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Found 1,329 results
  1. Content Article
    This handbook produced by the Healthcare Financial Management Association (HFMA) is designed to help NHS governing bodies and audit committees in reviewing and reassessing their system of governance, risk management and control. This is to make sure the governance remains effective and fit for purpose, whilst also ensuring that there is a robust system of assurance to evidence it.
  2. News Article
    England's patient safety commissioner says her calls for changes following failings highlighted in three health scandals are "falling on deaf ears". Dr Henrietta Hughes made the comments at a meeting in Westminster on Tuesday of MPs and campaigners of medical scandals. It comes after Sir Brian Langstaff's highlighted a decades-long "subtle, pervasive, chilling" cover-up by successive governments and the NHS in the conclusion of his report on the infected blood scandal. Like the victims of that scandal, those affected by epilepsy drug Valproate, as well as vaginal mesh implants, and the hormone pregnancy test Primodos, are also waiting on the government to implement a redress scheme. The three campaign groups have already had a combined review. In July 2020, the Cumberlege review found similar failings to the blood scandal: damaging products, poor regulatory decisions, and one government after another refusing to accept wrong had been done. In February this year, the patient safety commissioner set out her "blueprint" of a redress scheme for victims. However, Ms Hughes, who attended the First Do No Harm All Parliamentary group meeting, said on Tuesday: "I'm itching to get the changes that are needed, but I feel my words are falling on deaf ears." Read full story Source: Sky News, 21 May 2024
  3. Content Article
    This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Mark talks to us about his role as a National Patient Safety Partner (PSP). He explains the important role that PSPs play at national, regional and local levels of the healthcare system and identifies key opportunities and challenges they face in bringing the voice of patients and families at a strategic level. He also highlights the challenge of implementing the Patient Safety Incident Response Framework (PSIRF) across a diverse range of providers and the complexities arising where PSIRF interfaces with systems and processes outside of the NHS.
  4. Content Article
    The use of restrictive interventions, such as mechanical restraints, has been a common practice in behavioural health settings since the field’s early infancy. The use of restraints has a harmful impact on both patients and providers alike, working against the therapeutic treatment environment aimed to support the healing journey. In this quality improvement project, the use of mechanical restraints was fully eliminated from a 252-bed inpatient setting in the US. This was achieved using a strategy of leadership, workplace development and data, and performance was sustained over the following year.
  5. Content Article
    The Thirlwall Inquiry is examining events at the Countess of Chester Hospital and their implications following the trial, and subsequent convictions, of former neonatal nurse Lucy Letby of murder and attempted murder of babies at the hospital. As part of this Inquiry, its Terms of Reference asks: “Whether recommendations to address culture and governance issues made by previous inquiries into the NHS have been implemented into wider NHS practice? To what effect?”. To help inform its work in this area, the Inquiry Legal Team has produced this Table of Inquiries and reviews which have been conducted in England and Wales over the last thirty years. Recommendations from each Inquiry have been set out in a comprehensive table, alongside details of whether or not those recommendations have been implemented.
  6. Content Article
    This fellowship program from the Patient Safety Movement Foundation offers a unique educational opportunity for healthcare professionals around the world to expand their knowledge in the theory and practice of patient safety. Building on the World Health Organization (WHO) Global Patient Safety Action Plan, the fellowship aims to develop future leaders particularly from lower middle- and middle-income countries. We aim to have learners from all WHO regions as learners on the program and from any profession within or allied to healthcare. The program combines a year-long curriculum developed by patient safety experts in a variety of areas, taught via monthly live virtual classroom sessions. Fellows complete monthly readings on specific topics, actively participate in discussions on the interpretation of theory and methods, and its implication to practice. Fellows submit monthly reflections on their learning as well as a longer reflection at the end of the fellowship. Applied learning is achieved by completing a hands-on improvement project that explores and advances issues of patient safety in each fellow’s respective professional environment. Fellows are encouraged to publish the outcome of their project and present at conferences. Our fellows are driven by a deep passion for patient safety, often sparked by first-hand encounters with patient harm events, and a desire to improve care outcomes in their home communities and workplace settings. They become part of a global social movement for patient and healthcare worker safety. The program consists of 12 sessions that run from will run from January to December 2025. Fellowship applications are accepted from 1 May to 1 August 2024.
  7. News Article
    The safety of a teaching hospital’s out-of-hours supervision has been questioned, including reports trainees were told not to ask for help “unless your patient is dying”. The General Medical Council put University Hospital Southampton Foundation Trust’s general surgery training under enhanced monitoring at the end of 2023 following a referral and quality management visit by NHS England South East, Workforce Training and Education – Wessex. The NHSE team’s visit and subsequent report said doctors in training had claimed senior staff were “not contactable” out of hours and there was “difficulty” in securing senior clinical advice, particularly on Sundays. The report added foundation year doctors were “discouraged” from contacting senior staff out of hours by “inappropriate” and “belittling” comments and behaviours, such as being told not to ask for help “unless your patient is dying”. Foundation doctors also reported starting rotation on call and conducting ward rounds without appropriate supervision. While the GMC open case is centred on patient safety concerns relating to supervising trainee doctors, the workforce and training directorate report also raised concerns about bullying, inappropriate sexual comments made by consultants, and a feeling that foundation doctors were unable to speak up. Read full story (paywalled) Source: HSJ, 1 May 2024
  8. Content Article
    In this HSJ blog, Ken Jarrold highlights three key things he learned during his ten years as chair of NHS trusts: Focus on the people that matter—service users and frontline staff Keep an appropriate level of contact and relationship with the chief executive Live the values of the trust. He emphasises chairs keeping their focus on the people they serve and ensuring they feel at home interacting with staff and service users, as well as other leaders. He also states his hope that the Leadership Competency Framework for conducting annual appraisals of NHS chairs published by NHS England in February 2024, if applied appropriately, will result in improvements in how chairs serve their organisations.
  9. Content Article
    This White Paper sets out the Labour Government's proposals to reform and expand community health and social care services in order to meet local needs, especially in poorer deprived communities. Four key objectives are highlighted in the White Paper: better health prevention services with earlier intervention; increased patient choice; tackling inequalities and improving access to community services; and increased support for people with long-term needs to live independently. Specific measures include: expansion of local care settings outside hospitals; increased joint commissioning between PCTs and local authorities to improve service integration; the introduction of practice based commissioning, where GPs are given more responsibility for local health budgets; increased provision for new primary care providers to compete for PCT contracts; and the introduction of a new NHS ‘Life Check’ to promote healthier lifestyles with a pilot scheme in spearhead PCTs by 2007-08.
  10. Content Article
    This report from the BME Leadership Network comprises examples of anti-racist initiatives from BME Leadership Network members, to help advance equality within the workforce and for service users.
  11. News Article
    Trusts and NHS England are failing to prioritise training for senior leaders on listening to whistleblowers — despite repeated findings of serious concerns going unheard — the National Guardian’s Office has said. The Guardian’s Office — set up by the government to ensure whistleblowers and other staff raising concerns are properly listened to — made the claim in its written evidence to an inquiry into NHS leadership, performance, and patient safety. The Commons health and social care committee is considering regulation of NHS leaders and managers, among other issues, including progress made on the 2022 report for ministers by General Sir Gordon Messenger. The NGO’s evidence, published on Wednesday, said: “In our opinion, there has been little progress on recommendations from the Messenger Review to date… “The NGO has developed, in collaboration with [NHSE], three e-learning modules (Speak Up, Listen Up, Follow Up) which are freely available for anyone who works in healthcare. We have recommended to the sector that these modules should be a minimum standard for all staff and be made mandatory. “Although accessible to all, many organisations have not adopted them, and NHS England has not prioritised these across the system.” Read full story Source: HSJ, 18 April 2024
  12. Content Article
    As the NHS’s digital transformation journey enters a new phase, there are opportunities to improve the quality and productivity of the healthcare system. This phase is not just about advancing the maturity of electronic health records (EHRs) but also about embracing the vast potential of generative artificial intelligence tools. In this HSJ article, Robert Wachter and Harpreet Sood explore the reasons why EHRs have not yet delivered promised productivity improvements and look at how GenAI offers opportunities for the NHS to realise productivity benefits faster, cheaper and at a greater scale.
  13. News Article
    The British government was willing to risk infecting NHS patients to get “lower-priced” blood products, according to a document that campaigners claim proves state and corporate guilt in one of the country’s worst ever scandals. A public inquiry into the deaths of an estimated 2,900 people infected with conditions such as HIV and hepatitis will publish its final report in May, four decades after the NHS started prescribing blood and blood products – including from drug users, prisoners and sex workers – sourced from the USA. Within the thousands of documents disclosed to the inquiry, internal company minutes have emerged that campaigners say provide the final compelling piece of evidence of the commercial greed and state negligence that destroyed thousands of lives. In November 1976, Immuno AG, an Austrian company that was a major supplier to the Department of Health, was seeking a licence change to allow it to supply a blood product from those paid to donate in the US rather than donors without a financial incentive in Europe. According to the minutes of a meeting of medics in the company, it had been “proven” that there was a “significantly higher hepatitis risk” from a concentrate known as Kryobulin 2 made from US plasma compared with that from Austria and Germany. The company had concluded there was a “preference” in the UK for the cheaper US option. The memo of the meeting said: “Kryobulin 2 will be significantly cheaper than Kryobulin 1 because the British market will accept a higher risk of hepatitis for a lower-priced product. In the long-term, Kryobulin 1 will disappear from the British market.” Read full story Source: The Guardian, 14 April 2024
  14. Event
    The TIPSQI Annual Quality Improvement Showcase returns once again in a virtual format. This virtual conference is open to all foundation doctors in the UK. This is a fantastic opportunity to present your QI project as a virtual poster or oral presentation; hear about other projects in the region; and hear our key note speaker Dr Hannah Baird, the founder of TIPS QI, alongside being higher specialty registrar in emergency medicine, Chief Registrar at Royal Bolton Hospital, the Vice-Chair of the Academy of Medical Trainees Doctors Group and the Co-Chair of the Emergency Medicine Trainees Association (RCEM). Junior doctors from around the UK will be presenting their quality improvement projects, highlighting some of the excellent leadership work being carried out amongst foundation doctors. There shall be prizes for the best projects, as well as the opportunity to learn more about the great QI work across the UK. Register
  15. Event
    Energising excellence. Bringing research, education, practice and leadership to life The RCM conference is back for 2024. Professional and educational standards of proficiencies have made clear the importance of midwives working across the professional pillars of the profession: research, education, clinical practice and leadership. Safe and effective care needs an evidence base from research, which is then disseminated and supported through education and strategically implemented into clinical practice and sustained through effective leadership. Furthermore, understanding midwifery professional pillars is relevant for promoting career pathways and ensuring professional recognition alongside our multi-disciplinary colleagues. Register
  16. Content Article
    The Health & Social Care Committee is examining the relationship between leadership in the NHS and performance/productivity as well as patient safety. It will consider the findings of and implementation of recent reviews of NHS leadership, such as the Messenger (2022) and Kark (2019) reviews as they relate to patient safety, as well as topics including how effectively leadership supports whistleblowers and learning from patient safety issues. Here is AvMA's response to the Committee's call for evidence.
  17. Content Article
    NHS England recently issued a national patient safety alert to all trusts providing maternity services after faults were discovered in IT software that could pose “potential serious risks to patient safety”. In this short blog, Clive Flashman, Patient Safety Learning’s Chief Digital Officer, calls for a closer look at the reasons into this and what we can learn from it.
  18. News Article
    In the next few days, once the data has been collected, the Government will come out and say that, thanks to its policies, the situation in A&E is improving. Despite estimates released recently by the Royal College of Emergency Medicine that soaring waits for A&E beds led to more than 250 needless deaths a week in England alone last year, the Government will point to declining numbers of patients who breached the four-hour target this March. The four-hour target means we're meant to see and either discharge or admit patients within four hours of their arriving in A&E. But it's a sham, writes Professor Rob Galloway in the Daily Mail. Because, for the past month, the four-hour data has been manipulated, the result of two policies introduced earlier in the month by the Government. Read full story Source: Daily Mail, 3 April 2024
  19. Content Article
    NHS England’s response to claims of excess deaths due to long A&E waits leaves a lot to be desired, writes Steve Black for the HSJ. The Royal College of Emergency Medicine (RCEM) claim that more than 250 A&E patients are dying each week because they waited more than 12 hours to be admitted. If long waits in A&E are killing an extra 250-400 people every week, it is the biggest performance problem in the NHS. NHSE should urgently ask their analysts to rework this analysis with current data to test (or refute) the validity of the claim. The first step to solving a huge problem is admitting the scale of the problem, not denying it exists. This analysis features a refinement of the RCEM estimate that includes estimated mortality from waits between four and 12 hours. This increases the estimate to 400 extra deaths per week compared to the RCEM number of 250.
  20. News Article
    The Care Quality Commission’s assessments of integrated care systems (ICSs) have been put on hold at the last minute, as the government declined to sign off on the process. They were due to begin this month, following pilots in Birmingham and Solihull and Dorset ICSs, but the Care Quality Commission (CQC) has put the brakes on assessments elsewhere until it receives government approval. Under the legislation brought in when ICSs were set up in 2022, the CQC can review and assess systems, but ministers must approve its methodology. Interim chief inspector of adult social care and integrated care James Bullion wrote to integrated care board chiefs this week stating that, following discussions with the Department of Health and Social Care, the CQC had agreed to a “short delay… to allow for further refinements to our approach”. He added: “In particular we have been working with NHS England on their strengthened approach to performance evaluation and rating of the ICB elements of the ICS which we will take into account as evidence for our scoring and reporting approach.” Read full story (paywalled) Source: HSJ, 8 April 2024
  21. Content Article
    Richard von Abendorff, an outgoing member of the Advisory Panel of the Healthcare Safety Investigation Branch (HSIB), has written an open letter to incoming Directors on what the new Health Services Safety Investigations Body (HSSIB) needs to address urgently and openly to become an exemplary investigatory safety learning service and, more vitally, how it must not contribute to compounded harm to patients and families. The full letter is attached at the end of this page.
  22. Content Article
    Read the Royal College of Emergency Medicine's general election manifesto. A one page summary is below and the full manifesto can be found at the link at the bottom of the page.
  23. Content Article
    The recently published results of the British Social Attitudes survey and the NHS Staff Survey, and recent performance data provide an in-depth backdrop to the health and care landscape in 2024 - a year that's likely to see a general election called. Ruth Robertson is joined by a panel of experts from The King's Fund to discuss the state of health and care. Throughout the conversation, the panel reflects on the prospect of a general election and the impact this might have on health and care services, both in the run up and after. They also discuss the tendency to rely on short-termism in policy-making, and why a long-term strategy might help build a stronger health and care system that will last.
  24. Content Article
    Prime Minister Rishi Sunak promised speedier care, but specialists believe long waits for hospital beds are costing thousands of lives. The pledge he made in January last year, as one of five priorities on which he said voters should judge him, was that “NHS waiting lists will fall and people will get the care they need more quickly”. New calculations by the Royal College of Emergency Medicine (RCEM) show that, with regard to the broader aim of delivering speedier treatment, his government is falling shockingly short.
  25. Content Article
    Lit Health will be lighting a fire underneath the status quo of healthcare through interviews with authors, healthcare leaders, and policymakers working to create a healthcare environment that is equitable, transparent, and that welcomes the needs of every patient – especially our vulnerable populations including the mentally ill, people of colour and women who feel they are at risk in our current system, the elderly, and anyone who feels bias or the isms affect their health and quality of life.
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