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Found 823 results
  1. Content Article
    NHS strikes have become such a familiar feature of our lives over the past two years that there is a risk we can become inured to their impact. This King's Fund article looks at the different ways in which strikes can impact the NHS and the people it serves.
  2. News Article
    The government is facing calls for a public inquiry into the scandal of sexual abuse in mental health hospitals, following an investigation by The Independent. Rape Crisis England and Wales has warned that the “alarming” scale of abuse within the UK’s psychiatric system requires “major intervention” from ministers. It comes after an expose by the Independent and Sky News revealed that almost 20,000 reports of sexual incidents – involving both patients and staff – had been made in more than half of NHS mental health trusts in the past five years. As well as a public inquiry, which would give survivors the chance to give evidence, Rape Crisis England and Wales wants the government to appoint a named minister with responsibility for addressing the problem. Chief executive Ciara Bergman said: “That anyone in the already vulnerable position of needing or being detained for in-patient care because of their mental health needs should experience sexual violence and abuse whilst in the care of the state, is deeply concerning. “We are concerned that without major intervention and leadership at the highest levels, this could lead to more incidents of sexual violence and abuse happening, and this behaviour being accepted as inevitable, when it is not, and is indeed absolutely preventable.” Read full story Source: The Independent, 15 March 2024
  3. Content Article
    The NHS regularly uses temporary staff to fill gaps in its workforce. This investigation explored the challenges of involving temporary clinical staff (bank only staff, agency staff and locum doctors working within trusts) in local trusts’ patient safety investigations. Trust-level investigations are important because they are a way to identify learning to improve healthcare systems, with the aim of reducing the potential for harm to patients. Identifying learning requires staff to be engaged in an investigation; if temporary staff are not involved, learning may be lost, posing a risk to patient safety. HSSIB identified this risk following analysis of serious incident reports provided by acute and mental health NHS trusts. To explore the issue further, the investigation carried out site visits and engaged with NHS trusts, providers of bank staff, agencies that supply staff to NHS trusts, substantive (permanent) NHS staff, bank and agency staff, and a range of national stakeholders.
  4. News Article
    Staff whistleblowers have raised concerns over patient safety at one of Northern Ireland's biggest health trusts. Information received by UTV under Freedom of Information shows that most of the worries from health workers at the Belfast Health Trust relate to the Royal Victoria Hospital. Belfast Health Trust said any concerns raised by staff are investigated. The Royal College of Nursing NI was due to hold a webinar with members on Tuesday evening to discuss concerns members have about safety of patients being treated on corridors. The RCN's Rita Devlin said that the number of concerns raised with health trusts through the whistleblowing policy is only the tip of the iceberg. The concerns included unsafe staffing levels, bed shortages, boarding of patients, ED overcrowding, alleged drug dealing on a hospital site, staff sleeping on night duty, lack of mental health beds and the quality of staff training. The Belfast Trust said all staff are encouraged to make management aware of issues giving them concern through the whistleblowing process. The Trust added: "Any concern we receive is subject to a fair and proportionate process of investigation. "Whistleblowing investigations are of a fact finding nature and all relevant learning is shared as appropriate and taken forward by the Trust." Read full story Source: ITVX. 12 March 2024
  5. News Article
    A board director has publicly criticised his trust for its treatment of Muslim staff and patients. Mohammed Hussain posted on social media that some board members at Bradford Teaching Hospitals “are not heard and listened to”, and that there is a “dissonance” between its espoused values and the “lived experiences” of minority ethnic staff. Mr Hussain, a non-executive director since 2019, was responding to a post by CEO Mel Pickup, who had said the trust had a “variety of support offers for colleagues observing Ramadan”. He said there are “many examples” of Muslim families experiencing poor responses to complaints to the trust, while claiming that “outstanding” Muslim staff are having to “move out of the area to progress because they are not promoted internally”. The trust said its launching an investigation into the concerns raised by Mr Hussain. Read full story (paywalled) Source: HSJ, 12 March 2024
  6. Content Article
    This parliamentary briefing discusses the NHS workforce in England, focusing on the clinical professions, including doctors and nurses. It gives an overview of workforce demographics and workforce policy and planning since 2019. It also looks at turnover and vacancy rates, the use of temporary staffing and how safe staffing levels are decided. It considers trends in domestic and international recruitment and factors affecting both recruitment and retention, including staff wellbeing, pay and pensions, and bullying, harassment and discrimination.
  7. News Article
    The Health and Social Care Committee has launched a new inquiry to examine leadership, performance and patient safety in the NHS. Inquiry: NHS leadership, performance and patient safety MPs will consider the work of the Messenger review (2022) which examined the state of leadership and management in the NHS and social care, and the Kark review (2019) which assessed how effectively the fit and proper persons test prevents unsuitable staff from being redeployed or re-employed in health and social care settings. The Committee’s inquiry will also consider how effectively leadership supports whistleblowers and what is learnt from patient safety issues. An ongoing evaluation by the Committee’s Expert Panel on progress by government in meeting recommendations on patient safety will provide further information to the inquiry. Health and Social Care Committee Chair Steve Brine MP said: “The role of leadership within the NHS is crucial whether that be a driver of productivity that delivers efficient services for patients and in particular when it comes to patient safety. Five years ago, Tom Kark QC led a review to ensure that directors in the NHS responsible for quality and safety of care are ‘fit and proper’ to be in their roles. We’ll be questioning what impact that has made. We’ll also look at recommendations from the Messenger review to strengthen leadership and management and we will ask whether NHS leadership structures provide enough support to whistleblowers. Our Expert Panel has already begun its work to evaluate government progress on accepted recommendations to improve patient safety so this will build on that. We owe it to those who rely on the NHS – and the tax-payers who pay for it – to know whether the service is well led and those who have been failed on patient safety need to find out whether real change has resulted from promises made.” Terms of Reference The Committee invites written submissions addressing any, or all, of the following points, but please note that the Committee does not investigate individual cases and will not be pursuing matters on behalf of individuals. Evidence should be submitted by Friday 8 March. Written evidence can be submitted here of no more than 3,000 words.  How effectively does NHS leadership encourage a culture in which staff feel confident raising patient safety concerns, and what more could be done to support this? What has been the impact of the 2019 Kark Review on leadership in the NHS as it relates to patient safety? What progress has been made to date on recommendations from the 2022 Messenger Review? How effectively have leadership recommendations from previous reviews of patient safety crises been implemented? How could better regulation of health service managers and application of agreed professional standards support improvements in patient safety? How effectively do NHS leadership structures provide a supportive and fair approach to whistleblowers, and how could this be improved? How could investigations into whistleblowing complaints be improved? How effectively does the NHS complaints system prevent patient safety incidents from escalating and what would be the impact of proposed measures to improve patient safety, such as Martha’s Rule? What can the NHS learn from the leadership culture in other safety-critical sectors e.g. aviation, nuclear? Read full story Source: UK Parliament, 25 January 2024
  8. News Article
    Physician associates should never see ‘undifferentiated’ patients in a GP setting, the BMA has declared in new ‘first of its kind’ guidance. Today, the union has published a national scope of practice laying out how physician associates (PAs) and anaesthesia associates (AA) should work safely in GP practices and secondary care. According to the BMA, the guidance is different from what it describes as the current ‘piecemeal or fragmented approach’ whereby individual organisations set their own guidelines for how PAs should be supervised. In general practice, the guidance said a GP ‘should first triage’ all patients and ‘decide which ones a PA can see’, suggesting annual health checks as an appropriate contact. The union is also clear that PAs ‘must not make independent management decisions for patients’ and must be clear in all their communications that ‘they are not doctors’. Read full story Source: Pulse, 7 March 2024
  9. Content Article
    Landmark national guidance outlining how MAPs (medical associate professionals) can work safely and effectively in the NHS, has been published by the British Medical Association (BMA). The association has unveiled its report Safe Scope of Practice, which sets out in highly detailed terms the responsibilities of MAPs including PAs (physician associates) and AA (anaesthesia associates). Described as a ‘first of its kind’ the report uses a traffic light-style system to illustrate what clinical duties MAPs should be able to carry out, as well as those responsibilities from which they should be prohibited.  The guidance also sets out six general principles for how MAPs should be deployed in primary and secondary-care settings. The guidance comes as the Government continues to press ahead with its plans to have PAs regulated by the GMC despite intense opposition to such a move from the BMA.
  10. Content Article
    The NHS Staff survey is one of the largest workforce surveys in the world and is carried out every year to improve staff experiences across the NHS. It asks staff in England about their experiences of working for their respective NHS organisations. Of the 1.4 million NHS employees in England, 707,604 staff responded to the survey in 2023.
  11. Content Article
    Hospital nurse staffing, and the proportion of nurses with bachelor’s education, are associated with significantly fewer deaths after routine surgery, according to research published in the Lancet. A team of researchers conducted the study across nine European countries and found that a better educated nursing workforce reduced unnecessary deaths. Every 10%increase in the number of bachelor’s degree educated nurses within a hospital is associated with a 7% decline in patient mortality. Patients in hospitals, in which 60% of nurses had bachelor’s degrees and nurses cared for an average of six patients, had almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor’s degrees and nurses cared for an average of eight patients. The study shows that, in hospitals in England, an average only of 28% of bedside care nurses had bachelor’s degrees, among the lowest in Europe, which averaged 45%. The study shows that increasing the production of graduate nurses is necessary if the NHS is to realise the potential of lower patient mortality and fewer adverse patient outcomes.
  12. News Article
    Staff have assaulted patients and falsified medical records following deaths, according to a shocking new report into a scandal-hit mental health hospital where Nottingham killer Valdo Calocane was a patient. Multiple incidents of staff physically assaulting patients and workers feeling too scared to report problems at Highbury Hospital have been uncovered by the Care Quality Commission (CQC). The watchdog revealed police have investigating the deaths of at least two patients in which staff involved were later found by the hospital to have falsified their medical records in a new report, published on Friday. The news comes after The Independent revealed Nottinghamshire Healthcare Foundation Trust, which runs Highbury Hospital, had suspended more than 30 staff members following allegations of mistreating patients and falsifying records of medical observations. The trust also faces a further CQC review, commissioned by health secretary Victoria Atkins, following the conviction of killer Valdo Calocane who was a patient of Highbury Hospital’s community service teams. This review is due to be published later this year. Read full story Source: The Independent, 1 March 2023
  13. Content Article
    A new BMA report, “It’s broken” Doctors’ experiences on the frontline of a failing mental healthcare system", based on first-hand accounts of doctors working across the NHS, reveals a ‘broken’ system of mental health services in England. The current economic cost of mental ill health has been estimated to be over £100 billion in England alone*, but this report demonstrates that across the NHS, doctors are in an ongoing struggle to give patients the care they need because the funding is just not enough, there are not enough staff, and the infrastructure and systems are not fit for purpose. The report makes plain that without a concerted effort from central government to resource mental healthcare based on demand (which continues to grow beyond what the NHS can respond to) as well as changes in society to promote good mental health, the future looks bleak. The BMA carried out in-depth interviews with doctors across the mental health system, including those working in psychiatry, general practice, emergency medicine, and public health.
  14. Content Article
    Female urologists report higher rates of work-related physical discomfort compared to male urologists. This study in the American Journal of Surgery compared ergonomics during simulated ureteroscopy—the most common surgery for kidney stones—between male and female urologists. The authors found that across all conditions, women required greater muscle activation in multiple muscle groups and had greater NASA Task Load Index (NASA-TLX) scores compared to men. These results suggest there may be gender differences in ergonomics during ureteroscopy based on muscle activation and subjective workload. There is therefore potential for personalising surgical workspaces and equipment.
  15. News Article
    Health secretary Victoria Atkins has said mental health patients and staff must report the “horrific” sexual abuse allegations uncovered by The Independent to the police. Ms Atkins said victims would have her full support if they reported their claims to the police. Her intervention comes following a joint investigation by The Independent and Sky News, which revealed almost 20,000 reports of sexual harassment and abuse on NHS mental health wards in England. The allegations uncovered include patients claiming to have been raped by staff and other patients while being treated on mental health wards. In response to the initial investigation, Ms Atkins said a review launched last year into mental health services would now also look into sexual assault within the sector. Speaking on Sky News, she said: “These are horrific allegations that should not and must not happen in our care. Very, very vulnerable people have to stay in mental health inpatient facilities, and they do so because they need care, support, and treatment. “Some of the behaviours that have come to light are criminal offences, and so I would encourage anyone who feels able to – and I appreciate it is a difficult step – to go to the police and please report them, because they are crimes and we must drive them out.” Read full story Source: The Independent, 21 February 2024
  16. Content Article
    In this interview, Professor Martin Marshall, former GP and Chair of the Royal College of General Practitioners, shares his concerns for the future of general practice in the UK. He outlines the danger that more of the workforce will turn to private practice due to current pressures facing NHS GPs.
  17. News Article
    Ambulance trusts have often prioritised capacity and response times over dealing with cases of misconduct, a review of culture in the sector for NHS England has found. The review says ambulance trusts need to “establish clear standards and procedures to address misconduct”. The work was carried out by Siobhan Melia, who is Sussex Community Healthcare Trust CEO, and was seconded to be South East Coast Ambulance Service Foundation Trust interim chief from summer 2022 to spring last year. Her report says bullying and harassment – including sexual harassment – are “deeply rooted” in ambulance trusts, and made worse by organisational and psychological barriers, with inconsistencies in holding offenders to account and a failure to tackle repeat offenders. She says “cultural assessments” of three trusts by NHSE had found “competing pressures often lead to poor behaviours, with capacity prioritisation overshadowing misconduct management”, adding: “Staff shortages and limited opportunities for development mean that any work beyond direct clinical care is seen as a luxury or is rushed. “Despite this, there is a clear link between positive organisational culture and improved patient outcomes. However, trusts often focus on meeting response time standards for urgent calls, whilst sidelining training, professional development, and research.” Read full story (paywalled) Source: HSJ, 15 February 2024
  18. Content Article
    The press has all been full of headlines about staffing levels in the NHS, but this is probably a problem across healthcare around the country. What this does is provide the perfect patient safety quandary, how do we keep all the areas safe. This often results in the redeployment of nursing staff to different areas, but does this provide the required levels of safety. It appears that having several areas in an “amber” staffing level is preferable than one red area. It is simple logic, but does this create an unrealistic expectation on staff that means the safety is better but only at a barely satisfactory level? Do we think that any of these decisions influences the efficiency of a ward? Is the ward safe and effective? In this blog, Chris Elston explores these issues and uses a Safety Engineering Initiative for Patient Safety (SEIPS) to show some of the lesser appreciated risks to redeploying staff and consider some ways to reduce the risks.
  19. News Article
    The NHS has been accused of putting patients' lives at risk after it allowed hundreds of staff, including senior consultants and managers, to work thousands of miles from the UK. A Mail on Sunday investigation has discovered that NHS staff at every level are working remotely in places as far flung as Australia and Japan. Critics last night warned that the 'unacceptable and dangerous' arrangements could threaten patient safety. Professor Karol Sikora, a former director of the World Health Organisation cancer programme, said: "Allowing staff to work from abroad is a huge mistake that can only undermine patient safety and the efficacy of treatment." At least 335 NHS staff from 33 trusts have been allowed to work abroad in the past two years, according to data from Freedom of Information requests. Until last year, Constantine Fragkoulakis, 42, was employed as a consultant radiologist at Sherwood Forest Hospitals Foundation Trust in Nottinghamshire. The trust said its radiologists "routinely interpret images and write reports away from the hospitals where they are based". But Mr Fragkoulakis admitted there had been "a lot of IT issues, so there was no patient care involved or clinical work'. He added: 'Essentially it was just meetings that I did." Another consultant radiologist, Branimir Klasic, 50, is being allowed to work two weeks each month in Croatia by the Aneurin Bevan University Health Board in South Wales. It said recruitment was "increasingly challenging" and that it was "open to exploring ways of working that ensures we can provide the skills and expertise that our patients need". A Department of Health spokesman said: "We are clear that ways of working, which are agreed between NHS employers and its staff, should never impact on NHS patients or services." Read full story Source: Daily Mail, 10 February 2024
  20. News Article
    Dozens of new allegations of sexual assault and abuse, including claims of rape and of patients being made pregnant, have emerged following an investigation into Britain’s mental health wards. One patient with a mental health disorder became pregnant by a member of staff. Allegations of rape, and of children being groomed by healthcare assistants, were among the 40 horrifying new reports of abuse made against rogue NHS Trusts. The investigation, conducted by The Independent, alongside Sky News, revealed more than 20,000 allegations of sexual assault and harassment across more than 30 NHS England mental health trusts since 2019. Several patients, who have come forward with their own harrowing stories, had allegedly been harmed by healthcare assistants, who currently are not regulated. Natalie, whose name has been changed, was one of several patients groomed and asked to share sexually explicit photos by a healthcare assistant working at a children’s mental health ward in 2020. Natalie, who was 16 at the time, told The Independent: “The first few conversations [after I was discharged] were very innocent. However after weeks and months, he started speaking in a sexual nature, asking me to send explicit photos of myself, posting explicit photos of himself and asking to meet up for sexual advances, I didn’t realise it at the time, but he was grooming me; this was all over Snapchat. “I feel and still feel very small, and that I wasn’t looked at as a person [by the hospital], and they only saw me as a patient with no feelings that mattered. It felt like another incident at ... that just got swept under the rug.” Read full story Source: The Independent, 10 February 2024
  21. News Article
    Rishi Sunak has admitted the government has failed on a pledge to cut NHS waiting lists in England. The prime minister said the government had "not made enough progress" but that industrial action in the health service "has had an impact". Mr Sunak made the comments in an interview with TalkTV. Cutting NHS waiting lists is one of five priorities Mr Sunak set out in January 2023, along with measures on the economy and illegal immigration. At the time he said "NHS waiting lists will fall and people will get the care they need more quickly" but did not set a timeframe for achieving that. Asked if his government has failed to achieve that pledge, Mr Sunak said: "Yes, we have." The prime minister continued: "What I would say to people is that we've invested record amounts in the NHS - more doctors, more nurses, more scanners. "All these things mean the NHS is doing more than it ever has but industrial action has had an impact." Read full story Source: BBC News, 5 February 2024
  22. Content Article
    As health care specialists, we spend a huge amount of time considering, empathising with, and addressing the needs of the people we want to help. We intimately understand the challenges children and young people face, and how these may impact their health and development long term. Exposed daily to this kind of emotional and physical distress, it can be easy for compassion fatigue to creep in. Our brains work automatically to protect our own mental health, almost desensitising us to the trauma experienced by others. It’s much easier to think of people as statistics, especially when it comes to children and young people. But the more we think in terms of statistics, the more immune to them we become, the more empathy we lose and the less potential there is for an effective, caring health care system that works well for everyone. We need to put the care back into health care.
  23. Content Article
    This report sets out the findings of an Independent Review into the care and treatment provided by Greater Manchester Mental Health NHS Foundation Trust. The review was commissioned following reports of failings within the Trust’s services at the Edenfield Centre and the failure within the organisation to escalate concerns and mitigate patient harm.
  24. Content Article
    This is the video recording of a House of Lords debate on the delivery of maternity services in England, put forward by Baroness Taylor of Bolton.
  25. Content Article
    In 2023, the Royal College of Surgeons of England surveyed the UK surgical workforce to identify the key challenges facing surgical teams and to inform workforce planning. Respondents included consultants, surgeons in training, Specialist, Associate Specialist and Specialty (SAS) surgeons, Locally Employed Doctors in surgery (LEDs) and members of the extended surgical team (EST).   Advancing the Surgical Workforce reveals a number of interesting insights and paints a picture of a surgical workforce working long hours and in stressful environments. Too many staff are trying to navigate a system which frustrates the delivery of surgical services rather than enabling them. Surgical trainees in particular are increasingly being affected by these pressures. 
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