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Found 570 results
  1. Content Article
    It is well known that the NHS is suffering from staff shortages, with 121,000 full-time equivalent (FTE) vacancies and only 26% of the workforce stating there are enough staff at their organisation. The reasons why staff are leaving are well documented (burnout, lack of work–life balance, low pay etc), and the direct impact on patients is obvious – staff shortages are one of the main reasons why there is a backlog of care. But these headlines mask nuance. They hide the areas where staff shortages are even more acute than the average, and they obscure the indirect impact on patients. Where are these areas, what are the impacts, and will the NHS Long Term Workforce Plan help?
  2. Content Article
    This month marks two years of the hub's Patient Safety Spotlight interview series. Patient Safety Learning's Content and Engagement Manager Lotty Tizzard reflects on the value of sharing personal insights and identifies the key patient safety themes that interviewees have highlighted over the past two years.
  3. Content Article
    Nicholas Gerasimidis had a history of mental illness manifesting as obsessive compulsive disorder (OCD) and anxiety. In 2022, his condition deteriorated. His GP referred him twice to the Community Mental Health Team but the referrals were rejected with medication being prescribed instead, together with advice to contact Talking Therapies.   He was taken on to CMHT workload after being assessed by the Psychiatric Liaison Team in Royal Cornwall Hospital in November 2022. The preferred course of treatment was psychological treatment in the form of Cognitive Behavioural Therapy with Exposure Response Prevention. There was a waiting list of a year. In May 2023, Mr Gerasimidis became worse. It was felt an informal admission to hospital was required but a bed was not available. He was found hanged at his home address on 3 June 2023.
  4. Content Article
    This manifesto draws on the views of NHS Confederation members—health and care leaders across England, Wales and Northern Ireland. It suggests five changes that the next government will need to make in order to place the health and care system on a sustainable footing: Put the NHS on a more sustainable footing, with no top-down structural reform in England for the next parliament. Commit to a short-term stabilisation plan during the first 12 months of parliament to help get performance in the English NHS back on track. Increase NHS capital spending across the UK and reform how the capital regime operates. Specifically in England, capital funding needs to increase to at least £14.1 billion annually, a £6.4 billion increase from the current level of £7.7 billion. This is vital if we are to increase productivity and reduce waiting lists. Commit to fund and deliver the NHS Long Term Workforce Plan for England, alongside an equivalent plan for social care. Provide more care closer to home by enabling local health systems to proportionately increase investment upstream into primary care and community-based services, mental health and social care. Deliver a strategy for national health given that most policy that impacts people’s health is made outside the NHS. The Prime Minister should lead a cross-government national mission for health improvement to shift the focus from simply treating illness to promoting health and wellbeing, reducing inequalities and tackling the wider determinants of health, and supporting the public to be active partners in their own health.
  5. Content Article
    The Government plans to expand physician associate (PA) and anaesthesia associate (AA) roles and to establish the General Medical Council (GMC) as their statutory regulator. There has been concerted opposition to the plans by groups including the Doctors’ Association UK (DAUK) and the British Medical Association (BMA). Earlier this month, the House of Lords sent the draft legislation to the main chamber for proper scrutiny, stating that this was the procedure when an issue "is politically or legally important or gives rise to issues of public policy". In this Medscape article, Dr Sheena Meredith outlines the Government's proposals and why the issue has become so contentious.
  6. Content Article
    The King's Fund 'Mental health 360' aims to provide a ‘360-degree’ review of mental health care in England. It focuses on nine core areas, bringing together data available at the time of publication with expert insights to help you understand what is happening in relation to mental health and the wider context. The nine core areas covered are: Prevalence Access Workforce Funding and costs Quality and patient experience Acute mental health care for adults  Services for children and young people Inequalities Data.
  7. 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.
  8. Content Article
    This is an independent review commissioned by NHS England, chaired by Siobhan Melia, Chief Executive, Sussex Community NHS Foundation Trust, to support the improvement of the culture within the ambulance service. The review considers the prevailing culture within ambulance trusts in England. It considers the core factors impacting cultural norms and offers actionable recommendations for improvement. Based on insights from key stakeholders, this review has identified six key recommendations to improve the culture in ambulance trusts.
  9. Content Article
    The adrenal glands are found in the fatty tissue at the back of the abdomen above each kidney, and produce steroid and adrenaline hormones. Surgery on tumours of the adrenal gland is uncommon compared with surgery for other tumours such as those of the breast, bowel, kidney and lung. Research has shown that the more adrenal operations a surgeon undertakes per year, the better the overall outcomes for patients undergoing that type of surgery. In this study, the outcomes from adrenal operations recorded over 18 years in the national adrenal surgical registry were analysed. The results confirmed previous findings showing that postoperative complications and length of hospital stay were reduced for patients operated by surgeons who did more adrenal operations per year. Operations done by keyhole surgery had better outcomes. Operations done either in older patients, or for the rare adrenal cancer tumours had worse outcomes, as did operations in which both adrenal glands were removed. The authors recommended that all surgeons performing adrenal surgery should monitor the outcomes of their operations, ideally in a national registry, and discuss these with patients before surgery; and undertake a minimum of six adrenal operations per year, but a minimum of 12 per year if doing surgery for adrenal cancer or surgery to remove both adrenal glands.
  10. 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.
  11. 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
  12. Content Article
    There are many unheard and under-acknowledged voices and perspectives in the health and social care workforce, and they usually belong to those in the most junior, poorest-paid and precarious roles. All these voices deserve more attention than they get, but those of newly qualified and registered nurses and midwives are especially important given the current retention crisis in both professions. Since spring 2023, the King's Fund have been working with 22 newly qualified - newly registered if they trained internationally – nurses and midwives on a project called Follow Your Compassion. A documentary record of the everyday working lives of these nurses and midwives across a variety of settings across the UK health and care system, the project is a companion piece to The Courage of Compassion (2020), a report by The King’s Fund and RCN Foundation which described the core workplace needs of nurses and midwives, and what must be done to meet them.
  13. 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
  14. 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.
  15. 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. 
  16. Content Article
    Sickness absence in the English NHS in 2022 was 5.6% – higher than the 4.3% rate three years earlier pre-covid, and totalling some 27 million days sickness absence. Moreover, 54.5% of staff reported they had gone into work in the previous three months despite not feeling well enough to perform their duties. This is a challenge for staff, managers, employers and occupational health services. Sickness absence measured and reported accurately can help identify trends that may assist with both understanding individual causes and preventing or mitigating sickness absence patterns by addressing their root causes. The NHS, along with many other public sector organisations, however, relies on a system of sickness absence measurement called the “Bradford Factor” which some suggest is counterproductive, without research underpinning and needs to be replaced. The Bradford Factor is a system which creates individual level, “trigger points” at which line managers consider investigation which may lead to disciplinary action to supposedly prompt improved attendance and referral to occupational health. The NHS’s over reliance on the Bradford Factor is potentially discriminatory and highlights the urgent need for a shift in how the service manages sickness absence, writes Roger Klein in this HSJ article.
  17. Content Article
    Plans to increase their number in England to plug workforce gaps have been criticised – but their work is valued by hospital colleagues. Sammy Chan is very proud to be a physician associate, despite the controversies. “I find it particularly rewarding because I get to build relationships with patients,” she said. Chan works in respiratory medicine, mainly in outpatients. As well as more routine monitoring of patients and booking scans, she has been trained to perform chest drains and to insert pleural catheters. “While it’s quite emotionally challenging, it’s nice to be a constant presence on their journey,” she said. Chan is one of 40 physician associates employed at the Royal Berkshire foundation trust in Reading. Introduced nearly two decades ago, physician associates have some medical training but are not doctors. They can take medical histories, carry out physical examinations and help develop treatment plans – but cannot prescribe medicine or order X-rays. The NHS aims to increase the number of physician associates working in England from about 4,000 to 10,000 to help plug widespread gaps in the workforce.
  18. Content Article
    This staffing calculator has been developed by the US Association for Professionals in Infection Control and Epidemiology (APIC). The tool is in beta version and uses input from individual healthcare facilities to provide recommendations to assist with infection prevention staffing decisions. There are three separate calculators: Acute care hospital calculator Long-term care calculator Ambulatory clinic calculator As the tool is currently in development, the data collected from participating organisations will be used to update the calculators and provide the most accurate staffing recommendations.
  19. News Article
    Ministers are facing calls to tackle the NHS’s chronic lack of staff as figures reveal that the bill for hiring temporary frontline workers has soared to more than £10bn a year. Hospitals and GP surgeries across the UK are paying a record £4.6bn for agency personnel and another £5.8bn for doctors and nurses on staff to do extra “bank” shifts to plug gaps in rotas. Widespread short staffing has increasingly forced the service in all four home nations to hand colossal sums to employment agencies to hire stand-in workers. In England alone, the bill for agency staff, particularly nurses and GPs, has risen from £3bn to £3.5bn over the past year – a 16% rise. Wes Streeting, the shadow health secretary, said years of neglect of the growing NHS staffing crisis by Conservative governments had obliged “desperate” hospitals to spend “huge” sums on agency staff, including doctors who can cost more than £5,000 to hire for a single shift. The Royal College of Nursing said the levels of agency spending were “staggering”. It would be cheaper to employ more nurses as staff instead of having tens of thousands of vacancies, the general secretary Pat Cullen said. The NHS in England currently has 42,306 vacant nursing posts. Read full story Source: The Guardian, 16 January 2024
  20. Content Article
    in this podcast, Mark Doblas, lead clinical practice facilitator at Royal United Hospitals Bath NHS Foundation Trust and Ruby Faruqi, Stay and Thrive matron at Doncaster and Bassetlaw Hospitals NHS Trust, share their first-hand experience of being international recruits to the NHS. They talk about how the #StayAndThrive programme has enabled them to support international recruits in their respective organisations. Simon Littlefield, director of nursing and integrated care at St. Georges, Epsom and St. Helier NHS Trust (GESH) explores the role of leaders in setting a culture that welcomes new international recruits.
  21. News Article
    The scale of the crisis in social care is laid bare as figures show that dementia patients occupy a quarter of all beds in the NHS. People living with the disease often go into hospital after falls or infections as well as for acute medical or surgical problems. Dementia patients often experience longer hospital stays than the average patient and can be delayed leaving wards due to a shortage of care in the community. At any one time in the NHS, one in four hospital beds are occupied by people living with dementia, according to the National Institute for Health and Care Excellence, which says stays on wards can trigger distress, confusion and delirium for patients. Doctors must carry out a discharge assessment of patients to ensure they are healthy before they can leave hospital. Medics assess a dementia patient’s care needs outside of hospital and discharge can be delayed if these are deemed not adequate. Demand for social care continues to rise as the population grows older but there is a shortage of workers in the sector. Skills for Care estimated that, in 2022/23 an average of 9.9 per cent - or 152,000 - roles in adult social care in England went unfilled. This was the equivalent to 152,000 vacancies - down by 11,000 from the previous year, although vacancies remain high compared to the wider UK economy. Services are so overstretched that people are left struggling without vital support to carry out everyday tasks in their own homes, and lives are being blighted. Read full story Source: The Independent, 14 January 2024
  22. Content Article
    The USA National Nurses United is proposing for minimum, mandated, nurse-to-patient staffing ratios to protect patients’ right to nursing care. Every patient deserves a single standard of high-quality care. The ratios, coupled with nurses’ powerful voice of advocacy secured in collective bargaining, protect patients from complications that arise from missed care such as medical errors, health care disparities, infections, and so much more.
  23. Content Article
    The Royal College of Nursing (RCN) held its first ever safe staffing summit, bringing together global nursing workforce experts with senior nurses across the UK to agree a vision for the future and how to fight for it.   When there are too few nursing staff, they can be stretched dangerously thin. With tens of thousands of vacant nurse posts across the UK right now, this happens too often. The summit heard compelling evidence about the impact of safe nurse-to-patient ratios, set in law in other countries, where there are limits on the number of patients one nurse can safely care for.  Nicola Ranger, RCN's Chief Nurse, reflects on the outcome of the RCN’s first ever safe staffing summit.
  24. Content Article
    This narrative review in the journal Anaesthesia reviews the background to overlapping surgery, an approach in which a single senior surgeon operates across two parallel operating theatres. Anaesthesia is induced and surgery commenced by junior surgeons in the second operating theatre while the lead surgeon completes the operation in the first. The authors assessed whether there is any theoretical basis to expect increased productivity in terms of number of operations completed. A review of observational studies found that while there is a perception of increased surgical output for one surgeon, there is no evidence of increased productivity compared with two surgeons working in parallel. There is potential for overlapping surgery to have some positive impact in situations where turnover times between cases are long, operations are short and where ‘critical portions’ of surgery constitute about half of the total operation time. However, any advantages must be balanced against safety, ethical and training concerns.
  25. Content Article
    This performance tracker produced by the Institute for Government looks at the state of adult social care in 2023. It highlights that although the Government has provided more funding, the sector may struggle to address unmet need in the face of rising costs and competing priorities. Key findings Spending remains well above pre-pandemic levels The government continues to rely on a model of ‘crisis-cash-repeat’ for the service Without extra funding, reforming the charging model for adult social care in 2023 would have been difficult Cost pressures mean that increased funding might not achieve all the government’s objectives Vacancy rates are falling, but remain high Staff turnover is high in some key roles The size of the workforce recovered somewhat in 2022/23 International recruitment has been crucial in filling vacancies Recruitment and retention are hampered by low pay… as well as poor career progression and lack of training Requests for support increased after a drop in the first year of the pandemic Local authorities have not cleared the assessment backlog More people are providing large amounts of unpaid care The number of people receiving long-term care rose in 2022/23 A decline in people receiving long-term support is unlikely to be because other models are working
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