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Found 1,020 results
  1. Content Article
    Read the latest case studies from the National Guardian’s Office.
  2. Content Article
    Nurses, midwives and paramedics make up over half of the healthcare workforce in the UK National Health Service and have some of the highest prevalence of mental ill health. This study in BMJ Quality & Safety explored why mental ill health is a growing problem and how we might change this. The authors identified the following key themes:It is difficult to promote staff psychological wellness where there is a blame cultureThe needs of the system often over-ride staff psychological well-being at workThere are unintended personal costs of upholding and implementing values at workInterventions are fragmented, individual-focused and insufficiently recognise cumulative chronic stressorsIt is challenging to design, identify and implement interventions.They suggest that healthcare organisations need to rebalance the working environment to enable healthcare professionals to recover and thrive. This requires:high standards for patient care to be balanced with high standards for staff mental well-being.professional accountability to be balanced with having a listening, learning culture.reactive responsive interventions to be balanced by having proactive preventative interventionsthe individual focus balanced by an organisational focus.
  3. Event
    until
    Although healthcare worker violence ranks high among today's top patient safety concerns, healthcare workers continue to be harmed, and healthcare has been identified as the profession with the highest percentage of nonfatal workplace violence injuries. Over the last few years, a Pennsylvania facility found that assaults on nursing in their acute care organisation were more than double the national rate. In the webinar, Loni Francis, MSN, RN, director of Behavioral Health Services, and Erin Marinchak, MSN, RN, senior director of clinical practice, Reading Hospital, Tower Health, will explain how proactive rounding by internal experts an prevent assaults and how behaviour management plans can reduce physical assaults. Register for the webinar This event takes place at 12:00 EDT and 17:00 BST
  4. Content Article
    Increasingly, some nursing leaders say it’s time to move away from the 12-hour nursing shifts used by many hospitals. They say that health systems must develop other scheduling options to accommodate the changing needs of nurses as they progress in their careers. This article by Ron Southwick looks at the arguments for moving away from the 12-hour shift, including the risks that the current system poses to patient safety.
  5. Content Article
    This is the recording of a webinar on hosted by the Safety for All Campaign to present findings from a survey on violence and aggression sustained by nursing and midwifery students in a UK university. The findings were presented by Dr Kevin Hambridge, Lecturer in Adult Nursing (Education), Francis Thompson, Associate Professor in Mental Health Nursing (Education) and Dr Matt Carey, Associate Professor in Child Health Nursing – Acute Care, all from the University of Plymouth. The results highlighted worrying trends of verbal violence or aggression, physical violence and sexual violence towards students. The responses also highlighted a culture of acceptance among students who have been programmed to see violence at work as part of the job. There was a detailed question and answer session following the presentation in which webinar attendees asked questions about prevention, protection and collaboration.  
  6. News Article
    An ambulance trust with a long history of cultural problems saw the proportion of staff reporting being bullied or harassed increase in 2023. The survey by East of England Ambulance Service Trust found 35 per cent of staff who responded said they had experienced bullying or harassment over the last 12 months—up from 32 per cent in 2022, and 25 per cent in 2020. The work commissioned by the trust also found that many staff who had experienced or seen bullying, or racial or sexual harassment, did not report it, with fear of retaliation being a key factor in their decision. Less than 40 per cent said they would speak to a Freedom to Speak Up Guardian about concerns. The trust—which has made high-profile efforts to address cultural issues in recent years—said it was normal to see a rise in complaints as staff became aware poor behaviour would not be tolerated, and felt safer to speak out. Hein Scheffer, the trust’s director of strategy, culture and education, said: “Bullying, harassment and poor behaviour have no place in our organisation and we regularly survey our people’s experience of workplace behaviours to help us root this out. We are working hard to improve our culture and we are among the most improved NHS organisations in England for staff feeling confident in speaking out – with 63% describing the trust as supportive." Read full story (paywalled) Source: HSJ, 12 June 2024
  7. Content Article
    This study explored the beliefs and organisational contexts of nursing aide (caregivers henceforth) assaults and their subsequent reporting of these events. Although this data is a pretty specific cohort and setting (rural nursing homes), the social and systems lenses that the authors take, and the silence resulting from blame attributions have broader applications.
  8. News Article
    The proportion of NHS staff who have experienced physical violence from patients has fallen to its lowest levels in five years, according to the latest survey data. New figures showed the percentage of staff reporting at least one incident of physical violence from patients or the public, within the last 12 months, had declined from 15.1 per cent in 2019, down to 13.7 per cent in 2023. That is also almost one percentage point lower than 14.6 per cent in 2022, which is the biggest year-on-year percentage point fall in the five years. The 2023 NHS staff survey, first published in early March, was updated recently to include the questions on physical violence. NHS England said earlier this week it had received a “higher than expected rate of missing data” for the questions, which meant they were not originally reported, but these issues had now been resolved. However, ambulance workers remain disproportionately affected by physical violence compared to other roles, with 27.6 per cent saying they had experienced at least one instance of physical violence from patients or the public in the past year. This is down from 32.5 per cent five years ago in 2019. Acute and community staff were the next highest (13.7 per cent), followed by mental health (13.5 per cent), community (7 per cent), and then acute specialist (5.3 per cent). Read full story (paywalled) Source: HSJ, 5 June 2024
  9. Content Article
    Deborah Filipek, author of this article for the Healthcare Financial Managment Assication (US), looks at research linking staff burnout to patient safety. Key points: Authors of two published studies reviewing clinician burnout found increased burnout affecting clinician mental and physical health and posing concerns for patient care and safety. One of the studies also looked at which interventions clinicians preferredImprovement in care delivery was rated by both physicians and nurses as more important to their mental health and well-being than interventions directed at improving clinicians’ mental health. On average, under single coverage, female employees have approximately $266 more in out-of-pocket spending per year than male employees, excluding pregnancy-related services. Only 227 American Indian/Alaska Native students entered U.S. medical schools during the 2021-22 academic year. Click on the link below to see the full article.
  10. Content Article
    In this editorial for BMJ Quality and Safety, Kate Kirk explains why staff well-being is the foundation to improving patient safety.
  11. Content Article
    Medtech companies are continually developing new medical devices and products for use in healthcare, and ensuring that each one is safe to use should be the top priority of every company. In this anonymous blog, a nurse shares their experience of being employed by a start-up producing a new piece of equipment for use in cardiac surgery. They soon discovered their values did not match up, as the company prioritised getting their new product to market above patient safety. The writer talks about the personal cost of repeatedly speaking up for safety and describes the importance of working for an employer that sees patient safety as the top priority and recognises that it goes hand in hand with commercial success.
  12. Content Article
    When GP practices have a patient who is violent or exhibiting behaviour that makes them fear for their safety, the patient should immediately be removed from the practice list. This guidance from the BMA explains how to do this as well as outlining the special allocation scheme (SAS), which provides primary care medical services in a secure environment to patients who meet the criteria. In the SAS, designated GP practices provide services to patients by appointment at specific locations and times as detailed in individually agreed contracts. Patients join the scheme after being immediately removed as a result of an incident that was reported to the police. It aims to protect GPs, practice staff and patients who have the right to be in the practice without fear of intimidating behaviour. 
  13. Content Article
    The National Association for Healthcare Security (NAHS) was formed in 1994 as a UK non profit-making professional organisation. The NAHS operates in a single national network and aims to support and enable healthcare provision through the delivery of professional security management; promoting and ensuring members are best placed and equipped to provide a safe and secure environment for their organisations staff, patients and visitors. This process ultimately enhances and improves staff wellbeing and the healthcare environment along with improving the quality of a patient’s treatment journey. The website includes a library of resources relating to security in healthcare settings.
  14. Content Article
    The last two decades have seen substantial advancement in the practice of team-based, safe care delivery. In parallel, burnout has been recognised as prevalent among US doctors and influenced by workplace structure and experiences. This study assessed US doctors’ perceptions of team-based care delivery and safety climate within their institutions and how these domains were associated with burnout.
  15. Content Article
    This standard, which complements existing health and safety legislation, has been developed by NHS England. NHS employers have a general duty of care to protect staff from threats and violence at work, and the standard delivers a risk-based framework that supports a safe and secure working environment for NHS staff, safeguarding them against abuse, aggression and violence. It employs the Plan, Do Check, Act (PDCA) approach, an iterative four-step management method to validate, control and achieve continuous improvement of processes. It was developed in partnership with the Social Partnership Forum and its subgroups, including trade unions and the Workforce Issues and Violence Reduction Groups.
  16. News Article
    Attacks on health workers, hospitals and clinics in conflict zones jumped 25% last year to their highest level on record, a new report has found. While the increase was largely driven by new wars in Gaza and Sudan, continuing conflicts such as Ukraine and Myanmar also saw such attacks continue “at a relentless pace,” the Safeguarding Health in Conflict coalition said. Researchers recorded more than 2,500 incidents of “violence against or obstruction of healthcare” in 2023, including the killing or kidnapping of health workers and the bombing, looting and occupation of hospitals. The coalition called for national and international prosecutions of “war crimes and crimes against humanity involving attacks on the wounded and sick, health facilities and health workers.” Its report highlighted cases of attacks on children’s hospitals and sites running immunisation campaigns, leaving people vulnerable to infectious diseases. It also warned of a new trend in which drones armed with explosive weapons are used to target health facilities. Leonard Rubenstein, of the Johns Hopkins school of public health, who chairs the coalition, said violence inflicted on healthcare workers and facilities had “reached appalling levels”. The report included examples where workers had been deliberately targeted, and others where combatants were reckless or indifferent to the harm caused, he said. “The lack of restraint we are seeing, from the beginning of conflicts, suggests to me that the law on protecting healthcare has had no meaning to combatants.” Read full story Source: The Guardian, 22 May 2024
  17. Content Article
    This study in Surgery aimed to assess the impact of presenting the STOPS framework (stop, talk to your team, obtain help, plan, succeed) on how surgeons cope in the operating room. It also looked at the related outcome of burnout and examined sex differences. The results suggest that there is evidence of efficacy in the STOPS framework—female surgeons who were presented this material reported higher levels of coping in the operating room compared to those who did not receive the framework. In addition, an increase in coping ability was associated with reduced levels of burnout for both genders.
  18. Content Article
    This article by Saoirse Mallorie, Senior Policy Analyst at The King's Fund, looks at the detail behind the results of the 2023 NHS Staff Survey. She highlights that although it looks as though there has been improvement in some areas, staff satisfaction is not where it should be. The article also looks at variation between staff groups in terms of work-related stress, autonomy, belonging and workload, representing these differences visually in graphical form.
  19. Content Article
    Despite growing awareness of diagnostic error, most healthcare systems do not track or record diagnostic quality, and many diagnostic safety events are not recognised. Without methods to identify, measure, investigate and analyse events, healthcare organisations cannot understand causes of diagnostic errors, identify contributing factors or create solutions. One of the best ways to collect information about diagnostic errors is through self-reporting by patients and healthcare professionals. This issue brief from the Agency for Healthcare Research and Quality looks at how to foster psychological safety and organisational safety culture in order to reduce harm from diagnostic error. 
  20. Content Article
    The Safe Learning Environment Charter supports the development of positive safety cultures and continuous learning across all learning environments in the NHS. It is underpinned by principles of equality, diversity and inclusion. It has been developed by over 2482 learners, educators and key stakeholders in health education. The Charter was created by NHS England in response to healthcare learners’ feedback on their clinical experiences in maternity services, set out in the Kirkup (2015 and 2022) and Ockenden (2020 and 2022) reports. The Charter is designed for learners and those responsible for supporting placement learning across all learning environments and all professions within them. It is aligned to the NHS People Promise in recognition that learners are vital to the workforce and are included in the promises NHS staff and leaders must all make to each other, to improve everyone’s experience of working in the NHS. The Charter sets out the supportive learning environment required to allow learners to become well-rounded professionals with the right skills and knowledge to provide safe and compassionate care of the highest quality.
  21. News Article
    More than 50 NHS whistleblowers claim to have lost their jobs—with some driven to the brink of suicide—after standing up to protect patients’ lives as bosses bury their concerns. The group of doctors and nurses said that they had been targeted after raising concerns about more than 170 patient deaths and nearly 700 cases of poor care. One consultant said that it was the “biggest scandal within our country” and claimed the true number of avoidable deaths was “astronomical”. Instead of addressing the problems, the whistleblowers claim that NHS bosses are spending millions of pounds of taxpayers’ money on hiring law firms and private investigators to investigate them instead. Last year Rob Behrens, the health ombudsman, warned The Times Health Commission that patient safety was at risk due to “toxic” and hierarchical behaviour among NHS doctors. Professor Phil Banfield, the chairman of the council of the British Medical Association, which represents doctors, wrote in The Daily Telegraph that whistleblowing “is not welcomed by NHS management… NHS trusts and senior managers are more concerned with protecting personal and organisational reputations than they are with protecting patients.” In one case, the NHS spent more than £4 million on legal action against a single whistleblower, which included £3.2 million in compensation. Among the clinicians interviewed, 40 said that their employer took “no positive action” to address patient safety concerns; 36 said that patients remained at risk at their place of work; 19 said that NHS trusts covered up the problems, and ten said that their employers had denied there was a problem. Whistleblowers’ representatives are urging the government to require independent medical assessments for claims and to ban the suspension or exclusion of doctors for speaking out about patient safety. Dr Naru Narayanan, president of the hospital doctors’ union, has called for an independent national whistleblowing body outside of the NHS to register protected disclosures and protect individuals against recriminations. The Times Health Commission recommended that a no-blame compensation scheme should be introduced for medical errors, with settlements determined according to need. Backed by Jeremy Hunt, the chancellor, the scheme would help end the deadly cycle of NHS scandals and cover-ups and ensure families receive timely support. Read full story (paywalled) Source: The Times, 15 May 2024
  22. Content Article
    This systematic review aimed to find out the prevalence of sexual harassment, bullying, abuse, workplace discrimination and other forms of harassment among medical students, residents, fellows and attending physicians in obstetrics and gynaecology. It found that many of these behaviours were frequent among respondents of the ten studies used in the review. The findings suggest that there is high prevalence of harassment in obstetrics and gynaecology despite the field being female-dominant for the last decade.
  23. Content Article
    In this article, published by Pragmatic Improvement, Pete Gordon discusses the 2023 NHS staff satisfaction survey and the link with emergency department performance.
  24. News Article
    The safety of a teaching hospital’s out-of-hours supervision has been questioned, including reports trainees were told not to ask for help “unless your patient is dying”. The General Medical Council put University Hospital Southampton Foundation Trust’s general surgery training under enhanced monitoring at the end of 2023 following a referral and quality management visit by NHS England South East, Workforce Training and Education – Wessex. The NHSE team’s visit and subsequent report said doctors in training had claimed senior staff were “not contactable” out of hours and there was “difficulty” in securing senior clinical advice, particularly on Sundays. The report added foundation year doctors were “discouraged” from contacting senior staff out of hours by “inappropriate” and “belittling” comments and behaviours, such as being told not to ask for help “unless your patient is dying”. Foundation doctors also reported starting rotation on call and conducting ward rounds without appropriate supervision. While the GMC open case is centred on patient safety concerns relating to supervising trainee doctors, the workforce and training directorate report also raised concerns about bullying, inappropriate sexual comments made by consultants, and a feeling that foundation doctors were unable to speak up. Read full story (paywalled) Source: HSJ, 1 May 2024
  25. Event
    The second Healthcare Fatigue Forum is being held on Tuesday 5th November 2024 at the Hyatt in Birmingham. Registration will open soon. This event will cover topics including the current state of fatigue risk management in the NHS, relevant and ongoing research, countermeasures and tools to mitigate fatigue. Attendees are invited to submit posters of research that is, or has, been undertaken in the field of fatigue management in health and social care workers.
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