Search the hub
Showing results for tags 'Policies'.
Found 147 results
-
Content ArticleIn 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.
-
Content Article
A new job for the CQC (HSJ, 30 May 2025)
Patient Safety Learning posted an article in Integrated care systems
To make integrated care a success, someone needs to monitor the gaps between services, and the Care Quality Commission is the best pick for it, writes Jacob Lant in this HSJ opinion piece. It may be an unpopular view, but if we are going to make a success of integrated care, then someone really needs to be watching what happens in the gaps between services. Having already developed an approach for reviewing how local systems work, the CQC is arguably best placed to pick up this function. -
News Article
ICB functions radically reduced in national ‘blueprint’
Patient Safety Learning posted a news article in News
More than a dozen functions have been earmarked for “transfer” out of integrated care boards, including workforce planning, primary care, and digital leadership. Several of them will transfer to emerging “neighbourhood health providers”, according to NHS England’s new “model ICB blueprint”, which is meant to help the boards cut 50% from their overheads. The document also orders integrated care boards to reduce their board-level headcount to focus on ”core model ICB priorities”. The document names 18 functions and activities which ICBs should “transfer [out] over time”, six they should “selectively retain and adapt”, and 11 which should “grow”. NHSE financial reset and accountability director Glen Burley, who has been overseeing the work so far, told HSJ it was a “first step in a joint programme of work to reshape the focus, role, and functions of ICBs”. “We are seeking to reduce the management costs of the NHS so that more money can be spent on the frontline,” he said. “This won’t be achieved by simply moving functions to different organisations – instead ICBs need to be working together to merge functions to cut duplication.” Read full story Source: HSJ, 6 May 2025 -
Content ArticleThis Model ICB Blueprint has been developed by a group of Integrated Care Board (ICB) leaders from across the country, representing all regions and from systems of varying size, demographics, maturity and performance. It is a joint leadership product, developed and written by ICBs in partnership with NHS England. The group has worked together to develop a shared vision of the future with a view to providing clarity on the direction of travel and a consistent understanding of the future role and functions of ICBs. Future of ICB functions (click on image to enlarge): Source: HSJ The document sets out a blueprint for how ICBs can operate within a changing NHS landscape. It covers the following areas: purpose – why ICBs exist core functions – what they do enablers and capabilities – what needs to be in place to ensure success managing transition – supporting ICBs to manage this transition locally and the support and guidance that will be available.
- Posted
- 4 comments
-
- (and 2 more)
-
News Article
Flagship NHSE tech policy creating ‘patient safety risks’, claim analysts
Patient Safety Learning posted a news article in News
Patient safety risks are being created by central demands that NHS organisations adopt the new federated data platform and “close down” existing systems, according to the body representing the service’s analysts. In a letter to NHS England chief data and analytics officer Ming Tang, the Chief Data and Analytical Officers Network (CDAON) has stepped up earlier complaints about the FDP and its rollout, calling for a “reset” of NHSE’s approach. The letter also questions whether the FDP is fit for purpose in achieving the government’s goal of moving care into the community. The £330m seven-year contract to deliver the FDP platform was won by US data company Palantir in 2023. The FDP was originally launched on the basis that it could be used on a voluntary basis. However, under direction of ministers, NHSE has now moved to an “FDP-first policy”, to the alarm of many senior figures working in NHS technology. The letter, seen by HSJ, is signed by CDAON chair and Kent and Medway Integrated Care Board data chief Marc Farr and says: “Anecdotally we are aware of systems being directed to close down existing systems because the functionality is planned within the FDP… “However we are not convinced that the functionality is imminent and therefore that a risk to patient safety exists – we can cite specific examples.” Read full story (paywalled) Source: HSJ, 23 April 2025 -
Community Post
Relational community engagement - webinar
JULES STORR posted a topic in Leadership for patient safety
- (and 3 more)
An interesting webinar will take place on Tuesday 8 April 1-2pm UK time (2pm - 3:30pm CEST): Humanizing health care through relationality: Exploring the science and practice of community engagement. You can register for the webinar here: https://us02web.zoom.us/meeting/register/lXMLhE6MRhiOlrnLKoe8Uw#/registration It’s part of a series being run by WHO and the Global Health Partnerships (GHP) (formerly THET), building on last year’s policy report on this issue launched at the World Innovation Summit for Health (WISH) https://wish.org.qa/wp-content/uploads/2024/09/Relationality-in-Community-Engagement.pdf We seem to have been taking in patient safety circles about the criticality of building a culture of safety for my entire career – but achieving this seems ever elusive. This work jumps out as offering something new. I will be writing a blog for PSL on this in the coming weeks.- Posted
- 4 replies
-
1
-
- (and 3 more)
-
Content ArticlePublished every 4 years to coincide with federal leadership transitions, the National Academy of Medicine’s Vital Directions for Health and Health Care series analyses the top health policy needs for the nation. The 2025 edition, published in Health Affairs, presents an expert overview of six key priorities: transforming health care payment and delivery; integrating AI into health care; modernising public health; addressing the health impacts of climate change; improving women’s health; and advancing the biomedical research enterprise. As leaders inside and outside government navigate complex challenges, the Vital Directions series provides actionable, evidence-based guidance. From Laggard To Leader: Why Health Care In The United States Is Failing, And How To Fix It Artificial Intelligence In Health And Health Care: Priorities For Action Four Opportunities To Revitalize The US Biomedical Research Enterprise Updating US Public Health For Healthier Communities Critical Steps To Address Climate, Health, And Equity New Directions For Women’s Health: Expanding Understanding, Improving Research, Addressing Workforce Limitation
-
News ArticleFailings at a hospital contributed to the death of a 55-year-old woman who suffered abdominal sepsis after weight loss surgery at the time of a junior doctors’ strike, a coroner has said. Susan Evans returned to Queen Alexandra hospital in Portsmouth, Hampshire, with stomach pains two days after undergoing elective gastric bypass surgery. She was sent home without being seen by a member of the specialist bariatric team or a senior doctor, though hospital policy says this should happen, and became seriously unwell. Evans returned to hospital and underwent two further operations but died a month after the original procedure. In a prevention of future deaths report, the coroner Sally Olsen said neither written nor informal policies had been followed and failures “contributed more than minimally” to Evans’s death. Read full story Source: The Guardian, 1 January 2025
-
Content ArticleOn 11 July 2023, Susan Evans underwent elective Roux-en-Y gastric bypass surgery. The surgery went to plan and appropriate measures were taken to avoid the possibility of an anastomotic leak, a rare but recognised complication of gastric bypass surgery. Initially, Ms Evans recovered well, but she experienced abdominal pain in the early hours of 13 July 2023. It is likely that this was due to an anastomotic leak. 13 July 2023 was the first day of a junior doctors’ strike. Unrelated to this, the hospital only had the equivalent of one full time specialist bariatric nurse, who was not on duty. Contrary to Queen Alexandra hospital’s written policy for gastric bypass patients, Ms Evans was not seen by a member of the specialist bariatric team on 13 July 2023 and was not seen by a senior doctor after reporting pain in order to rule out the possibility of an anastomotic leak. The hospital at night nursing team, who administered pain relief, were unaware of the latter requirement. In addition, Ms Evans not seen by a member of the bariatric team or any doctor prior to her discharge from hospital on the morning of 13 July 2023. Ms Evans was still in a degree of pain when she left hospital. She was re-admitted to hospital on 15 July 2023. By this point she was extremely unwell with abdominal sepsis from an anastomotic leak. She underwent remedial surgery on 15 July 2023 and a further operation was required on 25 July 2023. Despite appropriate medical care following her re-admission, her condition deteriorated, and she died at Queen Alexandra Hospital on 12 August 2023. It is likely that, if she had been seen by a member of the bariatric team on 13 July 2023, she would have been kept in hospital and would have been operated upon sooner. The failures identified contributed more than minimally to her death. Matters of concern Queen Alexandra’s written post operative care pathway for patients who have undergone a gastric bypass operation states that: There is to be a daily review by a bariatric specialist nurse, consultant or registrar. A senior doctor is to review within 2 hours if there is increased abdominal pain in order to rule out anastomotic leak or bleed. In addition to this, the inquest heard evidence that patients should be seen by a member of the specialist bariatric team prior to discharge. This is not included in the written policy. Neither the written nor informal policy set out above were followed in Ms Evans’ case. She was not reviewed by a member of the specialist bariatric team at any point on day 2 after surgery and the pain she experienced from the early hours of 13 July 2023 was not escalated to a senior doctor at all. The inquest heard evidence that medical staff who were not part of the specialist bariatric team were unlikely to appreciate the significance of pain. The failure to follow policy contributed more than minimally to Ms Evans death and is therefore a matter of concern.
-
Content ArticleThe Patient Information Forum (PIF TICK) criteria have been updated after consultation with the PIF TICK Steering Group. The update takes in new developments including artificial intelligence and health information translation. This webinar explains the changes in the criteria, the timetable for implementation and how PIF will support members through the change. To support members with the responsible use of AI, a Framework for Policy Creation on the Use of AI in Health Information was also launched at the event. Speakers from PIF and Prostate Cancer Research introduced the new criteria and showcased examples of how AI can be used for good in health information. Related reading: Balancing the risks and benefits of AI in the production of health information
-
Content ArticleRight Care, Right Person (RCRP) is an approach that is aimed at ensuring that people of all ages who have health and/or social care needs, are responded to by the right person, with the right skills, training, and experience to best meet their needs. Home Office and Department of Health and Social Care (DHSC) analysts evaluated the implementation of RCRP through a rapid process evaluation covering police, fire, health and social care services. The findings highlighted the importance of communication, openness and transparency across agencies when implementing RCRP. While generally supportive of RCRP principles, participants highlighted some implementation challenges, such as capacity limitations for health and social care services. Early data monitoring showed a reduction of police time spent on health-related incidents post RCRP implementation. Recommendations to support the implementation of RCRP are included.
-
Content ArticleThe first WISH report on tackling antimicrobial resistance (AMR) was published more than a decade ago. Section 1 of this report reviews progress on recommended actions in the five areas identified by the 2013 report. Section 2 of the report considers opportunities for action in three areas: global citizen engagement, translational science and policy and regulation, illustrated by case studies from around the world. Section 3 of the report takes stock of what has emerged from the United Nations (UN) General Assembly High-Level Meeting on tackling AMR and makes six recommendations. Recommendation 1 International organisations should put into action the 2024 UN AMR high-level meeting recommendation to establish an independent body to advise on the evidence and inform action. This panel will identify gaps in the current evidence on AMR, assess emerging and future risks of AMR, and inform cost-effective options for mitigating AMR, including global targets. Recommendation 2 Countries and international bodies should engage their citizens in tackling AMR, with clear plans to do so by 2028. Recommendation 3 Governments should give more priority to water and sanitation in addressing AMR. This includes increasing investment in water, sanitation and hygiene (WASH) to reduce infections and environmental microbe exposure, and the development of national programs to surveil antibiotic residues, resistance genes and resistant pathogens in the water supply and factory effluent. Recommendation 4 By 2027, high-income countries should commit to only prescribing antibiotics (with a few defined exceptions) when need is confirmed by a diagnostic test. Low- and middle-income countries should achieve this by 2030. Recommendation 5 By 2026, all high-income countries should have introduced pull incentives for the development of new antimicrobials, to deliver on global antibiotic priorities. Recommendation 6 Global health organisations should use the forthcoming centenary of the discovery of penicillin (2028) to accelerate progress on the AMR agenda. We have four years before the centenary of the discovery of penicillin (2028) to accelerate progress on tackling AMR, so that we can keep antibiotics working for the next 100 years.
-
Content ArticleThe considered shift from individual blame and sanctions towards a commitment to system-wide learning from incidents in healthcare has led to increased understanding of both the moral and epistemic importance of involving those affected. It is important to understand whether and how local policy describes and prompts involvement with a view to understanding the policy landscape for serious incident investigations in healthcare. This study aimed to explore the way in which involvement of those affected by serious incidents is represented in incident investigation policy documents across acute and mental health services in the English NHS, and to identify guidance for more effective construction of policy for meaningful involvement. The study found that more effective representation in policy of the moral and epistemic reasons for stakeholder involvement in serious incident investigations may lead to better understanding of its importance, thus increasing potential for organisational learning and reducing the potential for compounded harm. Moreover, understanding how structural elements of policy documents were central to the way in which the document is framed and received is significant for both local and national policy makers to enable more effective construction of healthcare policy documents to prompt meaningful action.
-
Content ArticleNHS England has launched this new policy and supporting assurance framework for integrated care boards and trusts to adopt and adapt, ensuring that any member of staff who has experienced inappropriate and/or harmful sexual behaviours at work is supported by their employer. It will help staff to: understand their rights and responsibilities recognise and report sexual misconduct at work get advice and support. An overview of the policy is also available. Alongside the policy is a new e-learning resource, designed to equip people working and learning in the NHS with the knowledge and skills to recognise and respond to sexual misconduct.
-
Content ArticleThe National Confidential Enquiry into Patient Outcome and Death (NCEPOD) is a UK organisation that investigates the outcomes and deaths of patients in hospitals. In this report NCEPOD summarises common themes that have come out of their reports. Multidisciplinary review Communication with family, parents and carers Consent Monitoring and early warning scores Documentation Transition planning Clinical networks Local policies, protocol, proforma and guidelines Follow-up post discharge
-
Content Article
NHS Resolution: Clinical Negligence Claims Agreement 2024
Patient Safety Learning posted an article in Policies
NHS Resolution has announced the implementation of a new Clinical Negligence Claims Agreement for 2024. This agreement has been developed in collaboration with key stakeholders, including Action against Medical Accidents (AvMA) and the Society of Clinical Injury Lawyers (SCIL). Key features of the new agreement include: Extended limitation periods for certain cases, providing flexibility for claimants and their representatives. Emphasis on early disclosure of relevant documentation to help narrow issues and reduce investigation costs. Improved communication protocols, including ongoing acceptance of electronic correspondence and service of documents. Encouragement of pre-action discussions and dispute resolution to avoid unnecessary litigation. "The agreement encourages apologies where appropriate and reflects that harmed individuals and their families often want to ensure that similar errors are avoided in the future. Defendant organisations are encouraged to provide apologies and identify where lessons have been learned and what steps have been taken to prevent further harm." Sharon Allison, Chair of SCIL (Society of Clinical Injury Lawyers -
EventThis conference brings together leading experts at the forefront of Martha’s Rule implementation and offers a comprehensive and practical guide for clinical staff to seamlessly integrate Martha’s Rule into their daily practice. The conference delves into the caregiver’s perspective, principles and implications of Martha’s Rule, legal and patient safety considerations, effective communication strategies, and the use of technology in the adoption of Martha’s Rule. Throughout the day, there will be interactive sessions, small breakout groups, and collaborative exercises, fostering a dynamic learning experience. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/virtual-online-courses/marthas-rule-patient-safety or email [email protected] hub members receive a 20% discount. Email [email protected] for discount code.
-
Community Post
World Patient Safety Day 2024: many calls to action
JULES STORR posted a topic in Leadership for patient safety
- (and 3 more)
Tuesday 17 September 2024. Another year, another World Patient Safety Day. This years theme “Improving diagnosis for patient safety”. Last years' report by the World Health Organization https://www.who.int/publications/i/item/9789240095458 first introduced the theme and talked about the need for multifaceted interventions rooted in systems thinking, human factors and active engagement of patients, their families, health workers and healthcare leaders. Improving healthcare processes that will result in improvements to diagnosis requires action at every level of the health system and looking at this years' calls to action https://www.who.int/campaigns/world-patient-safety-day/world-patient-safety-day-2024/calls-to-action leadership is both implied and front and centre. Focusing on these calls to action, here is what the campaign suggests individuals/entities across a range of settings can do to help improve patient safety in diagnosis. Patients, families and caregivers are - be informed, involved, and proactive in your diagnosis Be actively engaged in the diagnostic process and with your health care team: share accurate and comprehensive information about your symptoms and medical history; make sure you understand the diagnostic process, your illness’ or symptoms expected progression, and next steps; check your information is up-to-date, and keep track of your symptoms, medical visits, tests and treatments. Share your questions and concerns: don’t be afraid to ask questions; speak up, ask about alternative options or seek a second opinion if you need to; share your experiences and contribute to making diagnosis safer for others. Health workers providing clinical care - make diagnostic excellence integral to your daily practice Keep focussed on the person at the centre of the diagnosis: listen to your patient, ask them about their concerns and tailor the interventions to their needs; take a careful and thorough history and physical examination of your patient; talk openly and empathetically with your patients, and encourage them to ask questions. Leverage available technology, tools, and tests to reach a diagnosis. Be a good team player and contribute to a safe and collaborative professional environment, where information is shared in a timely manner. Keep learning: participate in regular training and seek feedback from your peers and patients; contribute a culture of continuous improvement by sharing best practices, and information about errors and near misses with peers. Healthcare facility leaders and managers - implement safer systems to improve diagnosis, support your clinical teams and empower patients Empower the health workforce through policy, culture and practice: ensure adequate staffing, resources and regular capacity development; make sure quality and well-maintained tests and technologies are available; implement and monitor the use of diagnostic safety guidelines, protocols and practices to ensure errors are minimised; promote a culture of continuous learning and safety, and take action to address problem areas; establish a conducive, collaborative and safe work environment free from distractions. Continually seek feedback from patients and their families and reserve space for advocates on advisory bodies. Celebrate diagnostic excellence within your teams. Policy-makers and programme managers - champion diagnostic excellence in health policy Prioritise patient safety in policy, legislation and regulation: ensure that appropriate guidelines and protocols to support diagnostic processes exist at a national level and are implemented; provide the necessary budget, staff, training and access to tools and technologies for national health systems. Establish national collaboration mechanisms to sustainably engage stakeholders. Promote accountability through monitoring and evaluation mechanisms, and ensure health leadership prioritize transparency. Set up national knowledge-sharing systems and encourage continuous learning. Invest in research into diagnostic errors, patient harm and the development of diagnostic tools and technologies. Patient organizations and civil society - advocate for quality and safe diagnosis Champion diagnostic safety in health policy and practice: work with patients, policy-makers and health care leaders to build health systems that deliver correct and timely diagnosis; facilitate patient advocacy and support their role in promoting and improving diagnostic safety; work with policy-makers, academics, health care leaders, health workers and patients to help identify areas for improvement. Contribute to the development of educational and training resources for health workers and patients. Diagnostics and medical devices’ regulators, manufacturers, innovators and managers - innovate for smart solutions and diagnostic excellence Drive research and development for diagnostic tools and technologies. Ensure diagnostic solutions meet the highest standards of safety, quality, and reliability. Create user-friendly products and instructions and provide regular training for health workers and patients. Collaborate with patients, health workers and health care leaders to build products tailored to the needs of end-users. I'm a strong believer in the power of campaigns. They act as a tool to raise awareness on important matters and trigger action that will result in change and improvement and there is evidence that they can have an impact on patient outcome. Before the end of 2024 there will be many more awareness days and weeks all of which will use campaigning to get their messages across in the noisy world of health care. It will be interesting to see the evaluation of WPSD 2024. More on this in due course. -
Community Post
Better use of data for medication safety in hospitals
Kenny Fraser posted a topic in Medicine management
- (and 46 more)
NHS hospital staff spend countless hours capturing data in electronic prescribing and medicines administration systems. Yet that data remains difficult to access and use to support patient care. This is a tremendous opportunity to improve patient safety, drive efficiencies and save time for frontline staff. I have just published a post about this challenge and Triscribe's solution. I would love to hear any comments or feedback on the topic... How could we use this information better? What are hospitals already doing? Where are the gaps? Thanks- Posted
- 2 replies
-
1
-
- (and 46 more)
-
Content ArticleRebecca Bauers, Interim Director for People with a Learning Disability and Autistic People, and Chris Dzikiti, Director for Mental Health, talk about CQC’s new cross-sector policy position statement on restrictive practice, what it means for providers, and what people receiving healthcare services have the right to expect. As well as sharing the new policy, they discuss what forms restrictive practices can take, and explain how the use of blanket restrictions diminishes the therapeutic power of person-centred, trauma-informed care.
-
Content ArticleThis procedure describes the Trust wide process of retrospective case review that is to be implemented following an in-hospital death. The document outlines roles and responsibilities and provides guidance on the process of identifying, reviewing, sharing and escalating mortality case reviews.
-
Content ArticleThis policy sets out a framework describing how the Trust and its staff will respond to and learn from deaths that occur under their care.It will provide guidance for all staff involved in the mortality review process ensuring clarity on roles, responsibilities and expectations. Reviewing mortality can help make improvements to the quality of care received by patients at the Trust by identifying care related issues. This enables the identification of learning themes and provides evidence of a high standard of care. Mortality is a fundamental component of clinical effectiveness, one of the three dimensions of quality described by Lord Darzi in High Quality Care for all (2008). The Trusts aims are to: Have continuous improvement of our Hospital Standardised Mortality Ratios (HSMR) and the Trusts Standardised Hospital-Level Mortality Index (SHMI) Achieve a year-on-year reduction in avoidable mortality Improve learning from mortality reviews Ensure robust and timely governance processes regarding mortality outcomes and reviews Provide assurance of mortality processes in the Trust.
-
Content Article9.1 million people will be living with major illness by 2040, 2.5 million more than in 2019, according to this new report published by the Health Foundation. The analysis is part of a four-year project led by the Health Foundation’s Real Centre in partnership with the University of Liverpool, focusing on levels of ill health in the adult population in England up to 2040. It lays out the scale and impact of the growth in the number of people living with major illness as the population ages. The analysis finds that 19 of the 20 health conditions studied are projected to increase in prevalence, including a rise of more than 30% in the number of people living with conditions such as cancer, diabetes and kidney disease. Overall, the number of people living with major disease is set to increase from almost 1 in 6 of the adult population in 2019, to nearly 1 in 5 by 2040, with significant implications for the NHS, other public services and the public finances. The challenges of improving care for an ageing population and enabling people to live independent lives for longer are not unique to England, with countries across the globe facing similar pressures on their health services. However, with the NHS already under unprecedented strain, the findings point to big changes in how care should be delivered in future. Much of the projected growth in illness relates to conditions such as anxiety and depression, chronic pain and diabetes, which are predominantly managed outside hospitals in primary care and the community. This reinforces the need for investment in general practice and community-based services, focusing on prevention and early intervention to reduce the impact of illness and improve the quality of people’s lives. The analysis finds that 80% of the projected increase in major illness (2 million people) will be among people aged 70 and over, with the remaining 20% (500,000 people) among the working-age population (20-69 years old). It also projects that improvements in some of the main causes of poor health, such as fewer people smoking and lower cholesterol rates, will be offset by the impact of obesity as many people who have been obese for long periods of their lives reach old age. The report warns that there is no silver bullet to reduce the growth in people living with major illness and that supporting people to live well with illness will increasingly be an essential function of health care and other services in the future. Its findings underline the need for a long-term plan to reform, modernise and invest in the NHS alongside a bold, new approach that invests in the nation’s health and wellbeing.
-
Content ArticleThe International Alliance of Patients’ Organizations (IAPO) is an alliance of patient groups in official relationship with the WHO and is representing the interests of patients worldwide IAPO P4PS Observatory is a single-point global platform for gathering and analysing patients’ expertise and experience to feed evidence to the national, regional and global policies aimed at improving patient and quality of care for patients by the patients.
-
Content ArticleThis improvement plan sets out targeted actions to address the prejudice and discrimination – direct and indirect – that exists through behaviour, policies, practices and cultures against certain groups and individuals across the NHS workforce. It has been co-produced through engagement with staff networks and senior leaders.
