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Content ArticleThis rapid evidence review and economic analysis makes the business case for investing in the wellbeing of NHS staff. It was written by a team from the University of East Anglia, RAND Europe and the International Public Policy Observatory (IPPO) and includes a narrative review of data on the current state of the mental health and wellbeing of NHS staff. Data shows that nearly half of staff reported feeling unwell as a result of work-related stress in the most recent survey, that sickness absence has increased and that there are high vacancy and turnover rates in some trusts. Research also shows that patient care can be affected by poor healthcare staff wellbeing.
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Content ArticleIn a video and article published in Trends in Urology and Men's Health, Peter Duffy shares his experience of what it is to be a whistle-blower in the NHS, in the context of historical scandals of UK healthcare and whistleblowing, examining the roles of the NHS itself, the regulators and the law in the ensuing events.
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News Article
Half trust’s staff told CQC they had ‘no confidence’ in its leaders
Patient Safety Learning posted a news article in News
More than half of a trust’s staff told the Care Quality Commission (CQC) they did not have confidence in its executive leadership, with just 16% saying they did, the regulator has reported. The CQC surveyed staff as part of its inspection of East Kent Hospitals University Foundation Trust. Eighty-four per cent either said they disagreed with the statement “I have confidence in the executive team”, or neither agreed nor disagreed. That leaves just 16% who said they did have confidence. Some said they felt “traumatised”, “devalued” or “damaged” by a recent restructuring programme at the trust, which has been grappling major care quality and performance problems for several years. The CQC also revealed in a report today that it issued a warning notice to the trust after inspections at its two main sites in July. They ordered immediate improvements in its emergency departments, medical care and children and young people’s services. Read full story (paywalled) Source: HSJ, 20 December 2023 -
News ArticleThe national clinical director for older people has announced he is leaving NHS England and said a major government funding settlement will be needed to maintain progress and take community services to the ‘next stage’. Adrian Hayter joined NHSE in 2019 as NCD for older people and integrated person centred care. Dr Hayter, who is also a longstanding GP partner in Berkshire, said community services were now much more prominent at NHSE — and in its asks of the service – than they were four years ago. He said: “When I first came in, there wasn’t very much in planning guidance about what was happening in the community at all. Now that is different and we are expecting a range of initiatives in 2024. “But the future is that all of these things are not individual programmes - they’re all part of a particular approach to how we manage and support people for as long as possible in their own homes. “Urgent community response [where services are required to respond within two-hours to urgent needs, referred from a range of services] and virtual wards are a continuum of care. “And the growth of virtual wards have helped extend what happens in the community all the way through to the acute level care.” National long-term funding for several of the new services – badged in the 2019 long-term plan as “Aging Well” – is also now due to end, with integrated care boards instead asked to commission them locally. Dr Hayter warned that, as well as moving those services closer together, there needed to be a future government spending review settlement aimed at growing community services, to meet the needs of the rapidly ageing population. Read full story (paywalled) Source: HSJ, 18 December 2023
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Content Article
Who’s who at NHS England (updated 23 November 2023)
Patient Safety Learning posted an article in NHS England
This overview provides detail on the structure of NHS England’s executive group. -
Content ArticleThis toolkit from the Institute from Healthcare Improvement (IHI) equips patient safety and finance leaders with tools and a collaborative approach to make a compelling business case for organizational investments to advance patient and workforce safety initiatives.
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EventuntilThe health and care workforce continues to face profound challenges, with severe staff shortages and increasing financial pressures across health and care. While the NHS Long Term Workforce Plan aims to support the NHS’s future needs, it does not cover the social care workforce, resulting in a knock-on effect across the entire health and care system, particularly for those who rely on social care services. To resolve the challenges facing health and care, the sector needs to embrace positive disruption and its potential to change the nature of work and to improve recruitment, retention and the health and wellbeing of the workforce. This event from the King's Fund will explore the changing nature of work and how this can support the health and care system to adapt to future challenges. It will look at the different expectations between those already in the workforce and those joining it, and the challenges and opportunities this presents – whether it’s redesigning job roles, reforming education and training and providing different routes into health and care careers, developing a system that embraces flexible working, creating spaces for digital collaboration, or supporting moves to shift care out of hospital and into the community. Attendees will consider how those working in health and care can be supported to make the most of these opportunities against the backdrop of deep-seated cultural issues in the health and care system. Conference sessions will explore how to support the health and care workforce to succeed in their roles, and how organisations can be more responsive to the needs of people who work in them, whether through redesigning job roles to enable staff to deliver the best possible care, reforming regulation to support managers to succeed, or creating development opportunities to enable staff to work in a way that supports their health and wellbeing. Please join us to learn and share your leadership and workforce challenges. You will also have the opportunity to collaborate with experts and leaders from across the health and care system through keynote speeches, panel debates and interactive workshops. Register
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Content ArticleJames Titcombe, Melanie Leis, and Peter Howitt delineate the major themes of a roundtable to address challenges in improving patient safety, emphasising the need for data sharing nuances, cultural shifts, optimising limited resources, prioritising workforce plans, and staff well-being.
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News Article
Black Country doctors back vote of no confidence in management
Patient Safety Learning posted a news article in News
Doctors at a Black Country mental health trust have backed a vote of no confidence in their management team. Sources say that the Black Country Healthcare NHS Trust is not acting in the best interests of patients and they believe it wants to cut beds. They also have no confidence in the way that the trust has removed its chief medical officer, Mark Weaver. The NHS Trust said it was aware of concerns and had agreed to work on them going forward. The doctors wrote to the trust board following a meeting of the Medical Advisory Committee claiming that over the past two years the relationship with the board had become fractured. In the letter they claimed the voice of doctors was not being taken seriously by the board and that clinical priorities were secondary to financial performance. They also said they were seriously disturbed with the way in which Mr Weaver had been asked to step down and that the deputy chief medical officer Dr Sharada Abilash had not been asked to take over while due process occurred. Read full story Source: BBC News, 9 December 2023 -
Content ArticleLucy Letby was allowed to continue working with new-born babies despite her colleagues raising concerns about her for months. Her conviction highlighted how NHS executives put the reputation of the Countess of Chester NHS Trust ahead of patient safety. But what happened in Cheshire was far from a one-off. File on 4 hears from doctors with unblemished medical careers who were sacked after raising patient safety concerns. The programme follows one medic through an Employment Tribunal as he attempts to save his career, and hears the emotional, brutal toll the process takes on him. For the first time, a top doctor who won record damages talks about the extraordinary steps her managers took to undermine her. Their tactics included relocating her to an empty office with a broken chair and telling colleagues that she agreed with their assessment she was incompetent. And a former NHS executive tells the programme that trusts are more interested in “flying LGBT flags” than tackling concerns about patient safety. With widespread calls for NHS managers to be regulated, File on 4 asks who should take on the role, given the willingness of the NHS to redeploy managers found to have ignored patient safety concerns, or even punished those who dared to raise them.
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Content Article
This book sets out what the terms governance and leadership mean, and how thinking about them has developed over time. Using real-world examples, the authors analyse research evidence on the influence of governance and leadership on quality and safety in healthcare at different levels in the health system: macro level (what national health systems do), meso level (what organisations do) and micro level (what teams and individuals do). The authors describe behaviours that may help boards focus on improving quality and show how different leadership approaches may contribute to delivering major system change. -
Content ArticleThe second annual Safety For All conference was held at the Royal College of Physicians in London on Tuesday 5th December 2023. Over 100 members of the healthcare community attended this event, including occupational health professionals, patient safety experts, frontline staff, patients and academics. The conference was hosted by the Safer Healthcare and Biosafety Network and Patient Safety Learning as part of the Safety For All campaign, supported by B. Braun, BD, Boston Scientific and Stryker. Attendees had the opportunity to hear from two keynote speakers: Lynn Woolsey, UK Deputy Chief Nurse at the Royal College of Nursing and Dr Henrietta Hughes, Patient Safety Commissioner for England. The conference was chaired and facilitated by Dr Rob Galloway, A&E Consultant at Brighton and Sussex Hospital NHS Trust, with a welcome introduction from Dr Ian Bullock, CEO of the Royal College of Physicians. There were a number of panel sessions and presentations throughout the day which are summarised in the attachment below, including on sustainability, antimicrobial resistance and antibiotic underdosing, violence at work, clinical communications, human factors, implementing the Patient Safety Incident Response Framework (PSIRF), and women's health and the menopause.
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Content ArticleLeadership walkarounds (LWs) have been promoted in practice as means to drive operational, cultural and safety outcomes. This systematic review in BMJ Open Quality aimed to evaluate the impact of LWs on these outcomes in the US healthcare industry. The authors found only positive association of LWs with operational and perception of cultural outcomes.
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News ArticleFormer Prime Minister Boris Johnson is scheduled to provide evidence at the Covid Inquiry on the 6 and 7 of December. Long Covid is one of the most catastrophic consequences of the pandemic and it deserves a prominent place in the discussions during this critical phase of the inquiry. The Long Covid Groups will be delivering a letter to No.10 Downing Street today, urging attention to the unique challenges faced by those with Long Covid. Read the letter and sign the petition
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News Article
NHS trust under investigation accused of hypocritical email to staff
Patient Safety Learning posted a news article in News
The boss of a hospital trust being investigated by police for alleged negligence over 40 patient deaths has been accused of sending a hypocritical email urging staff to have the courage to raise concerns despite the dismissal of whistleblowing doctors. The investigation, Operation Bramber, was sparked by two consultants who lost their jobs after raising concerns about deaths and patient harm in the general surgery and neurosurgery departments of the Royal Sussex County hospital in Brighton. In an email to staff on Friday, the chief executive, George Findlay, said the trust was committed to learning from its mistakes. He said: “When things do go wrong, we must be open, learn and improve together. That openness is how we give people courage to raise concerns and make a positive difference to patient care.” James Akinwunmi, a consultant neurosurgeon who was unfairly dismissed by the trust in 2014 after he raised the alarm about patient safety, said Findlay’s email was “laughable”. He told the Guardian: “Whistleblowers, including myself, have done exactly what he is encouraging in the email and they were sacked for it, so you can draw your own conclusions. I suspect what they are doing is damage limitation. Instead, they should be dealing with surgeons who have been a problem for years.” Another more recent whistleblower, who did not want to be named, expressed incredulity at Findlay’s claim that he wanted to encourage staff to raise concerns. They said: “The email is hypocritical. How can staff have the ‘courage to raise concerns’ after what has happened to those who have? Those brave enough to blow the whistle about patient safety have been sanctioned, lost their job and had their lives destroyed.” Read full story Source: The Guardian, 3 December 2023 -
News Article
Minister: There’s systemic racism in the NHS
Patient Safety Learning posted a news article in News
A health and social care minister privately said there was ‘systemic’ racism within the NHS and called for an investigation into it. Helen Whately told Matt Hancock of her belief in a private message which was today shown to the covid public inquiry. An inquiry hearing with Mr Hancock – who said he agreed with the point – was shown an exchange between Ms Whately, then care minister, and Mr Hancock in June 2020. The Guardian had reported the previous day that an internal report had found systemic racism at NHS Blood and Transplant. Ms Whately, who is now minister of state covering social care and urgent and emergency services, said: “I think the Bame next steps proposed are important but don’t go far enough. There’s systemic racism in some parts of the NHS, as seen in NHSBT.” She added: “Now could be a good moment to kick off a proper piece of work to investigate and tackle it.” Read full story (paywalled) Source: HSJ, 1 December 2023 -
News Article
Health secretary told to intervene over ‘systemic’ ambulance deaths
Patient Safety Learning posted a news article in News
Ministers must intervene over systemic failures which are “too big for hospital or ambulance trusts to fix on their own” and have led to multiple preventable deaths, a senior coroner has warned. In a move usually considered rare for such an official, Cornwall and Isles of Scilly coroner Andrew Cox has written to the Department of Health and Social Care a second time over ongoing delays to ambulance responses and long ambulance handovers in the area. Last year he warned the NHS was “broken” after he ruled ambulance and emergency care delays contributed to the deaths of four people. Now, he has sent a similar report on the same types of failings in the deaths of John Seagrove, Pauline Humphris, and Patricia Steggles at Royal Cornwall Hospital to new health secretary Victoria Atkins. Mr Cox wrote: “I set out in my [prevention of future death report] last year my understanding of the reasons for the difficulties that are continuing in the Cornwall & Isles of Scilly coroner area. I do not believe those reasons will have changed significantly. ”The challenges are systemic in nature. They are too big for a single doctor, nurse or paramedic to fix. They are too big for either the hospital trust or the ambulance trust to fix on their own.” Read full story Source: HSJ, 1 December 2023 -
News Article
Infected blood: Tory rebellion expected on payouts amendment
Patient Safety Learning posted a news article in News
The government faces a rebellion with at least 30 Tories backing an amendment to extend interim payouts to more victims of the infected blood scandal. Up to 30,000 people were given contaminated blood products in the 1970s and 80s. Thousands have died. A Labour amendment will be brought on Monday calling for a new body to be set up to administer compensation. More than 100 MPs, including Tories Sir Robert Buckland, Sir Edward Leigh and David Davis, are backing the move. In a letter sent to Chancellor Jeremy Hunt, shadow chancellor Rachel Reeves called the scandal "one of the most appalling tragedies in our country's recent history." She added: "Blood infected with hepatitis C and HIV has stolen life, denied opportunities and harmed livelihoods." She praised Theresa May, who set up the Infected Blood Inquiry when she was prime minister in 2017. But she warned: "For the victims, time matters. It is estimated that every four days someone affected by infected blood dies." The chancellor, himself a former health secretary, told the inquiry in July that the government accepted the moral case for compensation. But he said no final decisions could be made before the inquiry publishes its findings - now expected in March next year. In August 2022, the government agreed to make the first interim compensation payments of £100,000 each to about 4,000 surviving victims and bereaved widows. But inquiry chairman Sir Brian Langstaff, said in April this year that the parents and children of victims should also receive compensation and also called for a full compensation scheme to be set up immediately. The Commons Speaker will decide on Monday which amendments to the bill MPs will vote on. But the government has said it will not be supporting the amendment. A Department of Health spokesperson said: "We are deeply sympathetic to the strength of feeling on this and understand the need for action. However, it would not be right to pre-empt the findings of the final report into infected blood." Read full story Source: BBC News, 3 December 2023 -
News Article
People with Covid discharged to care homes over fears for NHS, inquiry told
Patient Safety Learning posted a news article in News
People with Covid-19 were discharged to care homes over fears about the NHS getting “clogged up”, the pandemic inquiry has heard. Professor Dame Jenny Harries, England’s deputy chief medical officer during the pandemic and now head of the UK Health Security Agency, told the inquiry of how an email she sent in mid-March 2020 described the “bleak picture” and “top line awful prospect” of what needed to happen if hospitals overflowed. Discharging people to care homes – where thousands of people died of Covid – has been one of the central controversies when it comes to how the Government handled the pandemic. On Wednesday, the Covid inquiry was read an email exchange between Rosamond Roughton, an official at the Department of Health, and Dame Jenny on March 16 2020. Ms Roughton asked what the approach should be around discharging symptomatic people to care homes, adding: “My working assumption was that we would have to allow discharge to happen, and have very strict infection control? Otherwise the NHS presumably gets clogged up with people who aren’t acutely ill.” Ms Roughton added that this was a “big ethical issue” for care home providers who were “understandably very concerned” and who were “already getting questions from family members”. In response, Dame Jenny emailed: “Whilst the prospect is perhaps what none of us would wish to plan for, I believe the reality will be that we will need to discharge Covid-19 positive patients into residential care settings for the reason you have noted. “This will be entirely clinically appropriate because the NHS will triage those to retain in acute settings who can benefit from that sector’s care. “The numbers of people with disease will rise sharply within a fairly short timeframe and I suspect make this fairly normal practice and more acceptable, but I do recognise that families and care homes will not welcome this in the initial phase.” Read full story Source: The Independent, 29 November 2023 -
News Article
Trust leaders raise alarm over ‘mad’ approach to scrutiny of maternity services
Patient Safety Learning posted a news article in News
The management of fragile maternity services is being hamstrung by a lack of clear standards and direction from government and regulators, trust chairs and chief executives have told HSJ. Kathy Thomson, the retiring chief executive of Liverpool Women’s Foundation Trust, told HSJ that a major overhaul of regulation and oversight of maternity care was needed. She warned that trust leaders were confused about what was expected of their stewardship of maternity services. Much of the increased scrutiny of the sector was coming from people with little knowledge and experience of maternity care, and maternity was beset by too many initiatives which “somebody thinks are a nice thing to do”. Ms Thomson’s comments were echoed by a wide range of other NHS leaders (see ’damaging confidence’ below). Ms Thomson told HSJ: “How clear are we nationally about the real ask of maternity services? Are we going to say it’s the ten NHS Resolution (NHSR) safety standards, which are really tough to achieve and which we agonise over? Or is it the CQC standards, because they will often take a different view around very similar issues? “We’ve had that this year after we’ve been assessed as compliant by NHSR, but then had to re-provide evidence after we’ve been criticised by the CQC for something… and then NHSR have written back to say we’re still fully compliant. “So, should you put your time and energy into the NHSR standards, or do you spend the time on the more subjective drivers? Because we can’t keep doing all of it and having different parts of the NHS saying this is what you need to do or expecting something different.” Read full story (paywalled) Source: HSJ, 30 November 2023 -
Content ArticleHospital leaders need to embed a safety culture across their organisations - read the latest guest blog on the Patient Safety Commissioner website from Maria Caulfield, the minister for mental health and women's health strategy. Maria gives three examples of how we are advancing patient safety across our NHS.
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Content ArticleCancer Research UK has set out how the next UK Government could dramatically improve cancer outcomes and prevent 20,000 cancer deaths a year by 2040. 'Longer better lives: A manifesto for cancer research and care' has been developed with the insights of cancer patients and experts from across health, life sciences, government and academic sectors. The charity said that huge strides have been made in beating cancer – with survival in the UK doubling over the last 50 years. But it warned that with NHS cancer services in crisis and around half a million new cancer cases each year expected by 2040 – this hard-won progress is at risk of stalling. With the UK lagging behind comparable countries when it comes to cancer survival, the charity is calling on all political parties to make cancer a top priority in their party manifestos.
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Content Article
Developing cultural change in healthcare: Part 1 – by Dawn Stott
Dawn Stott posted an article in Good practice
If we are to continue improving healthcare services, then developing cultural change in healthcare is crucial. Improving the quality of care, reducing medical errors and, ultimately, enhancing patient outcomes is essential for the future. Transforming the culture within healthcare organisations requires a comprehensive approach that involves leadership commitment, employee engagement, continuous education and a focus on patient-centred care. In a two-part blog for the hub, Dawn Stott, Business Consultant and former CEO of the Association for Perioperative Practice (AfPP), talks about the strategies that can help you develop cultural change in your organisation. In part one, Dawn sets out the steps to develop a programme of change to support you to achieve good solutions. -
Content ArticleProductivity is misunderstood at every level in the NHS, not least because the leadership so often use the word to mean something entirely different. So what is it and what are the big misunderstandings about it? In his LinkedIn post, Stephen Black discusses what productivity is and what misunderstandings are feeding the problem.
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Content ArticleHospital and health system CEOs have a lot of issues dominating their thoughts, including questions about navigating financial, operational and workforce challenges in the industry. Some of these problems may not have an obvious or immediate solution, leaving leaders with unanswered questions. To gain more insight into executives' top concerns, Becker's asked hospital and health system leaders to share the questions they need answered right now.
