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Found 30 results
  1. News Article
    Working with physician and anaesthesia associates actually increases a doctor’s workload rather than freeing up time to focus on care of patients, a BMA survey finds.1 The association surveyed more than 18 000 UK doctors to inform its position on physician and anaesthesia associates. Some 55% (7397 of 13 344 who responded to this question) reported that their workload had risen since the employment of medical associate professionals, with only 21% (2799 of 13 344) reporting a decreased workload. The House of Lords will shortly consider legislation to regulate physician associates under the General Medical Council rather than the Health and Care Professions Council. Read full story (paywalled) Source: BMJ, 2 February 2024
  2. Content Article
    Patients who visit their GP practice with an ongoing health problem may see several different GPs about the same symptoms. To make sure they receive safe and efficient care, there needs to be a system in place to ensure continuity of care. In the context of this report, continuity of care is where a patient has an ongoing relationship with a specific doctor, or when information is managed in a way that allows any doctor to care for a patient. While some GP practices in England operate a formalised system of continuity of care, many do not. This investigation explored the safety risk associated with the lack of a system of continuity of care within GP practices. The investigation focused on: How GP practices manage continuity of care. This includes how electronic record systems alert GPs to repeat attendances for symptoms that are not resolving and how information is shared across the healthcare system. Workload pressures that affect the ability of GP practices to deliver continuity of care. This investigation’s findings, safety recommendations and safety observations aim to prevent the delayed diagnosis of serious health conditions caused by a lack of continuity of care and to improve care for patients across the NHS.
  3. Community Post
    NHS hospital staff spend countless hours capturing data in electronic prescribing and medicines administration systems. Yet that data remains difficult to access and use to support patient care. This is a tremendous opportunity to improve patient safety, drive efficiencies and save time for frontline staff. I have just published a post about this challenge and Triscribe's solution. I would love to hear any comments or feedback on the topic... How could we use this information better? What are hospitals already doing? Where are the gaps? Thanks
  4. Content Article
    The government’s long term workforce plan, developed by NHS England, was finally published on 30 June, having first been promised more than five years ago by the then secretary of state for health and current chancellor, Jeremy Hunt. The plan is a welcome and necessary step towards solving the workforce challenges that have vexed the health service, although it is more of a jigsaw puzzle than a masterplan. The overall picture of a future NHS workforce with many more staff, increasingly working in more diverse multidisciplinary teams, and with greater support from technology, is encouraging but several pieces are missing from the vision and roadmap for its delivery, writes William L Palmer and Rebecca Rosen in this BMJ Editorial.
  5. News Article
    Nearly 170,000 workers left their jobs in the NHS in England last year, in a record exodus of staff struggling to cope with some of the worst pressures ever seen in the country’s health system, the Observer can reveal. More than 41,000 nurses were among those who left their jobs in NHS hospitals and community health services, with the highest leaving rate for at least a decade. The number of staff leaving overall rose by more than a quarter in 2022, compared to 2019. The figures in NHS workforce statistics of those leaving active service since 2010 analysed by the Observer show the scale of the challenge facing prime minister Rishi Sunak. He launched a new workforce plan on Friday to train and keep more staff. Sir Julian Hartley, chief executive of NHS Providers, said: “Staff did brilliant work during the pandemic, but there has been no respite. The data on people leaving is worrying and we need to see it reversed. “We need to focus on staff wellbeing and continued professional development, showing the employers really do care about their frontline teams.” Read full story Source: The Guardian, 1 July 2023
  6. News Article
    It is ‘not right to normalise’ the current workload in general practice as numbers of GPs and practices goes down, the RCGP chair told delegates at Pulse Live this week. Professor Kamila Hawthorne highlighted the pressure GPs are under with general practice appointments increasing most last year, compared to A&E and outpatients. She also said her priority from a new GP contract would be better resourcing for GPs working in deprived areas. Her speech looked at the challenges facing general practice and imagined what the future could look like, including what the college can do to bring about change. Professor Hawthorne said: ‘The workload that we’re facing – it’s not right to normalise it. The sort of work days that we have in general practice, it is not right to normalise this. ‘The number of GPs is going down because they’re leaving the profession faster than they’re entering it. The number of practices in England is going down, and compared with affluent areas, GPs in deprived areas earn less but see more patients with more chronic illness.’ Read full story Source: Pulse, 21 March 2023
  7. Content Article
    This study in the British Journal of Nursing aimed to explore whether fatigue, workload, burnout and the work environment can predict the perceptions of patient safety among critical care nurses in Oman. A cross-sectional predictive design was used on a sample of 270 critical care nurses from the two main hospitals in the country's capital, with a response rate of 90%. The authors found a negative correlation between fatigue and patient safety culture (r= -0.240), which indicates that fatigue has a detrimental effect on nurses' perceptions of safety. There was also a significant relationship between work environment, emotional exhaustion, depersonalisation, personal accomplishment and organisational patient safety culture. Regression analysis showed that fatigue, work environment, emotional exhaustion, depersonalisation and personal accomplishment were predictors for overall patient safety among critical care nurses.
  8. Content Article
    In this study, Hawkins and Morse explored nurses’ work in the context of medication administration, errors and the organisation. Secondary analysis of ethnographic data included 92 hours of non-participant observation, and 37 unstructured interviews with nurses, administrators, and pharmacists. Think-aloud observations and analysis of institutional documents supplemented these data. Findings revealed the nature of nurses’ work was characterised by chasing a standard of care, prioritising practice and renegotiating routines. The rich description identified characteristics of nurses’ work as cyclical, chaotic and complex, shattering studies that explained nurses’ work as linear. A new theoretical model was developed, illustrating the inseparability of nurses’ work from contextual contingencies and enhancing our understanding of the cascading components of work that result in days that spin out of the nurses’ control. These results deepen our understanding why present efforts targeting the reduction of medication errors may be ineffective and places administration accountable for the context in which medication errors occur.
  9. Content Article
    Laura Pickup and Suzy Broadbent present on the impact staff fatigue has on patient safety.
  10. Content Article
    This report from the Institute for Fiscal Studies examines how NHS funding, resources and treatment volumes compare with pre-pandemic levels. The study examines how the funding, staffing and hospital beds available to the NHS have changed since 2019, comparing the number of patients treated by the NHS in eight different areas compares with 2019 levels. For most areas of care, the NHS is still struggling to treat more people than it was pre-pandemic, despite having – on the face of it – additional staff and funding. The report considers a range of different factors that could explain this seeming fall in performance and output. 
  11. Content Article
    Calculating nurse staffing in the acute hospital has become a key issue but solutions appear distant. Community, mental health and areas such as learning disability nursing have attracted less attention and remain intractable. This review from Leary and Punshon aimed to examine current approaches to the issue across many disciplines.
  12. Content Article
    Healthcare settings are high-risk environments for fatigue and staff burnout. The Need For Recovery (NFR) scale quantifies inter-shift recovery, which contributes to cumulative fatigue and may precede occupational burnout. Advanced clinical practitioners (ACPs) are an established feature of the emergency medicine workforce in the UK, however, little is known about factors affecting their inter-shift recovery, fatigue or how NFR correlates with formal burnout inventories.
  13. Content Article
    Nursing workload is increasingly thought to contribute to both nurses' quality of working life and quality/safety of care. Prior studies lack a coherent model for conceptualising and measuring the effects of workload in healthcare. In contrast, this study, published in BMJ Quality & Safety, conceptualised a human factors model for workload specifying workload at three distinct levels of analysis and having multiple nurse and patient outcomes.
  14. Content Article
    Healthcare is a $4 trillion component of the US economy, and the well-being of the clinician workforce is a major factor determining its effectiveness. Extensive evidence indicates that inefficiency, poorly designed workflows and processes, suboptimal teamwork, work overload, isolation, problems with work-life integration, and a professional culture that expects perfection and discourages help-seeking are currently contributing to high levels of occupational distress among clinicians. Although the problem and its impact on the health care delivery system are well defined, there is minimal evidence regarding effective interventions to drive progress. This knowledge gap is, in large part, due to the near-complete absence of federal funding for research to address one of the critical challenges facing the US health care delivery system.
  15. News Article
    The trusts which are likely to face the fiercest struggle to deliver quality care in the immediate future have been identified through an analysis carried out exclusively for HSJ. Analyst company Listening into Action has taken data from the NHS Staff Survey 2019 to produce “a set of ‘workforce at risk’ numbers that point to the likelihood (or not) of workforce stability and continuity challenges adversely affecting the care a trust’s key assets are able to deliver in the year ahead”. The analysis shows a strong correlation between staffs’ perceptions of how well they are supported, and care quality — and therefore reveals which trusts face the toughest challenge to improve performance. Read full story (paywalled) Source: HSJ, 9 March 2020
  16. Content Article
    COVID-19 has meant activity in general practice has changed dramatically over the last 2 years. Practices have moved rapidly towards remote triage and care delivery to reduce risk of infection. Many have also delivered a large proportion of the COVID-19 vaccination programme as part of Primary Care Networks (PCNs), alongside their usual patient care. Understanding the total workload of general practice is vital for planning, research and supporting practices under pressure. However, the data we have on activity in general practice are limited, especially compared with hospital data. This has made it challenging to accurately track the ongoing impact of COVID-19 on general practice. This short analysis from The Health Foundation uses data from different sources, some publicly available and some not, to explore recent trends in general practice activity in England. We also present data on the general practice workforce, to help contextualise activity levels. It highlights what the data can tell us – and importantly, what it can’t.
  17. Content Article
    Continuity, usually considered a quality aspect of primary care, is under pressure in Norway, and elsewhere. An association lasting more than 15 years between a patient and a specific GP reduces the probability of any of these factors by 25-30%, a study by Sandvik et al. found. The researchers said 'promoting stability among GPs' should be a priority for health authorities, and warned that continuity of care was under pressure.
  18. Content Article
    Achieving safe district and community nurse caseloads, staffing levels and skill mix in order to deliver the increasing demand for care close to or in the home are a key challenge for primary and community care organisations in the UK. However there is a national crisis in relation to robust workforce evidence due to a lack of tools available to capture the complexity of care being delivered in different geographical locations to meet rural and urban patient population need. This paper presents a case study to illustrate the potential benefits of implementing Cassandra, a community workload analysis tool in one community provider organisation in the south of England. The Cassandra tool provides potential to: i) model the multidimensional complexity of care in different contexts and populations; ii) develop a potential blueprint for robust monitoring of decisions related to safe caseloads, staffing levels and skill mix; iii) when triangulated with other metrics, provides additional value to organisations as it enables an accurate picture to be created to monitor safe caseload, staffing levels, skill mix and competence and impacts on quality of patient care and commissioning of services in different geographies. As a place based demand tool this offers real opportunity to improve the evidence base of workforce planning and development driven by the needs of community populations.
  19. Content Article
    This blog for The Kings Fund looks at how chronic excessive workload is damaging staff health, patient care and healthcare workers' long-term ability to provide high-quality and compassionate care for people in their communities. The authors argue that the issue of excessive workload is the major barrier preventing improvements in patient satisfaction, staff retention, financial performance and care outcomes.
  20. Event
    The 2023 Mental Health Network Annual Conference and Exhibition will bring together over 130 senior leaders from the mental health, learning disability and autism sector for lively discussions on the future of services, to share good practice, horizon scan, and network with their peers. The next year brings a range of opportunities and challenges for mental health providers. Organisations are continuing to deliver services whilst facing unprecedented community need, workforce shortages and with the cost of living risking eroding the mental wellbeing of the wider population. Even with these challenges, 2023 presents a year of opportunities. This includes funding secured to continue to deliver the NHS Long Term Plan, a new landscape of integrated care, significant community transformation work underway, and key bills passing through parliament aimed at improving the policy environment mental health providers operate in. The Network’s members will once again come together to focus on the challenges and opportunities the mental health sector faces within the changing context. Register
  21. Content Article
    On paper, a GP’s working schedule can look quite inviting: consulting for three and a half hours in the morning, with a coffee break in the middle, then a gap for lunch and home visits before a similar length afternoon surgery. However, this is rarely the reality for NHS GPs. In this BMJ opinion piece, GP Helen Salisbury talks about what working life is really like for GPs and highlights the mismatch between their scheduled hours and tasks and the reality, which often involves them doing much more. She highlights how the unrealistic demands GPs face have been exacerbated by a movement of work from secondary to primary care, and argues that this is contributing to the workforce crisis that general practice faces.
  22. Content Article
    Jeremy Hunt, former Secretary of State turned patient safety campaigner, will be joined by the newly appointed Patient Safety Commissioner, Dr Henrietta Hughes OBE as part of a panel of keynote speakers at an annual congress [15-16 September] which pledges to 'drive forward' the current national commitment of putting patient safety and quality at the heart of patient care
  23. Content Article
    This report, from Deloitte, examines how the healthcare workforce is responding to the inexorable rise in demand for healthcare and the challenge of meeting this demand with the right numbers of appropriately skilled staff. It provides actionable insights and evidence-based case solutions to these challenges.
  24. Content Article
    This is a simple tool that helps you to understand the time you have available for your main work activity, e.g. seeing patients or managing a service. It is an excel spreadsheet that calculates this for you if you enter the time spent on various activities. When analysing and planning capacity, it’s important to look at time available for people to do the work required. This means understanding how much time people can actually spend on the required tasks. The tool provides a helpful way to understand this for individuals and teams and therefore can help plan work and improve productivity.
  25. Content Article
    The Health Foundation’s Report, Untapped potential: Investing in health and care data analytics, highlights nine key reasons why there should be more investment in analytical capability.
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