Search the hub
Showing results for tags 'Redeployment'.
-
Content Article
Changes in the way staff work, including staff taking on new roles and responsibilities, is a well-known policy solution in the NHS, and there are some really good instances where skill mix works well and has real benefits. But are there downsides to the drive to employ new types of staff to help doctors and nurses? What are the implications for continuity of care, staff experience and outcomes? Is the idea of ‘top of the licence’ working a reason for concern in terms of burnout, the fragmentation of care or is it an unavoidable response to the workforce crisis? Chair: Nigel Edwards, Chief Executive, Nuffield Trust Prof Alison Leary, Chair of Healthcare and Workforce Modelling, London South Bank University Dr Louella Vaughan, Senior Clinical Fellow, Nuffield Trust- Posted
-
- Workforce management
- Recruitment
- (and 10 more)
-
News Article
NHS organisations have been told to prepare for redeploying or dismissing thousands of unvaccinated staff without an exit payment, and to raise the alarm about services which may be rendered unsafe. NHS England today issued guidance on ‘phase two’ of the government’s “vaccination as a condition of deployment”, which requires all patient-facing staff to have had two covid vaccinations by 1 April. Tens of thousands of staff are believed to still be unvaccinated, and the cut off for having a first dose is 3 February. The guidance said efforts should be made to adjust roles or redeploy staff, but added: “From 4 February 2022, staff who remain unvaccinated (excluding those who are exempt) should be invited to a formal meeting chaired by an appropriate manager, in which they are notified that a potential outcome of the meeting may be dismissal.” It continued: “Whilst organisations are encouraged to explore deployment, the general principles which apply in a redundancy exercise are not applicable here, and it is important that managers are aware of this.” Employers will “not be concerned with finding ‘suitable alternative employment’ and there will be no redundancy entitlements, including payments, whether statutory or contractual, triggered by this process”. Trusts also do not have to “collectively consult” with staff being dismissed — as they would with a restructure — although this is “ultimately a decision for each organisation to take”. Read full story (paywalled) Source: HSJ, 14 January 2022 -
News Article
‘Low priority’ community cases to be deferred as staff redeployed
Patient Safety Learning posted a news article in News
NHS England has told local systems to defer ‘low priority’ cases across 11 community services, because of the pressures created by the omicron wave. NHSE has issued guidance for the prioritisation of the community health workforce “given the increasing pressures on the health system due to the omicron wave of COVID-19 this winter and the need to provide booster jabs as quickly as possible”. It is hoped the guidance will encourage the redeployment of community staff to help reduce the strain on acute services. Staff working in musculoskeletal services are being asked to deprioritise some low priority rehabilitation work, with patients enabled to self-manage at home. It adds: “Where possible, provide capacity to support other community resources focused on rehabilitation and recovery for those discharged from acute care and those whose functioning is deteriorating at home, and/or the administration of vaccines.” A host of other services have been advised to continue, but with “prioritised” waiting lists and a deferral of provision considered for “low priority cases” to “free up workforce capacity”, including children’s therapy interventions, children’s community paediatric services and audiology services for older adults. Read full story (paywalled) Source: HSJ, 11 January 2022- Posted
-
- Community care
- Redeployment
- (and 4 more)
-
News Article
Occupational health professionals should avoid employment and management matters related to unvaccinated NHS staff, new guidance has warned. The Faculty of Occupational Medicine guidance comes as trusts are considering their options of how to approach patient-facing staff who remain unvaccinated, including their potential redeployment or dismissal. However, HSJ understands some occupational health practitioners are concerned they may become entangled in difficult ethical issues, such as the vaccination status of individual employees, or disciplinary processes. Today’s FOM guidance said: “There is no scope for occupational health practitioners to provide an opinion on medical exemptions, whether to confirm or refute them… “Redeployment, dismissal and other employment consequences of vaccine refusal by a worker, within the scope of the proposed regulations, are entirely employment and management matters, and not an area in which occupational health should be involved.” FOM president Steve Nimmo said: “When the programme is implemented, occupational health professionals should be mindful of ethical and consent issues, and be careful not to be associated with any disciplinary process.” Read full story (paywalled) Source: HSJ, 7 January 2022- Posted
-
- Occupational medicine
- Staff factors
- (and 6 more)
-
News Article
NHS to begin move to dismiss staff who refuse covid vaccine or redeployment
Patient Safety Learning posted a news article in News
Trusts will be told next week how they should go about dismissing potentially thousands of NHS staff who have decided not to be vaccinated against covid, HSJ has learned. Last year, the government decided all patient-facing NHS staff would need to have received their first dose of the covid vaccine by 3 February, and two doses by April 2022. The stipulation covers non-clinical staff who may have face-to-face contact with patients, such as receptionists, porters and cleaners. NHS England published the first part of its guidance for employers in December last year, which warned staff who have to be redeployed because of a refusal to have the covid vaccination could be forced to compete for their job and also have their pay and pension affected. HSJ understands NHSE will issue its ‘phase two’ guidance’ next week. To date, government and NHSE announcements or guidance have not mentioned what will happen to patient-facing staff who refuse to be redeployed or are exempt from the requirement. However, HSJ understands the new guidance will make it clear that — while redeployment remains the preferred outcome — some staff are likely to be dismissed and trusts should be prepared for taking that action next month. Read full story Source: HSJ, 6 January 2022 -
Content Article
By the end of the course, you‘ll be able to: Apply the current and evolving principles of personal protective equipment (PPE) in the care of COVID-19 patients. Apply evidence-based principles of advanced organ support and monitoring to the COVID-19 critically ill patient. Apply evidence-based daily practices to care of the critically ill patient. Develop a range of specialised self-caring practices Reflect critically on the complex elements required to achieve both self-awareness and self-compassion in a high-tension environment.- Posted
-
- ICU/ ITU/ HDU
- Redeployment
-
(and 1 more)
Tagged with:
-
Content Article
-
Content Article
Professional boundaries are hampering the care of covid patients
Patient Safety Learning posted an article in Blogs
-
Content Article
When and how should we transition safely into ‘normal work’ in healthcare?
Claire Cox posted an article in Blogs
It's been a busy few months to say the least. Preparing for the pandemic, sourcing correct personal protective equipment (PPE), redeploying staff, acquiring new staff, making ventilators, redesigning how we work around the constraints, writing new policies, new guidance, surge plans, and then the complex part… caring for patients. If I am honest, when this all started it felt exciting. Adrenaline was high, motivation was high, we felt somewhat ready. There was a sense of real comradeship. It felt like we were all working for one purpose; to safely care for any patient that presented to us in hospital. We were a little behind London by about 2–3 weeks, so we could watch from afar on how they were coping, what they were seeing and adapting our plans as they changed theirs. Communication through the ITU networks was crucial. Clinical work has been difficult at times. The initial confusion on what the right PPE to wear for each area added to the stress of hearing that our colleagues in other places were dying through lack of PPE. The early days for me were emotionally draining. However, this new way of dressing and level of precaution is now a way of life for us. I have come to terms that I am working in a high-risk area and I may become unwell, but following guidance and being fastidious with donning and doffing helps with ‘controlling’ my anxieties in catching the virus. Some parts of the hospital remained quiet. Staff had been redeployed, elective surgery cancelled and the flow of patients in the emergency department (ED) almost stopped. I remember walking through ED and thinking: where are the people who have had strokes? Have people stopped having heart attacks? Are perforated bowels not happening anymore? The corridor in ED is usually full. Ambulances queuing up outside, but for a good few weeks the ambulance bays were deserted. The news says over and over again "we must not overwhelm the NHS". I always have a chuckle to myself as the NHS has been overwhelmed for years, and each year it gets more overwhelmed but little is done to prevent winter surges, although it's not just winter. The surge is like a huge tidal wave that we almost meet the crest of, but never get there, and emerge out the other side. I sit in the early morning ITU meeting. We discuss any problems overnight, clinical issues, staffing and beds. We have seen a steady decline in the number of ITU patients with COVID over the last week or so. The number of beds free for COVID patients were plentiful. We have enough ventilators and staff for them. This is encouraging news. I take a sigh, thinking we may have overcome the peak. In the next breath, the consultant states that we don’t have any non COVID ITU beds. We have already spread over four different areas and are utilising over 50 staff to man these beds (usually we have 25 staff). So that’s where the perforated bowels, heart attacks and strokes are. The patients we are caring for had stayed at home too long. So long, that they now have poorer outcomes and complications from their initial complaint. These patients are sick. Some of the nurses who are looking after them are redeployed from other areas; these nurses have ITU experience, but have moved to other roles within the hospital. This wasn’t what they had signed up for. They were signed up for the surge of COVID positive patients. I’m not sure how they feel about this. As the hospital is ‘quiet’ and surgical beds are left empty, there is a mention of starting some elective surgery. This would be great. It would improve patient outcomes, patients wouldn’t have to wait too long, so long that they might die as a consequence. However, we don’t have the capacity. We have no high dependency/ITU beds or nurses to recover them. We would also have to give back the nurses and the doctors we have borrowed from the surgical wards and outpatients to staff ‘work as normal’, depleting our staff numbers further. Add to the fact that lockdown has been lifted ever so slightly, the public are confused, I’m confused. With confusion will come complacency, with complacency will come transmission of the virus and we will end up with a second peak. If we end up with a second peak on top of an already stretched ITU and reduced staffing due to the secondary impact on non COVID care, the NHS will be overwhelmed. This time we will topple off that tidal wave. It’s a viscious cycle that I’m not sure how we can reverse. My plea, however, is to ensure we transition out of this weird world we have found ourselves in together. We usually look for guidance from NHS England/Improvement, but no one knows how best to do this. The people who will figure this out is you. If your Trust is doing something that is working to get out of this difficult situation, please tell others. We are all riding the same storm but in different boats. I would say that I am looking forward to ‘business as usual’ – but I can’t bare that expression. Now would be a great time to redesign our services to meet demand, to involve patients and families in the redesign – to suit their needs. We have closer relationships now with community care, social care and primary care, we have an engaged public all wanting to play their part. Surely now is the time we can plan for what the future could look like together? The Government has announced that Ministers are to set up a ‘dedicated team’ to aid NHS recovery. We need to ensure that patient and staff safety is a core purpose of that team’s remit and the redesign of health and social care. Would you be interested in being on our panel for our next Patient Safety Learning webinar on transitioning into the new normal? If so, please leave a comment below.- Posted
- 1 comment
-
1
-
- Virus
- Secondary impact
- (and 6 more)
-
Content Article
This web page sets out the AHSN's response to Coronavirus including their programmes; Industry and Innovation Medicines Optimisation Primary Care Innovations Patient Safety Collaborative Healthy Ageing National Programmes.- Posted
-
- Redeployment
- Virus
-
(and 1 more)
Tagged with:
-
Content Article
COVID-19 FAQs: Royal College of Nursing
Claire Cox posted an article in Good practice and useful resources
- Posted
-
- Redeployment
- PPE (personal Protective Equipment)
- (and 2 more)
-
Content Article
Human factors and the ad hoc team during the pandemic
Claire Cox posted an article in Blogs
What is an ad hoc team? An ‘ad hoc’ team is a team that is made up of various healthcare workers that have never met before. An example of this is the medical emergency team or the cardiac arrest team – doctors, anaesthetists, nurses and other allied health professionals scrambled from around the hospital expected to assess and treat a patient in crisis. Often, we don’t know each other’s names, roles or what skills we each have. What we did in Brighton is to get to know each other… We had a MET meeting every morning. We all got together and introduced ourselves, found out what skills we all had and made full use of any learning opportunities that arose. The ad hoc team worked well. We all knew what to expect, even when a complex situation arose – we all knew who to contact and how we could get the best for our patient. Then in comes a pandemic... Staff have been redeployed; rotas have been changed; the usual rhythm of the hospital has disappeared. Our regular meeting doesn’t happen. This causes problems: Who is who? What skills do people have? Has everyone been fit tested? Where do we get the PPE from during a MET call? How do we communicate to each other? What is the guidance to take blood, do an ECG, defibrillate, order an X-ray during the pandemic? All these questions and anxieties could be discussed at this meeting, but due to a change in working patterns, the change in doctors seeing different patients (Green and Red – COVID + or COVID –), its not possible to meet up. Our technical skills are not a problem – the team have great skills in advanced life support, using life saving equipment. What we are finding difficult is the non-technical skills: communicating, tone of voice, body language. It was hard enough to communicate in a high stress situation before all this pandemic… now its even harder and so much more important! Simulation Simulation has been a large part of how we train in low volume, high risk scenarios in hospital. Cardiac arrests, medical emergencies, emergency intubation, transfer, pacing… you name it we have probably simulated it here at Brighton. I have been on the medical emergency team for 9 years now. I like to think I have experience in most emergencies and know what to do and who to call. All of a sudden, I feel a novice. I don’t even know how to go into the room correctly, I don’t know what I should take in to the room, I don’t know what I should wear; every action, every protocol I would normally do can't happen due to current constraints. I am worrying so much that I feel paralysed to do anything for fear I’m doing it wrong. We have simulations every day at 3 pm at our hospital. These simulations are very low fidelity and include how a medical emergency or cardiac arrest in the COVID-19 patient should run. Simulation can never replace what a real-life scenario will feel like. What simulation can do is allow you to understand what needs to happen, in what order and lets you make mistakes in order for you to learn. Most adults learn from ‘doing’ and from experiences – I am so glad we had this simulation as I was about to attend my first MET call a few days later. My experience attending an airway medical emergency The call went out. "Medical emergency XXX ward – COVID positive". Shortly followed by "Anaesthetic emergency XXX ward- COVID positive". I ran faster knowing that as a team we all had to get there and put full PPE on before we could attend to the patient. If the patient has an airway problem, they will not be able to breathe properly and be at high risk of stopping breathing. I remembered at the simulation exercise that one person needs to be the ‘gate keeper’. I decided to take on this role as I wasn’t sure who had attended the simulation before and knew about this role. My role as gate keeper is to make a note of who is in the room, what role they have and to take messages in and out of the room from the doorway. The notes are not able to be taken into the room, so it would be the gate keeper's role to get the information across to the team inside. I was opening and closing the door and trying to hear muffled voices; I was equally trying to convey important medical information, but they couldn’t hear me well enough. It didn’t help that for many of the team English is not their first language; this made it even more difficult. Our anaesthetic team simulate situations on a regular basis as part of normal work. They turned up at the call already kitted up in PPE and wheeling a trolley with everything they needed on it; all their drugs and equipment were there. One of them – the lead anaesthetist – had a headset on which was connected to a walkie talkie. This made conversing with the team so much easier. We could ask questions from outside the room into the room and vice versa without having to open the door. Clearly, they had rehearsed this scenario before – they too couldn’t hear well so had solved the problem by obtaining walkie talkie devices. They asked for equipment, called for X-ray or asked for more information and I could either relay information, pass equipment or order tests for them – so much easier and safer. The patient had a complex airway and needed to be seen by a specialist. A consultant arrived; one I had not met before. He arrived anxious. He was worried about donning the PPE in the correct order and in swift time. I helped him donn and, while I did that, I reassured him on who was in the room, what had happened and what treatment the patient had had. He entered the room knowing he had the right gear on and what he was facing. This enabled him to think clearly and treat the patient. When it was time to transfer the patient to intensive care, we came across a problem. We had two differing protocols. One was from yesterday, the other was rewritten this morning… which was correct? This was quickly cleared up by calling the author of the protocol, but what would happen at 3 am if this was to happen again? Reflections It was my first time as gate keeper. To be honest, I didn’t know what I should be doing… some of the information from the simulation flew from my mind. Looking back, I should have asked for the name and role of who walked into the room and wrote it on their PPE or used stickers. People were in such a rush to get in and save the patient's life that it didn’t feel like a priority at the time. The walkie talkies were a genius idea from the anaesthetists – this is something that I will take back and see if we can implement the same for all MET calls (anaesthetists do not attend MET calls normally). It reduced the opening and closing of the door, which reduced the amount of aerosoled particles to come out from the room that may increase risk of infection to others. Flattened hierarchy – the moment I had with the consultant outside that room was something I hadn’t experienced before. I noticed his vulnerability, he looked for me – a nurse – for reassurance and guidance which was given with no judgement. At that moment we knew we were one team. Protocols keep changing. We are working where national guidance and local policy changes daily. Without robust ways of disseminating this information we run the risk of doing the wrong thing. As clinicians we are not at our desks monitoring for changes in guidance – we need ways of getting this information to us. We use the ‘workplace’ app – we have a ‘microguide’ for all our up to date policies. This is great to use in normal circumstances but when dressed in PPE we are not always able to access our mobile phones. I wasn’t inside the room. I could see the patient. I could see that he was scared. He couldn’t breathe, he was unable to talk anyway due to his altered airway. How were the team communicating with him? How was he being reassured? Our facial expressions say a thousand words – behind a mask the patient sees nothing. I have heard of the CARDMEDIC flash cards, but can we use them in an emergency? Perhaps we could add them on to the cardiac arrest trolley? The patient is doing well on intensive care now. It would have been ideal for us to debrief; however, half the team go with the patient the other half of the team need to get back to other sick patients, so this can't happen. So much learning comes from these calls; we haven’t got this bit right yet.- Posted
- 5 comments
-
9
-
- Team culture
- Teamwork
- (and 6 more)
-
News Article
NHS staff will be given “COVID-19 passports” to help hospitals redeploy workers during a feared second wave of infection. Bosses at NHS England say the digital passports, which are stored on workers’ phones, have been successful in pilots across the country and are being rolled out “to support the COVID-19 response”. The COVID-19 crisis has triggered a major reorganisation of NHS care, with hospitals now having to plan to restart routine services while at the same time maintain their readiness for any increase in coronavirus cases. The passports will help redeploy staff quickly to where they are needed most. Read full story Source: The Independent, 12 August 2020 -
News Article
Nurse shortage causes Nightingale hospital to turn away patients
Patient Safety Learning posted a news article in News
Dozens of patients with Covid-19 have been turned away from the NHS Nightingale hospital in London because it has too few nurses to treat them, the Guardian can reveal. The hospital has been unable to admit about 50 people with the disease and needing “life or death” care since its first patient arrived at the site, in the ExCeL exhibition centre, in London’s Docklands, on 7 April. Thirty of these people were rejected because of a lack of staff. The planned transfer of more than 30 patients from established London hospitals to the Nightingale was “cancelled due to staffing issues”, according to NHS documents seen by the Guardian. The revelation raises questions about the role and future of the hospital, which up until Monday had only treated 41 patients, despite being designed to include almost 4,000 beds. One member of staff said: “There are plenty of people working here, including plenty of doctors. But there aren’t enough critical care nurses. They’re already working in other hospitals and being run ragged there. There aren’t spare people [specialist nurses] around to do this. That’s the problem. That leads to patients having to be rejected, because there aren’t enough critical care nurses.” Read full story Source: The Guardian. 21 April 2020- Posted
-
- Virus
- Redeployment
-
(and 2 more)
Tagged with: