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Coronavirus: Unprecedented demand for action on NHS workforce shortages
Patient Safety Learning posted a news article in News
The NHS will be unable to meet the needs of patients unless significant action is taken to tackle staff shortages, an unprecedented coalition of health leaders has warned. Medical royal colleges, NHS trade unions and bodies representing senior hospital managers and other health organisations have joined together to warn bosses at NHS England and the government that they must act to ensure the health service workforce is supported in the wake of coronavirus. The organisations said they were united in the belief that meaningful action on long-standing workforce issues would be the best way to repay the efforts of NHS staff during the virus outbreak – calling for a public commitment to boost numbers, increase flexible working, and improve leadership and support for staff. Professor Carrie MacEwen, chair of the Academy of Medical Royal Colleges, which organised the statement, told The Independent: “Continued staff shortages in the NHS will be hugely damaging for patients. It has long been recognised that there is a serious shortage of doctors and nurses and right now we need to keep the staff we have, who have done a brilliant job during the pandemic, as well as increase the size of the workforce." Read full story Source: The Independent, 7 July 2020 -
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Hospital’s critical care unit overwhelmed by coronavirus patients
Patient Safety Learning posted a news article in News
A major London hospital has declared a “critical incident” due to a surge in patients with coronavirus, with one senior director in the capital calling the development “petrifying”. In a message to staff, Northwick Park Hospital in Harrow said it has no critical care capacity left and has contacted neighbouring hospitals about transferring patients who need critical care to other sites. The message, sent last night and seen by HSJ, said: “I am writing to let you know that we have this evening declared a ‘critical incident’ in relation to our critical care capacity at Northwick Park Hospital. This is due to an increasing number of patients with Covid-19. “This means that we currently do not have enough space for patients requiring critical care. “As part of our system resilience plans, we have contacted our partners in the North West London sector this evening to assist with the safe transfer of patients off of the Northwick Park site” Read full story (paywalled) Source: HSJ, 20 March 2020 -
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Stop moaning and get a grip, doctors told by their leader
Patient Safety Learning posted a news article in News
Doctors need to stop moaning and take responsibility for improving the NHS, the leader of Britain’s medics has said. Ministers have given the NHS a “substantial sum” of money and doctors must now stop blaming the government for all its problems, Carrie MacEwen, Chairwoman of the Academy of Medical Royal Colleges, told The Times. Britain’s 220,000 doctors have a professional duty to make the health service’s ten-year plan work and can no longer “sit on their hands”, Professor MacEwen said. After years in which the loudest medical voices have tended to complain about government funding and staffing levels, she said that doctors should take advantage of a “golden opportunity”. Read full story (paywalled) Source: The Times, 25 February 2020 -
Content ArticleThe WHO Flagship Initiative “A Decade of Patient Safety 2020-2030” will: Respond to global movement and latest developments in the area of patient safety. Give due prominence to the concept “First do not harm” and patient safety area of work. Call for political commitment and immediate action at country level. Leverage resources (internal and external/financial and human). Ensure institutional mechanisms within the organisation for coordinated work across departments/divisions, especially with disease-specific programmes.
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Nurse Staffing Levels (Wales) Act 2016
Patient Safety Learning posted an article in Safe staffing levels
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News Article
Woman with anorexia 'faced delays' before death
Patient Safety Learning posted a news article in News
A woman described as a "high risk" anorexia patient faced delays in treatment after moving to university, an inquest has heard. Madeline Wallace, 18, from Cambridgeshire, was told there could be a six-week delay in her seeing a specialist after moving to Edinburgh. The student "struggled" while at university and a coroner said there appeared to be a "gap" in her care. Ms Wallace died on 9 January 2018 due to complications from sepsis. A parliamentary health service ombudsman report into her death was being written at the time of Ms Wallace's treatment in 2017 and issues raised included moving from one provider to another and higher education. Coroner Sean Horstead said Ms Wallace only had one dietician meeting in three months, despite meal preparation and planning being an area of anxiety she had raised. Dr Hazel said she had tried to make arrangements with the Cullen Centre in Edinburgh in April 2017 but had been told to call back in August. The Cullen Centre said it could only accept her as a patient after she registered with a GP and that an appointment could take up to six weeks from that point. Read full story Source: BBC News, 10 February 2020 -
News Article
Nearly 35,000 patients overdue follow-ups at single trust
Patient Safety Learning posted a news article in News
Nearly 35,000 patients are overdue a follow-up appointment at North Lincolnshire and Goole Foundation Trust, HSJ has learned. Almost 20% of the 34,938 follow-up appointments are in ophthalmology. A paper from the trust’s November board meeting said the “backlog of follow-up appointments… clearly remains a risk”. The report also said the service was failing some of the quality guidelines set out by the National Institute for Health and Care Excellence (NICE). The trust told HSJ it had introduced a clinical harm review process last year to address the backlog. It has reviewed “more than 5,000 patients”, out of the 34,938 cases to date, according to Chief Operating Officer Shaun Stacey. He said the trust had initially identified 83 patients who could have come to “potential harm”. Read full story Source: HSJ, 28 January 2020 -
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NHS England asked ‘inadequate’ hospital to admit patient despite ban
Patient Safety Learning posted a news article in News
NHS England asked an “inadequate” hospital for people with learning disabilities and autism to admit a patient, despite the service having a “voluntary” ban on admissions in place — and shortly before inspectors decided to impose a legal restriction. The provider said it was an “exceptional case”, where the individual “had several failed placements”, and had stayed at the hospital — Jeesal Cawston Park in Norfolk — “in the past”. However, it appears to highlight the shortage of good quality accommodation and placements available and pressure on commissioners to make use of “inadequate” facilities. Read full story (paywalled) Source: HSJ, 21 January 2020 -
Content ArticleCase study examples The following case studies show how trusts have been using the tool. Roles and responsibilities of staff have been reviewed and new workforce plans have been co-designed with staff at the frontline to deliver new ways of working that put the patient at the centre of care – whatever the setting. The Hillingdon Hospitals - Safety Supervision and Savings.pdfThe Hillingdon Hospitals - Ward Reconfiguration for Safety.pdf GIG Cymru NHS Wales - Residential Nursing homes Case Study.pdfChelsea and Westminister Hospital Case Study - Empowering Staff.pdf GIG Cymru NHS Wales - District Nursing Principles Case Study (1).pdfBerkshire Health Community Nursing Case Study.pdf Organisational benefits Integrated care levels, costs and common language enables clinical and corporate leads to collaborate and meet the requirements of a next-generation health and social care workforce: Precise staffing profiles and options appraisal support CIP development and budgeting. Gap analysis compared to budget and standards for exact hours and WTE requirement for each band. Uplift for leave is specific to each role and expected joiners, avoiding blanket uplifts that may not fit the needs of the unit. Governance and control underpinned by agreed, costed roster templates, with ready reckoners to keep within range. Improved recruitment and retention with evidence of staffing levels and support. Outcomes track quality, with benchmarking to assure. Clinical benefits Professional judgement in workforce planning is supported by this NICE-endorsed tool: Planning care levels and WTE for expansion, efficiency, reconfiguration and new service models. Evaluating alternative shift models to reorganise, invest or save. Modelling skill-mix and impact of new roles. Understanding and validating variation. Challenging peaks and troughs in cover to improve safety, release capacity and release cost savings. Benchmarking and triangulation of patient care levels, with outcomes for correlation. Mapping other staff group input across each setting. Background on 'Establishment Genie' Creative Lighthouse was founded in response to frustration at the focus on financially led decisions in health and social care management that did not consider the safety and care of patients or staff. We set out to build a platform that would allow all management groups in the healthcare sector to collaborate on safe staffing and financial governance. Creative Lighthouse self-funded the development of a unique workforce-planning tool under the brand name ’Establishment Genie’, endorsed by the National Institute of Health and Care Excellence (NICE) in 2017. In April 2017, the Creative Lighthouse team were awarded a grant from Innovate UK to continue to develop the tool to include all settings of care in the knowledge that patient safety and workforce planning is not only the responsibility of acute services, but of all providers and commissioners of care. This is a critical aspect of enabling the improvement of quality and patient outcomes in a cost effective way, whilst providing data driven analytics to support professional judgment. About the author I am a healthcare professional with over 15 years’ experience working in and consulting to public and private health and social care organisations. I have worked with a variety of health and care sector clients in the delivery of complex change, from transformational change and organisational design process to programme leadership and execution. I am passionate about the safe staffing agenda, recognising that in order for any organisation to ensure appropriate care and evidence for professional judgement, there must be consistency in approach and a way of linking staffing levels to quality outcomes that can then be benchmarked within and across organisations. This passion resulted in the birth of ‘Establishment Genie’.
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News Article
Safety fears as hospitals redeploy nurses to care for patients in corridors
Patient Safety Learning posted a news article in News
Hospitals are having to redeploy nurses from wards to look after queues of patients in corridors, in a growing trend that has raised concerns about patient safety. Many hospitals have become so overcrowded that they are being forced to tell nurses to spend part of their shift working as “corridor nurses” to look after patients who are waiting for a bed. The disclosure of the rise in corridor nurses comes days after the NHS in England posted its worst-ever performance figures against the four-hour target for A&E care. They showed that last month almost 100,000 patients waited at least four hours and sometimes up to 12 or more on a trolley while hospital staff found them a bed on the ward appropriate for their condition. “Corridor nursing is happening across the NHS in England and certainly in scores of hospitals. It’s very worrying to see this,” said Dave Smith, the Chair of the Royal College of Nursing’s Emergency Care Association, which represents nurses in A&E units across the UK. "Having to provide care to patients in corridors and on trolleys in overcrowded emergency departments is not just undignified for patients, it’s also often unsafe.” A nurse in south-west England told the Guardian newspaper how nurses feared the redeployments were leaving specialist wards too short of staff, and patients without pain relief and other medication. Some wards were “dangerously understaffed” as a result, she claimed. She said: “Many nurses, including myself, dread going into work in case we’re pulled from our own patients to then care for a number of people in the queue, which is clearly unsafe. We’re being asked to choose between the safety of our patients on the wards and those in the queue." Read full story Source: The Guardian, 12 January 2020 -
News Article
Health strike: RCN nurses in second day's strike
Patient Safety Learning posted a news article in News
About 9,000 nurses across Northern Ireland have begun a 12-hour strike today in a second wave of protests over pay and staffing levels. More than 2,000 appointments and procedures have been cancelled, including a number of elective caesarean operations. The Health and Social Care Board said it expects "significant disruption" Royal College of Nursing (RCN) Director Pat Cullen told BBC Radio Ulster's Good Morning Ulster programme that nurses felt "bullied" by health officials. Her comments followed a warning by the heads of Northern Ireland's health trusts on Tuesday that this week's strikes could push the system "beyond tipping point". Valerie Thompson, a deputy ward sister at Londonderry's Altnagelvin Hospital, said concerns over safe staffing levels and pay parity had brought her to the picket line. "We need to have the proper amount of staff to care for our patients, give them the respects, dignity, care they deserve," she said. "We are a loyal workforce; we get on with it, and rally around. But it is difficult. We miss breaks, go home late, staff are just exhausted." Read full story Source: BBC new, 8 January 2020 -
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Doctors told to use 'least unsafe' option in Norwich hospital
Patient Safety Learning posted a news article in News
An NHS hospital has been so overwhelmed that it told senior doctors to make “the least unsafe decision” when treating patients. Medical groups have voiced concern that Norfolk and Norwich hospital trust’s instruction to its consultants this week showed it was struggling so much to cope with the number of people needing care that patient safety was being put at risk. At the time the hospital had no spare beds, a full accident and emergency department, 35 patients waiting on trolleys to be admitted, and had declared a major internal incident. In its message, seen by the Guardian, it said: “We would like you to know that the trust will support you in making difficult decisions that may be the least unsafe decision, and we would appreciate your cooperation over the coming days with this.” The circular from the Norwich hospital added: “We are facing our most challenging situation with our trust today,” because it was so overcrowded and unable to find a bed for the 35 patients doctors had decided needed to be admitted as emergencies. Read full story Source: The Guardian, 20 December 2019 -
News Article
NHS bed occupancy beyond safe levels ahead of Christmas
Patient Safety Learning posted a news article in News
Hospital wards across the country are having to look after an unsafe number of patients, with hundreds of beds closed due to an outbreak of norovirus. NHS England has said that on average almost 900 beds were closed each day during the week to Sunday 15 December. Hospitals have reported fewer empty beds with bed-occupancy rates reaching as high as 95 per cent, 10 per cent higher than the recommended safe level. Read full story Source: The Independent, 20 December 2019 -
News Article
Using temporary nurses can increase risk of patients dying, warns new study
Patient Safety Learning posted a news article in News
Patients are more likely to die on wards staffed by a high number of temporary nurses, a study has found. Researchers say the findings, published in the Journal of Nursing Scholarship, are a warning sign that the common practice by many hospitals of relying on agency nurses is not a risk-free option for patients. The University of Southampton study found that risk of death increased by 12 per cent for every day a patient experienced a high level of temporary staffing – defined as 1.5 hours of agency nursing a day per patient. For an average ward, this increased risk could apply when between a third and a half of the staff on each shift are temporary staff, according to Professor Peter Griffiths, one of the study’s authors. He told The Independent: “We know that patients are put at risk of harm when nurse staffing is lower than it should be. “One of the responses to that is to fill the gaps with temporary nursing staff, and that is an absolutely understandable thing to do, but when using a higher number of temporary staff there is an increased risk of harm. “It is not a solution to the problem.” Read full story Source: The Independent, 10 December 2019 -
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