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Found 597 results
  1. News Article
    NHS England is introducing a new ceiling on the amount spent within each integrated care system on agency staff — cutting it by at least 10% in each area in one year — as part of a drive to find further savings across the health service. Integrated Care Services (ICSs) have been told to cut spending on temporary staff by providers in their area by at least 10%, or £257m, on 2021-22 levels, taking expenditure down to a total of £2.3bn nationally. A letter to finance directors sent today, seen by HSJ says: “This will mean that some systems will need to go beyond their current financial plans to reduce agency expenditure.” The move is part of a wider efficiency crackdown from NHS England, with further national control measures to be introduced over the next 18 months. HSJ understands that the renewed drive will focus on five other areas in addition to agency spend: medicines, pathway redesign, corporate services, procurement and specialised commissioning. The extra savings ask comes on top of ICSs already committing to £5.5bn in efficiencies over 2022-23, which Nuffield Trust CEO Nigel Edwards said was “not a credible savings target”. Read full story (paywalled) Source: HSJ, 20 July 2022
  2. News Article
    A shortage of maternity staff is putting women and babies at risk in Gloucestershire, inspectors have said. The county's maternity services have been downgraded by two levels, from good to inadequate, by the Care Quality Commission (CQC). Its report highlighted staff shortages, missed training, exhaustion among workers and concerns over equipment. Gloucestershire Hospitals NHS Foundation Trust issued an apology and said improvements have been made. CQC inspectors visited maternity wards, birth units and community midwives in Gloucester, Cheltenham and Stroud in April after receiving concerns about the "culture, safety and quality of services". They found the service did not have enough midwifery staff with the "right qualifications, skills, training and experience to keep women safe from avoidable harm or to provide the right treatment all the time". Read full story Source: BBC News, 22 July 2022
  3. News Article
    More than a quarter of nursing staff in hospitals across the UK say patient care is being compromised due to treatment taking place in the wrong setting. Investment in the nursing workforce is needed now, the Royal College of Nursing insists, as survey findings show clinical care is taking place in settings such as hospital corridors and waiting rooms rather than on wards. The poll of more than 20,000 nursing and midwifery staff found the situation is worst in emergency care settings where nearly two-thirds of respondents reported the problem. Elsewhere, more than a quarter of nursing staff who responded say patients are being treated in the wrong setting, meaning their care is being compromised and even made unsafe. Staff shortages are a key factor, and across health and social care settings this is causing delays to patients being discharged into the community. This leaves hospitals full, with emergency care staff having to provide care in inappropriate settings. One specific issue identified by respondents was extra beds being added to wards, making carrying out care more difficult, and leading to a lack of privacy for patients and their families. A nurse who works on an NHS adult acute ward in Scotland said patients and their relatives had complained about an extra bed being squeezed into a four-bedded bay, meaning they had no buzzer, no curtains and were not two-metre distanced. She added: “I feel incredibly frustrated and embarrassed. It is totally inappropriate for ward rounds, nursing procedures, COVID precautions and an extra stress on staff.” Read full story Source: Royal College of Nursing, 14 July 2022
  4. News Article
    Hospital doctors are being sent home from daytime shifts and told to come back and work overnight in the latest stark illustration of the NHS’s crippling staff shortage. Medics are having to change their plans at the last minute because hospitals cannot find any others to plug gaps in the night shift medical rota and need to ensure they have enough doctors on duty. Hospital bosses are forcing last-minute shift changes on junior doctors – trainees below the level of consultant up to the level of senior registrar – because staff sickness and the scarcity of locum medics has left them struggling to ensure patients’ safety is maintained overnight. One trainee doctor in south-west of England told how they started their shift as planned at 8am. However, “by mid-morning the doctor that was meant to be working that night, that I would hand over to, had called in ill”. The doctor stopped working at 11am, drove home – an hour away – and came back to work the night shift at 11pm. “By the time I returned I had already worked for three hours and driven for three hours. That’s an extra six hours on top of a busy night shift of 12.5 hours,” they said. Dr Julia Patterson, the chief executive of EveryDoctor, said: “We are hearing of escalating problems with NHS doctors being forced to work unsafe, unfair hours." “Patient safety is of paramount importance to all doctors, but this situation is simply not sustainable. When mistakes occur, staff are blamed. But staff are working in an unworkable system.” Read full story Source: The Guardian, 11 July 2022
  5. News Article
    An ‘outstanding’ rated mental health trust has been criticised by the Care Quality Commission (CQC) for ‘unsafe’ levels of staffing and inadequate monitoring of vulnerable patients. The CQC said an inpatient ward for adults with learning disabilities and autism run by Cumbria Northumberland Tyne and Wear Foundation Trust “wasn’t delivering safe care”, and some staff were “feeling unsafe due to continued short staffing”, following an unannounced inspection in February. The inspection into Rose Lodge, a 10-bed unit in South Tyneside, took place after the CQC received concerns about the service. Inspectors highlighted a high use of agency staff, with some shifts “falling below safe staffing levels”, which meant regular monitoring of patients with significant physical health issues “was not always taking place”. They said the trust had “implemented a robust action plan” following the inspection. The CQC did not issue a rating. The trust’s overall rating for wards for people with a learning disability remains as “good”, and its overall rating remains “outstanding”. Read full story (paywalled) Source: HSJ, 8 July 2022
  6. News Article
    The shortage of GPs in England is set to become worse, with more than one in four posts predicted to be vacant within a decade, an analysis suggests. The Health Foundation study said the current 4,200 shortfall could rise to more than 10,000 by 2030-31. The think tank believes the government will struggle to increase the number of GPs, while demand will continue to rise - creating a bigger shortfall. The government has promised to recruit 6,000 extra GPs by 2024, but ministers have admitted they are struggling to achieve that. The analysis said the numbers entering the profession are on the rise, but this will be offset by GPs retiring or moving towards part-time working, according to current trends. The worst-case scenarios suggested more than half of GP posts could even be vacant. Anita Charlesworth, director of research at the Health Foundation, said: "It's sobering that over the next decade things are set to get worse, not better." "It's critical that government takes action to protect general practice and avoid it getting locked in a vicious cycle of rising workload driving staff to leave, in turn creating more pressure on remaining staff and fuelling even more departures." Prof Martin Marshall, chairman of the Royal College of GPs, said the predictions were "bleak" and the worst-case scenario would be a "disaster". "Our members have told us they lack the time to deliver the care that they want to deliver for patients - and that patients need," he said. Read full story Source: BBC News, 30 June 2022
  7. News Article
    A drive to ‘transform’ access to urgent, emergency and planned care will be added to the goals of the NHS long-term plan, a document leaked to HSJ has revealed The long-term plan for the NHS was originally published in January 2019. Last September, NHS England said it was reviewing the commitments made within the plan, with senior officials warning that many of them could not be met after the damage of the pandemic. HSJ has seen a document prepared for the most recent meeting of the NHS Assembly which sets out NHSE’s approach to the refresh. Strategic developments expected include better joined-up community based and preventive care, transform access to urgent, emergency and planned care, improve care quality and operations, and tackle health inequalities, improve population health and develop a sustainable health service through greater collaboration. Read full story (paywalled) Source: HSJ, 24 June 2022
  8. News Article
    Polling by the Royal College of General Practice (RCGP) as part of a campaign to make NHS GP services sustainable for the future found that 42% of 1,262 GPs and trainees who took part said they were likely to quit the profession in the next five years. A workforce exodus on this scale would strip the health service of nearly 19,000 of the roughly 45,000 headcount GPs and GP trainees currently working in general practice. RCGP chair Professor Martin Marshall warned that general practice was a profession in crisis - with the intensity and complexity of GP workload rising as the workforce continued to shrink. He warned that 'alarming' findings from the RCGP poll must serve as a stark warning to politicians and NHS leaders over the urgent need for solutions to begin to tackle the crisis facing general practice. Four in five respondents told the RCGP they expect working in general practice to get worse over the next few years - while only 6% expected things to improve. Nearly two in five respondents said GP practice premises are not fit for purpose, and one in three said IT for booking systems is not good enough. Professor Marshall said: 'What our members are telling us about working on the frontline of general practice is alarming. General practice is significantly understaffed, underfunded, and overworked and this is impacting on the care and services we’re able to deliver to patients. Read full story Source: GP, 22 June 2022
  9. News Article
    Vulnerable patients cared for in secure mental health units across England could miss out on vital medications due to a shortage of learning disability nurses, the Healthcare Safety Investigation Branch (HSIB) has warned. The report into medication omissions in learning disability secure units across the country highlights problems with retaining learning disability nurses, with the number recruited each year matching those leaving. Figures quoted in the report suggest the number of learning disability nurses in the NHS nearly halved from 5,500 in 2016 to 3,000 in 2020. The HSIB launched a national investigation after being alerted to the case of Luke, who spent time in NHS secure learning disability units but was not administered prescribed medication for diabetes and high cholesterol on several occasions. At Luke’s facility, which included low and medium secure wards, HSIB investigators considered that the quality and style of care provided to patients had been directly impacted by a lack of nurses with required skill sets. Findings from HSIB’s wider national investigation link a shortfall of learning disability nurses to instances of patients missing their medication, with the report’s authors describing a “system in which medicines omissions were too common and prevention, identification and escalation processes were not robust”. Read full story (paywalled) Source: HSJ, 23 June 2022
  10. News Article
    The NHS is facing a major exodus of doctors of ethnic minority backgrounds due to persistent levels of racism faced at a personal and institutional level, a ground breaking study has revealed. Nearly one third of doctors surveyed have considered leaving the NHS or have already left within the past two years due to race discrimination, with 42 per cent of Black and 41 per cent Asian doctors in particular having considered leaving or having left. The survey paints a picture of institutional barriers to career progression, dangerously low levels of reporting of racist incidents and a growing mental health burden on ethnic minority doctors. With more than 2,000 responses from doctors and medical students across the UK, the BMA – a professional association representing all doctors in the UK – believes that this survey is one of the largest of its kind to document the experience of racism in the medical profession and workplace. Dr Chaand Nagpaul, BMA chair of council, said: “The NHS was built on the principle of equality of care for patients whoever they are, but this report shows that the NHS is shamefully failing in this principle for its own doctors, with those from ethnic minorities reporting alarming levels of unfair treatment and racial inequality at work. Read full story Source: The Independent, 15 June 2022
  11. News Article
    The number of calls for an ambulance in England have almost doubled since 2010, with warnings of record pressures on the NHS that are seeing A&E patients stuck in corridors and many paramedics quitting the job. Ambulance calls have risen by 10 times more than the number of ambulance workers, according to a new analysis of NHS data carried out by the GMB union. An increase in people seeking emergency treatment, GPs unable to cope with demand and cuts to preventive care are all being blamed for the figures. While the figures represent all calls for an ambulance, some of which go unanswered and do not lead to a vehicle being sent, they reveal the increasing pressures that have led to claims that patient safety is being put at risk by ambulance waiting times. There has been a significant increase in the number of the most serious safety incidents logged by paramedics in England over the past year. Paul, a paramedic and GMB deputy branch secretary, said he had recently seen a crew waiting almost 10 hours between arriving at hospital and transferring a patient to hospital care. “They arrived at the hospital at 20.31,” he said. “They then cleared from the hospital at 05.48 in the morning. The impact of the lack of resources is affecting the ambulance service. “We are also seeing people become aggressive to the ambulance crew, because they’ve waited hours upon hours in an ambulance." Read full story Source: The Guardian, 12 June 2022
  12. News Article
    Concerned healthcare workers in Illinois and Indiana are calling on The Joint Commission to add a safe staffing standard to its accreditation process. Yolanda Stewart, a patient care technician at Northwestern Memorial Hospital, once injured her back so badly on the job that she couldn’t work for six months. But when she talks about that time, she doesn’t mention her own pain. Instead, she talks about the patient she’d been trying to help, recalling his extreme discomfort. Because the unit was short-staffed, Stewart lifted and turned the patient on her own. The move helped the patient but cost Stewart. Many healthcare workers have similar stories, she says, adding, “Working short-staffed is a safety issue for workers and patients.” In fact, reports show that lack of staff in hospitals leads to higher patient infection and death rates. Covid-19 has greatly worsened the healthcare staffing shortage, with 1 in 5 hospital employees — from environmental services workers to nurses — leaving the field. Hospitals have grappled with staffing issues since before the pandemic, but Covid-19 highlighted the challenges — and exacerbated them. Now, concerned healthcare workers throughout Illinois and Indiana are sounding the alarm. They’re calling on The Joint Commission — the third-party agency that accredits 22,000 US healthcare organisations — to add a safe staffing standard to its accreditation process, similar to student-to-teacher ratio requirements that many states have. “We have all kinds of rules to make sure that hospitals are safe: We make sure that healthcare workers wash their hands before procedures, that they wear gloves and protective equipment, that bed sheets are changed between patients. Yet there are no statewide regulations about hospital staffing levels,” said Service Employees International Union (SEIU) Healthcare Illinois President Greg Kelley at a demonstration in early June. Read full story Source: Chicago Health, 8 June 2022
  13. News Article
    The U.S. is facing high levels of burnout among health care workers, which could lead to serious shortcomings in patient care, a new report from the U.S. Surgeon General has found. Burnout among health care workers was a serious problem even before the COVID-19 pandemic, but the stress caused by the ongoing pandemic has made things much worse, said Surgeon General Dr. Vivek Murthy. “The pandemic has accelerated the mental health and burnout crisis that is now affecting not only health workers, but the communities they serve,” Murthy said. “Already, Americans are feeling the impact of staffing shortages across the health system in hospitals, primary care clinics, and public health departments. As the burnout and mental health crisis among health workers worsens, this will affect the public’s ability to get routine preventive care, emergency care, and medical procedures. It will make it harder for our nation to ensure we are ready for the next public health emergency. Health disparities will worsen as those who have always been marginalized suffer more in a world where care is scarce. Costs will continue to rise.” The report calls for several steps to address the burdens on health care workers. These include: Protecting the health, safety, and well-being of all health workers by ensuring they have proper equipment, training, and are protected against workplace violence. Eliminating punitive policies for seeking mental health and substance abuse care. Reducing administrative and documentation burdens and improving health information technology and payment models. Prioritising health worker well-being on an organizational level—this includes providing competitive wages, paid sick and family leave, rest breaks, educational debt support, and other steps to ease the burden on health workers. Read full story Source: BenefitsPro, 6 June 2022
  14. News Article
    Most nurses warn that staffing levels on their last shift were not sufficient to meet the needs of patients, with some now quitting their jobs, new research reveals. A survey of more than 20,000 frontline staff by the Royal College of Nursing (RCN) suggested that only a quarter of shifts had the planned number of registered nurses on duty. The RCN said the findings shone a light on the impact of the UK’s nursing staff shortage, warning that nurses were being “driven out” of their profession. In her keynote address to the RCN’s annual congress in Glasgow, general secretary Pat Cullen will warn of nurses’ growing concerns over patient safety. Four out of five respondents said staffing levels on their last shift were not enough to meet all the needs and dependency of their patients. The findings also indicated that only a quarter of shifts had the planned number of registered nurses, a sharp fall from 42% in 2020 and 45% five years ago, said the RCN. Ms Cullen will say: “Our new report lays bare the state of health and care services across the UK. “It shows the shortages that force you to go even more than the extra mile and that, when the shortages are greatest, you are forced to leave patient care undone. Read full story Source: The Independent, 6 June 2022
  15. News Article
    NHS England was aware of concerns about upper gastrointestinal surgery at a hospital nearly three years before the Care Quality Commission intervened to stop it being carried out, HSJ can reveal. NHSE in the South East commissioned a report into upper GI cancer services in parts of the region in January 2020. In particular, HSJ understands the review was prompted by concerns the small number of surgeries carried out at the Royal Sussex County Hospital in Brighton meant it may be unable to comply with parts of the service specification and face difficulties maintaining an adequate surgical workforce rota. Despite these concerns, Brighton continued to carry out upper GI surgery until the CQC suspended planned oesophagic-gastric resections last August. Read full story (paywalled) Source: HSJ, 14 March 2023
  16. News Article
    A staffing crisis in children’s dentistry has prompted the urgent removal of junior doctors from Great Ormond Street Hospital NHS Foundation Trust (GOSH. GOSH has struggled to recruit consultants for its paediatric dentistry services for at least two years, which has led to trainee doctors going unsupervised, according to a new report by regulator Health Education England. A report seen by The Independent said the service was running with just one part-time consultant but needed at least two. The news comes amid a national “crisis” in dentistry, with the latest data from the government showing that half of all children’s tooth extractions in 2021-22 were due to “preventable tooth decay”. GOSH told The Independent it was struggling with a “limited pool” of paediatric dentists and, as a result of shortages, many patients were waiting longer than the 18-week standard. Read full story Source: The Independent, 8 February 2023
  17. News Article
    A struggling acute trust says its failure to hit its elective care targets is directly linked to doctors’ demanding overtime rates in line with the British Medical Association’s rate cards, as national tensions around the issue intensify. University Hospitals of Morecambe Bay Foundation Trust’s January performance report said its elective activity was down by around 1,000 cases over a two-month period, due to the issue. Last summer, the BMA published a “rate card” outlining the “minimum” hourly pay consultants should receive for additional work, such as waiting list initiatives and weekend shifts. Some accused the union of “acting like football agents” by trying to inflate their members’ pay. NHS chiefs have long been warning of the risk the rate card poses to elective recovery. But there are few examples of a trust making such an explicit link between their struggle to staff overtime shifts because of the rate card and subsequent failure to hit their elective targets, and placing a number on how many patients they were forced to add to the list because of the issue. Read full story (paywalled) Source: HSJ, 1 March 2023
  18. News Article
    A criticised maternity service needs 37 more midwives, about a fifth of its total midwifery workforce. The Care Quality Commission has said Northampton General Hospital did not always have enough qualified and experienced staff to keep women safe from avoidable harm. Figures obtained by the BBC show that 49 serious incidents have occurred in its maternity services in four years. The hospital said it had undertaken "a lot of work" in the past 18 months and a recruitment process was under way. According to a Freedom of Information Act response, between November 2018 and November 2022, the hospital had 278 serious incidents, with the highest level coming across maternity services, including gynaecology and obstetrics. There are currently 37 vacancies for midwives but the trust said it manages staffing levels "closely and ensure that all shifts are covered by bank or midwives working altered shift patterns, to ensure that we are able to provide a safe maternity experience". Read full story Source: BBC News, 27 February 2023
  19. News Article
    Britain could double the number of doctors and nurses it trains under NHS plans to tackle a deepening staffing crisis, according to reports. The proposal to increase the number of places in UK medical schools from 7,500 to 15,000 is contained in a draft of NHS England’s long-awaited workforce plan, which is expected to be published next month. Labour has already announced this policy as a key element of its plans to revive the NHS. However, it could face opposition from the Treasury because of how much it would cost, according to the Times, which reported on the plan. The NHS in England alone is short of 133,000 staff – equating to about a tenth of its workforce – including 47,000 nurses and 9,000 doctors, according to the most recent official figures. There are also shortages of midwives, paramedics and operating theatre staff. Staff groups say routine gaps in NHS care providers’ rotas are endangering patients’ safety, increasing workload and costing the service money. Read full story Source: The Guardian, 22 February 2023
  20. News Article
    White applicants remain 54% more likely to be appointed from NHS job shortlistings compared to ethnic minority candidates, a metric that has hardly budged since 2016, a NHS England report has revealed. The 2022 NHS workforce race equality standard report, revealed a significant rise in the proportion of staff from ethnic minority backgrounds. And while there had been progress on some key targets since last year, others have stagnated. NHSE’s report showed ethnic minority staff comprise 24.2% of the workforce in 2022, up from 22.4% last year and from 17.7% six years ago. However, it also revealed the likelihood of white applicants being appointed from shortlists was 1.54 in 2022 than minority ethnic applicants – only a very small improvement on 1.57 in 2016, when WRES began Read full story (paywalled) Source: HSJ, 22 February 2023
  21. News Article
    The UK risks a shrinking workforce caused by long-term sickness, a new report warns. Pensions and health consultants Lane, Clark and Peacock (LCP) says there has been a sharp increase in "economic inactivity" - working-age adults who are not in work or looking for jobs. The figure has risen by 516,000 since Covid hit, and early retirement does not appear to explain it. The total of long-term sick, meanwhile, has gone up by 353,000, says LCP. It means there are now nearly 2.5 million adults of working age who are long-term sick, official data from the Labour Force survey reveals. The LCP says pressure on the NHS can account for some of the increase in long-term sickness. Delays getting non-urgent operations and mental health treatment are possible explanations. Others who would otherwise have had a chronic condition better managed may be in poorer health. One of the report authors, Dr Jonathan Pearson-Stuttard, said: "The pandemic made clear the links between health and economic prosperity, yet policy does not yet invest in health, to keeping living in better health for longer. NHS pressures have led to disruption of patient care which is likely to be impacting on people's ability to work now and in the future." Read full story Source: BBC News, 20 February 2023
  22. News Article
    Workforce problems in US hospitals are troublesome enough for the American College of Healthcare Executives to devote a new category to them in its annual survey on hospital CEOs' concerns. In the latest survey, executives identified "workforce challenges" as the number one concern for the second year in a row. Although workforce challenges were not seen as the most pressing concern for 16 years, they rocketed to the top quickly and rather universally for US healthcare organisations in the past two years. Most CEOs (90%) ranked shortages of registered nurses as the most pressing within the category of workforce challenges, followed by shortages of technicians (83%) and burnout among non-physician staff (80%). Read full story Source: Becker Hospital Review, 13 February 2023
  23. News Article
    Thousands of patients are being forced to wait more than 18 months for treatments such as knee and brain surgery as the health service is set to miss its flagship target because of NHS strikes. NHS England last week claimed it was “on track” to hit the mandated target, but senior sources have warned that the impact of prolonged walkouts combined with unprecedented demand for emergency care means that this is now unlikely. The sources say it is probable that up to 10,000 patients will still be waiting for 18 months or more by the end of March, as a knock-on effect of the cancellation of 140,000 appointments because of strike action. More walkouts are planned over the coming weeks. Patricia Marquis, RCN director for England, said the backlog was “yet even more evidence of what happens when you fail to invest in the workforce. If ministers are serious about preventing a further exodus and cutting the backlog, they need to hear the calls of NHS leaders and come to the table and talk about pay. Only then will patients receive the care they need and waiting lists start to come down.” Read full story Source: The Independent, 15 February 2023
  24. News Article
    GPs are attempting to deal with up to 3,000 patients each, amid worsening staff shortages, according to new analysis commissioned by the Liberal Democrats. The research shows that the number of patients per GP has risen sharply, as rising numbers of doctors reduce their hours, or opt for early retirement. The figures, which track the number of “full-time equivalent” fully qualified GPs, show the number has fallen from 29,320 in 2016 to 27,372 last year. The trend follows a rise in part-time work, with the average GP now working a three-day week. On average, there are now 2,273 patients per fully qualified doctor, up from 1,981 in 2016, the research commissioned by the Liberal Democrats shows. While the total number of GPs fell by almost 2,000, the number of registered patients grew from 58 million to 62.2 million, according to the House of Commons Library. Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, said the research “shows yet again how GPs and our teams are working above and beyond to deliver care to an ever-growing patient population, with falling numbers of fully qualified, full-time equivalent GPs.” Read full story (paywalled) Source: The Telegraph, 14 February 2023
  25. News Article
    Healthcare leaders have been warned by nearly 200 doctors that plans to give more work to private hospitals will “drain” money and staff away from NHS services, leaving the most ill patients at risk. In a letter seen by The Independent, almost 200 ophthalmologists urged NHS leaders to rethink plans to contract cataract services to private sector hospitals, as to do so “drains money away from patient care into private pockets as well as poaching staff trained in the NHS”. The doctors have called for “urgent action” to stop a new contract from being released, which would allow private sector hospitals to take over more cataract services. Professor Ben Burton, consultant ophthalmologist and one of the lead signatories of the letter, said, “What is needed is a long-term sustainable solution rather than a knee-jerk reaction which risks the future of ophthalmology as an NHS service. The long-term solution will be achieved by investing in NHS providers to deliver modern, efficient care, and the private sector only used as a last resort.” Read full story Source: The Independent, 10 February 2023
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