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Showing results for tags 'Organisational culture'.
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News Article
NHSE intervenes over ‘fear and bullying’ in surgery department
Patient Safety Learning posted a news article in News
Nearly a dozen junior doctors have been relocated from a London hospital’s general surgery department by NHS England, after concerns about a culture of fear, poor support, and reports of bullying. NHSE has withdrawn 11 surgical foundation year trainees from Barnet Hospital, in north London, after a review uncovered concerns regarding staff behaviour and safety. The General Medical Council has opened a case into the hospital’s department, which is run by the Royal Free London Foundation Trust, and the trainees have been placed elsewhere in the trust. Colin Melville, the GMC’s medical director and director of education and standards, told HSJ: “Doctors in training in the department reported a culture of fear, worry, and feeling unsupported and unable to raise concerns in the appropriate manner. “There are also concerns over their supervision, bullying, and undermining behaviours in the department, as well as doctors’ physical and mental wellbeing. “Because of the [trust’s] failure to meet the high standards we require, we stand firmly with NHSE workforce, training, and education London’s decision to relocate the 11 trainees, [to] where they can work and learn in a supportive environment. “This action is necessary not only to ensure their safety, but to protect the public as well.” Read full story (paywalled) Source: HSJ, 18 April 2024 -
News ArticleThree in four NHS staff have struggled with a mental health condition in the last year, according to a new poll. A survey of workers carried out by NHS Charities Together over medics’ mental health comes as healthcare leaders were forced to reverse cuts to NHS Practitioner Health, a service for medics. A backlash from NHS staff over the proposed cuts forced health secretary Victoria Atkins to intervene. In the new poll of more than 1,000 NHS staff, 76% said they have experienced a health condition in the last year with 52% reporting anxiety, 51% reporting low mood, while 42% of respondents also said they’d experienced exhaustion. Meanwhile, the most recent NHS data shows the most common reasons for staff sickness are anxiety, stress, depression or other psychiatric conditions, with more than 586,600 working days lost over this in November 2023. NHS Practitioner Health began as a mental health service for GPs but has since expanded to other specialities following funding from NHS England. However, last week the provider announced this national funding was due to end, so its service would be reduced. NHS England said the decision was so it could review the services available for all NHS staff. However, it was forced to u-turn on the decision and agreed to provide funding for an additional year. Read full story Source: The Independent, 17 April 2024
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News Article
Gang culture at neurosurgery department, doctor alleges
Patient Safety Learning posted a news article in News
A "gang culture" existed at an NHS neurosurgery department, a doctor has claimed at his employment tribunal. Neurosurgeon Mansoor Foroughi is one of two surgeons who alleges patients were put at risk at University Hospitals Sussex, where police are investigating 105 cases of alleged medical negligence. Four whistleblowers at the trust previously told BBC Newsnight that patients had died unnecessarily while others were "effectively maimed". They also complained of a "Mafia-like" management culture. Mansoor Foroughi alleges one colleague was approved to perform complex spinal surgery without adequate training. He claims a second surgeon undertook procedures that led to a "disproportionate" level of deaths. Mr Foroughi says a third surgeon undertook private work whilst on call to the NHS, which if true would be a breach of the NHS Code of Conduct. Universities Hospitals Sussex dismissed Mr Foroughi following a disciplinary hearing which upheld three allegations against him. He alleges the trust punished him because he raised these safety concerns. The trust said it would "vigorously contest" his claims. Read full story Source: BBC News, 11 April 2024 -
EventuntilThe federal Patient Safety and Quality Improvement Act was created in 2005 and established a national patient safety database and a system of Patient Safety Organizations (PSOs) in the US. Although PSOs have existed for more than 15 years, healthcare organisations still struggle to identify the best reporting structure and how to most effectively utilise protections in relation to patient safety work. In this ECRI webinar, Partner and Owner of Bolin Law Group, Andrew Bolin, will discuss: The establishment of a Patient Safety Evaluation System and how it relates to PSOs The differences between state protections and federal protections How to work with surveyors who request information protected under the Act Register for the webinar The webinar will take place at 13:00 ET (18:00 BST)
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Content Article
In this report, Patient Safety Learning analyses the results of questions in the NHS Staff Survey 2023 specifically relating to reporting, speaking up and acting on patient safety concerns. It raises questions as to why there has been so little progress despite policy intention in this area. It concludes by setting out the need to improve the implementation, monitoring and evaluation of work seeking to create a safety culture across the NHS. This article contains a summary of the report, which can be read in full here or from downloading the attachment below.- Posted
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News Article
Sexual harassment of NHS staff widespread
Patient Safety Learning posted a news article in News
NHS staff including ambulance workers, porters, nurses and cleaners have been shown pornographic images, offered money for sex, and assaulted at work, according to new research. The widespread incidents of sexual harassment are revealed in a wide-ranging survey published by the Unison union on the first day of its annual health conference in Brighton. In the study of more than 12,200 health workers, one in 10 reported unwanted incidents including being touched or kissed, demands for sex in return for favours, and derogatory comments. Royal College of Nursing chief nurse Professor Nicola Ranger said: “These figures paint an incredibly disturbing picture." In the survey, sexual assault was reported by 29% of respondents who had experienced harassment, while half said they have been leered at or been the target of suggestive gestures. One in four who had been harassed said they have suffered unwelcome sexual advances, propositions or demands for sexual favours. Half the staff had not reported sexual harassment to their employer, amid concerns of being considered “over-sensitive” or feeling complaints would not be acted on. Read full story Source: BBC News, 8 April 2024 -
Content Article
Press Ganey: Safety in healthcare 2024
Patient Safety Learning posted an article in International patient safety
A strong safety culture is the cornerstone of a thriving healthcare system. It underpins all experiences—for patients and employees—and drives key metrics like retention, loyalty, and “Likelihood to Recommend” (LTR) scores. Ultimately, a strong safety culture powers a virtuous cycle, leading to better outcomes for everyone. 'Safety in healthcare 2024' brings together Press Ganey's integrated dataset of patient and employee experience, clinical, and safety measures to analyse the landscape today. Representing 12 million patient encounters, the views of one million healthcare employees, and over 550,000 reported safety events, it explores emerging trends, as well as the strategies top-performing healthcare organisations leverage to improve patient and employee safety. -
News Article
USA: Hospitals' safety culture gap
Patient Safety Learning posted a news article in News
Healthcare workers' perceptions of safety at their organisations is improving, though a gap still remains between senior leaders and front-line workers, according to a Press Ganey report. Press Ganey surveyed more than 1 million employees from 200 health systems in the USA in 2023. The poll included 19 questions related to safety culture across three domains: prevention and reporting, pride and reputation, and resources and teamwork. Three takeaways: Staff safety culture scores have risen from an all-time low of 3.96 (out of 5) in 2021 to 4.01 in 2023. This increase was largely driven by improvements around staff members' perceptions of resources and teamwork, including views on adequate unit staffing. "While these improvements are encouraging, there's still a lot of work to do," Press Ganey said. "Pre-pandemic rates were never the desired end state, and it’s important to note that nearly half (48.5%) of employees still have a low perception of safety culture." Senior management reported the highest perceptions of safety culture at 4.53, while registered nurses and advanced practice providers reported the second- and third-lowest at 3.95 and 3.92, respectively. Security team members had the lowest perceptions of safety at 3.91. large gap was also seen between senior leaders and registered nurses regarding perceptions of workplace violence protections. Senior management gave their organizations a 4.30 out of 5 for having strong security measures in place to prevent violence, compared to just 3.36 for nurses. Read full story Source: Becker's Hospital Review, 3 April 2024 -
EventJoin Emergency Services Times to delve deep into fostering a culture of that encourages speaking up in emergency services, shedding light on effective strategies and leaving outdated approaches behind. Reports into culture may grab headlines but underneath, it is about behaviour and creating a working environment and channels that allow staff to have a voice, speak up and report without fear of reprisal. Through the lens of Crimestoppers and the National Guardian's Office, we look at what works and how to move on from approaches that simply don't serve the needs of those working within the emergency services sector. Register
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Content ArticleIn this episode, we hear from Sue Allison who blew the whistle on a Senior Radiologist within her department who repeatedly failed to diagnose women who had breast cancer at NHS Morecambe Bay Trust. She explains her battle to overturn her NDA at employment tribunal and the ‘insidious bullying’ that followed after blowing the whistle on concerns about patient safety. She is joined by Samantha Prosser an experienced employment law litigator from BDBF LLP who has specialist experience in advising private and NHS consultants from leading hospitals on private and NHS whistleblowing and discrimination claims.
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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. Rachel speaks to us about how patient partnership is key to tackling major issues facing the healthcare system and describes the central role of communication in improving patient safety. -
Content ArticleResearch conducted by a team at the University of Birmingham delves into the intricate dynamics of empathy towards patients and colleagues, revealing insights that challenge conventional wisdom. Empathy is widely recognised as a cornerstone of medical care. Increased physician empathy has been linked to better patient outcomes and satisfaction, yet there has been little exploration of its presence in surgical training. The study involved interviews with 10 surgical trainees at various stages of their careers to uncover a nuanced understanding of empathy within the profession. Contrary to the widely documented decline in empathy among medical students and professionals, participants described their experiences as a balance between empathy and the demands of surgical practice. Participants acknowledged the importance of empathy in patient care but highlighted the challenges of maintaining it amid the pressures of a surgical environment. They described a delicate balance between understanding patients’ needs and the efficiency required to manage high patient volumes and demanding workloads. The study revealed how empathy evolves throughout a surgeon’s career. Whilst some trainees experienced desensitisation to emotional stimuli, many described increased empathy as they gained more experience and exposure to patient care.
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News Article
Concerns over ‘Government’s failure’ to act on patient safety recommendations
Patient Safety Learning posted a news article in News
The Government has failed to implement a number of recommendations from significant inquiries into major patient safety issues, years after they were agreed to, according to an independent panel. The report, commissioned by the Health and Social Committee in the wake of the Lucy Letby case, voiced concerns about “delays to take real action”. As part of its investigation, the panel selected recommendations from independent public inquiries and reviews that have been accepted by government since 2010. Nine or more years have passed since these recommendations were accepted by the government of the day These covered three broad policy areas – maternity safety and leadership, training of staff in health and social care, and culture of safety and whistleblowing – and were used to evaluate progress. The panel gave the Government a rating of “requires improvement” across the policy areas. One of the recommendations was rated good. The report said that “despite good performance in some areas” the rating “partly reflects the length of time it has taken for the Government to make progress on fully implementing four of the recommendations which were accepted nine years ago, or longer”. “Progress is imminent in several areas, which is reassuring, but we remain concerned about the time it has taken for real action to be taken,” it added. Read full story Source: The Independent, 22 March 2024 Read Patient Safety Learning's response to the report: Response to Select Committee report: Evaluation of the Government’s progress on meeting patient safety recommendations -
Content Article
The Health and Social Care Select Committee’s Independent Expert Panel produces reports which assess progress the Government has made against their own commitments in different areas of health and care policy. On the 22 March 2024 they published a new report evaluating the implementation of accepted recommendations made by inquiries and reviews into patient safety. This blog sets out Patient Safety Learning’s response to its findings. -
Content ArticleThis report outlines the findings of an independent investigation into the conduct of a spinal consultant, Doctor F, who formerly worked at Salford Royal NHS Foundation Trust (now part of the Northern Care Alliance NHS Foundation Trust).
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Content ArticleNHS Boards are required under the National Whistleblowing Standards (the Standards) to publish annual whistleblowing reports setting out performance in handling whistleblowing concerns.
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News Article
Letby inquiry: NHS staff want their voices heard
Patient Safety Learning posted a news article in News
A group representing hundreds of clinicians has applied to contribute to the Lucy Letby inquiry, to challenge NHS culture around whistleblowing. Their experiences of raising concerns should inform the inquiry, they say. Letby murdered seven babies and attempted to murder another six while working at the Countess of Chester NHS trust between June 2015 and June 2016. The public inquiry is examining how the nurse was able to murder and how the hospital handled concerns about her. "The evidence of this group relating to how whistleblowers are treated, not just at one trust but across the UK, is of huge significance," Rachel di Clemente, of Hudgell Solicitors, acting for the clinicians, said. The group, NHS Whistleblowers, comprising healthcare professionals across the UK, including current and former doctors, midwives and nurses, has written to Lady Justice Thirlwall's inquiry, asking for them to be formally included as core participants. The inquiry has stated it will consider NHS culture. And the group says "a culture detrimental to patient safety" is evident across the health service. "NHS staff who have bravely spoken up about patient-safety concerns or unethical practices deserve to have their voices heard," Dr Matt Kneale, who co-chairs Doctors' Association UK, which is part of the group, said. Read full story Source: BBC News, 21 March 2024 -
Content ArticleFear of retaliation by leaders or colleagues can prevent staff from reporting adverse events, unsafe conditions, or near misses. This article presents strategies to improve just culture in the perioperative environment, which is prone to hierarchical structure. Strategies include creating an accessible reporting system, implementation of a "good catch" programme, and leadership support for staff who submit reports.
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Content ArticleThese principles underpin how NHS services must approach concerns that are raised by staff, students and volunteers about health services.
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Content ArticleIn this blog, Steve Turner reflects on why genuine patient safety whistleblowers are so frequently ignored side-lined or victimised. Why staff don’t speak out, why measures to change this have not worked and, in some cases, have exacerbated the problems. Concluding with optimism that new legislation going through Parliament offers a way forward from which everyone will benefit.
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Content Article
Just Culture - NHS Mersey Care documentary (2018)
Patient Safety Learning posted an article in Good practice
Imagine an organisational culture of trust, learning and accountability. In the wake of an incident, a restorative just culture asks: ‘who are hurt, what do they need, and whose obligation is it to meet that need?’ It doesn’t dwell on questions of rules and violations and consequences. Instead, it gathers those affected by an incident and collaboratively addresses the harms and needs created by it, in a way that is respectful to all parties. It holds people accountable by looking forward to what must be done to repair, to heal and to prevent. This film documents the amazing transformation in one organisation —Mersey Care, an NHS mental health trust in the UK. Only a few years ago, blame was common and trust was scarce. Dismissals were frequent: caregivers were suspended without a clear idea of what they might have done wrong. Mersey Care’s journey toward a just and learning culture has repaired and reinvigorated relationships between staff, leaders and service users. It has enhanced people’s engagement, joint ownership and sense of responsibility. It has taken the organization to a place where hurt doesn’t get met with more hurt, but with healing. -
News ArticleA secret report has warned that the NHS is failing to protect trainee paramedics from widespread sexual harassment and racism at work, The Independent has revealed. A confidential NHS England report uncovered by The Independent has found that “extremely alarming” conduct and undermining behaviour are rife in ambulance trusts across the country, with trainees subjected to derogatory comments about their age, ethnicity and appearance in front of patients. There is a “worrying acceptance” that this is “part of the job”, with students hesitant to raise complaints about sexual behaviour by male colleagues in case it gives them a reputation as “annoying snowflakes”, the report says. The revelations come after a recent NHS staff survey revealed that thousands of ambulance staff had reported unwanted sexual behaviour from colleagues and patients last year. One healthcare leader described the findings as “harrowing”, warning that much more needs to be done to protect junior staff. The national report, which is understood to have gone through several edited versions and is marked commercially sensitive, was not due to be released until The Independent obtained the document through a freedom of information request. It found an “undercurrent” of bullying in some areas, with examples of students leaving their jobs as a result of inappropriate behaviour. Trainees reported feeling undervalued and unwanted while on the job, with one apparently told: “Your concerns don’t matter – we have to meet patient demands.” Ambulance handover delays have also led to student paramedics having less experience and training on the job, prompting fears that newly qualified paramedics do not have sufficient levels of experience in life-critical situations. Read full story Source: The Independent, 19 March 2024
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Content ArticleThe stressful nature of the medical profession is a known trigger for aggression or abuse among healthcare staff. Interprofessional incivility, defined as low-intensity negative interactions with ambiguous or unclear intent to harm, has recently become an occupational concern in healthcare. While incivility in nursing has been widely investigated, its prevalence among physicians and its impact on patient care are poorly understood. This review summarises current understanding of the effects of interprofessional incivility on medical performance, service and patient care.
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News Article
NHS ombudsman warns hospitals are cynically burying evidence of poor care
Patient Safety Learning posted a news article in News
Hospitals are cynically burying evidence about poor care in a “cover-up culture” that leads to avoidable deaths, and families being denied the truth about their loved ones, the NHS ombudsman has warned. Ministers, NHS leaders and hospital boards are doing too little to end the health service’s deeply ingrained “cover-up culture” and victimisation of staff who turn whistleblower, he added. In an interview with the Guardian as he prepares to step down after seven years in the post, Rob Behrens claimed many parts of the NHS still put “reputation management” ahead of being open with relatives who have lost a loved one due to medical negligence. The ombudsman for England said that although the NHS was staffed by “brilliant people” working under intense pressures, too often his investigations into patients’ complaints had revealed cover-ups, “including the altering of care plans and the disappearance of crucial documents after patients have died and robust denial in the face of documentary evidence”. Read full story Source: The Guardian, 17 March 2024 -
Content ArticleNHS strikes have become such a familiar feature of our lives over the past two years that there is a risk we can become inured to their impact. This King's Fund article looks at the different ways in which strikes can impact the NHS and the people it serves.
