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News Article
Thousands of agency workers set to leave NHS and care roles, poll suggests
Patient Safety Learning posted a news article in News
Thousands of agency staff could leave the NHS and social care services in the next two years, new research has suggested. More than 20,000 agency staff work across health and social care in the UK – but now a poll of 10,000 workers has revealed that nearly one in five could leave their job by 2026. In the poll, carried out by consultancy Acacium Group, 24% of those surveyed reported feeling overstretched at work. Key reasons for agency workers wanting to leave the NHS and social care included concerns over poor working conditions leading to staff burnout, and a lack of support from managers. Olivia Swain, 29, who has worked as an agency paediatric nurse in the North East since 2019 after moving from a permanent NHS role, told researchers: “While I love my job, the transition into a flexible role has its challenges. You have to learn to adapt quickly. Sometimes I don’t have a login or password for computer systems or swipe access cards, which can be incredibly obstructive and puts undue pressure on colleagues. “This can be a particular issue if I need quick access to patient records or to complete a referral.” Read full story Source: The Independent, 23 June 2024 -
News Article
Four in five locum GPs in England unable to find work, BMA study finds
Patient Safety Learning posted a news article in News
More than four in five locum GPs in England are unable to find work with a third forced to leave the NHS because they cannot make ends meet, a survey has found. A survey of 1,852 locums, conducted by the British Medical Association (BMA), found that 84% cannot find work despite patients across the country waiting weeks for GP appointments. The study also found that more than half are considering a career change owing to a lack of work, while a third (33%) have made definite plans to work in a different career away from the NHS. Just under a third (31%) of respondents said that the lack of suitable shifts was leading them to leave the NHS entirely, while 71% said the government funding model was to blame for the levels of unemployment. More than half of GP appointments are now conducted by non-GP practice staff as they are cheaper, which is leading to locums being unable to find work. Read full story Source: The Guardian, 21 June 2024 -
Content Article
Director, Patient Safety Learning Salary: £70,417 to £81,138 (Equivalent to NHS Pay Band 8c) Appointment Type: The role is permanent in our structure however it could be offered on a secondment or as a fixed term contract. Working pattern: Full or part time. Location: Homebased anywhere in the UK, with expectation of regular travel including monthly to London HQ. Some international travel might be required. Reports to: Chief Executive This is an exciting and unique opportunity for an experienced safety expert to play a leading role in shaping approaches to patient safety. Reporting to the Chief Executive, you will use your influencing and networking skills, combined with your passion for developing patient safety-led culture and subject matter expertise, to influence the direction of the charity and our work. To succeed in this role, you will need to be a self-starter, with great inter-personal and networking skills within a range of professional networks. You will have demonstrated leadership in safety, and be confident at leading meetings and public speaking to raise awareness of good practice and the latest patient safety issues . We are looking for someone who can help us share widely our good and services, some of which will be generating revenue streams. -
News ArticleA scandal-hit hospital trust has come under fire yet again after advertising for a maternity doctor with "a desire to promote normal birth". Hampshire Hospitals NHS Foundation Trust said it was seeking an obstetrics and gynaecology consultant in its high risk baby unit who would support "active" labour. Yet safe birth campaigners have reacted with fury online, claiming 'normal' has become a codeword for 'natural' birth — a fixation which has led to many midwives frowning on medical intervention and caesareans, even when needed. This 'obsession', they add, has been linked to failures at a number of maternity units in recent years where hundreds of babies died, major inquiries have found. The trust was embroiled in a similar controversy last year after Winchester's Royal Hampshire County Hospital faced a claim of unfair dismissal by a former consultant obstetrician and gynaecologist. Martyn Pitman, who had worked at the hospital for 20 years, was sacked last March after raising concerns about midwifery care and patient safety at the hospital. In a post on X, Catherine Roy linked to the advert, adding: "Where Martyn Pitman used to work. The takeover by normal birth is now complete I think. What a scandal." In response, consultant paediatrician Dr Ravi Jayaram, whose evidence helped catch convicted serial baby-killer Lucy Letby at Countess of Chester Hospital, said: "Anyone who applies for this should be immediately excluded from consideration for the post." He added: "[It] should read 'desire to support and promote safe birth' — if it needed to be said at all." Read full story Source: The MailOnline, 13 June 2024
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Content ArticleThe Royal College of Radiologists (RCR) have published their 2023 clinical radiology and clinical oncology workforce census reports. These reveal dangerous shortages of doctors essential in the diagnosis and treatment of cancer, and other conditions including stroke.
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News Article
Staff shortages stop 1.4 million NHS operations each year, top doctors warn
Patient-Safety-Learning posted a news article in News
Hospitals in the UK are facing shortages of almost 2,000 anaesthetists, leading the NHS to miss 1.4 million operations a year, doctors have warned. The government has been urged to increase funding for the number of newly qualified doctors who can train as anaesthetists as more than 2,000 miss out on places each year. The Royal College of Anaesthetists has said the NHS will not be able to tackle waiting lists without more of these specialist doctors. Their warning comes amid fears hospitals are substituting doctors for staff without sufficient training, called anaesthesia associates. This week the NHS will publish new waiting list figures. They stood at 7.6 million in March. Dr Fiona Donald, president of the Royal College of Anaesthetists warned: “The shortage of anaesthetists has reached crisis levels and is preventing patients from getting the operations they so desperately need. During the election campaign, I’m sure we’ll see all parties pledge to reduce NHS waiting lists but unless their policies include plans for more anaesthetists they will have limited impact.” According to the college, each year 2,600 doctors apply for anaesthetist training however only 550 places are funded. For more advanced training there are around 650 applicants a year yet only 400 are funded. Read full story Source: Independent, 8 May 2024 -
News ArticleHospitals which rely heavily on locum doctors are 'undoubtedly' risking patient safety, a study of NHS practice found. While temporary staff are a 'vital resource' to plug workforce gaps, issues such as unfamiliarity with protocols and procedures mean they 'pose significant patient safety challenges' for the NHS, experts say. The report warned many were left feeling isolated and stigmatised by resident staff, creating a 'hostile environment'. This has led to a 'defensive' culture over mistakes, hindering improvements to care, according to researchers. Calling for greater monitoring by inspectors, NHS leaders must rethink how these professionals are supported and used, the authors said. Writing in a linked editorial, Professor Richard Lilford, of the Institute of Applied Health Research at the University of Birmingham, said the findings suggested 'the life of the locum is a difficult and lonely one, opening up many pathways to unsafe practice.' Likening it to airline pilots, he suggested staff would benefit from standardised practices – such as how the medicine cabinet is stocked – to minimise mistakes. Agencies providing staff should be given routine feedback by employers and locum staff, to enhance patient safety, he said. Read full story Source: MailOnline, 16 April 2024
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Content ArticleThe use of temporary doctors, known as locums, has been common practice for managing staffing shortages and maintaining service delivery internationally. However, there has been little empirical research on the implications of locum working for quality and safety. This study aimed to investigate the implications of locum working for quality and safety. The participants of the study described the implications of locum working for quality and safety across five themes: (1) ‘familiarity’ with an organisation and its patients and staff was essential to delivering safe care; (2) ‘balance and stability’ of services reliant on locums were seen as at risk of destabilisation and lacking leadership for quality improvement; (3) ‘discrimination and exclusion’ experienced by locums had negative implications for morale, retention and patient outcomes; (4) ‘defensive practice’ by locums as a result of perceptions of increased vulnerability and decreased support; (5) clinical governance arrangements, which often did not adequately cover locum doctors. The study concluded that locum working and how locums were integrated into organisations posed some significant challenges and opportunities for patient safety and quality of care. Organisations should take stock of how they work with the locum workforce to improve not only quality and safety but also locum experience and retention.
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News Article
Doctor exodus: tens of thousands planning to move abroad, NHS warned
Patient Safety Learning posted a news article in News
Tens of thousands of doctors are hoping to quit the NHS and move abroad this year in search of better pay, the medical regulator has warned. Half of the doctors planning to leave said they wanted to move to Australia, which has been the most popular destination for emigrating UK doctors for the past five years. The General Medical Council surveyed 3,154 doctors about their attitudes towards leaving the UK, including 1,000 who had recently left to practise abroad. Some 13% of those working in the NHS said they were “very likely” to move in the next 12 months, while another 17% said they were “fairly likely” to move. The GMC said this would amount to 96,000 doctors quitting over the next year if applied to the total number of doctors on the medical register, although it acknowledged that the actual rate of departures was likely to be much lower. Read full story (paywalled) Source: The Times, 12 April 2024 -
News Article
NHS told to cut spending on doctors and nurses to save £4.5bn
Patient Safety Learning posted a news article in News
Hospitals are preparing to cut spending on doctors and nurses by hundreds of millions of pounds after being ordered to plug a £4.5 billion hole in the NHS budget. Chief executives at hospitals, mental health trusts and community services in England have been ordered to review staffing levels and draw up plans to close some services and merge others. They are also looking at banning or restricting the use of some agency workers. NHS bosses have been alerted in recent days to the scale of the cuts needed after negotiating financial plans for next year. The health service in England has a budget of £165 billion for the 2024-25 financial year, which starts next week. The budget rose by 3.2% in real terms between 2018-19 and 2023-24. Spending has been put under additional pressure by the cost of covering strikes by junior doctors which NHS England has said has cost more than £1.5 billion and affected more than 430,000 patients’ appointments. Saffron Cordery, deputy chief executive of NHS Providers, said services had been stretched by the need to pick up the pieces from a shortage of social care and other community services. She said an ageing population and poor public health meant patients in hospital were sicker and staying longer, needing more care. She said: “Trust leaders are being pushed to the very limits of what is possible, and there will be a situation where they have to make difficult choices about keeping basic services going versus investing in quality and improvement for the future. We are in a situation where we will be patching something that’s already a bit patched-together.” Read full story (paywalled) Source: Times, 31 March 2024 -
Content ArticleThe World Health Organization (WHO) is in the process of establishing a Roster of consultants in the area of patient safety with the main objective of identifying experts from all over the world in different patient safety areas who may support the implementation of the Global Patient Safety Action Plan (GPSAP) 2021-2030 at global, regional, country and institutional levels. The experts with the successful outcome of their application will be placed on the Roster and subsequently may be selected for consultancy assignments in the specified area of work, primarily across the seven strategic objectives of the GPSAP 2021-2030. More information can be found in the link below. Closing date for applicants: 3 April 2024.
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News Article
Thousands of foreign nurses a year leave UK to work abroad
Patient Safety Learning posted a news article in News
Almost 9,000 foreign nurses a year are leaving the UK to work abroad, amid a sudden surge in nurses quitting the already understaffed NHS for better-paid jobs elsewhere. The rise in nurses originally from outside the EU moving to take up new posts abroad has prompted concerns that Britain is increasingly becoming “a staging post” in their careers. The number of UK-registered nurses moving to other countries doubled in just one year between 2021-22 and 2022-23 to a record 12,400 and has soared fourfold since before the coronavirus pandemic. Seven out of 10 of those leaving last year – 8,680 – qualified as a nurse somewhere other than the UK or EU, often in India or the Philippines. Many had worked in Britain for up to three years, according to research from the Health Foundation. The vast majority of those quitting are heading to the US, New Zealand or Australia, where nurses are paid much more than in the UK – sometimes up to almost double. Experts have voiced their alarm about the findings and said the NHS across the UK, already struggling with about 40,000 vacancies for nurses and hugely reliant on those coming from abroad, is increasingly losing out in the global recruitment race. “It feels like the NHS is falling down the league table as a destination of choice for overseas nurses,” said Dame Anne Marie Rafferty, a professor of nursing studies at King’s College London. “Worryingly, it feels as if the UK is perceived not as a high- but middle-income country in pay terms and as a staging post where nurses from overseas can acclimatise to western-type health systems in the search for better pay and conditions.” Read full story Source: The Guardian, 25 March 2024 -
News ArticleNHS England’s workforce ambitions are based on ‘significant’ substitution of fully qualified GPs with trainees and specialist and associate specialist (SAS) doctors, the public spending watchdog has revealed. In a new assessment of the NHS long-term workforce plan, the National Audit Office (NAO) found that NHS England’s modelling of the future workforce had ‘significant weaknesses’ and that some of its ‘assumptions’ may have been ‘optimistic’. Last year, the national commissioner committed to doubling medical school places to 15,000 and increasing GP training places to 6,000 by 2031. This was based on modelling which predicted that, without these changes, the NHS could face a staffing shortfall of 360,000 and a GP shortfall of 15,000 by 2036. The NAO’s report has examined the robustness of NHS England’s predictions, and made a number of recommendations which could influence the refreshed projections NHSE has committed to publishing every two years. The long-term workforce plan (LTWP) projected only a 4% increase in fully-qualified GPs between 2021 and 2036, compared to a 49% growth in consultants. "The total supply of doctors in primary care is projected to increase substantially over the modelled period but the total number of fully qualified GPs is not," the report said. It found that NHSE’s projected supply growth in general practice "consists mainly of trainee GPs", who accounted for 93%, as well as "making increased use of specialist and associate specialist (SAS) doctors in primary care". Read full story Source: Pulse, 22 March 2024
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News Article
Six in 10 nurses in England turning to credit or savings as costs rise
Patient Safety Learning posted a news article in News
Six out of 10 NHS nurses have had to use credit or their savings over the last year to help them cope with the soaring cost of living, according to new research. Acute financial pressures are forcing some nurses to limit their energy use while others are going without food. Many are doing extra shifts to help make ends meet. The findings have added to fears that money worries and inadequate pay will prompt even more nurses to quit the NHS, which is already short of almost 35,000 nurses. The Royal College of Nursing (RCN), which undertook the survey of almost 11,000 nurses in England, claimed that too many in the profession had been left without enough money to cover their basic needs as they paid the price for “the government’s sustained attack on nursing”. Read full story Source: The Guardian, 22 March 2024 -
Content ArticleDoctors working in temporary positions (known as locums) are a key component of the medical workforce and provide necessary flexibility and additional capacity for NHS organisations and services. There have been concerns about the quality and safety of locum practice and the way NHS uses locum doctors. The number of doctors working as locums, and the costs of this to the NHS have caused some concerns nationally in recent years. It has also been suggested that locum doctors may not provide as good a quality of care as permanent doctors. Research carried out by a team at the University of Manchester provided important new information on these issues. The findings indicated that locum working and how locums were integrated into organisations could pose significant challenges for patient safety and quality of care.
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News Article
William Wragg acts as Parliamentary Ombudsman Office faces life without a boss
Patient Safety Learning posted a news article in News
William Wragg, the Tory chair of the Public Administration and Constitutional Affairs Committee (PACAC), has belatedly intervened in the growing crisis over the failure of the Prime Minister to appoint a new Parliamentary Ombudsman to replace Rob Behrens who quits the Parliamentary and Health Service Ombudsman on 31 March 2024. In a letter published on the committee’s website, Mr Wragg asks Sir Alex Allan, the senior non executive director on the Parliamentary and Heath Services Ombudsman board, what measures will be taken to keep the office going and what is going to happen to people who, via their MP, want to lodge a complaint to the Ombudsman. He also raises whether reports can be published and complaints investigated. The letter discloses that recruitment for a new Ombudsman began last October and a panel chose the winning candidate at the beginning of January. Since then the Cabinet Office and Rishi Sunak, who has to approve the appointment, have not responded. The silence from Whitehall and Downing Street means no motion can be put to Parliament appointing a new Ombudsman, who then appears before the PACAC for a pre appointment hearing. PACAC has only a couple of weeks to set up the hearing. Read full story Source: Westminster Confidential, 12 March 2024 -
Content ArticleThis parliamentary briefing discusses the NHS workforce in England, focusing on the clinical professions, including doctors and nurses. It gives an overview of workforce demographics and workforce policy and planning since 2019. It also looks at turnover and vacancy rates, the use of temporary staffing and how safe staffing levels are decided. It considers trends in domestic and international recruitment and factors affecting both recruitment and retention, including staff wellbeing, pay and pensions, and bullying, harassment and discrimination.
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Content ArticleThe Falls and Fragility Fractures Audit Programme (FFFAP) is looking to recruit new members to their award-winning Patient and Carer Panel. FFFAP is a national clinical audit run by the Royal College of Physicians (RCP) and commissioned by the Healthcare Quality Improvement Partnership on behalf of NHS England and the Welsh Government. Their work aims to improve the care that patients with fragility fractures receive in hospital and after discharge and to reduce inpatient falls.
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Content ArticleIt 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?
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News ArticleThe 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
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Content ArticleNorthumbria University is exploring the experiences of NHS Trusts taking steps to move towards a Restorative Just Culture to develop and share an informative ‘how to’ guide. They would like to hear your views if you are you an NHS Trust who has attended the Northumbria University and Mersey Care NHS FT programme: Principles and Practices of Restorative Just Culture and have implemented, or attempted to implement, restorative just culture. It will take approximately 45 minutes of your time to take part in an online interview/focus group. If you are interested in participating or have any questions please contact bl.rjc@northumbria.ac.uk. Download the attachment below for more information.
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News Article
NHS across UK spends a ‘staggering’ £10bn on temporary staff
Patient Safety Learning posted a news article in News
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 -
Content ArticleThis 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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Content ArticleThat safety is paramount in healthcare goes without saying. There are though variations in patient outcomes between hospitals that cannot be explained by different population characteristics. Based on aggregate staffing data, a number of studies have shown that skill mix can be a factor accounting for these variations – essentially the higher the ratio of unregistered staff to registered staff the greater the incidence of adverse outcomes including mortality rates. Professor Richard Griffin explores this further in his LinkedIn article.
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Content ArticleIncreasing interest in general surgery from students who are Under-Represented in Medicine (URiM) is vital to advancing diversity, equity and inclusion efforts. This study in The American Journal of Surgery examined medical student third year surgery clerkship evaluations quantitatively and qualitatively to understand the experiences of URiM and non-URiM learners. The authors found that URiM students are less likely than non-URiM students to see surgical residents and faculty as positive role models. They highlight that integrating medical students into the team, taking time to teach and allowing students to feel valued in their roles improves the clerkship experience for trainees and can contribute to recruitment efforts.
