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Showing results for tags 'Workforce management'.
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Content ArticleUniversity Hospitals Sussex NHS Foundation Trust identified two main solutions: Annualised self-rostering/self-preferencing rotas so staff had more control over their working hours. Introduction of a clinical fellow role with 25% non-clinical time to allow these staff to undertake other projects – for example, teaching medical students. These two solutions were initially started for the A&E departments and then medical juniors whilst implementing the same systems but also allowing for continuity of ward care. The Trust decided to use the HealthRota system, to implement an annualised system for consultants (using a period-of-activity contract), middle grades (using a combination of period-of-activity and hours contract) and junior rotas (using hourly contracts), alongside self-rostering or self-selecting preferences, with staff choosing the amount of clinical work they wish to do. The Trust now benefits from 24/7 A&E consultant cover at Brighton, and cover between 8am and 10.30pm every day of the week at the Princess Royal Hospital. In five years, the Trust went from seven consultants and seven registrars on A&E (for two sites) to 23.8 full-time equivalent consultants and 20 registrars. In addition, the costs of using locum doctors have been massively curtailed. For example, before the annualised rota system was introduced, in A&E alone £1.3M was spent on locums at RSCH and PRH. For 2022-23, the only locum need has been for sickness cover.
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Content ArticleRecommendations Physicians at all stages in their careers need to be conscious of the demands placed on them professionally and personally and should balance those demands with rest to avoid excessive fatigue or overcommitment. The medical directors of outpatient units and chairs of hospital departments of obstetrics and gynaecology may consider developing call schedules and associated policies that balance the need for continuity of care and the health care providers’ need for rest. With the growing concern about the potential consequences of health care provider fatigue on patient safety, physicians should commit to evaluating the effects that fatigue has on their professional and personal lives and should demonstrate willingness to adjust workloads, work hours, and time commitments to avoid fatigue when caring for patients.
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News Article
NHS faces ‘alarming’ exodus of doctors and dentists, health chiefs warn
Patient Safety Learning posted a news article in News
The NHS faces an alarming mass exodus of doctors and dental professionals, health chiefs have said, as a report reveals 4 in 10 are likely to quit over “intolerable” pressures. Intense workloads, rapidly soaring demand for urgent and emergency healthcare and the record high backlog of operations are causing burnout and exhaustion and straining relationships between medics and patients, according to the report by the Medical Defence Union (MDU), which provides legal support to about 200,000 doctors, dental professionals and other healthcare workers in the UK. In an MDU survey of more than 800 doctors and dental professionals across the UK, conducted within the last month and seen by the Guardian, 40% agreed or strongly agreed they were likely to resign or retire within the next five years as a direct result of “workplace pressures”. Medical leaders called the report “deeply concerning”. There are already 133,000 NHS vacancies in England alone. NHS chiefs said it laid bare the impact of the crisis in the health service on staff, and MPs said it should serve as a “wake-up call” to ministers on the urgent need to take action to persuade thousands of NHS staff heading for the exit door to stay. Read full story Source: The Guardian, 29 January 2023 -
News Article
NHS ‘haemorrhaging’ senior emergency department nurses
Patient Safety Learning posted a news article in News
Experienced emergency department nurses are “leaving in droves” because they feel unable to do their jobs properly under the current conditions, a doctor has warned. Giving evidence to the Health and Social Care Select Committee yesterday, Dr Adrian Boyle, president of the Royal College of Emergency Medicine, raised concern about nurse retention and morale in emergency departments. “We are haemorrhaging experienced emergency nurses because they are finding it very frustrating" He said: “What I'm also seeing is that a lot of nurses, particularly the experienced nurses, they're almost like the [non-commissioned officers] of the health service, the sergeants who know how to get things done, are leaving in droves.” Dr Boyle added: “We are haemorrhaging experienced emergency nurses because they are finding it very frustrating. “The problem is not because there's too much work but they're unable to do the work that they're trained to do." Read full story Source: Nursing Times, 25 January 2023 -
Content ArticleThe census had responses from all 12 major Emergency Departments in Wales and found: There is one WTE Consultant per 7784 annual attendances, considerably less than the RCEM recommended figure of 1:4000. Of these 101 consultants, 19 are planning to retire in the next six years – a fifth of the consultant workforce. There were 90 gaps in the consultant rota, 33 in the middle grade rota and eight in the junior rota. Inability to recruit was the primary reason for rota gaps. This is leading to departments in Wales not meeting RCEM best practice recommendations of having an EM consultant presence for at least 16 hours a day in all medium and large systems. When asked for future staffing needs, departments across Wales reported needing an increase of 75% consultants, 120% increase in the ACP/ANP/PA workforce, 44% increase in the ENP workforce, 30% increase in the Higher Specialist Trainees/ Non-consultant Senior Decision Maker and a 50% increase in Junior Doctors in the next six years. The census also found that junior doctors were also being overstretched: At the time of collection there were 52 trainees in the ST1-6 programme as well as 95 non- Emergency Medicine trainees working in EDs across Wales Junior doctors work one weekend every three weekends, consultants work one weekend every 6.2 weekends. Junior doctors in training also do the most night shifts with an average of 52 per year.
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Content ArticleChanges in the way staff work, including staff taking on new roles and responsibilities, is a well-known policy solution in the NHS, and there are some really good instances where skill mix works well and has real benefits. But are there downsides to the drive to employ new types of staff to help doctors and nurses? What are the implications for continuity of care, staff experience and outcomes? Is the idea of ‘top of the licence’ working a reason for concern in terms of burnout, the fragmentation of care or is it an unavoidable response to the workforce crisis? Chair: Nigel Edwards, Chief Executive, Nuffield Trust Prof Alison Leary, Chair of Healthcare and Workforce Modelling, London South Bank University Dr Louella Vaughan, Senior Clinical Fellow, Nuffield Trust
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Content ArticleHe looks at the following claims: “The NHS has has plenty of money pumped into it by this Government and well above inflation.” “We are funded as well, if not better than many/most systems now, so resource is not an excuse” "This Government has recruited X thousand additional nurses and Y thousand additional doctors” “We need to move towards a European style social insurance based model as those systems have better outcomes and no other country has copied the NHS” “The NHS wastes far too much money on useless, overpaid managers and people in non-jobs” “People should take more responsibility for their own health so we can become a wellness service not an illness service" The NHS is in need of root and branch reform but always resists it." Ten point plan to tackle the problems faced by the NHS Train enough staff at home to meet future workforce needs Have a proper short, medium and long term workforce plan for health and social care Treat existing staff better and more flexibly to help retention and morale Use ethical immigration policy to attract and keep key workforce groups who trained overseas or come here for lower paid but vital care work Reverse the cuts in bed capacity and invest more in capital expenditure on buildings, facilities, equipment and functioning IT Come up with a long term sustainable plan for social care funding and provision, reverse the cuts and plan for future rises in care needs Invest properly in public health and prevention policy – addressing wider determinants of preventable ill health across the life course, health inequalities and inequalities in access to healthcare and ensure that health is a key part of all public policy making Accept that this focus on prevention does involve state intervention in key areas around housing, education, food, drink, obesity, smoking and mental health. Level with the public about what can realistically be expected in terms of access, wait time, staffing and the time it will take to recover from the disruption caused by covid. Better to under promise and over deliver rather than vice versa Restore annual funding increases to the NHS to at least the historic average
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Content ArticleKey points Rural and remote areas experienced problems that differentiate them from their more urban counterparts even before the Covid-19 pandemic. However, the pandemic has both exacerbated some of these challenges, as well as thrown up new ones. Covid-19 has had a more detrimental effect on hospital waiting times in rural and remote trusts than for trusts in more urban areas. In April 2020, the proportion of patients seen for their first consultant appointment for cancer fell by two-thirds (66%) in rural trusts compared with April 2019, whereas a decrease of 59% was seen in trusts located in more urban areas. Activity has fallen particularly dramatically in rural areas. Emergency admissions in April to June 2020 fell by 57% in rural trusts compared with the year before, while they fell by 45% elsewhere. The level of referral for talking therapies – via the Improving Access to Psychological Therapies (IAPT) programme – in rural areas was below half the level in April 2020 than it was a year before. The pandemic has exacerbated workforce issues in remote trusts. Remote trusts spend more on temporary staff (8% of their staffing budget) compared with other areas (6%). While the number of hospital and community health staff increased by 7% nationally in the year to June 2020, the workforce of remote trusts grew by only 5% over the same period. The underlying financial position of rural and remote services was worse than the position of more urban trusts before the pandemic started, and the pandemic may well have exacerbated this. Remote trusts’ debt was equivalent to more than half (56%) of their annual operating income in 2018/19. Remote trusts also typically do not seem to get their fair share of additional funding that goes into the NHS.
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Doctors union plans 72-hour strike
Patient-Safety-Learning posted a news article in News
Junior doctors across England will walk out for 72 hours in March if a ballot for industrial action is successful, the British Medical Association has told ministers. The BMA confirmed the move ahead of the opening of its ballot on Monday (9 January). The union is calling for real terms pay cuts over the past decade to be reversed, claiming the last 15 years have led to a 26 per cent decline in the value of junior doctors’ pay. Robert Laurenson and Vivek Trivedi, co-chairs of the BMA’s junior doctors committee, said: “Pay erosion, exhaustion and despair are forcing junior doctors out of the NHS, pushing waiting lists even higher as patients suffer needlessly.” Read full story (paywalled) Source: HSJ, 8 January 2023 -
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Content ArticleTen key themes Prevention Early intervention Access to quality, compassionate care Seeing the bigger picture Whole-person care Equality focus Co-production Autonomy, human rights and community support A stronger workforce Outcomes that matter Three requirements to make the vision a reality Sustained and sufficient investment Effective long-term workforce development and planning A deep commitment to large-scale reform, innovation and change
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Content ArticleTrade unions representing some NHS staff are in dispute with the Government over the 2022/23 pay award. In addition to the RCN strike action on 15 and 20 December, GMB, Unite, and Unison members will take part in industrial action with nine ambulance trusts expected to be affected on 21 December and eight ambulance trusts expected to be affected on 28 December. This letter outlines three essential measures: Ensure measures are in place to enable all ambulances to handover patients no later than 15 minutes after arrival. Free up maximum bed capacity by safely discharging patients, working closely with system partners, in advance of industrial action. Confirm system-level operational plans for the days of ambulance industrial action with NHS England regional teams by 16:00 Monday 19 December to allow for any additional support to be considered and arranged. These plans must include how Emergency Departments will ensure the release of all ambulances within 15 minutes.
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News Article
Pandemic collaboration ‘no longer exists’ between NHS and private hospitals
Patient Safety Learning posted a news article in News
The collaboration seen between the independent sector and the NHS during the peaks of the pandemic “doesn’t exist any more”, the boss of one of the UK’s largest private hospital companies has said. Mr Justin Ash, chief executive of Spire Healthcare and a member of the government’s recently convened elective recovery task force, whose purpose is to ”focus on how the NHS can [better] utilise independent sector to cut the backlog’.” He told the Westminster Health Forum earlier this week: “In spirit there is collaboration but in practice, it doesn’t exist anymore. There is no more commissioning by trust[s]”. Mr Ash told the conference Spire had previously had administrative teams working at 39 different NHS hospitals examining which NHS patients could be treated at one of its facilities. That number was now three, a decline which he described as “a shame”. He said: “There has to be a mindset change. We have people say ‘you have our nurses and consultants working for you’. “[But] just like patients, nurses and consultants should be able to move around the system [as] one workforce.” Read full story (paywalled) Source: HSJ, 16 December 2022 -
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Content ArticleThe authors conducted a literature search to identify quality improvement initiatives that aimed to decrease the environmental impact of the operating room while reducing costs. Data were included from 23 unique quality improvement initiatives that described 28 interventions. Eleven (39.3%), eight (28.6%), three (10.7%), and six (21.4%) interventions, respectively, were categorised as refuse, reduce, reuse and recycle. The researchers found that the potential annual cost savings varied from $2,233 (intervention: transition to a waterless surgical scrub; environmental impact: 2.7 million litre of water saved annually) to $694,141 (intervention: education to reduce regulated medical waste; environmental impact: 30% reduction in regulated medical waste), although the methods of measuring environmental impact and cost savings varied considerably among studies. "The opportunity to reduce our carbon footprint falls squarely on us, and I see surgeons taking a prominent role in leading efforts, not just locally with their green implementation teams, but in setting national standards and policies that will move this effort forward for an overall sustainable way of approaching health care delivery," a coauthor said in a statement.
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News Article
Largest nursing strike in NHS history starts
Patient Safety Learning posted a news article in News
Nurses in England, Wales and Northern Ireland have started a nationwide strike in the largest action of its kind in NHS history. Staff will continue to provide "life-preserving" and some urgent care but routine surgery and other planned treatment is likely to be disrupted. The Royal College of Nursing said staff had been given no choice after ministers refused to reopen pay talks. RCN general secretary Pat Cullen has called on the government to "do the decent thing" and resolve the dispute before the year ends. Ms Cullen told BBC Breakfast the strike marked "a tragic day in nursing". "We need to stand up for our health service, we need to find a way of addressing those over seven million people that are sitting on waiting lists, and how are we going to do that? By making sure we have got the nurses to look after our patients, not with 50,000 vacant posts, and with it increasing day by day," she said. Health Minister Maria Caulfield, a former nurse, accepted "it is difficult" living on a nurse's wage, but said that a 19% pay rise "is an unrealistic ask". Under trade union laws, the RCN has to ensure life-preserving care continues during the 12-hour strike. Chemotherapy and kidney dialysis should run as normal, along with intensive and critical care, children's accident and emergency and hospital neonatal units, which look after newborn babies. Read full story Source: BBC News, 15 December 2022 -
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Roy Lilley eLetter - Helpless (12 December 2022)
Patient-Safety-Learning posted an article in Safe staffing levels
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Content ArticleKey points The study found successful strategies are typically associated with a concert of activities that simultaneously ensure sufficient supply of health care, manage demand and optimise the conditions within the health care system itself. In England in the 2000s, a number of activities were associated with reduced waiting times. These activities were concentrated within the categories of increasing supply and optimising conditions within the health care system itself to achieve the goal of an 18‑week referral to treatment target by 2008. These activities were underpinned by a bigger idea about what the health service as a whole should look and feel like, and incorporated how waiting times are brought down as much as what activities might be used. For the experts interviewed, the achievement of the 18 weeks target was made possible as a result of: valuing and investing in people working in the NHS; a clear, central vision and goal for waiting and an ambition that those working within health care felt equipped to take on; cultivating relationships and leadership at all levels of the health care system; accountability, incentives and targeted support to encourage performance against waiting times targets and other measures of quality of care; and seizing the momentum of wider NHS reform. Whereas the improvement in waiting times performance of nearly 20 years ago took place in a very different political and economic context, the research highlighted not only hope but opportunities to reduce waiting times in the present day: by addressing shortages of health care staff and physical resources urgently; by working with integrated care systems in the spirit of prevention, collaboration, inclusion and community‑based models of care; and by aligning a vision for the health services with a plan that brings staff, patients and the public along on the journey to get there.
