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Found 112 results
  1. Content Article
    The trend towards health system mergers and acquisitions in the US is likely to continue in 2024. Mergers can be beneficial. However, post-merger integration can take years to complete and can have an adverse effect on patient safety, care culture and care quality. Some healthcare researchers have dubbed mergers as 'life events' for health systems.[1] Health system mergers and acquisition projects need to include a special task force to assess the risks to patient safety management practices. 
  2. Content Article
    This 'Element' from Cambridge Core, reviews the evidence for three workplace conditions that matter for improving quality and safety in healthcare: staffing; psychological safety, teamwork, and speaking up; and staff health and well-being at work. The authors propose that these are environmental prerequisites for improvement. They examine the relationship between staff numbers and skills in delivering care and the attainment of quality of care and the ability to improve it. They present evidence for the importance of psychological safety, teamwork, and speaking up, noting that these are interrelated and critical for healthcare improvement. They present evidence of associations between staff well-being at work and patient outcomes. Finally, they suggest healthcare improvement should be embedded into the day-to-day work of frontline staff; adequate time and resources must be provided, with quality as the mainstay of professionals' work. Every day at every level, the working context must support the question 'how could we do this better?' This title is also available as Open Access on Cambridge Core.
  3. News Article
    One of the NHS’s biggest hospital trusts is facing major problems after its IT system failed because of the extreme temperatures earlier this week. Guy’s and St Thomas’ trust (GSTT) in London has had to cancel operations, postpone appointments and divert seriously ill patients to other hospitals in the capital as a result of its IT meltdown. The situation means that doctors cannot see patients’ medical notes remotely and are having to write down the results of all examinations by hand. They are also unable to remotely access the results of diagnostic tests such as X-rays and CT and MRI scans and are instead having to call the imaging department, which is overloading the department’s telephone lines. GSTT has declared the problem a “critical site incident”. It has apologised to patients and asked them to bring letters or other paperwork about their condition with them to their appointment to help overcome doctors’ loss of access to their medical history. One doctor at GSTT, speaking on condition of anonymity, said: “This is having a major effect. We are back to using paper and can’t see any existing electronic notes. We are needing to triage basic tests like blood tests and scans. There’s no access to results apart from over the phone, and of course the whole hospital is trying to use that line. “Frankly, it’s a big patient safety issue and we haven’t been told how long it will take to fix. We are on divert for major specialist services such as cardiac, vascular and ECMO.” Read full story Source: The Guardian, 21 July 2022
  4. News Article
    Being in a productive and supportive work environment is linked to better mental health. However, those experiencing mental health problems are often either excluded from the workplace or not supported appropriately when in work, according to new guidance from the Royal College of Psychiatrists. As many as one in six people of working age are diagnosed with a mental health condition. Mental health problems are a leading cause of absence from work, but ‘good’ work can improve overall wellbeing. This is achieved by improving self-esteem, feeling useful, building a routine, and importantly, avoiding poverty, which adversely impacts health in many ways. ‘Good’ work should offer standard benefits such as job security, an appropriate wage, positive work/life balance, and opportunities for career progression as well as supportive mental health and wellbeing policies. These practices should support employees with existing mental health disorders while minimising the risk of developing issues with mental health and well-being. This includes flexible working policies, use of appropriate reasonable adjustments to help people maintain employment and access to counselling and support services as needed. The Royal College of Psychiatrists is calling for better support for people with mental health problems to find, return to, and remain in good work, and for employers and Government to recognise the valuable contribution these people make to the workforce. Dr Adrian James, President of the Royal College of Psychiatrists, said: “We all need to do more if the workplace is to consistently play a positive role in a person’s mental health and wellbeing. We know that issues such as insecure work and unemployment can have a disproportionate impact on the wellbeing of people with mental health conditions. “Psychiatrists and occupational therapists can play a key role between employers and patients, ensuring staying in good work is seen as an important outcome of treatment. We must put in place better support for people with mental health problems to find, return to, and remain in good work and for employers and Government to recognise the valuable contribution these people make to the workforce.” Read press release Source: Royal College of Psychiatrists, 14 July 2022
  5. News Article
    A spike in Covid absences and the extended heatwave have left NHS hospitals and ambulance services struggling to cope. The hot weather is also driving more patients to A&E departments, and callers are being urged not to use 999 except in serious emergencies. All 10 ambulance trusts in England are on black alert, the highest level, while health leaders warn that “ill-equipped” hospital buildings are struggling to store medicines correctly amid the abnormally high temperatures. Martin Flaherty, managing director of the Association of Ambulance Chief Executives, said: “The NHS ambulance sector is under intense pressure, with all ambulance services operating at the highest level of four within their local resource escalation action plans, normally only ever reserved for major incidents or short-term periods of unusual demand. “Severe delays in ambulance crews being able to hand over their patients at many hospital emergency departments are having a very significant impact on the ambulance sector’s ability to respond to patients as quickly as we would like to, because our crews and vehicles are stuck outside those hospitals.” Read full story Source: The Independent, 12 July 2022
  6. News Article
    Patients may be turned away at A&E in Portsmouth as the UK’s heatwave drives extreme hospital pressures. Staffing pressures coupled with additional strain from the current heatwave have forced Portsmouth Hospitals University Foundation Trust to declare a critical incident. The trust said it only had space in its emergency department for patients with life-threatening illnesses and critical conditions and so would be forced to redirect other patients elsewhere. In a statement, Portsmouth Hospitals University FT said: “Our emergency department remains full with patients and we have very limited space to treat emergency patients. We are only able to treat patients with life-threatening conditions and injuries, so anyone patients who arrive at ED without a life-threatening condition or injury, will be redirected to alternative services that can help... “Our immediate priority is to ensure there are beds available to admit our most seriously ill patients into and we are focusing on safely discharging as many patients as possible. We ask that families and loved ones support us with this and collect patients as soon as they are ready to be discharged.” Read full story Source: The Independent, 11 July 2022
  7. News Article
    The number of overheating incidents in clinical areas reported by NHS trusts has almost doubled over the last five years, with directors saying ageing estates make them vulnerable to extreme weather events. Providers reported that temperatures went above 26°C – the threshold for a risk assessment – more than 5,500 times in 2021-22, according to official data. Overheating looks set to become an increasingly significant issue for NHS estates, HSJ was told, as climate change makes extreme weather events more frequent and more intense. Janet Smith, head of sustainability at Royal Wolverhampton and Walsall Healthcare Trusts, said: “We’re feeling it now. And it’s not going to change unless we do something about it. We need a climate resilient estate to actually deliver sustainable care.” An overheating incident is when the temperature surpasses 26°C in an occupied ward or clinical space in a day, with each area counting as a separate incident. When this happens, trusts should carry out a risk assessment and take action to ensure the safety of vulnerable patients. Read full story (paywalled) Source: HSJ, 16 February 2023
  8. News Article
    Nurses in England, Wales and Northern Ireland will strike today in an ongoing dispute with the government about pay and concerns about patient safety. Up to 100,000 members of the Royal College of Nursing (RCN) will take part after it balloted its members in October. It has said that low pay is the cause of chronic understaffing that is putting patients at risk and leaves NHS staff overworked. It will be the second day of strikes in December, after an initial day of industrial action on 15 December, the RCN’s biggest in its history. It meant the cancellation of thousands of outpatient appointments and non-urgent operations. More strikes have been threatened for January unless talks between union negotiators and the government takes place before Thursday, 48 hours after the strike on Tuesday. The RCN’s general secretary and chief executive, Pat Cullen, said: “For many of us, this is our first time striking and our emotions are really mixed. The NHS is in crisis, the nursing profession can’t take any more, our loved ones are already suffering. “It is not unreasonable to demand better. This is not something that can wait. We are committed to our patients and always will be.” Read full story Source: The Guardian, 20 December 2022
  9. News Article
    English hospitals have increased emergency fuel supplies and put staff on standby to postpone operations and switch off X-ray scanners amid heightened concerns over energy provision this winter. NHS hospital trusts across England have put their power plans under the microscope as they look to protect patients from potential outages for lifesaving equipment. Responses to freedom of information requests to 63 NHS trusts revealed that 41 are re-examining their plans for a loss of power for this winter. A further 10 trusts said they conducted routine reviews of their business continuity plans this year, while 12 had not revised their strategies. National Grid warned in October that, in extreme circumstances, it would be forced to enact planned three-hour power cuts with a days’ notice. Major hospitals are exempt from this system, called rota disconnection, however businesses and the government have studied their plans for a complete power failure on the network. Despite the pressure on the NHS budgets, the responses show that most hospitals have up-to-date plans and backup generators to ensure lives are not lost due to lack of power. A quarter of hospital trusts said they were able to run indefinitely on backup diesel generator power, providing they had access to fuel supplies. Just over 10% said they could run on backup power for 10 days. Read full story Source: The Guardian, 12 December 2022
  10. News Article
    The Royal College of Surgeons of England is conducting a census to gain a better understanding of the surgical workforce. Through the census, they will be able to gather comprehensive information on the composition of the surgical workforce, its demographics and working practices. Most importantly, it allows members of the surgical workforce to share the most pressing challenges they are facing. It aims to: Better appreciate the needs, challenges, and working practices of the surgical workforce. More effectively represent and advocate for the workforce. Offer better support Create a better working environment. Enhance sustainability, including measures to improve retention, recruitment and work-life balance. Improve future planning. Take part in the survey
  11. News Article
    A fifth of UK hospitals were forced to cancel operations during the three days in July last year when temperatures soared, research suggests. The findings, published in a letter to the British Journal of Surgery, are based on surveys from surgeons, anaesthetists and critical care doctors working during the heatwave from July 16-19 2022, when temperatures reached as high as 40C in some parts of the country. The researchers received 271 responses from 140 UK hospitals – with one in five (18.5%) reporting elective surgeries being cancelled due to the heatwave. The respondents also said surgical services were poorly prepared for heatwaves, with 41% of operating theatres having no means to control ambient temperature, while more than a third (35.4%) reported making changes to maintain routine surgical activity during the period. These include delayed discharge of high-risk patients, changes to surgical teams, selecting lower-risk patients to have surgery, and restricting surgical activity to day cases. Other measures included longer staff breaks, extra fluids to patients, and surgeries earlier in the morning when temperatures were lower. Read full story Source: The Independent, 23 March 2023
  12. Content Article
    In this episode of The Human Risk podcast, host Christian Hunt speaks to Dr Gordon Caldwell, a retired NHS Consultant and Clinical Lead about the impact of medical bureaucracy. In 2019, Gordon had a photograph taken of himself lying next to a long line of forms, to highlight the amount of paperwork healthcare professionals need to fill in. Gordon is a campaigner against bureaucracy, and he wanted to make the point that time spent filling in forms is time spent not looking after patients. In the podcast, Christian and Gordon discuss: the genesis of the photograph and why Gordon felt motivated to take it the reasons why there is so much bureaucracy within the NHS the impact this has on patient care what Gordon sees as ways to improve it. See also: The Spectator: The NHS is drowning in paperwork Pictured: Doctor shows army of ‘pointless’ forms burying NHS hospitals
  13. News Article
    A case of MRSA has been reported at the congested asylum processing centre at Manston in Kent, the Guardian has learned, after it emerged that Suella Braverman ignored advice that people were being kept at the centre unlawfully. The antibiotic-resistant bacteria was identified in an asylum seeker who initially tested positive for diphtheria. But the asylum seeker was moved out of the site in Ramsgate to a hotel hundreds of miles away before the positive test result was received, raising concerns about the spread of the infection. The Manston site is understood to now have at least eight confirmed cases of diphtheria, a highly contagious and potentially serious bacterial infection. Migrants are meant to be held at the short-term holding facility, which opened in January, for 24 hours while they undergo checks before being moved into immigration detention centres or asylum accommodation such as a hotel. But giving evidence to a committee of MPs last week, David Neal, the independent chief inspector of borders and immigration, said he had spoken to a family from Afghanistan living in a marquee for 32 days, and two families from Iraq and Syria sleeping on mats with blankets for two weeks. Conditions at the site left him “speechless”, he said. On a visit to the site on 24 October, Neal was told there were four confirmed cases of diphtheria. Protective medical equipment for staff has now been brought on to the site. Although diphtheria is a notifiable disease, meaning cases must be reported to authorities, those at Manston have not appeared on weekly public health reports. A Home Office spokesperson said it was “aware of a very small number of cases of diphtheria reported at Manston”, and that proper medical guidance and protocols were being followed. Read full story Source: The Guardian, 30 October 2022
  14. News Article
    Trusts need hundreds of millions of pounds to remediate dangerous roofs. A series of freedom of information requests submitted by New Civil Engineer has revealed five of the worst affected trusts have applied for £331.9m of additional funding to be spent on fixing reinforced autoclaved aerated concrete planks during the next three years. In response to NCE’s freedom of information investigation, Liberal Democrat deputy leader and health spokesperson Daisy Cooper said “patients are paying the price for years of neglect” by successive governments. “It is truly shocking that patients are being treated in crumbling buildings that could be at risk of collapse. The NHS is crying out for the funds to fix creaking roofs so that patients can be treated safely. The public needs to know that the funds to fix this are on the way as soon as possible.” Read full story Source: HSJ, 17 October 2022
  15. News Article
    Rolling power cuts enforced this winter if gas supplies run extremely low could endanger thousands of people who use life-saving machines at home, health leaders have warned. They spoke out after National Grid warned on Thursday that households could experience a series of three-hour electricity outages this winter to manage extreme gas shortages, for example if Vladimir Putin shuts off supplies from Russia and cold weather sends demand soaring. Such an event would mean consumers in different parts of the country being notified a day in advance of three-hour blocks of time during which their power would be cut off. The prospect of rolling power outages caused alarm among some health groups, with particular concerns for the thousands of vulnerable patients who rely on electrical devices to keep themselves alive and healthy. Laurie Cuthbert, a director of Kidney Care UK, a health charity, said thousands of adults and children depended on a constant source of power to provide life-saving dialysis at home. Andy Fletcher, the chief executive of Together for Short Lives, which advocates for the UK’s 99,000 seriously ill children and their families, said: “For seriously ill children a three-hour blackout could deprive them of vital life-saving equipment such as ventilators, oxygen and temperature control. Families would be forced to decide whether to admit their child to hospital, which would be extremely disruptive and distressing.” Read full story Source: The Guardian, 6 October 2022
  16. News Article
    Ill patients are refusing sicknotes from their GP because they cannot afford time off work, while doctors suffer “moral distress” at their powerlessness to do more to help the most vulnerable, the new leader of Britain’s family doctors has revealed. More patients are experiencing asthma attacks or other serious breathing problems because they cannot afford to heat their homes, said Dr Kamila Hawthorne, the chair of the Royal College of GPs, while many have reported deteriorating mental health due to financial stress. Soaring food costs are also leading to a rise in fatigue, mouth ulcers and weak muscles, with people deficient in key vitamins because they cannot afford to eat anything other than a poor diet. So many patients are presenting with complex physical and psychological problems related to poverty, domestic violence, childhood abuse or poor housing that GPs are suffering psychologically from their inability to take the requisite action, she said. Hawthorne said: “Recently I’ve had patients refusing sicknotes because they can’t afford not to work. Quite often, when it’s clear that somebody needs some time off, they won’t take it. “These are people who ideally, medically, should not be at work [because] they have a chronic condition such as asthma or diabetes, but quite often mental health problems, quite severe mental health problems, I [see] some cases that really do require a bit of sicknote peace and quiet to try and help them get better. “I’ve been really surprised in the last year that when I’ve offered a sicknote they’ve said: ‘Oh no, no, I can’t take time off. I need the money from work.’ They’ve refused. They say: ‘I need to keep working to earn and to feed myself and my family.’ I don’t take it personally, of course, but I feel sad for people because for a few minutes you enter their lives and see that it’s really tough.” Read full story Source: The Guardian, 23 November 2022
  17. News Article
    A coroner has written to the health secretary warning a lack of guidance around a bacteria that could contaminate new hospitals' water supply may lead to future deaths. It follows inquests into the deaths of Anne Martinez, 65, and Karen Starling, 54, who died a year after undergoing double lung transplants at the Royal Papworth Hospital in Cambridge in 2019. Both were exposed to Mycobacterium abscessus, likely to have come from the site's water supply. The coroner said there was evidence the risks of similar contamination was "especially acute for new hospitals". In a prevention of future deaths report, external, Keith Morton KC, assistant coroner for Cambridgeshire and Peterborough, said 34 people had contracted the bacteria at the hospital since it opened at its new site in 2019. He said the bacteria "poses a risk of death to those who are immuno-suppressed" and there was a "lack of understanding" about how it entered the water system. There was "no guidance on the identification and control" of mycobacterium abscesses, the coroner said. Mr Morton said documentation on safe water in hospitals needed "urgent review and amendment". "Consideration needs to be given to whether special or additional measures are required in respect of the design, installation, commissioning and operation of hospital water systems in new hospitals," he said. Read full story Source: BBC News, 22 November 2022
  18. News Article
    The health service lacks the beds, staffing and resources to cope with a serious outbreak of the coronavirus, The Independent has been told by senior doctors and nurses. NHS staff from across the country warned hospitals are already unable to cope, with patients being looked after in spill-over wards and waiting hours for a bed, with one doctor saying it was already a “one in, one out mentality” for intensive care. Other staff reported delays in lab tests, rationing of protective masks and equipment, and a lack of isolation areas for suspected coronavirus patients. Suggestions from the Health Secretary Matt Hancock that the NHS would use “home ventilation kits”, and that an extra 5,000 intensive care beds could be created, were labelled “fanciful” by the chair of the British Association of Critical Care Nurses today. Nicki Credland said: “If you already have a system running at 100 per cent capacity, the idea you can get a significant amount of additional beds is just not realistic. There simply aren’t enough beds for them. We will need to make difficult decisions about which patients are going to be admitted to intensive care." Read full story Source: The Independent, 5 March 2020
  19. News Article
    An advanced nurse practitioner working in primary care services at Grimsby Hospital has called on the hospital senior leadership to ‘see for themselves how unsafe it is’. The nurse, who has penned a letter to bosses at Northern Lincolnshire and Goole NHS Foundation Trust says they are having “worst experience to date” in their career and fears somebody will die unnecessarily unless something is urgently done. “I have never in my whole career seen patients hanging off trolleys, vomiting down corridors, having ECGs down corridors, patients desperate for the toilet, desperate for a drink. Basic human care is not being given safely or adequately," says the nurse. Hospital bosses say they are taking the letter seriously and are investigating. Earlier this month it was revealed that some hospitals were being forced to deploy ‘corridor nurses’ in a bid to maintain patient safety while dealing with unprecedented demand. Dr Peter Reading, Chief Executive, said: “I can confirm we have received this email and that the hospital and North East Lincolnshire CCG are taking these concerns seriously. The person who raised the concerns with us has been contacted and informed that we are jointly investigating what they have told us. Read full story Source: Nursing Notes, 22 January 2020
  20. News Article
    A hospital accused of bullying its staff is facing new claims that it failed to act on a leading doctor’s warning about a potentially fatal failure to monitor vulnerable patients, the Guardian newspaper can reveal. Dr Jonathan Boyle, the UK’s top vascular surgeon, had warned West Suffolk NHS trust that patients at risk of dying from burst aneurysms were not being safely monitored. An IT glitch meant that patients were not followed up to see how soon they would need potentially life-saving surgery. A doctor at the trust, however, says it initially repeatedly refused to take any action, raising further questions about its management. The trust initially suggested the problem was the result of senior doctors not keeping up with emails, but later accepted its IT systems were at fault. The hospital was forced to recognise that patients were potentially put at risk and took action only after a whistleblower alerted the NHS regulator. Read full story Source: The Guardian, 5 January 2020
  21. News Article
    IT systems in the NHS are so outdated that staff have to log in to up to 15 different systems to do their jobs. Doctors can find themselves using different logins for everything from ordering x-rays and getting lab results to accessing A&E records and rotas. The government in England said it was looking to streamline the systems as part of an IT upgrade. Around £40 million is being set aside to help hospitals and clinics introduce single-system logins in the next year. Alder Hey in Liverpool is one of a number of hospitals which have already done this, and found it reduced time spent logging in from one minute 45 seconds to just 10 seconds. With almost 5,000 logins per day, it saved over 130 hours of staff time a day, to focus on patient care. Health Secretary Matt Hancock said it was time to "get the basics right". "It is frankly ridiculous how much time our doctors and nurses waste logging on to multiple systems. Too often outdated technology slows down and frustrates staff." British Medical Association leader Dr Chaand Nagpaul said logging on to multiple systems did waste time. But he said on its own this move would not solve all the problems, pointing out that many of the IT systems themselves were "antiquated" and needed upgrading. Read full story Source: BBC News, 4 January 2020
  22. Content Article
    There is great disparity in the way we think about and address different sources of environmental infection. Governments have for decades promulgated a large amount of legislation and invested heavily in food safety, sanitation, and drinking water for public health purposes. By contrast, airborne pathogens and respiratory infections, whether seasonal influenza or COVID-19, are addressed fairly weakly, if at all, in terms of regulations, standards, and building design and operation, pertaining to the air we breathe. We suggest that the rapid growth in our understanding of the mechanisms behind respiratory infection transmission should drive a paradigm shift in how we view and address the transmission of respiratory infections to protect against unnecessary suffering and economic losses. It starts with a recognition that preventing respiratory infection, like reducing waterborne or foodborne disease, is a tractable problem.
  23. Content Article
    Have you ever come across a ‘problematic solution’ that was implemented in your workplace, and wondered, “How did this come to be?” Wherever you sit in an organisation, the chances are that you have. Many problematic solutions emerge from a top-down process that Steven Shorrock in this blog will call work-as-imagined solutioneering. In this post, he outlines a typical process of 10 steps by which problematic solutions come into being. Some of the steps may be skipped, but with the same outcome: a problematic solution. At the end of the post, you will find 10 ‘solutions’ from healthcare, provided by healthcare practitioners.
  24. Content Article
    This month an inquiry will deliver its verdict on the failures of maternity care at the Shrewsbury and Telford Hospital NHS Trust, the largest maternity scandal in NHS history, involving 1,862 families. The result of this inquiry will highlight how we may need to reconfigure maternity services to ensure the highest standard of care.  But what does good really look like? Is there really a way to be a safe maternity unit?  At last year's Patient Safety Congress, one of the sessions aimed to answer these questions. The panel discussed behaviours and practices that constitute safe care in hospital-based maternity units, and how organisations can take practical steps to make these features a reality. Click on the video below to watch the full session.
  25. Content Article
    A new BMJ Open study from Grimmond et al. compared global warming potential of hospitals converting from single-use sharps containers to reusable sharps containers. The study reveals that, on average, the 40 NHS trusts studied when converting from single use to reusable sharps containers reduced their sharps waste stream carbon footprint by 84%.
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