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Found 253 results
  1. News Article
    Hospitals which rely heavily on locum doctors are 'undoubtedly' risking patient safety, a study of NHS practice found. While temporary staff are a 'vital resource' to plug workforce gaps, issues such as unfamiliarity with protocols and procedures mean they 'pose significant patient safety challenges' for the NHS, experts say. The report warned many were left feeling isolated and stigmatised by resident staff, creating a 'hostile environment'. This has led to a 'defensive' culture over mistakes, hindering improvements to care, according to researchers. Calling for greater monitoring by inspectors, NHS leaders must rethink how these professionals are supported and used, the authors said. Writing in a linked editorial, Professor Richard Lilford, of the Institute of Applied Health Research at the University of Birmingham, said the findings suggested 'the life of the locum is a difficult and lonely one, opening up many pathways to unsafe practice.' Likening it to airline pilots, he suggested staff would benefit from standardised practices – such as how the medicine cabinet is stocked – to minimise mistakes. Agencies providing staff should be given routine feedback by employers and locum staff, to enhance patient safety, he said. Read full story Source: MailOnline, 16 April 2024
  2. Content Article
    The use of temporary doctors, known as locums, has been common practice for managing staffing shortages and maintaining service delivery internationally. However, there has been little empirical research on the implications of locum working for quality and safety. This study aimed to investigate the implications of locum working for quality and safety. The participants of the study described the implications of locum working for quality and safety across five themes: (1) ‘familiarity’ with an organisation and its patients and staff was essential to delivering safe care; (2) ‘balance and stability’ of services reliant on locums were seen as at risk of destabilisation and lacking leadership for quality improvement; (3) ‘discrimination and exclusion’ experienced by locums had negative implications for morale, retention and patient outcomes; (4) ‘defensive practice’ by locums as a result of perceptions of increased vulnerability and decreased support; (5) clinical governance arrangements, which often did not adequately cover locum doctors. The study concluded that locum working and how locums were integrated into organisations posed some significant challenges and opportunities for patient safety and quality of care. Organisations should take stock of how they work with the locum workforce to improve not only quality and safety but also locum experience and retention.
  3. Content Article
    Tommy Gillman died on 8 December 2022 from sepsis and multi organ failure secondary to Salmonella Brandenburg meningitis. There were missed opportunities to provide him with earlier antibiotics, fluid resuscitation and intensive monitoring from 12.35pm on the 7 December 2022 at Kings Mill Hospital. Once the severity of his illness had been recognised at approximately 17:00 hours on that day, he was provided with prompt treatment for septic shock and meningitis. Sadly however he did not respond to this treatment and died the following day following transfer to Leicester Royal Infirmary. Whilst there were serious missed opportunities to provide earlier treatment of sepsis and meningitis.
  4. News Article
    Tens of thousands of doctors are hoping to quit the NHS and move abroad this year in search of better pay, the medical regulator has warned. Half of the doctors planning to leave said they wanted to move to Australia, which has been the most popular destination for emigrating UK doctors for the past five years. The General Medical Council surveyed 3,154 doctors about their attitudes towards leaving the UK, including 1,000 who had recently left to practise abroad. Some 13% of those working in the NHS said they were “very likely” to move in the next 12 months, while another 17% said they were “fairly likely” to move. The GMC said this would amount to 96,000 doctors quitting over the next year if applied to the total number of doctors on the medical register, although it acknowledged that the actual rate of departures was likely to be much lower. Read full story (paywalled) Source: The Times, 12 April 2024
  5. Content Article
    The UK is suffering from a chronic shortage of midwives, a shortage that has had an inevitable impact on maternity safety. While services in Scotland, Wales and Northern Ireland certainly have their challenges, it is England where the problems have been most severe, with a current estimated shortage of 2,500 midwives. The result is that midwives and working an estimated 100,000 hours’ unpaid overtime every week— burnout is widespread and the NHS is struggling to retain staff. This report by the Royal College of Midwives makes several suggestions to recruit and retain midwives in our maternity services. These include improving the quality of midwifery education. paying student tuition fees and employers developing more flexible working practices.
  6. Content Article
    When Adam Luck’s mother, Ann, was admitted to hospital with a suspected stroke, it was the beginning of a distressing seven-week stay. The previously cheerful 82-year-old became stuck in a dysfunctional health system. Her story is presented here via her son Adam’s diary of her hospitalisation.
  7. Content Article
    NHS strikes have become such a familiar feature of our lives over the past two years that there is a risk we can become inured to their impact. This King's Fund article looks at the different ways in which strikes can impact the NHS and the people it serves.
  8. Content Article
    This blog identifies important features of the NHS Long Term Workforce Plan and looks at how focussing on these areas might help systems and providers develop their own plans and take agency to solve local challenges. The author, Nick Richmond, spotlights the following aspects of the plan: ‘All levers at all levels’ approach Diverse time frames for different levers The ‘train’ actions are the most significant investment in domestic supply ever The plan is integrated with service and financial planning – future demand is ‘owned’ by the government and the NHS.
  9. News Article
    Staff whistleblowers have raised concerns over patient safety at one of Northern Ireland's biggest health trusts. Information received by UTV under Freedom of Information shows that most of the worries from health workers at the Belfast Health Trust relate to the Royal Victoria Hospital. Belfast Health Trust said any concerns raised by staff are investigated. The Royal College of Nursing NI was due to hold a webinar with members on Tuesday evening to discuss concerns members have about safety of patients being treated on corridors. The RCN's Rita Devlin said that the number of concerns raised with health trusts through the whistleblowing policy is only the tip of the iceberg. The concerns included unsafe staffing levels, bed shortages, boarding of patients, ED overcrowding, alleged drug dealing on a hospital site, staff sleeping on night duty, lack of mental health beds and the quality of staff training. The Belfast Trust said all staff are encouraged to make management aware of issues giving them concern through the whistleblowing process. The Trust added: "Any concern we receive is subject to a fair and proportionate process of investigation. "Whistleblowing investigations are of a fact finding nature and all relevant learning is shared as appropriate and taken forward by the Trust." Read full story Source: ITVX. 12 March 2024
  10. News Article
    England’s NHS Ombudsman has warned that cancer patients could be put at risk because of over-stretched and exhausted health staff working in a system at breaking point and delays in diagnosis and treatment. The Parliamentary and Health Service Ombudsman (PHSO) revealed that between April 2020 and December 2023, his Office carried out 1,019 investigations related to cancer. Of those 185 were upheld or partly upheld. Issues with diagnosis and treatment were the most common cancer-related issues investigated by PHSO. These issues included treatment delays, misdiagnosis, failure to identify cancer, the mismanagement of conditions, and pain management. Complaints about cancer care also included concerns about poor communication, complaint handling, referrals, and end-of-life care. Most investigations were about lung cancer, followed by breast cancer and colorectal cancer. The Ombudsman recently closed an investigation around the death of Sandra Eastwood whose cancer was not diagnosed for almost a year after scans were not read correctly. The delay meant she missed out on the chance of treatment which has a 95% survival rate. In 2021, PHSO published a report about recurrent failings in the way X-rays and scans are reported on and followed up across the NHS service. Mr Behrens said, “What happened to Mrs Eastwood was unacceptable and her family’s grief will no doubt have been compounded by knowing that mistakes were made in her care. “Her case also shows, in the most tragic of ways, that while some progress has been made on my recommendations to improve imaging services, it is not enough and more must be done. “Government must act now to prioritise this issue and protect more patients from harm.” Read full story Source: Parliamentary Health and Health Service Ombudsman, 9 March 2024
  11. News Article
    A patient says he felt ignored and that NHS care was lacking after he spent 14 hours on a bed in a hospital corridor. Ivan Philpotts, 77, from Norwich, was transferred between wards at the Norfolk & Norwich University Hospital (NNUH), having contracted pneumonia. He said he was left in a bed in a corridor with no access to water, was unable to eat and that his wife was unable to visit. The hospital said it had experienced a high number of patients last week. "I felt very vulnerable," Mr Philpotts said. "Nobody seemed to be taking any notice of you and you were sitting there, people walking by you. "I was there from 8.30 in the morning until 9.10 at night before I actually got into a bay. We got no communication whatsoever." The hospital trust is one of just two in England that has been carrying out a trial of a "corridor care" scheme. The Royal College of Nursing's eastern regional director Teresa Budrey said: "We're starting to normalise it and that's not OK. "There are patients who are suffering for hours, without proper privacy or equipment and you've also got nurses dealing with an expanded number of patients. "We need government minsters and employers to come together for some bigger solutions across the system." Read full story Source: BBC News, 6 March 2024 Further reading on the hub: A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift
  12. Content Article
    Hospital nurse staffing, and the proportion of nurses with bachelor’s education, are associated with significantly fewer deaths after routine surgery, according to research published in the Lancet. A team of researchers conducted the study across nine European countries and found that a better educated nursing workforce reduced unnecessary deaths. Every 10%increase in the number of bachelor’s degree educated nurses within a hospital is associated with a 7% decline in patient mortality. Patients in hospitals, in which 60% of nurses had bachelor’s degrees and nurses cared for an average of six patients, had almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor’s degrees and nurses cared for an average of eight patients. The study shows that, in hospitals in England, an average only of 28% of bedside care nurses had bachelor’s degrees, among the lowest in Europe, which averaged 45%. The study shows that increasing the production of graduate nurses is necessary if the NHS is to realise the potential of lower patient mortality and fewer adverse patient outcomes.
  13. Content Article
    Hospital staff members experience 1.17 aggressive events — verbal and/or physical — for every 40 hours worked, with more aggression events occurring when staff have significantly greater numbers of patients assigned to them this study from DeSanto Iennaco et al. found. The study, published in The Joint Commission Journal on Quality and Patient Safety, examined incidence of patient and visitor aggressive events toward staff at five inpatient medical units in community hospitals and academic hospitals in the Northeastern U.S. The data was collected using even counters, aggressive incident and management logs and demographic forms over a 14-day period in early 2017.
  14. News Article
    A 73-year-old patient has said he was neglected at an NHS hospital and left to cry for help in "excruciating pain" during an ordeal that lasted months. Martin Wild was admitted to Salford Royal last year due to a spinal infection and claims he was denied pain relief and left lying in his own urine. Consultant Glyn Smurthwaite said Martin was "the most neglected acute patient I have ever seen". The trust that runs the hospital has apologised for failings in his care. Mr Wild came home from Salford Royal Hospital in January after an eight-month stay because of an infection following a private spinal operation. He said he was forced to phone 999 from his hospital bed when first admitted to the acute medical ward in May 2023 after struggling to get staff to give him pain relief and his Parkinson's medication. "I was left on my own in excruciating pain, with little pain relief, and I was laying on this bed for over a week before I saw a consultant." Mr Wild was discharged despite warning staff he was not well enough and no one could look after him at home, and ended up being readmitted days later via A&E. He said his poor care continued during his second stay, and Mr Wild recalled that he was shaking so much in pain that he knocked bottles of urine on to his bed after they had been left on the table with his food. Mr Wild was left lying in the urine-soaked sheets for hours before they were changed. Read full story Source: BBC News, 3 March 2023
  15. Content Article
    It is well known that the NHS is suffering from staff shortages, with 121,000 full-time equivalent (FTE) vacancies and only 26% of the workforce stating there are enough staff at their organisation. The reasons why staff are leaving are well documented (burnout, lack of work–life balance, low pay etc), and the direct impact on patients is obvious – staff shortages are one of the main reasons why there is a backlog of care. But these headlines mask nuance. They hide the areas where staff shortages are even more acute than the average, and they obscure the indirect impact on patients. Where are these areas, what are the impacts, and will the NHS Long Term Workforce Plan help?
  16. News Article
    Child and adolescent eating disorder services have never achieved NHS waiting time targets, and are not able to meet significant demand, according to analysis by the Royal College of Psychiatrists. Psychiatrists can identify and address many of the root causes of eating disorders, including neurodevelopmental conditions such as autism and ADHD. However, a current lack of capacity prevents this from happening. Due to a lack of resources, even children who meet the threshold for specialist eating disorder services are often in physical and mental health crisis by the time they are seen. Delays in treatment cause children with eating disorders physical and mental harm. NHS England set a target for 95% of children and young people with an urgent eating disorder referral to be seen within a week, and for 95% of routine referrals to be seen within four weeks. These standards have not been achieved nationwide, since they were introduced in 2021. RCPsych analysis of the latest data shows that just 63.8% of children and young people needing urgent treatment from eating disorder services were seen within one week. Only 79.4% of children and young people with a routine referral were seen within four weeks. The College also warns that there is an unacceptable gap between the number of children being referred to specialist eating disorders services, and those being seen. This is driven by a shortfall in the number of trained therapists and eating disorders psychiatrists. For Eating Disorders Awareness Week, the Royal College of Psychiatrists is calling on Government and Integrated Care Boards to invest in targeted support for children and young people to reverse this eating disorders crisis. The call is backed by the UK’s eating disorder charity Beat. Read full story Source: Royal College of Psychiatrists, 29 February 2024 Further reading on the hub: For Eating Disorders Awareness Week, Patient Safety Learning has pulled together 10 useful resources shared on the hub to help healthcare professionals, friends and family support people with eating disorders.
  17. Content Article
    Nicholas Gerasimidis had a history of mental illness manifesting as obsessive compulsive disorder (OCD) and anxiety. In 2022, his condition deteriorated. His GP referred him twice to the Community Mental Health Team but the referrals were rejected with medication being prescribed instead, together with advice to contact Talking Therapies.   He was taken on to CMHT workload after being assessed by the Psychiatric Liaison Team in Royal Cornwall Hospital in November 2022. The preferred course of treatment was psychological treatment in the form of Cognitive Behavioural Therapy with Exposure Response Prevention. There was a waiting list of a year. In May 2023, Mr Gerasimidis became worse. It was felt an informal admission to hospital was required but a bed was not available. He was found hanged at his home address on 3 June 2023.
  18. News Article
    Left in agonising pain, with staff ignoring his cries for help, Martin Wild called 999 from his hospital bed, desperate for someone to get him the medication he needed. This was just the beginning of the 73-year-old’s “nightmare” experience at the hands of Salford Royal Hospital. Over nearly five months, the former car salesman says he was subjected to prolonged periods of neglect, including being left to lie in urine-soaked sheets, pleading for medication. He lost so much weight that, according to his wife, he became skin and bone. One staff member involved in his care said they’d never seen a hospital patient neglected to such a serious degree. Mr Wild told The Independent that his time at Salford Royal Hospital has shattered his belief in the NHS and that he believes it is not fit for purpose. “It was a nightmare in that ward. I didn’t feel like there was much caring going on,” he said. “I used to lie there at night; I could hear people shouting and screaming for help. It was like being in the third world.” Read full story Source: The Independent, 24 February 2024
  19. Content Article
    The Scottish Government needs to develop a clear national strategy for health and social care to address the pressures on services, says a review by Audit Scotland. Significant changes are needed to ensure the financial sustainability of Scotland's health service. Growing demand, operational challenges and increasing costs have added to the financial pressures the NHS was already facing. Its longer-term affordability is at risk without reform.
  20. News Article
    Scotland's NHS is unable to meet the growing demand for health services, a spending watchdog has warned. A review by Audit Scotland said the increased pressure on the NHS was now having a direct impact on patient safety and experience. The watchdog also claimed there was no "overall vision" for the future of the health service. The annual report on the state of Scotland's health service highlighted that the NHS was facing soaring costs, patients were waiting longer to be seen and there were not enough staff. Stephen Boyle, Auditor General for Scotland, said this had "added to the financial pressures on the NHS and, without reform, its longer-term affordability". He added: "Without change, there is a risk Scotland's NHS will take up an ever-growing chunk of the Scottish budget. And that means less money for other vital public services. "To deliver effective reform the Scottish government needs to lead on the development of a clear national strategy for health and social care. "It should include investment in measures that address the causes of ill-health, reducing long-term demand on the NHS." Read full story Source: BBC News, 22 February 2024
  21. Content Article
    Corridor nursing is increasingly being used in the NHS as demand for emergency care grows and A&E departments struggle with patient numbers. In this anonymous account, a nurse shares their experience of corridor nursing, highlighting that corridor settings lack essential infrastructure and pose many safety risks for patients. They also outline the practical difficulties providing corridor care causes for staff, as well as the potential for moral injury.  Using the System Engineering Initiative for Patient Safety (SEIPS) framework, they describe the work system, the processes and how that influences the outcomes.
  22. News Article
    The government is considering plans to allow dentists from abroad to work without taking an exam to check their education and skills. The proposal, which is subject to a three-month consultation, aims to address the severe shortage of NHS dentists. It is hoped a quicker process would attract more dentists. The British Dental Association has accused the government of avoiding the issues "forcing" dentists to quit. The proposal forms part of the government's £200 million NHS Dental Recovery Plan for England, announced earlier this month. Under the plan, dentists could also be paid more for NHS work, while so-called "dental vans" would be rolled out to areas with low coverage, alongside an advice programme for new parents. There is also a proposal of £20,000 bonuses for dentists working in under-served communities, as part of an effort to increase appointment capacity by 2.5 million next year. At present, overseas dentists are required to pass an exam before they can start work in the UK - the new idea would see the General Dental Council (GDC) granted powers to provisionally register them without a test. Stefan Czerniawski, executive director of strategy at the GDC said: "We need to move at pace, but we need to take the time to get this right - and we will work with stakeholders across the dental sector and four nations to do so." Read full story Source: BBC News, 17 February 2024
  23. Content Article
    The press has all been full of headlines about staffing levels in the NHS, but this is probably a problem across healthcare around the country. What this does is provide the perfect patient safety quandary, how do we keep all the areas safe. This often results in the redeployment of nursing staff to different areas, but does this provide the required levels of safety. It appears that having several areas in an “amber” staffing level is preferable than one red area. It is simple logic, but does this create an unrealistic expectation on staff that means the safety is better but only at a barely satisfactory level? Do we think that any of these decisions influences the efficiency of a ward? Is the ward safe and effective? In this blog, Chris Elston explores these issues and uses a Safety Engineering Initiative for Patient Safety (SEIPS) to show some of the lesser appreciated risks to redeploying staff and consider some ways to reduce the risks.
  24. Content Article
    This is the video recording of a House of Lords debate on the delivery of maternity services in England, put forward by Baroness Taylor of Bolton.
  25. News Article
    Half of surgeons in England have considered leaving the NHS amid frustration over a lack of access to operating rooms, a new survey shows. More than 3,000 surgeons contemplated quitting the health service in the last year, with two-thirds reporting burn out and work-related stress to be their main challenge, a new survey by the Royal College of Surgeons England has revealed. As the NHS tries to reduce the 7.61 million waiting list backlog, the survey, covering one quarter of all UK surgeons, found that 56% believe that access to operating theatres is a major challenge. RCS England president, Mr Tim Mitchell, said: “At a time when record waiting lists persist across the UK, it is deeply concerning that NHS productivity has decreased. “The reasons for this are multifactorial, but access to operating theatres and staff wellbeing certainly play a major part. If surgical teams cannot get into operating theatres, patients will continue to endure unacceptably long waits for surgery. “There is an urgent need to increase theatre capacity and ensure existing theatre spaces are used to maximum capacity. There is also a lot of work to be done to retain staff at all levels by reducing burnout and improving morale.” Read full story Source: The Independent, 18 January 2024
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