulation to support managers to succeed, or creating development opportunities to enable staff to work in a way that supports their health and wellbeing. Please join us to learn and share your leadership and workforce challenges. You will also have the opportunity to collaborate with experts and leaders from across the health and care system through keynote speeches, panel debates and interactive workshops. Register
  5. Content Article
    James Titcombe, Melanie Leis, and Peter Howitt delineate the major themes of a roundtable to address challenges in improving patient safety, emphasising the need for data sharing nuances, cultural shifts, optimising limited resources, prioritising workforce plans, and staff well-being.
  6. Content Article
    Physician associates (PAs) support doctors in the diagnosis and management of patient. They are often employed in general practice as members of the multidisciplinary team, trained in the medical model. This update outlines the Royal College of General Practitioners' (RCGP's) policy position on PAs. The RCGP sees PAs as having an enabling role to play for general practice, but highlights that they must always work under the supervision of GPs and must be considered additional members of the team, rather than a substitute for GPs.
  7. Content Article
    Hospital and health system CEOs have a lot of issues dominating their thoughts, including questions about navigating financial, operational and workforce challenges in the industry. Some of these problems may not have an obvious or immediate solution, leaving leaders with unanswered questions.  To gain more insight into executives' top concerns, Becker's asked hospital and health system leaders to share the questions they need answered right now. 
  8. Content Article
    In this opinion piece for the BMJ, Partha Kar looks at the current debate surrounding the role of medical associate professionals (MAPs) in the NHS. He highlights the concerns raised by many that MAPs are “doctors on the cheap” and outlines the reasons for friction between junior doctors and MAPs, which include the issues of pay, training and regulation. He also outlines issues facing locally employed doctors (LEDs), international medical graduates (IMGs) and specialist, associate specialists (SASs) including lack of access to training, supervision and career progression. He makes five suggestions to improve the situation and calls for a pause to consider how these different roles can interact and work together, for the good of both staff and the health service.
  9. Content Article
    The UK’s healthcare systems are experiencing a prolonged period of high pressure, with industrial action, backlogs in elective care persisting, and a shortage of doctors that ongoing high vacancy rates evidence. This report by the GMC analyses trends in the medical workforce across the UK. It uses a variety of sources to provide insights for policymakers and workforce planners, as well as offering deeper analysis on specific themes.
  10. Content Article
    US healthcare organisations continue to grapple with the impacts of the nursing shortage—scaling back of health services, increasing staff burnout and mental-health challenges, and rising labour costs. While several health systems have had some success in rebuilding their nursing workforces in recent months, estimates still suggest a potential shortage of 200,000 to 450,000 nurses in the United States, with acute-care settings likely to be most affected.1 Identifying opportunities to close this gap remains a priority in the healthcare industry. This article highlights research conducted by McKinsey in collaboration with the ANA Enterprise on how nurses are actually spending their time during their shifts and how they would ideally distribute their time if given the chance. The research findings underpin insights that can help organizations identify new approaches to address the nursing shortage and create more sustainable and meaningful careers for nurses.
  11. News Article
    Forcing some medical staff to work through industrial action under new anti-strike laws could end up harming patient care, hospital trust leaders have said, as ministers claimed their new measures would keep public services running over Christmas. NHS Providers, which represents hospital, mental health and ambulance trusts, said there was a significant risk it would damage relationships between staff and employers that are already very challenged, in a way that could affect patients. In a submission to the consultation on minimum service levels in hospitals, it said: “Our key concern is that rather than strengthening services as intended, the legislation proposed would worsen relationships between employers and staff, and between trusts and local union representatives to the longer-term detriment of patient care.” Read full story Source: The Guardian, 17 November 2023
  12. News Article
    Attracting skilled overseas-trained doctors to the UK will remain "crucial", despite plans to train more healthcare staff here, the doctors' regulator has said. The General Medical Council (GMC) found that nearly two-thirds (63%) of new doctors in 2022 qualified abroad. The government launched a major plan in June to train and recruit more healthcare workers in England. But it will take many years for this to take effect, the GMC says. NHS England says it currently has 10,855 full-time doctor vacancies - a rate of 7.2%. Under NHS England's Long Term Workforce Plan, it hopes to recruit and retain "hundreds of thousands" more healthcare staff over the next 15 years. The plan includes spending £2.4bn on additional training places for healthcare workers, with the number of medical school places for student doctors set to double to 15,000 a year. Charlie Massey, the GMC's chief executive, said the drive to boost the workforce was "brilliant", but said "it takes a long time to make a doctor". "We're not going to see the impact of that coming on stream for probably the best part of a decade. And that means we're going to need to rely on doctors who have trained overseas coming to the UK in much greater numbers than in recent years to maintain the workforce that we need to meet the needs of the population." Read full story Source: BBC News, 13 November 2023
  13. News Article
    A growing number of doctors plan to leave the profession due to burnout and dissatisfaction, the General Medical Council has said, highlighting fears that the government’s long-term strategy for the NHS may have come too late. The GMC’s annual report on the medical workforce said the benefits of measures announced by the government in the NHS long-term workforce plan in June, such as the ambition to create more medical school places, “will only start to be seen a decade from now”. The report found that the number of licensed doctors increased in 2022, with 23,838 joining and 11,319 leaving. However, it said there were “still high vacancy rates and workforce pressure”, and that the rate of doctors leaving the profession was returning to pre-pandemic levels, at 4% last year. The GMC warned there were “worrying signs” that a growing number “plan to leave the profession as a result of high levels of dissatisfaction and high risk of burnout”. It added that there may be “a limited window of opportunity to address current issues” before more medics leave. Read full story Source: The Guardian, 12 November 2023
  14. Content Article
    “Crisis,” “collapse,” “catastrophe” — these are common descriptors from recent headlines about the NHS in the UK. In 2022, the NHS was supposed to begin its recovery from being perceived as a Covid-and-emergencies-only service during parts of 2020 and 2021. Throughout the year, however, doctors warned of a coming crisis in the winter of 2022 to 2023. The crisis duly arrived. In this New England Journal of Medicine article, David Hunter gives his perspective on the current state of the NHS.
  15. News Article
    New NHS England guidance has advised line managers to ‘remain calm’, ‘not panic’, and ‘show kindness’ when handling staff resignations. The Expectations of Line Managers in Relation to People Management framework, published on the NHS England website, contains guidelines on several areas for line managers, including equality, diversity and inclusion, recruiting and flexible working. In the “managing exits” section, managers are told they are expected to: “Support your colleague by showing kindness to them, respect their decision, and wish them well for the future”; “Lead by example and remain calm, ie do not panic when key colleague leaves”; “Use opportunity to reflect and innovate, ie should services be redesigned?”; and “Be mindful that the colleague may have mixed emotions about leaving. Include them in planning any leaving event”. Managers are also told they should “undertake an exit interview, or ask another manager if appropriate, to understand the employee’s experience of working in your organisation” and “consider skills gaps and risks of someone leaving”. Read full story Source: HSJ, 9 November 2023
  16. Content Article
    NHS England has launched this framework on the expectations of NHS line managers in relation to people management. The report contains a recommendation to create a clear view on the expectations of line managers in the service in relation to people management and the implications for provision of people services.
  17. News Article
    Three in five foreign doctors in the NHS face “racist microaggressions” at work, such as patients refusing to be treated by them or having their abilities doubted because of their skin colour. The widespread “thinly veiled, everyday instances of racism at work” experienced by medics trained overseas has been uncovered by a survey of more than 2,000 UK doctors and dentists. Almost three in five (58%) said they had encountered such behaviour, from colleagues as well as patients, although most did not report it because they thought that no action would be taken. Doctors affected can feel upset, humiliated, marginalised and not taken seriously as a result. The findings have raised fears that international medical graduates may choose not to work in the NHS, which is increasingly reliant on their skills given the service’s shortage of doctors. Dr Naeem Nazem, the head of medical at the medical defence organisation MDDUS, which acts for doctors accused of wrongdoing, said: “These findings show us that a worryingly large number of overseas-trained doctors working in the NHS face racist microaggressions in the course of their work, from both patients and colleagues, and that many do so regularly.” Read full story Source: The Guardian, 8 November 2023
  18. News Article
    Doctors are warning that patient safety is being put at risk as podiatrists and pharmacists replace GPs “on the cheap”. Dozens of family doctors have contacted The Telegraph claiming that talk of a GP shortage is “a big lie” and that they are being replaced by less qualified, cheaper staff, in a “crisis”. Documents seen by The Telegraph show staff including podiatrists, pharmacists and physician associates being used in lieu of GPs to diagnose and treat patients with conditions they are not trained in. In the most extreme cases, poorly children with viral infections, asthma-related issues and concerns about menstruation have been seen and diagnosed by a podiatrist – a healthcare professional trained exclusively to care for feet. It is not clear what happened to any of the patients afterwards, or if their parents were aware they had seen a podiatrist rather than a doctor. One GP said it was “a matter of patient safety” and the notion of “everything being supervised” did not work at a GP practice like it does in hospitals. Read full story (paywalled) Source: The Telegraph, 4 November 2023
  19. Content Article
    In this issue of Psychological Safety, Tom Geraghty, shares some stories of “bad” management that newsletter readers have shared with him, so we can all learn from them. A selection of the stories, chosen because they highlight key themes. Geraghty highlights the importance of self reflection and learning from our own mistakes in order to improve. Also noting that when we share our mistakes and what we’ve learned from them, the potential for learning extends beyond ourselves to everyone around us.
  20. News Article
    The UK’s rapidly growing number of specialist, associate specialist, and specialty (SAS) doctors and “locally employed” (LE) doctors need targeted and specific support to make the most of their expertise, the General Medical Council has said. SAS and LE doctors are the fastest growing part of the medical workforce, increasing by 40% in four years, from 45 578 in 2017 to 63 740 in 2021, said the regulator.1 This was largely driven by doctors from overseas coming to work in UK hospitals. SAS doctors are specialty and specialist grade doctors with at least four years of postgraduate training, including two in a specialty relevant to their area of work. Read full story (paywalled) Source: BMJ, 9 October 2023
  21. News Article
    High use of agency staff contributed to the care failings exposed at a mental health trust by undercover reporters, an internal inquiry has found. Essex Partnership University Trust was at the centre of a Channel 4 documentary last year which raised concerns over care, including the use of restraints and patient observations. The trust initially refused to release the final report after a freedom of information request by HSJ, but has now released a redacted version on appeal. The report identified a number of concerns in relation to patient and staff safety, saying factors that contributed to these concerns included high usage of temporary staff and high patient acuity on the two acute mental health wards recorded. The internal inquiry looked into allegations of the inappropriate use of restraints raised in the documentary. This section, which contained redactions, found restraint was taught to be used as a last resort, but suggested high temporary staffing levels and a “lack of confident and adequately skilled staff” contributed to guidance not being followed. Another concern was around staff sleeping on duty and the use of mobile phones during patient observations. The internal inquiry found there was an “absence of visible leadership and role modelling” to ensure this did not happen during clinical practice. Read full story (paywalled) Source: HSJ, 17 October 2023
  22. News Article
    The medical regulator has told NHS England to ‘directly tackle’ a perception there is a plan to replace doctors with physician associates amid an ‘intense’ debate about their future. General Medical Council chief executive Charlie Massey wants NHS England and health systems in the devolved nations to address several issues surrounding the expansion of medical associate roles. This follows intense debate over recent weeks, including multiple media reports of safety incidents where the involvement of physicians and anaesthesia associates has been questioned. The debate has been partially prompted by ambitions in the long-term workforce plan to increase their numbers, and the impact this would have on post-graduate medical training. Last week almost 90% cent of Royal College of Anaesthetists members voted to pause the rollout of anaesthesia associates, after an extraordinary general meeting. This prompted NHSE leaders to stress to trusts that associates should be working within established guidelines and have appropriate supervision. In response, Mr Massey has written to NHSE, calling for it to: “Directly tackle the perception that there is a plan for the health services to ‘replace’ doctors with PAs or AAs by convening and leading a system-wide discussion on an agreed vision for these roles.” Read full story (paywalled) Source: HSJ, 25 October 2023
  23. News Article
    You might not have heard of a ‘physician associate’ - and that’s not your fault. They probably won’t tell you. A physician associate walks and talks like a doctor, but they are no replacement for one. To become a physician associate you need to complete a two-year postgraduate course or three-year apprenticeship. But despite much less learning than the five years a junior doctor must undergo to be qualified, they are often paid more than them. Which is why the government’s plan to flood the NHS with 10,000 more of them over the next 15 years doesn’t make any sense. There’s certainly no money-saving aspect. This is simply another corner-cutting exercise to quickly plug gaps in a struggling NHS that will put patients at risk. Far from saving doctors work (their original purpose), they often create more. Physician associates are unregulated so cannot be held accountable for their mistakes, meaning doctors must recheck any critical decisions they make. Critical decisions are made quite frequently in hospitals. But they’re not just overstretching doctors and creating more work; they’re harming patients. A recent Daily Mail investigation has found brain bleeds misdiagnosed as inconsequential headaches and lung disease mistaken for a chest infection. Doctors say they are “increasingly concerned” by this. Read full story Source: LBC, 16 October 2023
  24. News Article
    Leaders of two maternity services have been told to take urgent action, after inspectors found understaffing and declining levels of care, despite safety warnings from midwives. Maternity services at University Hospital North Durham and Darlington Memorial Hospital have been downgraded from “good” to “inadequate” in Care Quality Commission reports, published today. The CQC noted a “concerning deterioration” in the care the two services provided, despite midwives telling managers they felt the service was unsafe. Sue Jacques, chief executive of County Durham and Darlington Foundation Trust, which runs the hospitals, said the CQC’s findings would be taken “extremely seriously”. The reports also said staff reported “feeling ‘frozen out’ or that their concerns were ignored by leaders” and that staff felt “‘continuity of carer’ was the trust’s main focus, despite depleted safe staffing levels, skill mix, and staff being pulled in to cover acute areas on a frequent basis”. Last year, trusts were told not to pursue continuity of carer models – which were previously championed by NHS England – unless they had adequate staffing levels to do so safely. Read full story (paywalled) Source: HSJ, 15 September 2023
  25. News Article
    NHS England’s national mental health director admitted she was ‘concerned’ that 20% of mental health nurse roles were unfilled and about the impact this could have on a nationwide push to improve safety and tackle closed cultures. Claire Murdoch was speaking to HSJ a year on from a series of high-profile documentaries exposing abuse and poor care at mental health trusts. In their wake, Ms Murdoch urged providers to urgently review safeguarding, while a separate three-year quality programme was also launched to look at closed cultures and improve safety. Now in the middle of that programme, Ms Murdoch stressed that stability in staffing is “vital” to developing safe and therapeutic care, but that many services across the country are struggling with significant nursing vacancies. She said: “The bit that absolutely we need to acknowledge [around changing cultures] is there are some significant workforce and staffing challenges, which I’m concerned about, with a 20%t vacancy of qualified registered mental health nurses nationally. “There are new support roles, psychology assistant roles, physician associates – there are all sorts coming into being in inpatient care, but a lot of services are still struggling with staffing". Read full story (paywalled) Source: HSJ, 21 September 2023
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