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Event
untilResource allocation is a constant struggle in healthcare facilities. Current literature, as well as personal interviews with patient safety professionals from US Pennsylvania facilities has highlighted opportunities to build experience in developing a business case for patient safety initiatives. Join Amber Capaldi, MSN, RN, patient safety officer at Lehigh Valley Health Network, as she describes why developing a business case is an essential skill for patient safety teams, defines the key components of a business case, and identifies available resources that can be used when developing a business case. Register -
Content Article
The concept of “patient power payments” was recently resurrected by Wes Streeting – but such a policy risks undermining clinical decision-making. Positioned as part of a wider push to strengthen patient voice, including within the new Women’s Health Strategy, the policy is intended to give patients greater influence over how care is assessed and how resources are allocated. However, although giving patients greater influence over provider payment could improve accountability, clinicians warn it may encourage defensive practice and place further strain on NHS services- Posted
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Content Article
Healthcare regulation refers to the formal oversight of healthcare practices and organisations through standards, monitoring, and accountability mechanisms. Although often operating in the background, regulation shapes how care is organised, delivered, and accounted for. In this BMJ article, Josje Kok and colleagues argue that amid growing pressures on health systems, healthcare regulation must evolve beyond compliance driven approaches.- Posted
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Content Article
Last month, Public Policy Projects hosted their annual Patient Safety Forum in partnership with Patient Safety Learning. Held at the Royal College of Surgeons of England in London, it was attended by senior healthcare leaders, patient safety experts, representatives from the HealthTech industry, frontline healthcare professionals and patients. In this article Patient Safety Learning reflects on a discussion at this event between a panel of experts to discuss the ambitions set out in the NHS 10 Year Plan and what it means for patient voice and patient safety. At the heart of the discussion was a simple but important question: are patients truly at the centre of the system, and how do we make sure their voices lead to meaningful change? A positive shift towards patient choice The NHS 10 Year Plan places strong emphasis on patient choice, agency and feedback. These commitments were widely welcomed by the panel. For many working in patient safety, the idea that patients should be central to their own care has long been a core principle. Giving patients greater choice and making it easier for them to share their experiences is a positive step. It reflects years of calls for healthcare systems to listen more carefully to the people they serve. However, some participants noted that, despite the focus on patient voice, patients themselves were not included on the panel. While there were patients on other panels during the conference, there was surprise that a patient safety partner or patient safety advocate had not been invited to contribute directly to the discussion. This absence highlighted a key tension: even when patient perspectives are recognised as vital, they are not always embedded in the decision-making or discussion processes themselves. However, while the overall direction of travel is encouraging, the discussion also highlighted areas where the 10 Year Plan could go further. What’s missing from the conversation? Although the plan speaks clearly about choice and feedback, it is less explicit about patient innovation, co-production and the experiences of harmed patients. These are crucial areas in patient safety. Patients and families often hold unique insights into where care has gone wrong and how it could be improved. When those perspectives are included early in improvement work, they can shape safer systems. Panel members felt these aspects need clearer recognition if the ambition of truly patient-centred care is to be realised. Trust, independence and the Dash Review The conversation also touched on Dr Penny Dash’s review of the patient safety landscape, published last year, shortly after the 10 Year Plan. The review included a number of proposals with direct implications for the visibility and independence of patient voice at a national and system level. This included plans to bring patient feedback mechanisms “in house” within a new patient experience directorate and moving functions of Local Healthwatch into Integrated Care Boards and providers. While this may improve efficiency, it raised concerns about independence and trust. If feedback systems are managed solely by the organisations being complained about, patients and families may feel less safe raising concerns. Independence plays an important role in ensuring transparency and confidence that concerns will be taken seriously. Maintaining that trust is essential if feedback is to remain open, honest and useful for learning. Are patient experiences just “stories”? Language became an unexpected but important theme. Patient experiences are often referred to as “stories”. While this language can humanise healthcare and highlight the real impact of harm, the panel reflected on whether the term always serves patients well. Referring to experiences as stories can unintentionally imply anecdote rather than evidence, potentially diminishing the seriousness of harm. The panel was asked a simple question: which patient story has actually led to meaningful change? When change only happens after escalation Paula Sussex, the Parliamentary and Health Service Ombudsman (PHSO), shared an example of a complaint that reached Ombudsman level. In that case, input from both the patient and the organisation led to significant improvements. It demonstrated the power of the patient voice when it is truly heard. But it also raised an uncomfortable question: should change only happen once a complaint escalates to that level? If meaningful improvements rely on escalation, it suggests earlier opportunities to listen and learn may have been missed. A similar example was shared by Norma Findley from Seating Matters, who described how a large legal claim had acted as the catalyst for organisational change. Again, the discussion returned to the same point: should it really require litigation and serious harm before learning happens? Too often, patient voices seem to gain traction only once they enter a formal or adversarial process. A more proactive model in maternity safety Louise Pye from the Maternity and Newborn Safety Investigations (MNSI) programme highlighted a different approach through their work around HEART and HEWS: HEWS: Health Equity Warning Score – this has been developed to classify a person’s risk of experiencing barriers to health equity. HEART: Health Equity Assessment and Resource Toolkit – this goes beyond HEWS and provides prompts and questions in relation to a person’s protected equality characteristics and social determinants. By using HEART and HEWS, MNSI aim to ensure that their investigators make safety recommendations and prompts to NHS trusts that focus on health equity to ensure that they consider personalisation in all areas of maternity care. Here, engagement with families is built into the investigative process from the beginning, rather than being added afterwards. Louise suggested that healthcare needs a clear and consistent model for working with patients and families — one that is embedded, compassionate and applied across organisations. The importance of co-production Chris Graham from Picker emphasised the value of co-production and involving people with lived experience directly in improvement work. Patient feedback can take many forms: Structured feedback Solicited surveys Systematic data collection Each serves a different purpose. For example, feedback collected for regulatory assurance may be very different from feedback intended to inform service redesign. Being clear about why feedback is collected makes it far more useful. Complaints as a gift Returning to the role of complaints, Paula Sussex explained how the PHSO analyses complaint data to identify recurring themes and systemic issues across healthcare. She encouraged organisations to view complaints as a gift, an opportunity to learn and improve rather than something to fear. For this to work, however, organisations must demonstrate visible change as a result of what they hear. Listening alone is not enough. Digital data and the risk of losing the human story The panel also explored the growing role of digital analysis. Large datasets can now be analysed quickly to identify patterns in patient feedback at scale. This can be powerful, helping organisations spot trends that might otherwise be missed. But there is also a risk. When experiences are reduced to coded data points, the emotional and relational context behind them can disappear. The challenge is to balance efficient analysis with preserving the human meaning behind patient experiences. Learning from social media Norma Findley also highlighted the potential value of social media communities, such as Facebook groups, as a source of patient feedback. Increasingly, patients are sharing experiences outside formal healthcare channels. These spaces can offer valuable insights into patient concerns, expectations and emerging issues. Used responsibly, they could help organisations become more responsive and transparent. From listening to action Across the discussion, one message came through clearly: Patients want to be heard — but more importantly, they want to see change. Acknowledging feedback is important, but what builds trust is demonstrable improvement. Paula Sussex also noted that the statutory duty of candour, while well established in policy, is not yet fully embedded in practice. This reflects a broader challenge in healthcare: the gap between policy intentions and lived experience. Key themes from the discussion Several key themes emerged from the forum: Escalation as a catalyst for change - Improvements often occur only once complaints reach Ombudsman level or result in legal action. Independence and trust - Bringing feedback systems in-house could risk reducing perceived independence. Language and framing - The term “patient stories” can humanise experiences but may unintentionally minimise harm. Data versus narrative - Digital analysis offers scale but risks losing context if not balanced with human insight. Co-production and lived experience - Genuine partnership requires structured engagement with patients and families. From feedback to action - Patients want to see tangible improvement, not acknowledgement alone. The implementation gap - Commitments such as the duty of candour are still not consistently realised in practice. A shared commitment to doing better What stood out most from the discussion was a shared commitment to strengthening patient voice and patient safety. The conversation recognised that progress has been made, but also that structural, cultural and linguistic shifts are still needed. Rather than becoming influential only once harm has escalated into a formal complaint or legal process, the patient voice is most powerful when it is: embedded early in improvement work treated with respect and seriousness analysed thoughtfully and linked directly to visible change. If the ambitions of the NHS 10 Year Plan are to be realised, ensuring that patient voices lead to meaningful improvement will remain one of the most important challenges ahead. Share your insights Have you seen the impact of the patient voice in patient safety? Share your thoughts on this article and the issues raised by commenting below (sign up first for free). Or you can email our editorial team at [email protected]. Find out more about the Patient Safety Forum 2026 You can read more about different discussions and panel sessions at this year’s event in the below: Designing AI with patient safety at its core: Reflections from the Patient Safety Forum 2026 Safe systems, safe cultures: reflections from the Patient Safety Forum 2026- Posted
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News Article
Trust using security staff for ‘inappropriate’ patient supervision
Patient_Safety_Learning posted a news article in News
Board papers for the Humber Health Partnership show that security staff are carrying out one-to-one supervision “due to reduced non-registered nurses in several of the clinical areas at the North Bank”. The North Bank is the name given to two hospitals run by Hull University Teaching Hospitals Trust. The trust formed the HHP with Northern Lincolnshire and Goole Foundation Trust in 2023. Major finance and governance problems mean the group is soon expected to enter NHS England’s new failure regime. A safer staffing paper presented to the HHP board last week said: “Additional investment in non-registered nursing workforce will support the reduction of inappropriate use of this [security staff] workforce and enhance patient experience.” Read full story (paywalled) Source: HSJ, 20 February 2026 -
Content Article
Since its introduction in 1990, the commissioning layer of the NHS has been the most reorganised part of the health service, and it is changing once again. In this article for the Nuffield Trust, Nigel Edwards reviews the lessons to learn from the past and describes what needs to happen for ICB-led strategic commissioning to succeed where previous models have fallen short. -
Content Article
The irony is palpable and unpleasant: unemployed and underemployed GPs are struggling to find NHS work, while patients can’t get a GP appointment when they want one. With public satisfaction with general practice at record lows, this is not a tenable situation for a government committed to improving access to general practice. For over a decade, England struggled with a lack of GPs. Faced with high and rising workloads, many GPs cut their clinical hours. Others retired, or took jobs outside general practice. Practices struggled to recruit, and GP training places went unfilled. Challenges with high GP workload, burnout and falling job satisfaction remain, but in the past two years the labour market in general practice has changed significantly. From practices clamouring for recruits, GPs are now clamouring for practices to recruit them. This short paper from the Nuffield Trust explores the mix of reasons behind the underemployment of GPs in England.- Posted
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News Article
Flu on the rise again after Christmas mixing, says NHS
Mark Hughes posted a news article in News
Christmas gatherings may have caused a resurgence in flu and other winter viruses, NHS leaders say. Figures show that the average number of patients in hospital beds in England with flu last week hit 2,924 - a rise of 9% on the previous week. This comes after two weeks of falls which prompted hope cases may have peaked. NHS England said a combination of the vicious cold snap and winter viruses was making services "extremely busy" with hospitals reporting icy conditions have led to a rise in slips and falls and people struggling with respiratory conditions. Concerns are also being raised about corridor care - where A&E patients are treated in make-shift areas because of a lack of beds. Read full article. Source: BBC News, 8 January 2026 -
News Article
Thousands of people who have had a stroke are ending up severely disabled or dying because the NHS has too few specialists to treat them quickly enough, senior doctors are warning. A chronic shortage of stroke consultants across the NHS means that patients are suffering horrendous consequences because of delays in getting clot-busting drugs and surgery, they said. “People are either dying or living with disability unnecessarily because they’re not getting the correct evaluation and treatment by the right expert at the right time,” Prof David Werring, the past president of the British and Irish Association of Stroke Physicians (BIASP), told the Guardian. Read full story Source: Guardian, 5 January 2026- Posted
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News Article
Doctors start five-day strike as hospital bosses warn of disruption
Patient_Safety_Learning posted a news article in News
Patients are being told to expect disruption as doctors start their five-day strike in England, with NHS bosses saying they are struggling to keep as many services going as they have done in recent walkouts. NHS England said with a wave of flu placing pressure on hospitals, non-urgent services would be affected by the strike, which began at 07:00 Wednesday. This is the 14th walkout by resident doctors, the new name for junior doctors, in the long-running pay dispute. Health Secretary Wes Streeting said the strike had been timed to inflict most damage on the NHS and put patients at risk, but the British Medical Association said it would work with NHS bosses to ensure safety. Read full story Source: BBC News, 17 December 2025 -
News Article
Flu surge a challenge for NHS 'unlike any' since pandemic, Streeting says
Mark Hughes posted a news article in News
A surge in flu cases will present the NHS with a challenge "unlike any it has seen since the pandemic", Health Secretary Wes Streeting has said. Writing in the Times, Streeting said the NHS was in a "precarious situation", and warned that next week's planned strikes by resident doctors could be the "Jenga piece that collapses the tower". The number of patients in hospital with influenza has risen more than 50% in the past week, with officials warning there is still no sign of it peaking yet. In the week up to Sunday there were 2,660 flu cases a day on average in hospital, which NHS England said was the equivalent of having three hospitals full of flu patients. Read full article. Source: BBC News, 11 December 2025 -
Content Article
Almost one in five patients in Emergency Departments were being cared for in trolleys or chairs in corridors in England this summer, with so-called ‘corridor care’ leaving people feeling ‘forgotten and vulnerable’. That’s among the key findings contained in a major report on the state of corridor care in A&Es by the All-Party Parliamentary Group (APPG) on Emergency Care. The research, compiled by the Royal College of Emergency Medicine (RCEM) which acts as secretariat for the APPG, reveals what patients are experiencing when they seek urgent or emergency care in ED, the harm they are exposed to, and what needs to be done to address this crisis. So-called ‘corridor care’ refers to the practice of providing patient care in clinically inappropriate areas such as corridors, waiting rooms or other temporary spaces which are not designed or equipped to treat patients in. Corridor care is a visible symptom of the pressures facing the entire system. These pressures include shortages of staffed hospital beds and delays in discharging patients due to gaps in community and social care provision. This creates a bottleneck in hospitals, with those requiring admission remaining in Emergency Departments for extended periods and care being delivered wherever space can be found. Between 30 July – 13 August 2025, RCEM polled Clinical leads – who oversee A&Es – to capture a snapshot of the prevalence of corridor care and the standard of care patients were receiving. In total, representatives from 58 Type 1 Emergency Departments across England responded. They revealed: Across the EDs in the sample, 19% of patients were being treated on trolleys or chairs in the corridor. That’s almost one in five attendances who were being cared for in an inappropriate setting, during a summer month, when there has historically been respite. 34.5% of respondents had patients being cared for in ambulances outside their department Over three quarters of respondents (78%) felt patients were coming into harm in their department due to the quality of care that can be delivered under current conditions Related reading on the hub: The crisis of corridor care in the NHS: patient safety concerns and incident reporting How corridor care in the NHS is affecting safety culture: A blog by Claire Cox Corridor care: are the health and safety risks being addressed? A nurse's response to the NHSE guidance on their principles for providing safe and good quality care in temporary escalation space A silent safety scandal: A nurse’s first-hand account of a corridor nursing shift- Posted
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Content Article
The Covid-19 pandemic, which rapidly escalated into a global crisis that impacted millions of lives and disrupted economies around the world, was a wake-up call for the management of infectious disease outbreaks. Dr Stella Chungong and Dr Landry Ndriko Mayigane work for the Health Security Preparedness Department in the World Health Organization’s Health Emergencies Programme. In this article, they encourage countries to implement early action reviews (EARs) of disease outbreaks. EARs help countries assess their vigilance, planning and responsiveness, and could help countries be better prepared during outbreaks. The guidelines detail three time-based metrics, named 7-1-7, which offer a simple, structured approach to outbreak management: 7 Days to Detect, which measures how quickly the country can detect a suspected disease outbreak, with the aim being detection within 7 days. 1 Day to Notify, which measures the time taken to notify relevant public health authorities and stakeholders, with the aim being notification within 1 day. This goal is not new; it is consistent with the International Health Regulations (2005) that require countries to notify the relevant authorities within 24 hours of detecting a disease outbreak. 7 Days to Respond measures how quickly the country can establish a response to the outbreak, the aim being the instigation of effective response actions within 7 days.- Posted
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Content Article
To deliver value for money over the medium to long term, a government needs to turn its objectives into outcomes in a way that delivers the best value for every pound of taxpayers’ money while managing its fiscal position. It needs to: plan and prioritise its spending (and other activities) to address those objectives. monitor and manage both costs and value delivered. evaluate the results. adjust as necessary. report to Parliament on how it has used taxpayers’ money. This report by the National Audit Office aims to provide useful insights as officials and ministers are making changes to the planning and spending framework. It will also be useful to Parliamentarians and stakeholders seeking to scrutinise government spending and delivery. -
News Article
USA: At little-known health agency, DOGE ends dream ‘to make a difference’
Patient Safety Learning posted a news article in News
Heather Sherman is one of the thousands of federal employees dismissed by a weekend email telling them they were “not fit for future employment.” The trauma of that abrupt ending in mid-February — giving her just a few hours before all access was shut off — still lingers. “This was my dream job,” Sherman said. If Sherman were an air traffic controller or nuclear materials expert, her work keeping the public safe would be obvious. But as a mid-level employee with a technical role at a little-known agency in the mammoth Department of Health and Human Services, her curt dismissal and that of an undisclosed number of AHRQ colleagues prompted not even a ripple of news coverage. Yet what a New York Times editorial decried as a “haphazard demolition campaign” by the Elon Musk-led Department of Government Efficiency, one that is undermining “the safety and welfare of the American people,” applies to agencies like AHRQ and low-profile jobs like Sherman’s just as much as to more high-profile positions. In complex systems, of which healthcare is surely one, carelessness has consequences. A 2023 report by the President’s Council of Advisors on Science and Technology declared patient safety “an urgent national public health issue.” In truth, the urgency is embraced mostly by a small number of individuals determined to drastically reduce the estimated 160,000 Americans perishing each year from preventable medical errors in hospitals. Read full story Source: Forbes, 13 March 2025- Posted
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Event
untilA crisis is deepening in NHS psychiatric care - but how can we turn the tide and stop a total collapse? Join The Independent’s health correspondent Rebecca Thomas and a panel of experts as they dive into the heart of the issues plaguing the NHS' mental health services. This exclusive event comes after joint Independent/Sky News investigation Patient 11 uncovered 20,000 sexual abuse, harassment and assault complaints involving both patients and staff in more than 30 NHS mental health trusts in England since 2019. Sparked by the testimony of former patient Alexis Quinn, who joins our panel, the investigation has prompted accusations by healthcare professionals that NHS psychiatric care in England is in a state of "collapse," due to "unsafe" mixed gender care spaces, inadequate safeguarding protections and bed shortages. Register for the webinar- Posted
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Community Post
Can the NHS learn from healthcare systems overseas?
Steve Turner posted a topic in Organisational
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- Just Culture
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- Organisational development
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- Speaking up
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Is it time to change the way England's healthcare system is funded? Is the English system in need of radical structural change at the top? I've been prompted to think about this by the article about the German public health system on the BBC website: https://www.bbc.co.uk/news/health-62986347.amp There are no quick fixes, however we all need to look at this closely. I believe that really 'modernising' / 'transforming' our health & #socialcare systems could 'save the #NHS'. Both for #patients through improved safety, efficiency & accountability, and by making the #NHS an attractive place to work again, providing the NHS Constitution for England is at the heart of changes and is kept up to date. In my experience, having worked in healthcare for the private sector and the NHS, and lived and worked in other countries, we need to open our eyes. At present it could be argued that we have the worst of both worlds in England. A partially privatised health system and a fully privatised social care system. All strung together by poor commissioning and artificial and toxic barriers, such as the need for continuing care assessments. In my view a change, for example to a German-style system, could improve patient safety through empowering the great managers and leaders we have in the NHS. These key people are held back by the current hierarchical crony-ridden system, and we are at risk of losing them. In England we have a system which all too often punishes those who speak out for patients and hides failings behind a web of denial, obfuscation and secrecy, and in doing this fails to learn. Vast swathes of unnecessary bureaucracy and duplication could be eliminated, gaps more easily identified, and greater focus given to deeply involving patients in the delivery of their own care. This is a contentious subject as people have such reverence for the NHS. I respect the values of the NHS and want to keep them; to do this effectively we need much more open discussion on how it is organised and funded. What are people's views?- Posted
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- Organisational culture
- Organisational development
- Organisational learning
- Safety culture
- Transformation
- Speaking up
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Content Article
The UK is the “sick man” of Europe at the moment—on almost every health indicator including life expectancy, healthy life expectancy, obesity rates and healthcare capacity—we lag behind our peers. Recent data from the Office for National Statistics shows the substantial impact this is having on our national prosperity. The number of people who cannot work primarily because of long-term illness reached a record nearly 2.6 million. In this article for The Guardian, Professor Dame Sally Davies, former chief medical officer for England, argues that this is not the first time the UK has lagged behind on health outcomes and faced the associated economic harm. During the 19th-century Industrial Revolution and the 20th-century post-war period, Britain faced health crises that, like today’s, also undermined labour supply, economic participation and growth. She highlights that in both of these instances, national leaders implemented bold new public health strategies on both health and economic grounds and asks the question, 'Why is the Government not taking a more comprehensive policy approach to tackling the serious health issues we face in 2023?'- Posted
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This is the report of a review into how the executive leadership of the NHS could be better supported and empowered to ensure the best possible service is delivered for patients. Sir Ron Kerr was commissioned by the Department of Health and Social Care (DHSC) to conduct the review, which focused on three issues in particular: The expectations and support available for leaders - particularly those in challenging organisations and systems The scope for further alignment of performance management expectations at the organisational and system level The options for reducing the administrative burden placed on executive leaders The report describes the methodology of the review, outlines its findings and makes a number of recommendations around these issues.- Posted
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Content Article
The government’s long term workforce plan, developed by NHS England, was finally published on 30 June, having first been promised more than five years ago by the then secretary of state for health and current chancellor, Jeremy Hunt. The plan is a welcome and necessary step towards solving the workforce challenges that have vexed the health service, although it is more of a jigsaw puzzle than a masterplan. The overall picture of a future NHS workforce with many more staff, increasingly working in more diverse multidisciplinary teams, and with greater support from technology, is encouraging but several pieces are missing from the vision and roadmap for its delivery, writes William L Palmer and Rebecca Rosen in this BMJ Editorial.- Posted
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Content Article
The presentation was held following the inaugural William Rathbone X Lecture, given by Professor Alison Leary, who spoke on the highly topical subject, ‘Thinking differently about nursing workforce challenges.’ The presentation can be watched from The Queen's Nursing Institute website.- Posted
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NHS Long Term Workforce Plan (30 June 2023)
Patient Safety Learning posted an article in NHS England
The first comprehensive workforce plan for the NHS, putting staffing on a sustainable footing and improving patient care. It focuses on retaining existing talent and making the best use of new technology alongside the biggest recruitment drive in health service history. Train – Grow the workforce By significantly expanding domestic education, training and recruitment, we will have more healthcare professionals working in the NHS. This will include more doctors and nurses alongside an expansion in a range of other professions, including more staff working in new roles. This Plan sets out the path to: Double the number of medical school training places, taking the total number of places up to 15,000 a year by 2031/32, with more medical school places in areas with the greatest shortages, to level up training and help address geographical inequity. To support this ambition, we will increase the number of medical school places by a third, to 10,000 a year by 2028/29. The first new medical school places will be available from September 2025. Increase the number of GP training places by 50% to 6,000 by 2031/32. We will work towards this ambition by increasing the number of GP specialty training places to 5,000 a year by 2027/28. The first 500 new places will be available from September 2025. Increase adult nursing training places by 92%, taking the total number of places to nearly 38,000 by 2031/32. To support this ambition, we will increase training places to nearly 28,000 in 2028/29. This forms part of our ambition to increase the number of nursing and midwifery training places to around 58,000 by 2031/32. We will work towards achieving this by increasing places to over 44,000 by 2028/29, with 20% of registered nurses qualifying through apprenticeship routes compared to just 9% now. Provide 22% of all training for clinical staff through apprenticeship routes by 2031/32, up from just 7% today. To support this ambition, we will reach 16% by 2028/29. This will ensure we train enough staff in the right roles. Apprenticeships will help widen access to opportunities for people from all backgrounds and in underserved areas to join the NHS. Introduce medical degree apprenticeships, with pilots running in 2024/25, so that by 2031/32, 2,000 medical students will train via this route. We will work towards this ambition by growing medical degree apprenticeships to more than 850 by 2028/29. Expand dentistry training places by 40% so that there are over 1,100 places by 2031/32. To support this ambition, we will expand places by 24% by 2028/29, taking the overall number that year to 1,000 places. Train more NHS staff domestically. This will mean that we can reduce reliance on international recruitment and agency staff. In 15 years’ time, we expect around 9– 10.5% of our workforce to be recruited from overseas, compared to nearly a quarter now. Retain – Embed the right culture and improve retention By improving culture, leadership and wellbeing, we will ensure up to 130,000 fewer staff leave the NHS over the next 15 years. We will: Continue to build on what we know works and implement the actions from the NHS People Plan to ensure the NHS People Promise becomes a reality for all staff by rolling out the interventions that have proven to be successful already. For example, ensuring staff can work flexibly, have access to health and wellbeing support, and work in a team that is well led. Implement plans to improve flexible opportunities for prospective retirees and deliver the actions needed to modernise the NHS Pension Scheme, building on changes announced by the government in the Spring Budget 2023 to pension tax arrangements, which came into effect in April 2023. From autumn, recently retired consultant doctors will have a new option to offer their availability to trusts across England, to support delivery of outpatient care, through the NHS Emeritus Doctor Scheme. Commit to ongoing national funding for continuing professional development for nurses, midwives and allied health professionals, so NHS staff are supported to meet their full potential. Support the health and wellbeing of the NHS workforce and, working with local leaders, ensure integrated occupational health and wellbeing services are in place for all staff. Explore measures with the government such as a tie-in period to encourage dentists to spend a minimum proportion of their time delivering NHS care in the years following graduation. Support NHS staff to make use of the change announced in the Spring Budget 2023 that extended childcare support to working parents over the next three years, to help staff to stay in work. Reform – Working and training differently Working differently means enabling innovative ways of working with new roles as part of multidisciplinary teams so that staff can spend more time with patients. It changes how services are delivered, including by harnessing digital and technological innovations. Training will be reformed to support education expansion. It will: Focus on expanding enhanced, advanced and associate roles to offer modernised careers, with a stronger emphasis on the generalist and core skills needed to care for patients with multimorbidity, frailty or mental health needs. This includes setting out the path to grow the proportion of staff in these newer roles from around 1% to 5% by the end of the Plan by: Ensuring that more than 6,300 clinicians start advanced practice pathways each year by 2031/32. We will support this ambition by having at least 3,000 clinicians start on advanced practice pathways in both 2023/24 and 2024/25, with this increasing to 5,000 by 2028/29. We will increase training places for nursing associates (NAs) to 10,500 by 2031/32. We will work towards this by training 5,000 NAs in both 2023/24 and 2024/25, increasing to 7,000 a year by 2028/29. By 2036/37, there will be over 64,000 nursing associates working in the NHS, compared to 4,600 today. o Increasing physician associate (PA) training places to over 1,500 by 2031/32. In support of this, around 1,300 physician associates (PAs) will be trained per year from 2023/24, increasing to over 1,400 a year in 2027/28 and 2028/29, establishing a workforce of 10,000 PAs by 2036/37. Grow the number and proportion of NHS staff working in mental health, primary and community care to enable the service ambition to deliver more preventative and proactive care across the NHS. This Plan sets out an ambition to grow these roles 73% by 2036/37. Work with professions to embrace technological innovations, such as artificial intelligence and robotic assisted surgery. NHS England will convene an expert group to identify advanced technology that can be used most effectively in the NHS, building on the findings of the Topol Review. Expand existing programmes to demonstrate the benefits of generalist approaches to education and training and ensure that, at core stages of their training, doctors have access to development that broadens their generalist and core skills. Work with partners to ensure new roles are appropriately regulated to ensure they can use their full scope of practice, and are freeing up the time of other clinicians as much as possible – for example, by bringing anaesthesia and physician associates in scope of General Medical Council (GMC) registration by the end of 2024 with the potential to give them prescribing rights in the future. Support experienced doctors to work in general practice under the supervision of a fully qualified GP. We will also ensure that all foundation doctors can have at least one four-month placement in general practice, with full coverage by 2030/31. Work with regulators and others to take advantage of EU exit freedoms and capitalise on technological innovation to explore how nursing and medical students can gain the skills, knowledge and experience they need to practise safely and competently in the NHS in less time. Doctors and nurses would still have to meet the high standards and outcomes defined by their regulator. • Support medical schools to move from five or six-year degree programmes to four-year degree programmes that meet the same established standards set by the GMC, and pilot a medical internship programme which will shorten undergraduate training time, to bring people into the workforce more efficiently so that in future students undertaking shorter medical degrees make up a substantial proportion of the overall number of medical students. The Plan is based on an ambitious labour productivity assumption of up to 2% (at a range of 1.5–2%). This ambition requires continued effort to achieve operational excellence, reducing the administrative burden through technological advancement and better infrastructure, care delivered in more efficient and appropriate settings (closer to home and avoiding costly admissions), and using a broader range of skilled professionals, upskilling and retaining our staff. These opportunities to boost labour productivity will require continued and sustained investment in the NHS infrastructure, a significant increase in funding for technology and innovation, and delivery of the broader proposals in this Plan. -
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The King's Fund compared the healthcare systems in different countries by doing three things: Reviewed the research literature and assessed previous attempts to rank and compare health care systems. Interviewed academic experts in international health care policy and experts who had extensive knowledge of the UK, German and Singaporean healthcare systems. Analysed the latest quantitative performance data for the UK health care system and the health systems of 18 higher-income peer countries. They analysed data in three main domains: the context the health system operates in (eg, the health status and behaviours of the population) the resources a health system has (eg, levels of staffing, equipment and health care spending) how well the health care systems uses its resources and what it achieves as a result (eg, measures of efficiency in delivering services, quality of care, financial protection from the costs of ill health, and health care outcomes). Key points: The analysis found the UK healthcare system has fewer key resources than its peers. It performs relatively well on some measures of efficiency but waiting times for common procedures were ‘middle-of-the-pack’ before the Covid-19 pandemic and have deteriorated sharply since. The UK performs well on protecting people from some of the financial costs of ill health, but lags behind its peers on important healthcare outcomes, including life expectancy and deaths. The latter could have been avoided through timely and effective healthcare, and public health and preventive services. There is little evidence that one particular ‘type’ of health care system or model of health care funding produces systematically better results than another. Countries predominantly try to achieve better health outcomes by improving their existing model of healthcare, rather than by adopting a radically different model.- Posted
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This stocktake by NHS Confederation highlights insights from medicines optimisation forums on the experience of ICS medicines optimisation so far: the opportunities that exist, the barriers experienced, the support that is needed, and what the vision for medicines optimisation could achieve. Recommendations System leadership. ICS leaders, including but not limited to chief pharmacists, should ensure that medicines optimisation teams are mainstream in projects and service redesigns from the start, so downstream effects and preventative impact of medicinal interventions, alongside social prescribing, can be considered and ensure best value. Establish the right governance. ICS should consider establishing a clear board-level medicines lead, supported by appropriate system-wide committees and sub-committees, which help to provide multi-disciplinary expertise to drive transformation across each system. Governance arrangements should ensure a better balance with medicines optimisation teams between time spent on operational and transformational activity. Build one medicines optimisation team. Alongside developing pharmacy workforce plans that develop innovative and rotational roles, ICBs should consider how they can build awareness of medicines optimisation right across the system including into social care, providing training where necessary. Harness digital and data. Use shared care records to enable access to medicines information for relevant healthcare professionals across care pathways. Meanwhile, use system-wide data to assess incidence of avoidable harm, specifically inappropriate sodium valproate prescribing, as well as medicines expenditure, to establish an initial baseline in each system to measure success and improvement going forward. Shared learning and self-improvement. ICSs should be supported to share learning about their respective progress transforming medicines optimisation to drive a process of peer learning and self-improvement. This could include learning on how different systems are delivering improvement in risk assurance; data analytics; digital interoperability; pharmacy workforce planning; development of rotational and cross-sector roles; and integrating medicinal and social prescribing.- Posted
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The NHS in England’s annual budget is £161 billion. Yet across the sector there is huge cause for concern, including the still-growing backlog, workforce issues, the state of the estate and the relentless demand on primary care. In this blog, ex-NHS strategic health authority chief executive Mike Farrar and Health Policy Insight editor Andy Cowper look at how these issues can be tackled to provide an NHS that meets the needs of the population. They cover the following subjects: Politics, policy and prevention System working and pivoting to prevention - how to shift resources Building a compelling case for change Moving towards less top-down-ism Being clear about what an ICS is for Culture change and mindsets shifts Resourcing change