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Impartiality is central to the role of an investigator working to understand how a health event occurred. Achieving impartiality is a difficult task as the psychological research demonstrates how experts' perceptions and cognitions are affected by context, motivation, expectation, and experience. A growing body of research has revealed the many sources of bias that affect experts' judgments as they perform their work. These sources of bias extend beyond the characteristics of the individuals who were involved in the event being investigated and include such things as the features of the information being considered, the reference materials, the investigative environment, and an individual’s base-rate expectations. Professionals in fields such as forensic science, intelligence analysis, criminal investigation, and judicial decision-making are at an inflection point where they are considering both their current practices and new approaches. The investigation of health-related events is a professional domain that is in many ways analogous to the aforementioned decision-making environments. Yet, this investigation environment is also unique, as the sources, magnitude, and direction of bias are specific to the workplace setting. This presentation will explore the broad issue of cognitive bias in investigative decision making, discussion sources of investigative bias, and offer suggestions to mitigate the effect of bias in an occupational health investigation. Register

Musculoskeletal (MSK) problems are a leading cause of disability and sick leave in the working population. The purpose of this meeting is to assist participants in developing and implementing effective strategies in their practice to address these issues. A panel of experts from various disciplines, including occupational health, orthopaedics, psychology, and policy steering groups, will provide comprehensive and practical information on the prevention, treatment, and rehabilitation of MSK problems. By attending, you will: Learn about the latest innovations in ergonomic settings at workplace. Understand supportive psychological factors for management of MSK pain. Learn about the state of art therapeutic interventions in some MSK conditions affecting workers. Gain insights into national policies/strategies for prevention and rehabilitation of the MSK problems. Register

The 4th #EndPJparalysis Global Summit will bring people from health and social care around the world together to share best practice, to explore the research, case studies and lived experience around the impact of deconditioning. The Summit will include a wide range of clinical presentations as well as leadership discussions and perspectives on looking after those in the caring professions. Like previous years, there will be an eclectic mix of speakers, panel discussions and the opportunity to ask questions and build up your peer network. The Summit will run online for 36hrs. Sessions will be recorded and available to those registered after the event. The Summit is free to all people in health and social care. Register

It has become imperative that we discuss the issue of mental health in doctors and other healthcare staff. The mental wellbeing of a healthcare staff forms the bedrock of patient safety. It takes a safe and supported person to deliver safe healthcare and we must give this attention as we try to find ways to improve the quality of care within our healthcare systems. Ehi Iden, hub topic lead for Occupational Health and Safety, OSHAfrica, reflects on the increasing workload and pressure healthcare professionals face, the impact this has on patient safety and why we need to start 're-humanising' the workplace. In March 2017 in Nigeria, we had two very shocking incidents which left everyone saddened and disturbed. The first case was Emmanuel Ogah, a medical doctor, who stabbed his 62-year-old mother to death in Lagos. Then, whilst we were all trying to come to terms with that incident, on the 19 March 2017 Allwell Orji, another medical doctor, asked his driver to stop in the middle of the popular ‘The Third Mainland Bridge’, got out of his car and jumped into the lagoon where he drowned before help could come. The loss of these two medical professionals happened within a space of one week. As an occupational health consultant and a patient safety advocate, this got me thinking about how it further increases the risk exposure to the patients. These were both doctors who were trained to care for patients. Could they have been overworked? Were there issues surrounding their personal lives, their family lives and other very personal issues that were responsible for these acts? Nigerians were not known to commit suicide, but we cannot boast that any more, we are fast losing our resilience and coping capabilities. The World Health Organization (WHO) 2016 report revealed that Nigeria had the highest suicide rate among African countries, ranking sixth globally. This is concerning and needs urgent actions to stem the tide. Let’s look at healthcare professionals being overworked as a key example. According to the Premium Times Report published in November 2015, the population of Nigeria was 173 million people in 2013. Going by that report, Nigeria needed a minimum of 237,000 medical doctors to care for the Nigerian population, in line with the WHO ratio of 1 doctor to 600 people within a population group. But from all reports available at that time, there was only 35,000 doctors actively working as medical doctors in Nigeria. According to this ratio there is no way that doctors will not be overworked. Using these figure, this meant 1 doctor to 4,960 people. Although, the Nigeria Medical College train more than this number of doctors, many move into other professions. Using these figures, we might conclude that workload could be a strong contributing factor to suicide or death amongst doctors and other healthcare workers in Nigeria. So the question is, how does this impact on patient safety? It is sad that mental health was not included amongst the list of occupational health diseases or illness in the International Labour Organisation list of occupational diseases until much later when the toll of mental health issues became so obvious. Psychosocial hazard has become a huge issue within the healthcare work environment leading to burnout, fatigue, exhaustion, stress, tiredness and sleep deprivation amongst healthcare workers, and these outcomes impact negatively on the safety and quality of care when treating patients. The need to keep healthcare workers safe and look after their mental health is something that needs our collective actions and commitment. It takes a safe healthcare worker to deliver safe healthcare to patients. We should be looking at the workload – the duration and frequency of duty shifts within the healthcare sector – which has long changed over the years, making healthcare professionals work longer hours per shift, dealing with a workload that is beyond their coping capacity. We all agree that in healthcare we deal with lives and any mistake within healthcare delivery is always a costly one which innocent people pay for with their precious lives. Work overload is a critical issue surrounding daily patient harm in the hospital. It hurts the patient as much as it hurts the healthcare workers. This workload, if allowed to persist for too long, alters the mental wellbeing of the healthcare worker leading to avoidable mistakes, irrational behaviour, lack of co-ordination and a disrespect to the right and dignity of patients. This is never in anyone’s best interest. There are many doctors, nurses and other healthcare staff who love their jobs and keep giving all they have, giving mutual support to colleagues when they perceive them to be overwhelmed with work, which sometimes leads to collective burnout within a team. which leads to patient harm. Such healthcare staff are seen as trusted by everyone and tagged 'MR FIX IT' because of their willingness and availability to always show up to help or assist. They become a victim of patients' and colleagues' continuous demands; they never say NO but instead are always there to help, but over time they become emotionally overdrawn and this can lead to patient harm. The mental health of doctors and other healthcare professionals should be taken seriously owing to new and emerging conditions and disruptive behaviour noticeable amongst healthcare workers. The two doctors cited at the beginning of this write-up were managing patients entrusted to their care. Any doctor that has suicidal thoughts is a risk within the healthcare environment, no matter the department or unit he or she works in. I really think this is where we must look more closely at human resources, management and leadership in the healthcare environment. These are not roles that should be assigned to a newcomer, but a role carried out by very experienced professionals with a strong analytical background in human psychology and a big heart for employees’ wellbeing. We cannot rule out the fact that the two doctors cited earlier never displayed violent or suicidal behaviours that would have attracted the attention of co-workers, or even the human resources managers who would have been expected to have a meeting with such an employee with obvious suggestive indicators. We need to start engaging our colleagues, we need to start setting up Employees Assistance Programs (EAP) and we need to start looking beyond work – taking an interest and asking what happens in the home of our employees and colleagues. Are there issues? Are there smart ways we can help out? This should be our thinking. It will save both the patient entrusted into the care of the healthcare workers and the healthcare workers themselves and maintain a good reputation for the healthcare facilities. We must understand that healthcare workers are human beings just like us all; they are not super men and women, and they are fallible like every one of us. We need to start re-humanising our workplaces. Let’s start reviewing the workloads, timelines and deadlines, let’s once again treat healthcare professionals the way we would want them to treat our patients. Let’s bring dignity of labour back to healthcare, let’s again work like one big family where we all continuously watch each other’s backs, let’s rebuild the lost confidence while having the patient at the centre of these thoughts. Losing more doctors from healthcare, seeing others behind bars due to homicide, and seeing others incapacitated and feeling invalid when we know the work pressure and work environment contributed to these conditions and states is no good to any of us. We can change it. It takes a HEALTHY doctor to offer a SAFE healthcare.

The theme of this year’s International Long Covid Awareness Day is ‘Confront Long Covid: Recognise, prevent, act’. In this interview, we speak to retired occupational physician Dr Clare Rayner about her work in understanding Long Covid and its impact on individuals, the health service and the wider economy. She talks about recent guidance she has developed on people with Long Covid returning to work and outlines the impact Long Covid has on the workforce. She calls on healthcare leaders and the Government to invest in treatment-related research as well as highlighting the significant health risks associated with Covid reinfection.

In this episode Dr Paul Grime, Chairman of the Safer Healthcare Biosafety Network, speaks to Dr Shriti Pattani, an accredited specialist in Occupational Health working for London North West University Hospitals NHS Trust as their Clinical Director. She also works as a GP and was recently awarded an OBE for her outstanding work in occupational health. Her particular interests include the mental health of Doctors, education of GPs and other physicians on the importance of work on health and how best to use the ‘fit note’ and opportunities for fast tracking NHS staff to promote their health and wellbeing. Safety Talks is a podcast series as part of the Safety for All Campaign, launched to shine a light on the symbiotic relationship and benefits of integrating the approach to deliver healthcare worker safety and patient safety.

#EndPJparalysis has become a global movement embraced by nurses, therapists and medical colleagues. Its aim: to value patients’ time and help more people to live the richest, fullest lives possible by reducing immobility, muscle deconditioning, and dependency at the same time as protecting cognitive function, social interaction and dignity. Many of the people we care for are in their last 1000 days and they are the very people who do not have time to waste. Yet they are the people who are most likely to get stuck in our hospital systems due to their complex health and social needs. There is plenty of evidence that immobility in hospital leads to deconditioning, loss of functional ability and cognitive impairment, all of which have the potential to increase a patient’s length of stay, using up their valuable time. One of the major impacts of the #EndPJparalysis campaign has been the focus on both the individual and the organisational impact of ‘staying in bed’.