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Found 500 results
  1. Content Article
    In January 2025, the Republican majority in the House of Representatives’ Budget Committee offered a list of possible spending reductions to offset revenue losses from proposed tax cuts. In May, the Committee advanced a bill incorporating several reductions on the list. The Committee estimated that the 6 largest potential Medicaid cuts (for example, work requirements for some Medicaid enrollees) would each reduce the federal government’s Medicaid outlays by at least $100 billion over 10 years. On the basis of the Committee’s estimates of savings; Congressional Budget Office analyses; and peer-reviewed studies of the coverage, financial, and health impacts of past Medicaid expansions and contractions, the authors project the likely effects of each option and of the House bill advanced by the Budget Committee in May. Each option individually would reduce federal Medicaid outlays by between $100 billion and $900 billion over a decade, increase the ranks of the uninsured by between 600 000 and 3 900 000 and the annual number of persons forgoing needed medical care by 129 060 to 838 890, and result in 651 to 12 626 medically preventable deaths annually. Enactment of the House bill advanced in May would increase the number of uninsured persons by 7.6 million and the number of deaths by 16 642 annually, according to a mid-range estimate. These figures exclude harms from lowering provider payments and shrinking benefits, as well as possible repercussions from states increasing taxes or shifting expenditures from other needs to make up for shortfalls in federal Medicaid funding. Policy makers should weigh the likely health and financial harms to patients and providers of reducing Medicaid expenditures against the desirability of tax reductions, which would accrue mostly to wealthy Americans.
  2. News Article
    On 9 June 2025, federal employees at the National Institutes of Health (NIH) stood up for the health and safety of the American people and faithful stewardship of public resources by authoring and signing the Bethesda Declaration. Read the open letter in support of the Bethesda Declaration.
  3. News Article
    Health Secretary Robert F. Kennedy Jr. has unveiled eight people he has chosen to serve on the Centers for Disease Control and Prevention's vaccine advisory panel – just two days after taking the unprecedented step of removing all 17 sitting members. On Wednesday, Kennedy listed the names and short bios of the new advisers who will join the Advisory Committee on Immunization Practices, or ACIP, at its upcoming meeting in late June. "All of these individuals are committed to evidence-based medicine, gold-standard science, and common sense," Kennedy said in a post on X, "They have each committed to demanding definitive safety and efficacy data before making any new vaccine recommendations." The new members are Dr. Joseph R. Hibbeln, Martin Kulldorff, Retsef Levi, Dr. Robert Malone, Dr. Cody Meissner, Dr. Michael A. Ross, Dr. James Pagano and Vicky Pebsworth. "This is a huge win for the medical freedom [m]ovement," David Mansdoerfer, former deputy assistant secretary for the Department of Health and Human Services in the first Trump administration, wrote in a post on X, "they did everything by the book to put together this excellent slate of appointees." Public health advocates are wary. "Kennedy did not pick people with strong, current expertise in vaccines," says Dorit Reiss, a professor at UC Law, San Francisco, who studies vaccine policy. "It tells me that Kennedy is setting up a committee that would be skeptical of vaccines, and possibly willing to implement an anti-vaccine agenda." Read full story Source: NPR, 11 June 2025
  4. Content Article
    In this blog, Dr Jessica Knurick lists the policies, executive orders and administrative actions that she believes runs directly counter to making America healthy and actively harm public health.
  5. News Article
    A hospital trust and a staff member have been found guilty of health and safety failings over the death of a young woman in a mental health unit. Alice Figueiredo, 22, was being treated at Goodmayes Hospital, east London, when she took her own life in July 2015, having previously made many similar attempts. Following a seven-month trial at the Old Bailey, a jury found that not enough was done by the North East London Foundation NHS Trust (NELFT) or ward manager Benjamin Aninakwa to prevent Alice from killing herself. The trust was cleared of the more serious charge of corporate manslaughter, while Aninakwa, 53, of Grays in Essex, was cleared of gross negligence manslaughter. The jury deliberated for 24 days to reach all the verdicts, setting a joint record in the history of British justice, according to the Crown Prosecution Service (CPS). Both the trust and Aninakwa were convicted under the Health and Safety at Work Act. It was only the second time an NHS trust has faced a corporate manslaughter charge. During the trial, prosecutors said that not only was Alice repeatedly able to self-harm while she was in hospital, but that these incidents were not properly recorded or assessed. The court also heard there were concerns about Benjamin Aninakwa's communication, efficiency, clinical and leadership skills. The trust had previously placed him on a performance improvement plan for three years, which ended in December 2014. In addition, there was a high turnover of agency staff on the ward, the court heard. Mrs Figueiredo says she raised concerns about her daughter's care verbally and in writing on a number of occasions to the hospital and to Mr Aninakwa. After Alice died, she said the family found it very difficult to get answers about what happened. For nearly a decade they gathered evidence and pressed both the police and the CPS to take action. Read full story Source: BBC News, 9 June 2025
  6. Content Article
    ‘The Month’ is a new publication from NHS England which provides a strategic update for health and care leaders. This edition includes details of the 100 day plan for Sir Jim Mackey’s first few months as NHS England Chief Executive, information about the new Urgent and emergency care plan 2025/26 and highlights of other recent healthcare publications and developments.
  7. Content Article
    We asked the Patient Safety Group (PSG) of The Royal College of Surgeons of Edinburgh (RCSEd) to draw up their top 10 priorities for patient safety in surgery. This resource is for surgeons, anaesthetists and other healthcare professionals who work in surgery and contains links to useful tools and further reading. See also: Safety in surgery series Top 10 tips for surgical safety: ‘Think Safety, think SEIPS’ Top 10 patient safety tips for surgical trainees 1. Foster a culture of safety through design Establish a psychologically safe environment, through design, where staff feel empowered to speak up without fear of blame. Promote a Just Culture, balancing personal accountability with systems-based learning from adverse events and near misses. Actively encourage multidisciplinary teamwork and peer support, with support from senior leadership, to enhance safety and well-being. Other useful RCSEd resources: Anti bullying and undermining campaign Sexual misconduct in surgery - Lets remove it campaign Addressing conflict in surgical teams workshop 2. Implement team-based quality and safety reviews Use team-based quality reviews (TBQRs) and structured case analysis to learn from everyday work, incidents and near misses. Translate findings into sustainable improvement initiatives that enhance both patient outcomes and staff experience. Foster a culture of collective learning, ensuring safety insights lead to actionable change. Other useful RCSEd resources: Making sense of mistakes workshop 3. Apply Human Factors principles and systems thinking principles in surgical and clinical practice Design resilient systems that mitigate work and cognitive overload and enhance performance reliability. Use TBQR principles to support this. Standardise workflows, optimise usability of IT systems and medical devices, and integrate cognitive aids (e.g. WHO Safe Surgery Checklists, prompts). Ensure governance processes support safe, efficient and user-friendly surgical environments. Other useful RCSEd resources: Systems safety on surgical ward rounds Improving the working environment for safe surgical care Improving safety out of hours 4. Enhance communication & handover processes Implement structured communication tools such as SBAR (Situation, Background, Assessment, Recommendation) to improve clarity and effective decision-making. Optimise handover processes with digital tools, checklists and standardised documentation. Reinforce closed-loop communication, ensuring critical information is confirmed and acted upon. Other useful RCSEd resources: Consultation Skills that matter for Surgeon (COSMOS) 5. Strengthen leadership & accountability in patient safety Senior leaders must visibly support safety initiatives and proactively engage frontline staff in decision-making. Embed structured mechanisms for raising concerns, including TBQR, safety huddles and escalation pathways. Ensure staff have access to training, resources and protected time for safety and quality improvement work. 6. Minimise medication errors in surgery Implement electronic prescribing and technology assisted medication administration to mitigate errors. Enforce double-check procedures for high-risk medications and standardised drug labelling. Improve intra and peri-operative medication safety with clear labelling, colour-coded syringes and real-time verification. 7. Improve early recognition & response to deterioration Appropriate regular training of teams on processes and pathways supported by good design of staff rota ensuring adequate staffing levels. Implement early warning scores and establish rapid response pathways for deteriorating patients. Standardise post-operative surveillance strategies, ensuring timely escalation and intervention. Other useful RCSEd resources: Recognition and prevention of deterioration and injury (RAPID) course for training in recognising critically ill patients 8. Engage patients & families as safety partners Encourage shared decision-making to align treatment plans with patient expectations and values. Provide clear communication on risks, benefits and post-operative care, using tools like patient safety checklists and focus on informed consent processes. Actively involve patients and families in safety and quality initiatives and hospital discharge planning. Other useful RCSEd resources: Patient/carer/families resources and information Informed consent courses (ICoNS) 9. Standardise, simplify & optimise surgical processes Reduce unnecessary complexity in clinical workflows, making processes intuitive, efficient and reliable. Co-design standard operating procedures, policies and pathways with frontline teams to minimise variation. Implement automation and digital solutions where feasible to streamline repetitive tasks. Other useful RCSEd resources: NOTSS (Non Operative Technical Skills for Surgery) courses for surgeons DenTS courses for dentists 10. Promote continuous learning & simulation-based training Conduct regular simulation training for critical scenarios (e.g. sepsis, airway emergencies, human factors). Use insights from TBQR and incident reviews to target training needs and refine clinical practice. Ensure ongoing professional development by providing staff with time, resources, incentives and institutional support for learning. Other useful RCSEd resources: Education pages Edinburgh Surgery OnLine MSc in Patient Safety and Clinical Human Factors
  8. Content Article
    When big problems in the NHS are highlighted by comparing it to other organisations, the service often reacts in a hostile and dismissive manner. But these complaints usually completely miss the point of the comparison. Recently Diane Coyle suggested the NHS could learn from the way a Formula 1 racing team operates, but it was met with unwarranted hostile reaction by some commentators. In this HSJ article, Steve Black explores how resistance to outside comparisons hides deep flaws in NHS systems, priorities, and data use.
  9. News Article
    The ‘inability or unwillingness’ of some NHS and social care providers to work together has contributed to an ‘unimaginable’ deterioration in emergency care performance, according to NHS England The claim is made in the urgent care recovery plan for 2025-26, released by NHS England and the Department of Health and Social Care. The plan includes a new target to reduce 12-hour accident and emergency waits and pledges to invest £370m of capital funding in improving urgent care and mental health facilities. The plan said, “Each part of the system has responsibility for improving urgent and emergency care performance. However, blame shunting has become a feature in some poorly performing systems and can no longer be tolerated." National urgent care director Sarah-Jane Marsh told HSJ that “the duty to collaborate and work together and do the best for patients is on all trust boards, and it shouldn’t rely on some overseer to make sure that happens. It’s a fundamental part of being a leader”. Trusts will be told to ensure the proportion of patients waiting over 12 hours for admission, transfer or discharge from A&E remains less than 10%. The 45-minute “maximum” ambulance handover time will become mandatory across all trusts ahead of winter, according to the plan. Chief executive of the College of Paramedics, Tracy Nicholls, said, “The plan sets out progressive structural proposals that have the potential to enhance public safety and strengthen paramedic autonomy. However, it may underestimate key challenges, including workforce readiness, the capacity of the mental health system, and practical implications of the Right Care, Right Person model. Without urgent alignment of funding, training, and alternative care pathways, there is a real risk that paramedics could be left navigating a reform process that shifts responsibility without equipping them with the necessary tools and support. Read full story (paywalled) Source: HSJ, 5 June 2025 Related reading on the hub: How corridor care in the NHS is affecting safety culture: A blog by Claire Cox My experience of the 'Wait 45' policy - Florence in the Machine A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift
  10. Content Article
    This webinar sponsored by the AHRQ-led  National Action Alliance for Patient and Workforce Safety, highlights the importance of safety culture and teamwork in healthcare settings. This webinar, held 15 April 2025, was the third in a three-part series on safety culture in healthcare. Speakers from AHRQ, Duke Center for the Advancement of Well-being Science and Westat discussed how strategies such as conflict resolution and leader engagement are essential for improving healthcare worker well-being and patient outcomes. Panelists answered audience questions on how to get physicians to participate in the patient safety culture surveys and recommended ways to encourage a teamwork climate. Access the recording and presenter materials from this event.
  11. News Article
    The White House has released its long-awaited 'MAHA Report' outlining the government’s target areas for addressing childhood chronic disease: diet, environmental chemical exposure, physical activity/stress and “overmedicalization.” The 68-page report, prepared by the Make America Healthy Again (MAHA) Commission—which is chaired by Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.—was ordered by President Donald Trump in February. It serves as an initial assessment for the commission, which now has 82 days to develop a strategy document for realigning federal practices to address the four highlighted factors. “After a century of costly and ineffective approaches, the federal government will lead a coordinated transformation of our food, health and scientific systems,” the commission wrote of its work in the report. “This strategic realignment will ensure that all Americans—today and in the future—live longer, healthier lives, supported by systems that prioritize prevention, wellbeing and resilience.” The report’s takeaways largely align with RFK Jr.’s advocacy priorities prior to entering the administration, some of which he and other government heads have already instructed their departments to act on. In a White House event held hours after the report's release, Trump described the findings around increased incidence of health conditions like obesity (affecting more than one child in five who is over 6 years of age) and autism spectrum disorder (1 in 31 children by age 😎 as "alarming." "Unlike other administrations, we will not be silenced or intimidated by the corporate lobbyists or special interests," Trump said of the findings and recommendations. "I want this group to do what they have to do. ... In some cases it won't be nice, it won't be pretty, but we have to do it." Read full story Source: Fierce Healthcare, 22 May 2025
  12. News Article
    The House of Representatives passed the President Donald Trump-backed “One Big Beautiful Bill” in a 215-214 vote on 22 May after debating for hours overnight on the controversial legislation that includes significant cuts to Medicaid. Healthcare revisions to the multitrillion-dollar legislation include a two-year acceleration of Medicaid work requirements for able-bodied people ages 18-64 no later than 31 December 2026. The work requirements were originally set for 2029, but have been accelerated to generate faster savings. Gender transition procedures will no longer be covered by ACA plans beginning 1 January 2027. The bill, which President Trump and GOP leaders argue is aimed at tackling “waste, fraud and abuse,” now heads to the Senate, where Republicans hold a 53-47 majority. However, it is not clear when the vote will be held. The bill’s revisions have also resulted in backlash from several healthcare advocacy groups. America’s Essential Hospitals President and CEO Bruce Siegel, MD, MPH, said that their organisation “strongly opposed” the “deep Medicaid cuts” in the bill, highlighting that the cuts would “threaten the health and well-being of millions of Americans.” Read full story Source: Becker's Hospital Review, 22 May 2025
  13. Content Article
    The deletions began shortly after Donald Trump took office. CDC web pages on vaccines, HIV prevention, and reproductive health went missing. Findings on bird-flu transmission vanished minutes after they appeared.  On 7 February, Trump sacked the head of the National Archives and Records Administration. More than a hundred and ten thousand government pages have gone dark in a purge that one scientist likened to a “digital book burning.” Racing to comply with executive orders banning “DEI” and “gender ideology extremism,” agencies have cut materials on everything from supporting transgender youth in school to teaching children about sickle-cell disease, which disproportionately affects people of African descent. But they have also axed records having little to do with the Administration’s ideological priorities, seemingly assisted by AI tools that flag forbidden words without regard to context.  However, a coalition of archivists and librarians are trying to save this data and knowledge. They belong to organisations such as the Internet Archive, which co-created a project called the End of Term Web Archive to back up the federal web in 2008; the Environmental Data and Governance Initiative, or EDGI; and libraries at major universities such as MIT and the University of Michigan. Here's where to continue accessing important information. Data Rescue Project Restored CDC Source Cooperative Wayback Machine
  14. Content Article
    Leadership Futures recently published a report 'Harnessing technology for human progress: Advancing into Industry 5.0', which is driven by a bold ambition: to transform organisations worldwide through technological advancements. In this blog, Caroline Beardall looks at the implications of this for healthcare and suggests five actions that organisation's should take to ensure we achieve the benefits from technology while keeping patient safety at the forefront of an evolving landscape. The recent Leadership Futures report 'Harnessing technology for human progress: Advancing into Industry 5.0' provides a valuable framework for integrating technology with human-centered leadership, which is highly applicable to advancing patient safety in health and care. Its vision of Industry 5.0 as a collaborative human-AI partnership offers a route to reduce errors, enhance clinician capacity and improve patient outcomes. However, realising these benefits requires caution—ethical and inclusive implementation strategies that address the complexities and risks unique to health and care settings. It throws up three fundamental challenges: How can healthcare leaders ensure AI tools are safe to use and that clinical staff can trust them? Who should be responsible if an AI system makes a mistake that affects a patient? How can healthcare organisations use technology to work better without losing the importance of human interaction and the skills needed for high levels of patient satisfaction and safety? In order to answer these questions, and deepen the discussion on harnessing technology responsibly to safeguard and improve patient care, there are some actions we can take to build on the report and begin to gain evidence and experience specific to healthcare. As the landscape of healthcare shifts and evolves, we should consider applying the following five actions (with examples of how to do this) so we can achieve the maximum benefits from technology for patient safety. 1. Foster collective, collaborative leadership across boundaries Leaders should actively promote cooperation and shared responsibility across organisational and professional boundaries, focusing on the overall patient journey rather than siloed departmental goals. This aligns with the report’s emphasis on human-machine collaboration and the need for integrative leadership cultures that support safe, seamless care delivery. By working collectively, leaders can ensure technology is implemented with broad input and oversight, reducing risks and enhancing patient safety. Implement interdisciplinary collaboration practices: Organise regular team meetings involving diverse healthcare professionals to discuss patient care holistically, ensuring all voices contribute to decision making. Create shared goals and aligned metrics: Develop common objectives focused on patient safety and quality that unify departments and reduce siloed working. Lead by example: Demonstrate collaborative behaviours and openness to input, encouraging a culture of trust and teamwork. 2. Embed ethical, human-centred use of technology Leaders must champion ethical principles in technology adoption, ensuring AI and digital tools augment rather than replace human judgment and empathy. This includes rigorous validation of new technologies, transparency in AI decision-making, and ongoing monitoring to prevent harm or bias. Prioritising patient experience and human values in technology deployment safeguards safety and trust. Prioritise transparency and clinician involvement: Engage frontline staff early in AI and technology design and deployment to ensure tools meet clinical needs and ethical standards. Establish continuous monitoring and feedback loops: Use data and user feedback to identify and mitigate risks or biases in technology that could impact patient safety. Promote ethical leadership training: Equip leaders with skills to balance innovation with patient experience and accountability. 3. Develop and support workforce readiness and engagement Preparing staff to work effectively alongside new technologies is vital. Leaders should invest in training that builds digital literacy, critical thinking and resilience, while also fostering a positive work climate where staff feel valued and supported. Engaged and confident clinicians are better able to use technology safely and maintain high standards of care. Invest in targeted training and digital upskilling: Provide contextual, in-app guidance and interactive training to help staff adopt new technologies confidently and efficiently. Foster a culture of psychological safety and empowerment: Encourage open discussion, honest feedback and staff involvement in decision making to build trust and resilience. Practice empathetic leadership: Focus on emotional and professional needs of staff to reduce burnout and improve engagement. 4. Set clear, aligned objectives focused on quality and safety Leadership should establish clear, challenging and aligned goals at every level that prioritise patient safety and quality improvement over mere efficiency or target-driven metrics. This clarity helps reduce staff stress and confusion, enabling teams to focus on delivering compassionate, safe care supported by technology. Communicate clear expectations and priorities: Use consistent, transparent communication to align teams around patient safety goals and reduce ambiguity. Implement continuous feedback and learning systems: Regularly review performance data and patient feedback to refine objectives and improve care quality. Balance efficiency with human factors: Ensure operational goals do not compromise critical human skills or patient-centred care. 5. Champion diversity, inclusion and accountability in leadership Inclusive leadership practices that promote equality and diversity are essential to fostering innovation and ethical decision-making in healthcare technology adoption. Leaders must also clarify accountability frameworks for technology-related decisions and errors, ensuring responsibility is shared and transparent to maintain patient safety. Promote inclusive leadership practices: Value diverse perspectives and foster equity to enhance innovation and ethical decision-making Clarify accountability frameworks: Define roles and responsibilities clearly, especially concerning technology-related decisions and errors, to maintain trust and safety Model human-centred leadership traits: Practice self-awareness, compassion and mindfulness to create cultures of excellence, trust, and caring. By integrating these strategies, human-centric leaders can effectively translate the insights from the Leadership Futures report into practical actions that improve patient safety, staff satisfaction and overall health system resilience. This approach embraces complexity and change as opportunities, not obstacles, which then enables sustainable progress in better health and care delivery. Further reading Amelia N. 6 Effective Leadership Strategies for Healthcare in 2025. Edstellar, 31 December 2024. West M, et al. Leadership in Healthcare: a Summary of the Evidence Base. Kings Fund; Faculty of Medical Leadership and Management; Center for Creative Leadership, 2015. LeClerc L, Kennedy K, Campis S. Human-Centered Leadership in Health Care: An Idea That's Time Has Come. Nursing Administration Quarterly 2020; 44(2):p 117-26.
  15. News Article
    The government ignored an early warning by two Nobel prize-winning scientists that all healthcare workers should be routinely tested for coronavirus in the pandemic, the Covid inquiry has heard. The advice came in a strongly-worded letter sent in April 2020 by the chief executive of the Francis Crick Institute, Sir Paul Nurse, and its research director, Sir Peter Ratcliffe, to the then health secretary Matt Hancock. NHS and care home staff were not offered Covid tests until November 2020 in England, unless they had symptoms of the disease. Matt Hancock is due to appear at the inquiry next week, along with other health ministers from the four nations of the UK. Giving evidence, Sir Paul, who won the Nobel prize for medicine in 2001, said it was "disturbing" that he did not receive a response to his concerns until July 2020. "For the secretary of state to ignore a letter from two Nobel laureates in physiology or medicine for three months is a little surprising, I would say," he told the inquiry. "Rather than acknowledge they couldn't do it, because that would have indicated a mistake in their overall strategy, they remained silent." It was likely that the decision not to routinely test NHS and care home staff led to an increase in infections and deaths in the early stages of the pandemic, he added. Read full story Source: BBC News, 15 May 2025 Further reading on the hub: "Forgotten heroes" – the sequel: a blog and resources from David Osborn The pandemic – questions around Government governance: a blog from David Osborn
  16. Content Article
    Professor Jeffrey Braithwaite is Founding Director of the Australian Institute of Health Innovation, Director of the Centre for Healthcare Resilience and Implementation Science and Professor of Health Systems Research at Macquarie University. Professor Jeffrey Braithwaite is a leading health services and systems researcher with an international reputation for his work investigating and contributing to systems improvement. He has particular expertise in the culture and structure of acute settings, leadership, management and change in health sector organisations, quality and safety in healthcare, accreditation and surveying processes in the international context and the restructuring of health services. Professor Braithwaite is well known for bringing management and leadership concepts and evidence into the clinical arena and he has published extensively, with over 788 refereed contributions (including 15 edited books, 95 book chapters, 506 articles and 65 refereed conference papers; and 320 peer-reviewed abstracts and posters; and 231 other publications, e.g., international research reports). Links to some of Professor Brainthwaite's work can be found below. Patient safety articles by Professor Braithwaite Implementation Science and Translational Health Research Articles by Professor Braithwaite Resilient healthcare series Professor Jeffrey Braithwaite on patient safety and health systems improvement
  17. News Article
    Very senior managers at the worst-performing trusts and ICBs will not receive annual pay rises from this year, under new national rules. The new very senior managers pay framework for trusts, foundation trusts and integrated care boards, published today, says some will for the first time be excluded for the annual pay uplift in 2025-26. They are: VSMs at organisations in segment five of NHS England’s new national oversight framework, except where they are “exempt” because they are less than two years into the job. Segment five is being introduced for the worst-performing organisations which are also deemed in a “diagnostic” to need the most intervention. Organisations currently in RSP – of which there are 25 – are due to “automatically” enter segment five (see list below); and Individuals who are “failing to meet their own objectives or targets” or are subject to investigation for “conduct and capability”. VSMs at segment three and four trusts will get the 2025-26 pay award, but warns “new provisions are expected to apply” from 2026-27. Read full story (paywalled) Source: HSJ, 15 May 2025
  18. Content Article
    In this blog, Siân Slade shares how, through her research interest into the difficulties of navigating the healthcare system in Australia, she created a policy and advocacy project: #NavigatingHealth. The aims of the project are to streamline the silos and address the fragmentation of healthcare by bringing together all those who are developing solutions to enable patients and carers to better navigate healthcare journeys.  Background About 10 years ago, I listened to a friend’s experience navigating cancer and puzzled over the challenges encountered. These made me question my prior assumption of 'patient-centricity' across healthcare. In 2015, the Organisation for Economic Co-operation and Development (OECD) released a report highlighting the complexities of the Australian healthcare system. This led me to realise that while we do have patient-centred care, it is often provider dependent, not system-wide, and relies on the patient (or carer) to navigate the system; a time when individuals are at their most vulnerable. Given 'the standard you accept is the standard you walk past”, I decided to do 'my bit' to address this. I enrolled in a Master of Public Health, researching healthcare navigation in Australia. I found there was a fragmented approach to try and address an already fragmented problem. This led me to embark on a PhD as well as develop a policy and advocacy platform: #NavigatingHealth. Setting up a national network and community of practice My focus has always been on a practical approach that solves problems for individuals but also seeks to understand how to scale these at a systems level to sustain change in the long-term. If this was a known problem, why was nothing being done to address it? Surely this was something government were addressing... or there must be an app? I spoke to lots of people—patients, carers, speakers at conferences, those who had written books of their healthcare experience and, yes, those developing apps. Everyone agreed it was a problem, but nothing was addressing the totality of the problem. The problem was not just in navigating healthcare, but also the challenges navigating related systems, such as those for people with disabilities, or for aged care, as well as social services and education. #NavigatingHealth started life as two, 60-minute webinars held in mid and late September 2021, supported by the Australian Disease Management Association. The inaugural webinar speakers provided vignettes across a life journey—from childhood through to getting older—based on their own lived-experiences as patients, carers or professionals (not-for-profit, health services and government). The positive reception of the webinars led to setting up a bimonthly national network and community of practice in Australia that ran until the end of 2024. The meetings were deliberately not recorded to build a safe space for people to share ideas, build tacit (word of mouth) knowledge and a like-minded solutions focused community. Summaries of all the events and speakers are available on the #NavigatingHealth project page. In health, information and projects evolve. Building an online community was low-cost and accessible to everyone. The success of the Australian approach led to a series of global webinars using the same format of expertise provision from individuals in research, policy, and advocacy and health services. The first global webinar was held in 2022 attracting over 20 countries. Connecting and collaborating The 'glocal' community continues to grow. Projects are constantly evolving, elevating and expanding as well as exiting often impacted by funding constraints. In the spirit of a complex adaptive learning health system, core to our success is the community knowledge built through relationships, trust, like-values and non-linear interactions. Taking an approach that is resourceful versus one requiring constant resourcing (we use accessible tools such as LinkedIn and more recently Bluesky) to provide an effective, free platform to keep individuals in touch with one another. Our dedicated #NavigatingHealth project page on the Nossal Institute for Global Health website at the University of Melbourne acts as a central hub for events and resources. The genesis during the pandemic and expansion virtually through Teams and Zoom, as well as in-person post-pandemic, has enabled different ways to expand the national community, the global network and we welcome all-comers. The project is voluntary and our success is based on linking people, developing relationships, sharing expertise, maintaining momentum and the opportunity we all have to impact into #NavigatingHealth. The annual forums, 2024 #NavigatingHealth Simplifying Complexity and 2025 #NavigatingHealth Enabling Patients, System-Wide, focused on bringing together colleagues nationally in Australia. The in-person workshops created the opportunity to build community, share ideas, leverage learnings and also provide educational content. These collaborations have allowed development of materials for curriculum and teaching, and an evolving conversation about the importance of systems-thinking. We developed a short global project collecting stories from individuals who are happy to be involved. Our video, NavigatingHealth - why this matters, provides a glimpse of our approach. Looking forward The Future of Health Report published in 2018 highlights that our health systems, locally and globally, will change from 'one size fits all' to one that is personalised. The challenge is how? Future of Health Report, CSIRO 2018. The 'secret sauce' is that by working collaboratively we can all be part of evolving and effecting systems change. The work is underpinned by equity and a focus on enabling early access to care, addressing barriers, such as financial or cultural constraints, and helping to make visible information asymmetries and power imbalances to ensure effective collaboration and co-production. Building on the success of our past forums, planning for 2026 is underway. Block out 1 April 2026 in your calendar for the inaugural #NavigatingHealth Day! Our collective expertise is our power—let’s do this! Want to know more? Please get in touch with Siân at [email protected] or via LinkedIn. Further reading on the hub: The challenges of navigating the healthcare system How the Patients Association helpline can help you navigate your care Lost in the system? NHS referrals
  19. Content Article
    At the beginning of 2025 we launched our video interview series Speaking up for patient safety. The series is hosted by Peter Duffy, NHS whistleblower and Chair of the Healthcare Working Group at WhistleblowersUK, and Helen Hughes, Patient Safety Learning’s Chief Executive.  In each interview we hear from someone who has raised concerns about patient safety in healthcare, often at great cost to their own career and personal life. They share their story and their reflections on what needs to be done to improve organisational cultures so that when staff raise patient safety issues, their concerns are responded to appropriately and not dismissed because they are inconvenient to address. Alongside the thread of bravery and tenacity that runs through each contributor, a number of common themes come up time and again as people share their experiences. In this blog, Helen and Peter look at some of these themes and outline their implications for people who speak up or whistleblow. We are now three months into the series, which seems like a good time to stop and reflect on what we have learned so far. Our introductory blog about ‘Speaking up for patient safety’ explains why we launched the series and what we hope it will achieve. It also explains in more detail what we mean when we talk about speaking up and whistleblowing. Briefly, speaking up in healthcare is when a member of staff raises concerns about something that is worrying them to a manager or someone else within, or outside of, their organisation. In some cases—but not all—when someone speaks up, it is also defined as ‘whistleblowing’. Whistleblowing always involves a concern that is in the public interest and might relate to a criminal offence, health and safety risks, failures to carry out legal obligations, a miscarriage of justice, or an attempt to conceal and cover up any of these things. Three key themes from the interviews so far These are the top three recurring themes we have noticed coming up in the interviews so far. Other issues we have noticed include the lack of clarity about who should take responsibility for whistleblowing and the reality of threats and bullying, and we will continue to explore these issues going forward. 1. “I didn’t realise I was speaking up, I was just doing my job!” Perhaps the comment we have heard most frequently is that people didn’t realise they were formally speaking up or whistleblowing—they just thought they were doing their job. Every healthcare profession has a set of professional standards which all practitioners are expected to keep to. For example, the General Medical Council (GMC) states that all doctors have a duty to take action by raising concerns if they believe patient care or safety are at risk.[1] In addition, each healthcare organisation has a code of conduct, which will include requirements for staff to be honest, open and accountable for their work. For the interviewees we spoke to, to not raise their concerns would be a failure to fulfil their duty to both their patients and their organisation. When people speak up, they often find themselves in the middle of a process that they had no idea they were entering. This can be very disorientating and leave them unprepared for the path ahead of them. At the end of this blog, we share some advice from our interviewees about what to do if you find yourself in this position. 2. There is a whistleblowing ‘playbook’ Most organisations have policies and support in place to listen to staff members who raise concerns, including access to a Freedom to Speak Up Guardian. We have interviewed Jayne Chidgey-Clark, the National Guardian, who described the good practice that many are developing. However, we are hearing about several common tactics that some organisations use when dealing with people who speak up or blow the whistle. The experiences of our interviewees suggest that these approaches may be deliberately designed to disadvantage the individual throughout the process—from investigation through to employment tribunals. Some of the key activities we have heard about include: Organisations not responding—or responding at the very last minute—to communications from the staff member. Interviewees said they received emails with key information at 5pm on a Friday, which left them with no opportunity to ask questions or respond until the next working week. They expressed their belief that this may be a deliberate tactic to exert pressure on the individual speaking up, which amounts to emotional bullying. The use of occupational health as a way to cast doubt on the mental state of the person. Occupational health providers are often very supportive, but we are concerned that organisations are fishing for reasons to question the believability and motives of staff who speak up. Over-focus on HR issues, rather than focusing on the patient safety issues someone has raised. Mandated isolation from colleagues while investigations take place. This can have a very damaging effect on the person’s mental health as well as restricting their ability to source evidence from other staff in support of the concerns they have raised. We have heard examples of colleagues agreeing to provide supportive testimony, but then feeling pressurised to withdraw this support. Retaliatory referrals against the person speaking up to professional regulators, such as the General Medical Council and Nursing and Midwifery Council, which can have a detrimental effect on a healthcare professional’s reputation and career. Regulators are aware of how such referrals can be used to intimidate whistleblowers and discourage them from raising concerns. Some have approaches to ensure that fitness to practice concerns are appropriately addressed without unfairly impacting doctors who have raised whistleblowing concerns. We believe it is important to identify and call out these tactics so that people raising concerns are aware of them and can seek support and advice. Organisational leaders need to look at their own practice and recognise the ethics of their approaches and whether their actions match their stated organisational values. They need to be aware of the significant damage these tactics cause to people who raise concerns and the chilling impact it might have on their organisational culture, effectively preventing others’ raising concerns. 3. Employment tribunals are unfit, unfair and imbalanced Every person we spoke to who had attempted to pursue justice at an employment tribunal commented that the process was unfit for purpose and not the right place for whistleblowing cases to be heard. Employment tribunals take no interest in the safety issues being raised. The main issue we keep hearing is that the tribunal system is weighted in favour of whichever side has the most financial resources—which will almost always be the employer. A single individual who has lost their employment can rarely succeed against the millions of pounds that organisations are willing to spend on highly specialised lawyers who have tried and tested ways of winning. The playbook we identified above also runs into employment tribunals, with whistleblowers reporting: The employer and their legal advisers withholding key documents, and emails, minutes, notes and other vital information going missing. Key witnesses, often in senior leadership positions, being unable to recall events. Receiving last minute threats from their former employer to come after them for costs and often being given a limited time to consider signing a non-disclosure (NDA) to settle a case. If rejected, often the NHS organisation will seek the full costs from the whistleblower, including expensive external legal costs and internal staff costs, which can amount to thousands of pounds—few whistleblowers can afford to take this financial risk, even if they and their advisers think they have a strong case. Advice from our interviewees if you find yourself speaking up Reflecting on their experiences, our contributors have made some observations about how you can protect yourself when speaking up, should the issue escalate. Try to resolve issues locally first. This is not always possible, but if a concern can be raised and dealt with within a team or with a manager, in some cases this will prevent the situation from escalating to a formal process. Keep a record of concerns and events as they happen. This means you will have some facts and clear observations to refer back to, if the situation does escalate. Don’t go to meetings alone. Take a trusted colleague with you so that every conversation is witnessed. Get your union involved if you are called to meetings about your concerns or receive counter-complaints or accusations. Regulation of NHS managers Some of the interviewees highlighted that regulating NHS managers may be a potential means of tackling some of these issues. The Department of Health and Social Care recently held a public consultation on proposals that could see managers who use misconduct to silence whistleblowers barred from working in the NHS. Patient Safety Learning has formally responded to the consultation, stating that there is a clear case for the regulation of NHS managers, for the protection and benefit of both staff and patients. Everyone in healthcare should be honest and transparent when something goes wrong. Patient Safety Learning’s response expressed support for a professional register of NHS managers and the requirement for individuals in NHS leadership to have a professional duty of candour. These measures would be a positive step in increasing accountability for healthcare organisations in how they respond to staff raising patient safety concerns. But this is only one part of a much wider set of changes needed—significant cultural change also needs to take place in tandem with these reforms. Staff across many organisations are still afraid to speak up, as indicated by the most recent NHS staff survey results. Thank you to our contributors, and an invitation to get involved We’d like to take this opportunity to express our gratitude again to each person who has been willing to share their experiences and insights with us—it can be very difficult to retell traumatic events that have changed the course of your life. We are also aware that there are many other individuals who have experienced unjust treatment because they have spoken up for safety. If that’s you, thank you for your commitment to standing up for safe, ethical care. We invite everyone with experience in this area to contribute to this vital conversation. We would particularly like to hear from: Allied health professionals. Staff from Black and minority ethnic backgrounds Staff in non-clinical roles such as administration. If you would like to share your story, you can: Contribute to our community conversation (you’ll need to sign up first). Comment on any hub post (you’ll need to sign up first). You can find information about organisations that offer support and guidance for staff about speaking up and whistleblowing on the hub. Watch the interviews Helené Donnelly Martyn Pitman Jayne Chidgey-Clark Gordon Caldwell Bernie Rochford Beatrice Fraenkel References General Medical Council. Professional Standards: Raising and acting on concerns about patient safety, 13 December 2024
  20. News Article
    Managers are having to be “re-educated” after losing skills in recent years, the chief executive of NHS England has said. Speaking at the Medical Journalists’ Association’s annual lecture on Thursday, Sir Jim Mackey was asked whether he was satisfied with the calibre of managers in the NHS. He said “generally people that work in the NHS really care about what they do” and that managers were working in highly challenging circumstances, and often in “really horrible jobs where all the risk is managed”. But he also acknowledged a concern expressed by other NHS leaders that many managers had become “deskilled at some things”, in part due to the coronavirus pandemic and how systems have worked in the recovery period since then. Sir Jim said: “We are having to re-skill [and] train people again in things like waiting list management, some stuff on flow and ED management, those sorts of things. “So, they are being rebuilt, and people are being re-coached and re-educated.” Read full story (paywalled) Source: HSJ, 9 May 2025
  21. News Article
    President Donald Trump unveiled his fiscal 2026 budget proposal on 2 May, cutting non-defense federal spending by $160 billion. The budget provides resources to HHS to promote nutrition, physical activity, healthy lifestyles and more, according to the White House press release. The funds will also tackle “over-reliance on medications and treatments” as well as food and drug quality and safety. The VA medical centers will receive additional funds for healthcare services. Qualified veterans can also receive care from local community providers to expand access for those who otherwise would have to drive hours for care. The budget would cut funds nearly in half for the National Institutes of Health and CDC. The budget further would eliminate divisions for the CDC focused on disease and injury prevention, including gun violence. It would also cut the programmes for environmental health, global health and public health preparedness, according to The Times. The CDC’s focus would narrow to cover just infectious disease. President Trump’s budget proposes $1 billion cuts from the Substance Abuse and Mental Health Services Administration. The budget does not cut funding for Medicare or Medicaid. Read full story Source: Becker's Hospital Review, 2 May 2025
  22. News Article
    A proponent of using the drug hydroxychloroquine to treat Covid-19 despite scant evidence of its efficacy has been named to a top pandemic prevention role at the Department of Health and Human Services, the Washington Post reports. Steven J Hatfill is a virologist who served in Donald Trump’s first administration, during which he promoted hydroxychloroquine to treat the virus in the early months of the pandemic, when vaccines and treatments were not yet available. He recently started as a special adviser in the office of the director of the administration for strategic preparedness and response, which prepares the country to respond to pandemics, as well as chemical and biological attacks. The Trump administration embraced using the antimalarial drug hydroxychloroquine, along with other drugs such as ivermectin and chloroquine, as treatments against Covid-19, despite concerns over both their efficacy and potentially serious side-effects. In June 2020, just months after the pandemic started, the Food and Drug Administration warned against using hydroxychloroquine and chloroquine to treat Covid-19 over “reports of serious heart rhythm problems and other safety issues”, even after Trump approved the ordering of millions of doses of the drug from Brazil for US patients. Last year, a study released at the onset of the pandemic that promoted hydroxychloroquine to treat Covid-19 was withdrawn by the publisher of the medical journal. In an interview with the Post, Hatfill defended his support of hydroxychloroquine, which remains in use to treat diseases including lupus and rheumatoid arthritis. “There is no ambiguity there. It is a safe drug,” Hatfill said, noting that “they gave the drug to the president” in 2020. Read full story Source: The Guardian, 5 May 2025
  23. Content Article
    Although there have been significant advancements over the past decades, substantial gaps in safety and quality remain in healthcare delivery, especially in low- and middle-income countries (LMICs) and the public sector. Even within the same country, there are notable geographical disparities in equitable access to safe care. Healthcare organizations (HCOs) and countries worldwide face numerous challenges and have competing priorities for focused interventions, often struggling to invest adequately in safety and quality. In alignment with the Global Patient Safety Action Plan 2021-2030 and JCI’s vision, JCI introduces Patient Safety Pathways. This pioneering initiative aims to develop, strengthen, sustain, and enhance patient safety initiatives with actionable plans, especially for organisations in the early stages of establishing their patient safety and quality infrastructure. JCI is working in collaboration with countries and organizations to advance safer patient care. The Patient Safety Pathways initiative focuses on the needs of HCOs starting their journey towards eliminating avoidable patient harm by creating pathways for incremental improvements and transformative changes. This collaboration includes working with Ministries of Health (MOHs), national and international HCOs, and patient advocacy organizations at various stages of development to enhance the quality of healthcare and patient safety. The Pathways Initiative components: Patient Safety Grand Rounds A series of online discussions to engage thought leaders in patient safety at policy, systems, and healthcare delivery levels through open dialogue, collaborative learning, problem-solving, and sharing of best practices and success stories. JCI Training of Trainers Develop a cadre of trainers as “Patient Safety Champions.” These champions will be equipped with the necessary knowledge and tools who in turn can help develop skills and competencies for healthcare professionals, fostering a culture of safety at the national and organizational level. Needs assessment and technical support Tailored technical support to selected HCOs from LMICs, based on their identified needs and gaps.
  24. Event
    Don't miss this insightful conversation with C-level executives Leah Binder, President and CEO of the Leapfrog Group and Devin Jopp, President and CEO of APIC. In this leadership conversation, they'll share their perspectives on how the new presidential administration presents both opportunities and challenges to advancing patient safety and infection prevention. Register
  25. News Article
    Most integrated care systems lack a women’s health hub offering full services — contrary to government claims — according to research seen by HSJ. In spring last year, the government and NHS England said all systems were expected to have at least one operational women’s health hub in place by the end of December 2024. They were required to provide clinical support and consultations/triaging in eight “core” services. Health minister Karin Smyth told Parliament at the start of this year the objective had been met in 39 out of 42 integrated care systems. But research by the Menstrual Health Coalition found only 14 integrated care boards had established hubs offering all eight core services, as required. The services are: menstrual problems assessment and treatment; menopause assessment and treatment; contraceptive counselling and provision of all methods; preconception care; breast pain assessment; pessary fitting and removal; cervical screening; and screening and treatment for sexually transmitted infections and HIV. The coalition, an alliance of patient and advocate groups, collected information from all ICBs between October and December. Its co-chair Anne Connolly, a GP specialising in gynaecology, said: “Our findings challenge the narrative that women’s health hubs have been successfully implemented nationwide. “While figures suggest that hubs are in place, the reality is that many do not provide the full range of services women were promised… There is now an urgent need for transparency alongside the rollout of women’s health services, particularly as the current funding is short term and lacks the necessary commitment to future-proofing these services.” Read full story (paywalled) Source: HSJ, 30 April 2025
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