Staff shortages cited as factor in delayed discharge (Nursing Times: 26 May 2016)

Workforce capacity issues in health and social care organisations are making it difficult to discharge older patients from hospital effectively, a report has warned.

Across the health and social care system, providers and commissioners said that staff recruitment and retention were a significant cause of delays, according to the National Audit Office report.

It warned that vacancy rates for nursing and home care staff were up to 14-15% in some regions, and fewer than half of hospitals felt they had sufficient staff trained in the care of older patients.

Efforts to speed up discharge was also being inhibited by health and social care organisations not sharing patient information effectively, despite a statutory duty to do so.

While hospitals were financially incentivised to reduce discharge delays, there was nothing similar to encourage community providers and councils to speed up receipt of patients, added the report titled Discharging older patients from hospital...read more

 

Economists claim there will be a 6% drop in student numbers after bursary scrapped (Nursing Times: 25 May 2016)

Economists have estimated that demand for healthcare courses will drop by at least 6% following the removal of bursaries next year, leading to thousands fewer nurses being trained in 2017.

They also predicted that universities would lose at least £57m next year, largely due to smaller student intakes, under the new arrangements that will see nursing, midwifery and allied health professional students in England having to take out loans to fund their tuition fees and living costs.

Meanwhile, the report – titled The Impact of the 2015 Comprehensive Spending Review on Higher Education Fees and Funding Arrangements in Subjects Allied to Medicine – estimated the government would fail to make the vast majority of savings it expects from the move because a large proportion of student loans would have to be written off.

According to the analysis, carried out by consultants London Economics for Unison and the National Union of Students, the cost to healthcare students to study at university would increase by 71% under the government reforms....read more

 

Why has the NHS deficit ballooned? One word: understaffing (The Guardian: 20 May 2016)

Why are NHS finances in such a mess? The biggest reason is staffing – or, to be more precise, understaffing. The NHS in England is struggling with a serious and growing lack of personnel, especially nurses and some specialist doctors. This is forcing hospital trusts to spend unprecedented amounts of money on locums, especially those supplied by employment agencies, many of which charge what have been described by the NHS England chief executive, Simon Stevens, and the health secretary, Jeremy Hunt, as “rip-off” rates.

The mark-ups these agencies charge takes money away from frontline care. Barts health trust in London – the largest in the NHS – spent about £80m on agency staff in 2015-16, roughly £30m of which was profit for the agencies.

The sharp increase in the bill for agency staff mirrors almost exactly the dramatic decline in the health service’s finances. These personnel cost the NHS £2.5bn in 2013-14, rising to £3.3bn in 2014-15. The bill for 2015-16 was expected to hit £4bn, but new caps on trusts’ agency staff spending, introduced by Hunt last year, brought that down to £3.7bn – a saving of £300m, but still astronomical. There has also been a crackdown on the use of management consultants.

Most trusts have hired extra staff, and increasingly rely on agency workers to fill rotas and wards to standards recommended by Robert Francis’s official report into the Mid Staffordshire hospital scandal,which identified a lack of nurses as a key reason for inadequate care at the trust.

However, Francis’s report was published amid the longest period of austerity in the 67-year history of the NHS, with its 1% annual real-terms budget increases far below the 4% year-on-year rise it had been used to....read more

 

'Almost half' of junior doctors 'will quit the NHS' if contract is imposed (Pulse: 17 May 2016)

Almost half of junior doctors plan to quit the NHS if health secretary Jeremy Hunt’s threatened contract imposition goes ahead, a survey has found.

The survey, launched by a GP trainee and attracting thousands of responses, was designed to gauge the opinions from doctors and medical students about the junior doctor contract row.

The GPC also reacted to findings, branding them ‘very worrying’ and with ’potentially serious ramifications’.

Out of 4,500 replies via kwiksurveys.com in April, 46% of eligible respondents said they would leave the NHS this summer if the contract goes ahead, with 28% saying they would work abroad in countries like Australia and New Zealand; 15% pledging to leave medicine and change career and 3% vowing to leave to work in private healthcare....

 

NHS facing potential 42,000 nursing shortfall by 2020 (National Health Executive: 2nd May 2017)

The NHS could face a crisis in nursing by 2020, as there may be a shortfall of 42,000 people, around 12% of the profession, according to new research.

In a report released today by the Health Foundation called ‘In Short Supply’, figures in the 2016 NHS Staff Survey were analysed, unearthing fresh concern that staffing levels are insufficient to support nurses to do their job properly.

Pay was also found to be a problem that is likely to worsen in the future, as it was revealed that NHS staff with salaries on pay bands five and above, which includes nurses, will drop by 12% between 2010-11 and 2020-21 in real terms. This is a figure that the Health Foundation believes is set to worsen in the future.

This follows Jeremy Hunt announcing a real terms pay cut at the end of March, a policy that was described as a “bitter blow” to nurses by union the Royal College of Nursing (RCN).

During the run up to the general election on 8 June, last week Labour pledged to axe the 1% pay cap for NHS staff in an effort to show the party’s support for health workers – something a number of unions immediately threw their support behind...read more

 

NHS England has made ‘no progress’ on increasing GP numbers, says PAC (National Health Executive: 27th April 2017)

There has been “no progress” made by NHS England on increasing the number of GPs despite NHS England targets to train 5,000 more doctors by 2020, MPs have today warned.

In its ‘Access to General Practice: progress review’ report, the Public Accounts Committee (PAC) said that since its last report a year ago, at the time when the GP Forward View was developed, little had been done to actually deliver the ambitions set out in the strategy.

This follows figures that showed the number of doctors in general practice had actually fallen between March 2016 and September 2016, contrary to the strategy’s plans. 

PAC stated: “The number of GPs has fallen in the last year, from 34,592 full-time equivalent doctors in September 2015 to 34,495 in September 2016.

“Increasing this number relies on both increasing the recruitment of trainees and improving the retention of the existing workforce, but Health Education England still lacks a credible plan for ensuring that there are enough GPs and that they are in the right areas.

“Health Education England accepted that more could be done to promote general practice as a career choice, and highlighted work underway to make training options more flexible. NHS England added it has a development programme in place to tackle workload in general practice.”

On top of this, the committee raised concern that patient outcomes were being affected due to GP services being closed at core hours...read more

 

Social care system 'beginning to collapse' as 900 carers quit every day (BBC: 11 April 2017)

More than 900 adult social care workers a day quit their job in England last year, new figures reveal.

Service providers warn that growing staff shortages mean vulnerable people are receiving poorer levels of care.

In a letter to the prime minister, the chairman of the UK Homecare Association said the adult social care system - which applies to those over the age of 18 - has begun to collapse.

The government said an extra £2bn is being invested in the system.

An ageing population means demand is increasing for adult social care services.

Those who provide care to people directly in their own homes, or in nursing homes, say a growing shortage of staff means people face receiving deteriorating levels of care.

"You just can't provide a consistent level of care if you have to keep recruiting new people", said Sue Gregory, who has been a care home nurse in North Yorkshire for 13 years.

"Its very simple, not many people want to do this kind of work, and this is a profession that relies on you getting to know the people you are looking after."...read more

 

Record number of GP closures force 265,000 to find new doctors (The Guardian: 7 April 2017)

A record number of GP practices closed last year, forcing thousands of patients to find a new surgery, in spite of government attempts to stop local doctors shutting their doors.

NHS England data showed nearly a hundred practices closed in 2016, a 114% increase in GP closures compared with figures from 2014. Of the 92 practices that shut, 58 did so completely, while 34 merged with other local surgeries in order to pool resources.

The drop in GP numbers meant 265,000 patients – an increase of 150% from 2014 – had to change their practice last year, often travelling further for care. Brighton was particularly badly affected with 9,000 patients displaced when four practices closed. There have been a total of seven closures in the city over the past two years.

The new data, obtained by the GP website Pulse, has renewed fears that family doctors are not coping with increased demand and need an urgent cash injection to survive. Senior doctors also expressed concern that government funding was not being targeted correctly. ...read more

 

More than 7,000 nurses could face axe under secret NHS plans (The Telegraph: 16 January 2017)

More than 7,000 nurse posts could be axed from NHS hospitals across the country despite a mounting Accident & Emergency crisis, new plans reveal.

Every area has been ordered to draw up meaures to save £22bn and reorganise health services in order to meet rising demand from an ageing population.

But new documents suggest that the proposals could result in the loss of more than 17,000 staff by 2020 - including 7,300 nurses and midwives.

Last night senior nurses said the implications for safety were “truly frightening” with widespread shortages of staff already in overstretched hospitals.

The forecasts, seen by Health Service Journal, also reveal that the plans rely on a dramatic reversal in trends which have seen casualty units under unprecedented pressure.

While A&E attendances across England have risen by 4.5 per cent and emergency admissions by 3.5 per cent in the past 12 months, the plans rely on a 4.2 per cent fall in attendances, and a 0.8 per cent drop in admissions.

Health authorities across England have been ordered to draw up 44 “sustainability and transformation plans” (STPs) to tackle rising pressures on the health service.

The controversial measures will see swingeing bed cuts in many parts of the country, and widespread closures of Accident & Emergency departments....read more

 

90% of GP trainees to shun full-time clinical work (Pulse: 5 May 2016)

Only one in ten GP trainees expect to be doing full-time clinical work in five years’ time, a major report from the King’s Fund think-tank has revealed.

The report – Understanding pressures in general practice – also claims that the crisis in general practice has been ‘invisible’ for policy-makers due to failure by the DH and NHS England to collect data.

Its analysis of 30 million patient contacts from 177 practices found that the number of consultations since 2010/11 had grown by 15%, echoing a recent study published in the Lancet.

GP leaders said that the lack of data on general practice had led ‘many to turn a blind eye to the ever-worsening crisis’ in the profession.

The report comes two weeks after NHS England released its ‘General Practice Forward View’, which committed to devoting more than 10% of the NHS budget into general practice.

The King’s Fund welcomed NHS England’s proposed measures, but warned that general practice was in a crisis.

It pointed to an increase in demand and a reduction in funding, as well as a recruitment crisis.

And it warned that the recruitment crisis could get worse, as a survey of 318 trainees revealed they were shunning a full-time career in general practice – and not only because of family commitments....read more

 

GPs still in favour of mass resignation despite support package (Pulse: 29 April 2016)

Almost half of GPs are still willing to submit undated resignations, despite the multibillion-pound ‘Forward View’ announced by NHS England last week.

A Pulse survey of 524 English GPs found that 45% would still support mass resignation from the NHS due to the current state of general practice, while a further one in four are undecided.

This is only a small decrease on the 49% who said that they would be willing to resign their contracts in December 2015.

The Special LMC Conference in January voted for the GPC to canvass support for submitting undated resignation letters if the Government fails to implement a ‘rescue package’ for general practice within six months.

Last week, Pulse exclusively revealed that the GPC was still considering the threat of mass resignation following the announcement of the General Practice Forward View, which committed £2.4bn extra funding a year by 2020 plus a £500m support package.

Today’s poll reveals that GP support for the so-called ‘nuclear option’ is maintained, with the percentage of GPs ruling mass resignation out decreasing from 35% in December to 29% today....read more

 

NHS looks to India for GPs in attempt to make up shortfall (The Guardian: 7 April 2016)

The NHS is looking at recruiting GPs from India in an attempt to tackle the serious shortage of family doctors.

Health Education England, the NHS’s training and recruitment agency, has signed a memorandum of understanding with the Apollo Hospitals chain in India about lending clinical staff between them.

GP leaders said the initiative amounted to “an admission of failure” by ministers to develop enough homegrown staff and that it cast doubt on their pledge to increase the number of GPs by 5,000 by 2020.

It also led to warnings that bringing in doctors who had not been trained in the UK could pose a threat to patient safety.

HEE, which is currently recruiting GPs, provided few details about the link-up.

Dr Ramesh Mehta, the president of the British Association of Physicians of Indian Origin, told the doctors’ magazine Pulse, which revealed the move, that his contacts in India had told him HEE is keen to hire “as many GPs as possible”....read more

 

Staff shortages spark CQC warning for mental health trust (The Nursing Times: 23 March 2016

Junior doctors to withdraw emergency care in escalation of action (Pulse: 23 March 2016

Hospital shuts beds after CQC raises staffing ratio concerns (HSJ: 21 March 2016)

Alarm raised over trust's 'risky' proposal to run A&E without specialist consultants (HSJ: 21 March 2016)

Health minister admits Government risks not delivering on GP recruitment goal (Pulse: 21 March 2016)

700 community staff to be transferred twice in months (HSJ: 18 March 2016)

Hospital staffing crisis as 40% of consultant posts remain vacant (The Guardian: 15 March 2016

Warning overseas recruitment is only a 'stop gap' for nurse shortages (Nursing Times: 10 March 2016)

Health trusts reveal thousands of doctor and nursing positions lie vacant (The Independent: 29 February 2016

Junior doctors defy health secretary with three 48-hour strikes (The Guardian: 23 February 2016

NHS Bosses Plan to sell Temp Agency (The Morningstar Online: 23 February 2016)

NHS staff survey: more staff working extra hours (HSJ: 23 February 2016)

We're not surprised half our psychologist colleagues are depressed (The Guardian: 18 February 2016)

Implement junior doctor contract or lose funding, hospital bosses warned (Pulse: 17 February 2016)

The number of doctors applying to work abroad surged by 1,000 per cent on the day Jeremy Hunt imposed new contract (The Independent: 17 February 2016

Liverpool NHS jobs face the axe because of community health funding cuts (Liverpool Echo: 17 February 2016)

Seven-day NHS may not cut death rates, say Hunt's own officials (The Guardian: 16 February 2016)

Revealed: GP training targets in doubt as applications tumble 5% (Pulse: 10 February 2016)

Higher number of HCAs linked with increased mortality, says study (HSJ: 9 February 2016)

Hospital death rates rise if fewer nurses are on wards, says new research (The Independent: 9 February 2016)

Junior doctors' strike to go ahead next week after talks fail (Pulse: 1 February 2016)

Mass GP resignations 'likely' as union urges LMCs to back crisis conference vote (GP Online: 27 January 2016)

More than a quarter of trusts asked to breach agency cap (HSJ: 26 January 2016)

NICE experts called for minimum staff ratios in leaked guidance (HSJ: 20 Janaury 2016

A&E departments may be too short-staffed 'almost half the time', says report (Independent: 20 January 2016)

Industrial action: junior doctors provide emergency-only care (BMA: 12 January 2016)

All NHS staff support the junior doctors’ strike action (The Guardian: 12 January 2016)

London nurse shortage 'critical' as vacancies rise to 10,000 (Nursing Times: 7 January 2016)

GPs under 50 leaving profession due to fear of burnout, NHS study finds (Pulse: 7 January 2016)

Junior doctors and Government to hold fresh conciliation talks (Pulse: 6 January 2016)

New wave of practice closures could mean 25,000 patients lose their GP (Pulse: 6 January 2016)

Directors to review NICE chief's decision not to release staffing guidance (Nursing Times: 5 January 2016)

Junior doctors in England to strike next week after talks break down (The Guardian: 4 January 2016)

Higher ratio of nurses per hospital bed linked to fewer patient deaths (Nursing Times: 18 December 2015)

Half of GPs willing to resign NHS contracts (Pulse: 10 December 2015)

Number of ambulance staff quitting almost DOUBLES leaving NHS facing crisis (The Mirror: 10 December 2015)

Almost half of junior doctors left NHS after foundation training (The Guardian 5 December 2015)

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