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Found 121 results
  1. News Article
    Healthcare staff working at the height of the covid-19 pandemic in England were not properly protected and were forced to work in an unsafe environment, MPs have been told. Appealing before the health and social care committee on 21 July, experts criticised the government and NHS management for their failure to provide staff with sufficient testing and personal protective equipment (PPE). The committee was gathering evidence for its inquiry into the management of the COVID-19 outbreak. Paul Nurse, director of the Francis Crick Institute, said he believed that the failure to implement better testing systems in the early days of the pandemic had contributed significantly to the problems. He said, “At the height of the pandemic, our own research—which backs up what’s been done elsewhere—found that up to 45% of healthcare workers were infected and they were infecting their colleagues and infecting patients, yet they weren’t being tested systematically. “In the healthcare environment we weren’t providing proper protection, and it’s important because it protects the most vulnerable in our society and it protects our healthcare workers. They deserve to work in a safe environment, and some of them are dying because of what they do. They deserve better.” Read full story Source: BMJ, 22 July 2020
  2. News Article
    More than 4 in 10 anaesthetists are not convinced their hospitals would be able to provide safe services should there be a second wave of COVID-19, a new survey has indicated. A survey of members of the Royal College of Anaesthetists (RCOA) showed 44% of respondents were not confident their hospitals would be able to provide safe covid and non-covid services should there be a second surge of infections. The survey also showed levels of mental distress and morale were worsening among anaesthetists – many of whom were drafted into intensive care units during the first wave. Almost two-thirds of respondents (64%) said they had suffered mental distress in the last month due to the pressures faced during the COVID-19 pandemic. Now the college is calling on the NHS to plan intensively for a second covid wave and to identify, train and maintain the skills of cross-specialty “reservists” – including current clinicians, recent retirees and senior trainees — who can support the health service in the event of future surges. One anaesthetist told the RCOA they were “exhausted with constantly having to think about covid and protecting yourself” and “struggling with the realisation that PPE is here to stay for some time.” Another said: “We have burned out our human resource. We need a period of rebuilding or patient harm will result.” Read full story (paywalled) Source: HSJ, 22 July 2020
  3. Content Article
    Key findings 44% of respondents were not confident their hospitals would be able to provide safe COVID and non-COVID services should there be a second surge of infections. Over one third (38%) of respondents also cited low or non-existent rapid testing for staff at their hospitals and one-in-five (20%) said there are currently insufficient infection prevention and control measures to prevent staff from infecting surgical patients with COVID-19. Results also highlighted the increasing trend in mental distress amongst anaesthetists and the disruption to the training opportunities for anaesthetists in training: nearly two-thirds of respondents (64%) have, to some extent during the past month, suffered mental distress due to the pressures faced during the COVID-19 pandemic over one-third of respondents (34%) reported a low or very low level of team morale, compared with nearly one-in-five (21%) in May nearly nine-in-ten trainees (89%) strongly agree that the pandemic is affecting their training opportunities, career and professional development.
  4. News Article
    Hospital nurses were told their "lives would be made hell" if they complained over conditions on a coronavirus ward, a union has claimed. Unison has raised a group grievance for 36 employees, most of them nurses, at Nottingham University Hospitals Trust. It said staff on the Queen's Medical Centre ward were not trained properly, faced bullying for raising concerns and denied PPE "as punishment". The trust said the allegations were "very troubling". The union said the staff, which included nurses, senior nurses and healthcare assistants, volunteered to work on the hospital's only ward dealing with end-of-life coronavirus patients. It claimed they were not given any specialist training or counselling for dealing with dying patients and their grieving relatives. An anonymous member of staff described it as "incredibly stressful". Another worker said a board with everyone's record of sickness was put on display in a break room to intimidate staff. Dave Ratchford from Unison said: "This is absolutely shocking stuff. We're talking about a very high-performing team who fell foul of a culture that permits bullying and fails to address it" "Staff were told their lives would be made hell for complaining." Read full story Source: BBC News, 21 July 2020
  5. News Article
    Amid warnings that BAME nursing staff may be disproportionately affected by the COVID-19 pandemic, a Royal College of Nursing (RCN) survey reveals that they are more likely to struggle to secure adequate personal protective equipment (PPE) while at work. The latest RCN member-wide survey shows that for nursing staff working in high-risk environments (including intensive and critical care units), only 43% of respondents from a BAME background said they had enough eye and face protection equipment. This is in stark contrast to 66% of white British nursing staff. There were also disparities in access to fluid-repellent gowns and in cases of nursing staff being asked to re-use single-use PPE items. The survey found similar gaps for those working in non-high-risk environments. Meanwhile, staff reported differences in PPE training, with 40% of BAME respondents saying they had not had training compared with just 31% of white British respondents. Nearly a quarter of BAME nursing staff said they had no confidence that their employer is doing enough to protect them from COVID-19, compared with only 11% of white British respondents. Dame Donna Kinnair, RCN Chief Executive & General Secretary, said: “It is simply unacceptable that we are in a situation where BAME nursing staff are less protected than other nursing staff. Read full story Source: Royal College of Nursing, 27 May 2020
  6. Content Article
    The results of the study, published in Anaesthesia, found that: Wearing PPE posed problems with fit. Several human factor/ergonomic issues were reported when working in PPE, including visual difficulties and problems with communication and hearing alarms. Hand (fine motor) function was impaired, with additional problems for non‐clinical activities including typing and using electronic interfaces. Reaching (gross motor) activities were restricted by both surgical gowns with sleeves and one‐piece coveralls. Skin breakdown, musculoskeletal injuries and overheating. The authors suggest that that more human factor/ergonomic research is needed to improve the functional design of PPE so that healthcare workers are better supported to carry out critical care and other medical treatment.
  7. Content Article
    Patients that I care for remain the same. Medically they are the same as they ever were. They have bowel obstructions, they have heart attacks, they have infections, they break bones, and there will always be a constant flow of patients that need the services of the NHS. One day it will be you and it will be me, at some point we will rely on NHS care. However, the way that care is organised and delivered around us will change. We have no idea what it will look like in the future, but it will be different to what we knew before the pandemic hit. At the moment we are all working in a state of flux. I work part time as a critical care outreach nurse, so there are times when I am not at the hospital for a few days in a row. When I am due back at work, I get what I call the ‘Sunday night fear’. I used to get this every Sunday night before I had to go to school. I would worry about fitting in, had I done my homework, have I got all my books together and whether I was going to have a good hair day. Now I find myself worrying about what new protocols I need to follow, what briefings have I missed, which wards are green, which are red. Now I have a new habit of looking through work emails to find out if I need to do anything different when I come to work. I’m not enjoying this habit one bit. I feel like I am starting a new job every time I turn up after two or three days. One of the roles of the critical care outreach nurse is to provide role modelling and support to staff on the wards. More often than not I have no idea what the ‘rules’ are now. Every decision is difficult. My patient needs to go to theatre urgently; they are slowly occluding their airway. Before the theatre will take them, they need a covid swab result. How do I get a swab result quickly? A new rapid test is now available (I only find this out by someone telling me this as they were passing). How do I get this swab? Does it look different? How do you perform the swab? How do I send it? How quick does it come back? How do I find the result? How reliable is it (at this point, I’m not bothered – just get it done, tick that box). Next call – cardiac arrest on one of the wards. Pre-covid we have been taught "Good chest compressions are linked with better outcomes for patients. Keep time off the chest to a minimum". This has been drummed in to us for years. It is now second nature to make sure that chest compressions are given as soon as we confirm cardiac arrest. But now we are advised by our Trust resuscitation team and the Resuscitation Council UK that performing chest compressions is an aerosol generating procedure (AGP), despite the advice from Public Health England who state that chest compressions is not classed as an AGP. There are a few issues here... As frontline healthcare staff we want to do the best for our patients, and we want to be kept safe by our employers. We need clarity on what we are supposed to be doing; this lack of clarity and standard guidance leads us into different interpretations of the rules and a lack of trust in our leaders. I recently taught on an Advanced Life Support Course. Here, I was teaching a range of healthcare professionals from differing hospitals from inner and outer London. I was amazed at the different practices that were going on. Some were wearing full personal protective equipment (PPE) for cardiac arrests despite covid status, some were not. The lack of clarity here made teaching very difficult as they were not sure who was right and who was wrong. They were then worrying if they had been exposed and are now losing trust in their leaders. In the NHS we use guidance that is evidence based. At present we have such a small evidence base, if any, on how we should treat patients during the pandemic. This is leading to differing local policies of which no one knows which is best. This lack of clarity and guidance also has an impact on the patient. If we are to wear full PPE for AGPs (in the cardiac arrest situation) there will be a delay in performing chest compressions; this has a negative impact on patient outcomes. Cardiac arrests are stressful; donning PPE at breakneck speed so that you can treat your patient is compounding the anxiety. It made me question – if covid is here to stay, should we be rewriting the resuscitation guidelines? Then I thought, how can you rewrite guidance in a time of flux? Things change all the time; nothing is the same from 48 hours ago – so how can meaningful standards and guidance be written if they will be out of date before they get uploaded? And re-writing guidance with consensus from experts and professional bodies takes time. What do we do in the meantime? At this stage we need guidance, we need clarity and we need to feel we can trust in those that lead us through. Call for action We need evidenced-based guidance, we need clarity and we need to feel we can trust in those that lead us through. How are leaders communicating best practice and updated relevant guidance to staff and instilling trust that patient and staff safety is a core priority?
  8. News Article
    The Public Accounts Committee has given the Department of Health and Social Care two months to report back with a plan to ensure personal protective equipment (PPE) provision during a second COVID-19 spike. The influential group of MPs said they were 'extremely concerned' by PPE shortages faced by NHS and care workers during the first wave of the pandemic in the UK. According to the DHSC it never ran out of stock of PPE but rather Covid-19 had 'put supply chains and distribution networks under unprecedented strain', posing challenges with ensuring the right equipment was at the right place at the right time. BMA council chair Dr Chaand Nagpaul said: 'We may be past the first peak of this virus, but we should be under no illusion that the demand for PPE is over – especially as the NHS begins to manage the huge backlog of demand caused by the pandemic, all under tighter infection control measures.' In light of the threat of a second wave of Covid-19 doctors and colleagues 'need cast-iron guarantees from Government that the failures of the past months will not be repeated, that there will be enough of the right PPE and that it will be properly tested, quality-controlled and safe to use', Dr Nagpaul added. Read full story Source: Pulse, 8 July 2020
  9. News Article
    The “hazardous” use of personal protective equipment (PPE) required because of COVID-19 is contributing to the spread of secondary infections in intensive care units and other hospital settings, a leading expert has told HSJ. Infection Prevention Society vice president Professor Jennie Wilson, said: “[PPE] has been used to protect the staff, but the way it has been used has increased the risk of transmission between patients. The widespread use of PPE particularly in critical care environments has exacerbated the problem (of patient to patient transmission). Unless we tackle the approach to PPE we will continue to see this major risk of transmission of infections between patients.” Professor Wilson warned this was espeically worrying as the risk includes spreading antibiotic resistant infections among ICU patients. There is increasing concern these are developing more often in covid patients due to widespread use of broad spectrum antibiotics in the early days of the pandemic, she added. Read full story (paywalled) Source: HSJ, 3 July 2020
  10. News Article
    Some hospitals have sought to water down PPE requirements in order to “accelerate” the return of planned surgery, senior doctors have said, as they issued new guidance aiming to inform the decision. The Royal College of Anaesthetists, along with partners including the Faculty of Intensive Care Medicine, released a document to members to tackle “marked uncertainty amongst operating theatre team members as to which infection prevention and control precautions should be taken when treating screened patients in planned surgical pathways”. The document provides recommendations for teams on how to adjust PPE usage, which the college said was “supportive and consistent” with current Public Health England guidance. Professor William Harrop-Griffiths, consultant anaesthetist and council member of the Royal College of Anaesthetists, told HSJ some hospitals wanted to decrease the amount of PPE used as it might enable them to “accelerate and increase the workload”. However, the college has argued that there is currently “no clear guidance on when you might consider making that change”. “You have to balance that to the risk to the staff,” Professor Harrop-Griffiths stressed. Read full story (paywalled) Source: HSJ, 29 June 2020
  11. Content Article
    Complaints from staff are not being heeded. Why is it that healthcare staff's opinions and pleas for their safety and the safety of patients do not matter? Here are just some examples of where safety has been compromised: Disposable gowns are being reused by keeping them in a room and then reusing after 3 days. There were no fit tests. Staff were informed by management that "one size fits all, no testers or kits available and no other trusts are doing it anyway". Only when the Health and Safety Executive (HSE) announced recently that fit tests were a legal requirement, then fit tests were given. I queried about fit checks only to discover that it was not part of the training and, therefore, staff were wearing masks without seals for three months before fit tests were introduced and even after fit tests! I taught my colleagues how to do fit checks via telephone. There was no processes in place at the hospital to aid staff navigation through the pandemic (no red or green areas, no donning or doffing stations, no system for ordering PPE if it ran out); it was very much carry on as normal. A hospital pathway was made one week ago, unsigned and not referenced by governance, and with no instructions on how to don and doff. Guidelines from the Association for Perioperative Practice (AFPP) and Public Health England (PHE) for induction and extubation are not being followed – only 5 minutes instead of 20 minutes. Guidelines state 5 minutes is only for laminar flow theatres. None of the theatres in this hospital have laminar flow. One of my colleagues said she was not happy to cover an ENT list because she is BAME and at moderate/high risk with underlying conditions. She had not been risk assessed and she felt that someone with lower or no risk could do the list. She was removed from the ENT list, told she would be reprimanded on return to work and asked to write a report on her unwillingness to help in treating patients. The list had delays and she was told if she had done the list it would not have suffered from delays. Just goes to show, management only care about the work and not the staff. It was only after the list, she was then risk assessed. Diathermy smoke evacuation is not being used as recommended. Diathermy is a surgical technique which uses heat from an electric current to cut tissue or seal bleeding vessels. Diathermy emissions can contain numerous toxic gases, particles and vapours and are usually invisible to the naked eye. Inhalation can adversely affect surgeons’ and theatre staff’s respiratory system. If staff get COVID-19 and die, they become a statistic and work goes on as usual. The examples listed above are all safety issues for patients and staff but, like me, my colleagues are being ignored and informed "it's a business!" when these safety concerns are raised at the hospital. The only difference is they are permanent staff and their shifts cannot be blocked whereas I was a locum nurse who found my shifts blocked after I spoke up. Why has it been allowed to carry on? Why is there no Freedom To Speak Up Guardian at the hospital? Why has nothing been done? We can all learn from each other and we all have a voice. Sir Francis said we need to "Speak Up For Change", but management continues to be reactive when we try to be proactive and initiate change. This has to stop! Actions needed We need unannounced inspections from the Care Quality Commission (CQC) and HSE when we make reports to them. Every private hospital must have an infection control team and Freedom To Speak Up Guardian in post.
  12. Content Article
    Follow the link below to watch a short video on how you can access dental care, treatment and advice as dental practices begin to reopen.
  13. Content Article
    The key challenges identified are: funding; capacity; rehabilitation; health inequalities; regulation and inspections; system working; and managing public expectations. It puts forward a number of practical solutions for the phase three guidance and beyond, including: An extension of emergency funding across all sectors of the NHS, given significant extra demand across all services. Longer term funding will be needed for rehabilitation and recovery services in the community, including for mental health, to manage patients at home and in the community. Putting in place an ongoing arrangement with the private sector – this will be vital to provide capacity to respond to the backlog of treatment. A review of the impact of COVID-19 on the NHS and social care workforce given the unprecedented pressure staff have been under A delay in returning to the inspection regime of the CQC to take into account the positive changes that have been achieved as a result of the lighter touch approach to regulation that has been in place during the pandemic. A commitment to acknowledge and address health inequalities wherever possible through upcoming guidance and policy reform. Clarity over when there will be a return the greater autonomy local organisations had before COVID-19 returned, as we move from Level 4 to Level 3. This should be considered as part of a wider move to less central command and control when the pandemic has subsided. A call for assurance that there will be a fully operational and robust test, track and trace system, as well as appropriate supplies of personal protective equipment (PPE),as services are resumed.
  14. News Article
    Dozens of hospitals are running short of scrubs in the latest problem to hit the NHS over the supply of personal protective equipment (PPE) during the coronavirus pandemic. The shortages are revealed in a survey of UK doctors undertaken by the Doctors’ Association UK (DAUK), which found that 61% said that the hospital where they worked was facing a shortage of scrubs. In recent months, many more NHS staff have begun wearing scrubs, which are usually used mainly by surgical staff, to protect themselves against COVID-19. The prevalence of coronavirus in hospitals has prompted many to switch from wearing their own clothes at work to using scrubs, and handing them in to be washed at the end of their shift. However, the big increase in demand for scrubs from doctors, nurses, physiotherapists and occupational therapists has left many hospitals unable to keep up and also put unprecedented pressure on hospital cleaning services. Some staff have even worn pyjamas intended for patients when scrubs have run out. “Protective clothing must be considered to be at a par with other PPE by Public Health England and must be provided to staff by the NHS," said said Dr Samantha Batt-Rawden, the president of the DAUK. She added: “A failure to adequately supply scrubs to staff may risk further community spread of Covid-19.” Read full story Source: The Guardian, 15 June 2020
  15. News Article
    Ministers are facing a high court legal challenge after they refused to order an urgent investigation into the shortages of personal protective equipment faced by NHS staff during the coronavirus pandemic. Doctors, lawyers and campaigners for older people’s welfare issued proceedings on Monday which they hope will lead to a judicial review of the government’s efforts to ensure that health professionals and social care staff had enough personal protective equipment (PPE) to keep them safe. They want to compel ministers to hold an independent inquiry into PPE and ensure staff in settings looking after Covid-19 patients will be able to obtain the gowns, masks, eye protection and gloves they need if, as many doctors fear, there is a second wave of the disease. About 300 UK health workers have so far died of COVID-19, and many NHS staff groups and families claim inadequate PPE played a key role in exposing them. Read full story Source: The Guardian, 8 June 2020
  16. News Article
    Almost three quarters of GP partners are concerned about how to keep colleagues safe as numbers of patients attending practices return to pre-pandemic levels - with access to PPE a major worry, a GPonline poll has found. Half of the 185 GP partners responding to the poll said that they were either 'very worried' or 'slightly worried' about the government's ability to supply the PPE that GPs and practice staff needed to keep them as safe as possible through the rest of the pandemic. Only 9% said they were 'very confident' that the government would be able to supply adequate PPE, with a further 20% saying they were 'slightly confident'. Some 73% of GP partners said that they were concerned about how to ensure the safety of practice staff as the number of patients attending the surgery begins to rise. BMA GP committee chair Dr Richard Vautrey said keeping staff safe was 'a challenge for everyone in the NHS'. He told GPonline: 'Even months now into this crisis the government still hasn’t sorted out PPE in a way that means people have absolute confidence that they will have enough to meet their needs, and the growing needs of practices as they will need to be seeing more patients face-to-face for important procedures that can’t be done remotely. Read full story Source: GPonline, 8 June 2020