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Found 618 results
  1. News Article
    The NHS should help social care recruit and retain nurses, including with better pay and conditions, particularly for new service models where care staff take on more health tasks. This is among the recommendations in the first workforce plan for adult social care, published by Skills for Care today, which also warns government must not delay promised improvements in staff pay, standards and conditions, while it waits to decide on funding reform. The report also recommends a pay uplift for care staff which it estimates would cost between about £2bn and £6bn a year – but it suggests there would be a significant net benefit overall due to reducing turnover costs and increasing care capacity. The report says integrated care systems should develop joint “one workforce” plans, “align terms and conditions, training and wellbeing support”, and “create the pipeline for registered nurses and nursing associates” to go into care roles. Nursing turnover in care providers is very high and it is thought nurses often leave for NHS jobs with better pay and conditions. However, nursing staff are increasingly needed to supervise “delegated healthcare tasks” for care users with rising acuity. It is an approach government, and many systems, want to grow as part of integrated teams, such as testing and monitoring in “virtual wards”. Read full story (paywalled) Source: HSJ, 18 July 2024
  2. Content Article
    For the first time ever, the adult social care sector has come together, led by Skills for Care, to develop the Workforce Strategy it needs. Adult social care needs a workforce strategy to ensure we have enough of the right people with the right skills to provide the best possible care and support for the people who draw on it.
  3. Content Article
    Safety is a core dimension of health care quality, and measurement of patient safety culture in Organisation for Economic Co-operation and Development (OECD) countries is increasingly conducted as part of efforts to monitor patient safety and to contribute to health system performance assessment. This Health Working Paper looks at the findings of the second OECD pilot on patient safety culture. This occurred in 2022-2023 and in total took data from 648,209 health care providers from 14 countries.
  4. News Article
    The NHS must concentrate on the basics of cancer treatment rather than the “magic bullets” of novel technologies and artificial intelligence, or risk the health of thousands of patients, experts have warned. In a paper published in the journal Lancet Oncology, nine leading cancer doctors and academics say the NHS is at a tipping point in cancer care with survival rates lagging behind many other developed countries. The NHS has not met its target for 85% of cancer patients to start treatment within two months since December 2015. International research shows that every four weeks of delay in treatment increases the risk of death by up to 10%. It means hundreds of thousands of people have to wait months to start essential cancer treatment, and only 67% begin treatment within 62 days. The paper highlights 10 pressure points that are contributing to entrenched cancer survival inequalities, diagnosis and treatment delays, and inappropriate care. In a sharply worded warning, the cancer experts say “novel solutions” such as new diagnostic tests have been wrongly hyped as “magic bullets” for the cancer crisis, but “none address the fundamental issues of cancer as a systems problem”. Read full story Source: The Guardian, 8 July 2024
  5. Content Article
    This policy review published in the Lancet Oncology discusses ten key pressure points in the NHS in the delivery of cancer care services that need to be urgently addressed by a comprehensive national cancer control plan. These pressure points cover areas such as increasing workforce capacity and its productivity, delivering effective cancer survivorship services, addressing variation in quality, fixing the reimbursement system for cancer care, and balancing of the cancer research agenda. These areas have been selected based on their relative importance to ensuring sustainable cancer services, persistence as key issues in the NHS, and their impact on delivering better and more equitable and affordable patient outcomes. Many of these pressure points are not acknowledged explicitly in any current discourse. The evidence provides points to their impact on the ability to deliver world class cancer care, but also to their amenability to affordable solutions if given the relevant prioritisation and investment. The current narrative needs to move away from a technocentric approach to improving care, to one focused on understanding the complexity of cancer services and the wider health system to drive improvements in survival, quality of life, and experience for patients.
  6. Content Article
    The UK, like many other countries, has developed occupations intended to alleviate the work of nurses. Variously called nursing assistants or associates, there are now over 10 000 registered in the UK. Unfortunately, the evidence on patient safety is far from reassuring. Experience with nursing assistants calls for extreme caution, write Rachel Greenley and Martin McKee in this BMJ opinion piece.
  7. Content Article
    Recent developments in artificial intelligence (AI) have sparked hope that this technology can play a significant role in helping the NHS tackle current pressures, as well as drive longer-term service transformation. But despite a range of important work on AI underway within the NHS, government and a wide array of other organisations, current efforts to harness AI in health care risk being hampered by the lack of an overarching strategy and lack of coordination among the various actors. The government and NHS leaders must develop a dedicated strategy for AI in health care. This report from the Nuffield Trust presents six key priorities policymakers and health care leaders must address through such a strategy if the benefits of AI are to be realised: meaningful public and staff engagement; effective priority setting; data and digital infrastructure that is fit for purpose; high-quality testing and evaluation; clear and consistent regulation; and the right workforce skills and capabilities. 
  8. Content Article
    In this Medscape article, Jane Dacre, President of the Medical Protection Society (MPS) looks at the importance of ensuring international medical graduates (IMGs) are given thorough and appropriate induction when they join NHS organisations. She highlights that although many trusts do offer IMGs appropriate induction, others are failing to do this She refers to the results of a recent MPS survey which demonstrate the impact of the issue: Nearly 6 in 10 (58%) IMGs said their induction was not adequate or appropriate for them as an IMG. Nearly half (48%) felt anxious about starting clinical duties because of this. 38% said they did not have sufficient time to shadow other doctors. 45% said their induction did not include training on cultural differences and acceptability in the UK. 61% went on to say they felt fearful of medicolegal issues arising from their work.
  9. News Article
    NHS patients are being left unseen in pain and in some cases to die alone because shifts do not have enough registered nurses, a survey shows. The Royal College of Nursing said analysis of a survey it carried out showed that only a third of shifts had enough registered nurses on duty. The union has also gathered testimonies from nurses who talk of always “rushing” and being asked to do more; working in “completely unsafe” levels of care; and having to make “heartbreaking” decisions on who does or doesn’t get seen. Shortages mean individual nurses are often caring for dozens of patients at a time, the RCN said. It has called for limits on the maximum number of patients for whom a single nurse can be responsible. Nicola Ranger, the RCN’s acting general secretary and chief executive, said the survey showed that patients were being failed. “In every health and care setting, nursing staff are fighting a losing battle to keep patients safe,” she said. “Without safety-critical limits on the maximum number of patients they can care for, nurses are being made responsible for dozens at a time, often with complex needs. “It is dangerous to patients and demoralising for nursing staff.” Read full story Source: The Guardian, 1 July 2024
  10. News Article
    The latest release of data from the Royal College of Nursing's Last Shift Survey shows the urgent need for investment in the nursing workforce and safety-critical nurse-to-patient ratios enshrined in law. New analysis finds more than 11,000 members reveals just a third of shifts had enough registered nurses. Chronic staff shortages mean individual nurses are often caring for 10, 12, 15 or more patients at a time. The RCN are now calling for safety-critical limits on the maximum number of patients a single nurse can be responsible for. Our survey found that 1 in 3 hospital shifts were missing at least a quarter of the registered nurses they needed. In A&E settings, significant numbers of nurses reported having more than 51 patients to care for. Across all settings, 80% of respondents said there aren't sufficient nurses to meet the needs of patients safely. RCN Acting General Secretary and Chief Executive Professor Nicola Ranger said: “Without safety-critical limits on the maximum number of patients they can care for, nurses are being made responsible for dozens at a time, often with complex needs. It is dangerous to patients and demoralising for nursing staff. “When patients can’t access safe care in the community, conditions worsen, and they end up in hospital where workforce shortages are just as severe. This vicious cycle fails staff and patients – it can’t go on. “We desperately need urgent investment in the nursing workforce but also to see safety-critical nurse-to-patient ratios enshrined in law. That is how we improve care and stop patients coming to harm.” Read full story Source: RCN, 1 July 2024
  11. 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.
  12. News Article
    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
  13. News Article
    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
  14. Content Article
    The 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.  
  15. Content Article
    Evidence shows that nurse staffing affects patient safety events (PSEs), but the role of an appropriate nursing care delivery system remains unclear. This Japanese study aimed to investigate whether nursing care delivery systems could prevent PSEs. The findings suggest that in an emergency intensive care unit, a collaborative nursing care delivery system was associated with a decrease in PSEs.
  16. Content Article
    In this article for Healthcare Quarterly, Leslee Thompson argues that Health Quality 5.0 moves people-centred, integrated health and social care systems to the forefront of our post-COVID-19 agenda – and that cannot happen without addressing our global workforce crisis. Building back a stronger, healthier workforce is the first of the five big challenges we address in our special series. Starting with the global health workforce crisis is fitting, given it is the most fundamental and formidable barrier to health and quality today. As we put the pieces of the Health Quality 5.0 puzzle together, a picture of a more resilient health system will emerge and a new leadership agenda to get there will take shape.
  17. Content Article
    This is the second ‘saving babies’ lives’ progress report from the Joint Policy Unit. When the first report was published in May 2023, the Unit committed to reassessing progress each year. Through this process it aims to hold government and decisionmakers to account, helping to ensure that saving babies’ lives and tackling inequalities in pregnancy and baby loss are the political priorities they deserve to be. This years report highlights that maternity services need a much more transformative approach from government, that matches the scale and impact of the issue. Maternity services are not on course to meet government ambitions to reduce rates of stillbirth, neonatal death or preterm birth, and there continue to be stark and persistent inequalities in rates of pregnancy and baby loss by ethnicity and deprivation. View a summary version of the report
  18. News Article
    An agency providing last-minute freelance nurses to NHS hospitals is routinely charging up to £2,000 a shift, BBC News has discovered. Glen Burley, chief executive of an NHS trust, said that Thornbury Nursing Services is targeting areas in England where nurses are in short supply. He says it is "profiteering" from an overstretched NHS, but Thornbury says it offers a valuable, flexible service. The government says new measures will end the use of expensive agencies. However, Labour has said the high costs are a result of the "Conservatives' failure to train enough nurses over the past 14 years". Under NHS rules, hospital managers are obliged to use staffing agencies that work within an agreed framework, with a limit or cap on how much should be paid. But when last-minute essential cover is needed, trusts may use off-framework agencies, such as Thornbury. These are not legally obliged to abide by pre-agreed pay scales. Workload pressures in the NHS and a desire for more flexibility over shifts are thought to be driving more nurses to work for such agencies, which tend to pay the people on their books more while also taking a payment for themselves. BBC News has discovered Thornbury charges almost £2,000 for a 12-hour bank holiday shift by a specialist paediatric nurse - an area of expertise where there are known staff shortages. Of that, BBC News calculates the nurse receives about £1,050 - meaning nearly £800 goes to the agency.  Read full story Source: BBC News, 8 May 2024
  19. Content Article
    In this opinion piece for the BMJ, Scarlett McNally looks at patient safety concerns relating to maternity care in the NHS. She considers the costs associated with additional spending in the sector intended to improve safety and emphases the need to train and retain more midwives.
  20. News Article
    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
  21. News Article
    Hundreds of breast cancer patients have travelled more than 100 miles for diagnosis and treatment after waiting times soared at another health board because of staffing shortages. NHS Grampian, which previously received NHS Tayside patients because of staffing problems in Dundee, is now sending its own cases to Larbert, near Falkirk, because its breast cancer department can no longer cope. About 520 people from the Aberdeen area urgently referred to hospital with breast cancer symptoms have travelled to the Forth Valley Royal Hospital for diagnosis with some going on to receive their treatment miles away from home. It is anticipated that at least another 330 Grampian patients will be sent to Forth Valley while the waiting lists are brought under control in Aberdeen. Read full story (paywalled) Source: The Times, 2 May 2024
  22. News Article
    The Biden administration set a first-ever minimum staffing rule for nursing homes Monday, making good on the president’s promise more than two years ago to seek improvements in care for the nation’s 1.2 million nursing home residents. The final rule, proposed in September, requires a registered nurse to be on-site in every skilled nursing facility for 24 hours a day, seven days a week. It mandates enough staff to provide every resident with at least 3.48 hours of care each day. And it beefs up rules for assessing the care needs of every resident, which will boost staff numbers above the minimum to care for sicker residents. For a facility with 100 residents, it translates to a minimum of two or three registered nurses and at least 10 or 11 nurse aides per shift, as well as two additional staffers who could be nurses or aides per shift, according to the administration’s interpretation of its new formula. Set to phase in over the next few years, the mandate will replace the current vague standard that gives operators wide latitude on how to staff their facilities. While the administration has said the rule will improve care, industry lobbyists have said it’s unworkable, with staffing goals that will be impossible to achieve because of a shortage of workers. The administration received 47,000 public comments on the rule since it was proposed last September. They included observations of people lying in their own filth for hours, not being fed appropriately and being left on the floor too long after falling, Secretary of Health and Human Services Xavier Becerra said in an interview Monday. Read full story Source: Washington Post, 22 April 2024
  23. Content Article
    The Nuffield Trust's Health and International Relations Monitor project, supported by the Health Foundation, tracks issues that are important for the delivery of health and care in the UK. It aims to understand how our changing relationship with Europe is changing the picture for the NHS and health more generally, and what the prospects are for the future. This latest report shows that global medicine shortages are being felt particularly acutely in the UK, and the country's reliance on migration as a source of health and social care staff is intensifying.
  24. News Article
    Hospitals 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
  25. Content Article
    The 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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