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Found 51 results
  1. News Article
    Regulators have uncovered multiple examples of patients being put at risk when junior doctors are left with tasks they are not trained for, lacking support, and facing bullying and inappropriate behaviour. Inspection teams have had to intervene – in some cases contacting senior trust staff – to ensure urgent issues are addressed, after the inspections. Health Education England oversees training nationally, which includes making the checks at trusts which have been put under “enhanced monitoring” by the professional regulator, the General Medical Council, because of concerns from trainees. HSJ has obtained and examined 20 reports, all produced since the beginning of 2019. Themes running through the reports included: Lack of support from consultants. Trainees struggled to contact consultants out of hours. Bullying and inappropriate behaviour was reported at several trusts. Inspectors found a reluctance to report concerns and/or a lack of knowledge of how to do it. Teaching was often of poor quality or cancelled – and sometimes trainees struggled to attend sessions because of how their shifts and rotations were scheduled. Trainees in several trusts reported IT problems, such as being locked out of systems so being unable to access clinical notes and blood tests, and IT systems taking up to 30 minutes to start up, sometimes delaying patient care. Read full story (paywalled) Source: HSJ, 29 June 2020
  2. Content Article
    The full impact of COVID-19 has not yet been realised, but what we do know is that we have been navigating with no roadmap or star to guide us. In terms of the three psychological phases of a crisis, we have worked through the initial state of ‘emergency’ where we have had (largely) shared goals and an urgency that made us feel energised, focused and even productive. However, this phase feels like it is in its descendancy and most of us are now in the next phase of ‘regression’ where the future feels uncertain and we have lost that sense of purpose. In my work with colleagues from across health and social care to understand what phase three ‘recovery’ looks like in workforce and wellbeing terms, it is clear that both aspects are starting to get the focus they always should have had but maybe not in the way we would have expected. It has not been cries of ‘more’ staff or money that have been echoing through the corridors, but the cry for ‘different’ and the freedom to make decisions without the shackles of bureaucracy and hierarchy holding the tide of necessary change at bay. In the past, workforce planning has had little shared meaning, and has often been more recruitment planning for a continuation of the same as opposed to thinking about what we need from our teams in terms of availability, skills, expectations, roles and the delivery of care designed around the person receiving it. Wellbeing seemed to be something that only HR considered if there was a staffing issue or high sickness, or even more cynically a poor outcome in survey results, resulting in lots of workshops, fabulous plans, but very little sustainable change. In the initial stages of the pandemic, I worked with a number of acute teams to look at staffing in the short term to face the initial onslaught of COVID-19. This meant looking at variation and where we could adjust care levels safely, planning to deploy a moderated skill mix of staff, and working through the cost of plugging gaps in largely traditional models of care using temporary and volunteer staff, with the hope that the 20% sickness rate wasn’t breached too often leaving us exposed to the hazards of unblocked holes in the workforce. This was acknowledged as an unsustainable and haphazard way of providing care for both staff and patients, which after the ‘emergency’ phase results in burnout, higher sickness, increased turnover, and certainly lacks in the resilience required to continue to manage COVID-19, non-COVID urgent care, elective care and the wellbeing of staff and carers. So, what do we need to do as we plan for recovery, or more precisely ‘post traumatic growth’? Despite an apparent increase in interest in joining the nursing profession since the start of the pandemic, the reported 40,000 gap in nursing numbers is not going to be closed overnight, so it seems that planning for different and capturing and capitalising on the innovation that has flourished in some areas is the only way forward. How do we do this? As an example, let me turn your heads to colleagues in social care who have known for some time that their current state was unsustainable. This has been compounded by COVID-19 and the (inevitable) delayed recognition by government of the essential role of social care in protecting the NHS and some of our most vulnerable people. Therefore, they chose to do for some what is unthinkable – they took their nurses away from direct patient care. In some of the teams I work with there was an expectation that they would have 50% of staff available to be deployed, and would have slower and more limited access to other services to support – including temporary staffing or volunteers. They collaborated swiftly both within and across organisations, changed models of care completely based on some of the data collated by Establishment Genie, and moved to a model of all registered nurses in a supernumerary supervisory role, providing support to staff in their own care home directly and also in other homes via ‘virtual’ collaboration, and using technology to connect, share, teach and learn ‘on the job’. This of course questions the future role of the nurse in these homes but is also an example of how we all may need to re-think roles and responsibilities to meet the challenges of today and the future in order to keep the people in our care – patients, residents and staff – safe. As we begin to reorient, revise our goals and focus on moving beyond rather than on just ‘getting by’, it is important that we look at all settings of care so we can learn from excellence, build on the best, and support a faster response in the future if required. The response to COVID-19 for many has been an example of how a system succeeds in varying conditions; a ‘Safety-II’ approach where humans are the necessary resource for system flexibility and resilience. We need to take the time to understand where things have gone right, to celebrate and acknowledge this, and then co-create a health and social care system that people want to work and be cared for in.
  3. News Article
    A hospital A&E department has been rated "inadequate" after inspectors found patients at "high risk of avoidable harm". The Care Quality Commission (CQC) reported a "range of regulation breaches" and a shortage of nurses at Stepping Hill hospital's A&E unit. It also criticised maternity and children's services. Stockport NHS Foundation Trust's chief executive said the trust had taken "immediate steps" to improve. The CQC inspected Stepping Hill Hospital in January and February and found A&E performance "had deteriorated significantly" since its last inspection in 2018. Inspectors found shortcomings "relating to patient-centred care, dignity and respect, safe care and treatment, environment and equipment, good governance, and staffing". Their report said the service "could not assure itself that staff were competent for their roles" and patient outcomes "were not always positive or met expectations in line with national standards". Read full story Source: BBC News, 19 May 2020
  4. Content Article
    Nursing and midwifery professionals are at the heart of responding to COVID-19 today, tomorrow and in the coming weeks ahead. We recognise this is undoubtedly the most challenging, difficult and pressurised time in generations for teams working in health and social care settings across the UK. Interventions to help maintain a balanced and positive mental health will be very important during this crisis. It will also be important to ensure they can also focus on the future. Nightingale Frontline will support nurses and midwives to continue to lead and support the NHS now and be inspired to lead beyond this crisis. It will complement the Health and Wellbeing Service recently launched by NHS England. Nightingale Frontline will provide remote, small group sessions offered to: Executive Directors of Nursing Senior Leaders Ward Managers/Team Leaders Newly Registered Nurses/Midwives Nurses/midwives: Redeployed or Returning to practice following retirement or non-clinical roles Nurses/midwives managing caseloads remotely Windrush and BAME Leaders The leadership support will be facilitated by our expert FNF Associate Facilitators and our senior nurse and midwife alumni network who are highly experienced and skilled in a method of Action Learning known as Co-consulting. This approach combines the benefits of coaching with peer learning in an environment underpinned by psychological safety. Book your free leadership support session. Sessions will be released monthly. If you have any questions, please email: academy@florence-nightingale-foundation.org.uk
  5. Content Article
    This guidance includes; What are RRTs and CCO services? What is COVID-19? Why is COVID-19 important to the RRT and CCO service? Overarching principles Safety of the RRT responders Identification of suspected / confirmed cases Use of NIV, CPAP and high flow nasal oxygen Method of activation of the RRT Coordinating a response to a patient with suspected / confirmed COVID-19 Use of non-ICU staff as members of the responding team Training of staff.
  6. News Article
    Medical students who are employed in the NHS as part of efforts to swell staff numbers to tackle covid-19 should not be expected to “step up” and act outside of their competency, says the BMA in new guidance. This is the first set of guidance released by the BMA specifically for medical students, who have had placements and exams cancelled and are uncertain about how they might be employed in the NHS in the current crisis. It says that any employment should be voluntary and within the competency of the student, who should have adequate access to personal protective equipment. The BMA refers to General Medical Council guidance that states that plans are not currently in place to move provisional registration forward from the normal August date. It warns that there are concerns around the boundaries of practice and the level of supervision that students who take on roles in the NHS would have, which could lead to unsafe working practices. The BMA is in talks to negotiate a safe national contract for such roles. Read full story Source: BMJ, 24 March 2020
  7. Content Article
    ITU handover Bedside checklists Transducing arterial lines Arterial line sampling Bedside monitoring Observations Ventilation basics Activity sheet. About the author Sam is a registered nurse who works for a Trust on the South Coast of England
  8. News Article
    NHS national leaders are set to reassure doctors they should not fear regulatory reprisals, within reason, if they end up working outside their areas of expertise during the coronavirus outbreak. HSJ understands the UK’s four chief medical officers and the General Medical Council are drafting a letter to be sent to all UK doctors, which will contain the reassurances, as the system braces for a sharp rise in covid-19 cases. The letter will also urge doctors to be flexible and not to resist new ways of working, with senior figures expecting many clinicians working in other specialities or locations during the outbreak. The letter will say doctors, while still expected to follow good medical practice, should not fear reprimand from their employers or national bodies such as the GMC, NHS England or other regulators. Read full story (paywalled) Source: HSJ, 11 March 2020
  9. News Article
    Third year undergraduate trainee nurses will be invited into clinical practice to support the coronavirus effort, while routine care quality inspections are “going to need to be suspended”, the Chief Executive of NHS England has said. Speaking at the Chief Nursing Officer’s summit event in Birmingham this morning, Sir Simon Stevens told delegates NHSE was working with the Nursing and Midwifery Council to “see how many of the 18,000 [relevant] undergraduates are available”. It is understood they would be paid, and follows government moves to pass emergency legislation to relax rules around working in healthcare. Asked about Care Quality Commission inspections during the outbreak, Sir Simon said: “There will be a small number of cases where it would be sensible to continue for safety related reasons… but the bulk of their routine inspection programmes is clearly going to need to be suspended and many of the staff who are working as inspectors need to come back and help with clinical practice.” Read full story (paywalled) Source: HSJ, 11 March 2020
  10. Community Post
    The Academy of Medical Royal Colleges have published the first National patient safety syllabus that will underpin the development of curricula for all NHS staff as part of the NHS Patient Safety Strategy: https://www.pslhub.org/learn/professionalising-patient-safety/training/staff-clinical/national-patient-safety-syllabus-open-for-comment-r1399/ Via the above link you can access a ‘key points’ document which provides some of the context for the syllabus and answers to some frequently asked questions. AOMRC are inviting key stakeholders to review this iteration of the syllabus (1.0) and provide feedback via completing the online survey or e-mailing Rose Jarvis before 28 February 2020. I would be interested to hear people's thoughts and feedback and any comments which people are happy to share which they've submitted via the online survey
  11. News Article
    Nurses will be trained to perform surgery under new NHS measures to cut waiting times. Nursing staff will be urged to undertake a two year course to become “surgical care practitioners” as part of the drive to slash waiting times but critics have warned it will worsen the nursing shortage. Nurses who qualify will be tasked with removing hernias, benign cysts and some skin cancers, according to the Daily Mail. They will also assist during major surgeries such as heart bypasses and hip and knee replacements. The re-trained nurses will be tasked with closing up incisions after operations. The proposals are contained within the NHS’s People Plan, due to be unveiled next month. Lib Dem health spokesman Munira Wilson said: "This is a sticking plaster solution to very serious staffing crisis across our NHS workforce.'" However the proposals were backed by Professor Michael Griffin, president of the Royal College of Surgeons of Edinburgh. He said: "We are totally supportive of this. We have very little anxiety about this.” Read full story Source: 24 February 2020
  12. News Article
    Almost half of hospitals have a shortage of specialist stroke consultants, new figures suggest. One charity fears "thousands of lives" will be put at risk unless action is taken, with others facing the threat of a lifelong disability. In 2016, Alison Brown had what is believed to have been at least one minor stroke, but non-specialist doctors at different hospitals repeatedly told her she did not have a serious health condition. One even described it as an ear infection. Ten months later, aged 34, she had a bilateral artery dissection - a common cause of stroke in young people, where a tear in a blood vessel causes a clot that impedes blood supply to the brain. She was admitted to hospital - but again struggled for a diagnosis. A junior doctor found an issue with blood flow to the brain but she says their comments were dismissed and she was told it was a migraine. It was only when she collapsed again, days later, and admitted herself to a hospital with a dedicated stroke ward that a specialist team was able to give her the care she needed. Alison's case highlights the importance of being seen by stroke specialists. However, according to new figures from King's College London's 2018-19 Snapp (Sentinel Stroke National Audit Programme) report, 48% of hospitals in England, Wales and Northern Ireland have had at least one stroke consultant vacancy for the past 12 months or more. This has risen from 40% in 2016 and 26% in 2014. The Stroke Association charity - which analysed the data - says the UK is "hurtling its way to a major stroke crisis" unless the issue is addressed. Read full story Source: BBC News, 17 January 2020
  13. News Article
    Hospitals will be required to employ patient safety specialists from next April as part of efforts by the health service to reduce thousands of avoidable errors every year. NHS trusts will be told to identify staff who will be designated as the safety specialist for each organisation. These workers, who will get specific training and work as part of a network across the country, will help to tackle a fragmentation in the way safety issues are dealt with in the NHS and ensure nationwide action on key safety risks is coordinated. The proposals are part of a national patient safety strategy which is aiming to save 928 lives and £98.5m across the NHS, as well as reducing negligence claims by £750m by 2025. The specialists will be identified from existing staff, with part of the role focused on embedding a so-called “just culture” approach to safety. This means reducing blame, supporting staff who make honest errors and tackling systemic causes of mistakes. Read full story Source: The Independent, 26 December 2019 What do you think? Join the conversation on the hub.
  14. Content Article
    This infographic sets out standardised, safe care of children and young people who are receiving or for consideration of receiving Heated humidified high flow therapy (HHHFT).
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