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The healthmatters blog; commentary, observation and review

HOW TO MEASURE YOUR WELLBEING IMPACT: NEW GUIDANCE

Posted by on Jan 17, 2018 in Blog, Public Health | 0 comments

How to measure your wellbeing impact: new guidance

Today we share a new guide to help charities understand, measure, evaluate and analyse their wellbeing impact. Ingrid Abreu Scherer, Programme Manager at the Centre, explains why we need the guide, and how it can help you, even if you’re not a data scientist.

VIEW HOW TO MEASURE YOUR WELLBEING IMPACT 

People are complicated, and measuring traditional outcomes can sometimes hide this complexity – and thereby hide the full impact of your activities.

At the Centre we study this complexity, and the different things that make up our wellbeing: the quality of our health, work, relationships; how happy, anxious or satisfied we feel; how confident, purposeful, or connected our lives are. It’s all interconnected, and changes many times over the course of our lives.

Wellbeing can be measured by looking at observable factors (like employment), as well as by looking at factors that are subjective to the person experiencing them, like how safe we feel.

Charities and social enterprises have an impact on wellbeing of the people and, in most cases, the communities they work with. Hopefully they improve wellbeing. But they may also make people’s wellbeing decrease, even while achieving their organisational mission.

For example – if a family is constantly being moved from one temporary housing to the next, they will at any point be considered to be ‘in housing’. However, the benefits of having a place to live may be undermined by the stress and uncertainty of constantly moving, by the inability of children to have stable schooling or friendships, and by the lack of connection to the local area. Just measuring a family’s housing situation is not going to give us a full picture of their wellbeing.

We know work is important for wellbeing, but if a new job leaves the newly-employed person feeling more isolated and unsafe, the unintended consequence is lower wellbeing. Having a job is good – but having a good quality job is better, as the graph below shows.

You probably already knew this. And if you work in a voluntary, community or charity organisation, you also probably design your services and approach around the complexities of people’s lives.

So why doesn’t the way we measure our impact, for the most part, take this complexity into account as well? Why do we still tend to focus on traditional outcomes, while so often missing out on evaluating vital wellbeing impacts?

We think there might be a number of reasons:

  • There’s not been, until now, a clear and simple way to understand, measure and analyse the wellbeing data
  • There’s a need to make a stronger case for valuing wellbeing impact
  • Some wellbeing impacts – like confidence or sense of belonging – are often taken for granted by voluntary and community groups, and not worth measuring
  • There’s a need for a reliable framework – based on evidence and robust methods – that the sector can use, and which is accepted by funders and commissioners
  • Funders and commissioners are not always asking for wellbeing impacts to be measured
  • Organisations may have been collecting the information in different ways, without knowing how to compare impact between projects – within the same rganization, within areas, or across sectors.

Whether you want to improve health, education or employment, measuring wellbeing can show you the wider impact you have on the people and communities you support.

How to Measure Wellbeing Impact will help you put together a simple questionnaire to measure the wellbeing of the people you work with – whether you write your own or use tried and tested questions.

It will help you understand how to compare your different projects, and see the impact you’re having overall. You can also find out how to compare your results against the national, regional or local averages to make the case for your service.

Ultimately, our hope is that measuring wellbeing will help you understand your projects better. By developing your own wellbeing survey, and linking your findings to data you already collect, you’ll understand your full impact on people’s wellbeing. You’ll also find out what works to improve wellbeing and why.

Beyond your organisation, wellbeing measures can help us create a bigger picture. If organisations use consistent measures and share their results with us, we can start to build a better, bigger picture of what works. And identify strengths, and where there’s room for improvement across the sector.

Unhealthy employees now cost British firms six working weeks a year in lost productivity

Posted by on Jan 15, 2018 in Blog, Public Health | 0 comments

 

  • Study shows employees lose an average of 30.4* working days each year due to sickness and underperformance in the office as a result of ill-health.
  • Productivity loss due to physical and mental health issues is costing the UK economy an estimated £77.5 billion a year**.

Research from the 2017 Britain’s Healthiest Workplace survey (BHW)***, a study of almost 32,000 workers across all UK industries, has revealed that employees lose, on average, the equivalent of 30.4 days of productive time each year as they take time off sick and underperform in the office as a result of ill-health (otherwise known as presenteeism). This is equivalent to each worker losing six working weeks of productive time annually. Importantly, while some sectors performed better than others, the results demonstrated high levels of productivity loss across all sectors and organisational sizes.

When translated into monetary terms, the combined economic impact of this ill-health related absence and presenteeism is £77.5 billion a year for the UK economy. Worryingly, employee work impairment and the associated productivity loss appears to be on a worsening trend, up from 27.5 days and £73 billion respectively in 2016.

Britain’s Healthiest Workplace, which was developed by VitalityHealth and is delivered in partnership with the University of Cambridge, RAND Europe and Mercer, also points to a growing presenteeism problem, with time missed by the average employee through absence reducing since 2016 (3.3 days to 2.7 days), while increases in presenteeism (24.2 days to 27.7 days) have more than offset the observed reduction in absence. This increase in presenteeism demonstrates the importance of having a holistic understanding of employees’ physical and mental health, both in and out of the workplace.

Shaun Subel, Director of Corporate Wellbeing Strategy at VitalityHealth, said: “The Britain’s Healthiest Workplace results illustrate the significance of the productivity challenge facing the UK, but importantly also point to an exciting alternative in how employers can approach this problem.

“For too long, the link between employee lifestyle choices, their physical and mental health, and their work performance has been ignored. Our data demonstrates a clear relationship – employees who make healthier lifestyle choices benefit from an additional 25 days of productive time each year compared to the least healthy employees, and also exhibit higher levels of work engagement and lower levels of stress. As a result, effective workplace health and wellbeing solutions can deliver tangible improvements in employee engagement and productivity, and make a significant impact on an organisation’s bottom line.”

Chris Bailey, Partner at Mercer Marsh Benefits, said: “Some employers still doubt the impact of presenteeism, dismiss the data, and fail to take action. It’s key to understand that people are not machines – we are not 100% task focused and performing at our best all of the time.

“It is not a case of having a presenteeism problem or not. All organisations will see a reduction in how productive their people are when they are experiencing physical or mental health issues. The data shows that those organisations who understand this and take steps to maximise their employees’ productive time at work, for example through supporting an active workforce, promoting good nutrition and enabling positive mental health, enjoy a competitive advantage.”

Crisis, crisis. crisis ………

Posted by on Jan 12, 2018 in Blog, NHS | 0 comments

Crisis, crisis. crisis ………

There are headlines in all the papers , on TV and social media about the difficulties in the NHS of coping with emergencies, ambulance services under strain , non emergency operations deferred to release hospital capacity – why is it so bad this year ?

Here are some reasons- there will be more .

Early January has always been a difficult time for hospitals to cope with emergency admissions. There have been 3 Bank Holidays , and the “slow ” days between Christmas and New Year when many routine services have been reduced- it is more difficult to discharge people who need community services or social care packages.  I remember the post Christmas period always being very tight for beds, because of the difficulty of discharging people home or accessing tests in a timely manner. But this year it is worse .

More people are attending A and E – is that because they cannot easily access other sources of help, such as general practice , or community mental health services ?

The number of older people and people with long term conditions is increasing, leading to increaseddemand.The number of admissions has gone up by 4.5% compared with last year.

Social care funding is tight, with local authority budgets having been cut by  up to 40%- leading to limited provision of care packages, increased eligibility criteria, and shortage of care home places as private providers withdraw from the market .

Busy A and E’s may delay accepting people from ambulances because of shortage of space- tying up ambulances in waiting at the entrance, rather than being available for call outs.

There is a skills shortage , particularly A and E medical staff and specialist nursing staff – reliance on locums is expensive and may lead to delayed decision making , as staff are less experienced  or may be working in an unfamiliar environment.

This year, there is virulent flu about, as well as a lot of respiratory infections . It is not a pandemic, but some people have become very ill, needing intensive care .

It’s easy to describe the problems  – what are the solutions, if any ? Because the situation is caused by a number of factors, there needs to be a variety of actions .

Hospitals have always used the beds ear marked for planned operations as overspill , to increase capacity . This has often meant people having their planned operations cancelled on the day , which is very distressing. The government solution is to avoid last minute cancellations by deferring non urgent ” operations for a month. This will release capacity – though stores up problems ahead trying to catch up- as well as causing distress to the poor person who has been deferred. To say nothing of the waste of capacity of the surgeons and theatre teams who have less to do .

If money was available, short term capacity could be purchased from the private sector- both hospitals and care homes .

We know that having  “clinical senior decision makers ” i.e. Consultants at the “front door ” means decisions are made more quickly – some admissions to hospital can be avoided , and other solutions found e.g. Urgent outpatients, community support , GP follow up.

The skills shortage in A and E  and the admitting wards will be addressed by longer term solutions – redeployment of numbers of staff in training to those emergency specialities ,  and a hard look at how many A and Es can be staffed . Individual hospitals could look at how staff are deployed – and move more staff to care for  the emergency patients .

Closer working between hospitals, social care and the voluntary sector may help with  discharges – this is about relationships, not structures, but adequate funding needs to be in place. Community health services – e.g. District nurses, also need to be adequately funded .

There needs to be a relentless drive in hospitals to make timely discharge of patients a priority . Although some of the block is caused by lack of provision in social care, some of it is caused by internal hospital processes . Patients not being reviewed at the weekends, no  discharge plan being made on admission, waiting for tests, slow decision making etc.

Theres no doubt that the NHS needs more money – as does social care . An emergency injection of cash now could mean more staff are pulled in to deal with the current situation and emergency capacity purchased .

We need longer term plans to increase workforce , and longer term plans for better working relationships and processes across the whole system. The current crisis in emergency care is not one of A and E departments but the whole system.

The politics of this will play out . The government does not want such headlines , so may be forced to release some more money. The danger is that this talk of crisis gives ammunition to those who claim the NHS cannot work , and who would prefer to move to an insurance system with private providers.

We need to call it how it is, but also remember that most patients  are receiving good care from hard working staff despite the circumstances . And to work towards longer term solutions , including lobbying for more resources to both local government and the NHS

 

Dr Linda Patterson

NHS BOWEL SCOPE UPTAKE BOOSTED BY A FIFTH WHEN PATIENTS SENT REASSURING REMINDERS 

Posted by on Jan 12, 2018 in Blog, Public Health | 0 comments

Bowel scope screening uptake increased by more than a fifth (21.5%) when people were sent additional reminders with a leaflet that addressed common concerns, according to a new study funded by Cancer Research UK and St Mark’s Hospital.*

The NHS bowel scope screening programme is gradually being rolled out in England to men and women aged between 55 and 59, prior to the bowel screening programme offered at 60.** It is a one-off, preventative and diagnostic test where a tiny camera is inserted into the bowel allowing doctors to find and remove any small bowel growths, called polyps, which could eventually turn into cancer.

The reminder letters, sent one and two years after the initial invitation, allowed people to choose the time of their appointment and the gender of the doctor performing the test.

The researchers found that the main concerns about the test included embarrassment, pain and fear of harm to the bowel. The leaflet, created by the researchers from University College London (UCL) with help from the public, included patient testimonials and advice from a named and pictured local GP to address this.

An invitation with an NHS information booklet and an appointment time is sent to the NHS-registered population at 55 years old. It is up to the recipient to confirm and attend their appointment. At two weeks, there is a further reminder to confirm the appointment. Around 40% of people attend their appointments with this system.***

Dr Robert Kerrison, lead researcher from University College London said: “Despite bowel scope screening attendance being low where it has been rolled out so far, this research shows that more could be done to improve uptake. Providing information targeting the concerns of patients is one way to break down the barriers to bowel scope screening uptake.”

Dr Jodie Moffat, Cancer Research UK’s head of early diagnosis said: “Cancer screening offers a lot of potential for reducing the burden of cancer but there are harms as well as benefits, so it’s important that people make their own decision about whether to take part or not. Studies such as this help us learn about the best way to provide information in a way that resonates with people and ensures we can minimise any unnecessary barriers to people taking part. To fully realise the potential of cancer screening we need a system that adopts research findings into practice and has enough of the right workforce to deliver what’s needed.”

Bowel cancer is the 4th most common cancer in the UK and over half of bowel cancer cases are diagnosed at a late stage in England.****

The study is published today in the Annals of Behavioural Medicine

Posted by on Jan 11, 2018 in Blog, NHS, Public Health | 0 comments

Muddling along

“Top dementia research charity calls on pharma to stay the course” is an odd headline, but the failure of trials of the “promising” new drug idalpirdine underline how expensive and unprofitable research into disease modifying drugs for Alzheimer’s Disease has become.

The charity, Alzheimer’s Research UK, has called for a recommitment from pharmaceutical companies to continue efforts to fund research into dementia.

Recent news that Pfizer – one of the manufacturers of the symptom-modifying cholinesterase inhibitor drugs for Alzheimer’s disease – will refocus efforts away from dementia research is a reminder of one of the barriers that stands in the way of bringing about the first life-changing treatment for dementia.

Investment in research comes with risks, says ARUK, and a number of initiatives are now in place to allow companies to spread this risk and continue investing in dementia. This includes collaborative efforts such as the Dementia Discovery Fund (DDF), which Alzheimer’s Research UK has invested in alongside Pfizer. The DDF works internationally with universities, pharmaceutical industry and biotechnology companies to identify and fund innovative early stage drug discovery research.

Dr Matthew Norton, Director of Policy at Alzheimer’s Research UK, the UK’s leading dementia research charity, said:

“We must continue to encourage companies to invest in research in dementia and neuroscience. We still lack life-changing treatments for dementia and the continued investment of pharmaceutical companies, which bring resources and expertise in drug discovery and clinical trials, is vital to improve the outlook for the 46 million people living with dementia worldwide.

“Although neuroscience research is high risk in that failure for pharmaceutical companies comes at a high price, the potential benefits of success to the millions of people around the world living with dementia are too great to ignore.

“Dementia is caused by diseases, which means it can be treated through advances in research. The UK is now a world leader in dementia research, and we hope that pharmaceutical companies will look at the long-term potential when deciding whether to participate in this effort. It is vital that all of us – charities, government and industry alike – make long-term commitments to dementia research if we are to bring an end to the fear, harm and heartbreak of dementia.”

Of course dementia may be a consequence of a life-time of accumulating harms and injuries to the brain. If it is there may be no cure. . Big Pharma may have come to this conclusion first. This is a disappointment for researchers, who focus on the chemicals in the brain rather than the brain’s experiences of the world. And it is a disappointment for psychiatrists, who would like a pill for every ill. Notice how the researchers have stopped talking about a cure (because it is unrealistic) and now talk of life-changing treatments rather than disease-modifying drugs. The language of dementia treatments is changing, perhaps to better manage expectations of success

 

Smooth operator?

Jeremy Hunt has kept his job and some people are pleased! Here’s Bruce Potter, chairman of national law firm Blake Morgan: “There has been much criticism of the so called ‘night of the blunt knives’ but one episode – Mr Hunt’s alleged refusal to move from health and to be given social care – seems to me to be an outbreak of sanity. First, health needs consistency not change like other parts of government.  Politicians efforts to distance themselves from the fate of the NHS have failed and arguably Hunt’s minimally invasive approach has been shrewder than many realise (with a few glaring exceptions). Second, Hunt’s demand to be given social care as well as health represents an aligning of responsibilities and challenges that has a surprising logic that has been absent from much recent health policy.  So well done Mr Hunt, let’s see what you can do!”

News from Nowhere’s moles agree about the social care responsibility but are puzzled by the “minimally invasive” attribute, and hope for clarification. They have no doubts, on the other hand, about the Secretary of State’s mellifluous use of words. Here is in 2015 saying how the NHS has to cope with demographic change, rising demand and technological advances (NHSEngland’s holy trinity).

“Let’s look at those challenges. And I think we have good news and bad news. If I start with the bad news it is that we face a triple whammy of huge financial pressures because of the deficit that we know we have to tackle as a country, of the ageing population that will mean we have a million more over 70s by 2020, and also of rising consumer expectations, the incredible excitement that people feel when they read about immunotherapy in the newspapers that gives a heart attack to me and Simon Stevens but is very, very exciting for the country. The desire for 24/7 access to healthcare. These are expectations that we have to recognise in the NHS but all of these add to a massive pressure on the system”.

 

Care Opinion: a new approach to feedback for a new kind of NHS organisation

Posted by on Jan 10, 2018 in Blog, NHS | 0 comments

 

 

Context

During 2018 the NHS in many parts of England will move towards ACO/ACS models of care. The approach will vary from place to place, and may also evolve over time as local collaborations change.

The King’s Fund points out:

There is no single model for an ACO and so local context is important in shaping the approach taken in different areas. In some places, it is likely that working towards integrating hospital, community, mental health and adult social care services will make sense, whereas in others there will be an appetite for more broadly-based partnerships. Elsewhere, horizontal integration, such as hospital chains and groups, may be the focus.

This context of emerging organisational forms, new networks of care and multi-agency collaboration requires a new, modern and flexible approach to gathering and learning from the experiences of those who use services. Care Opinion is a perfect fit for the new landscape of ACOs.

About Care Opinion

Care Opinion CIC is an award-winning, non-profit feedback platform for health and social care across the UK. Since 2005 we have pioneered a new approach to hearing and learning from people’s experiences of the health/care services they rely on.

Our mature and values-based service has gained a national and international reputation, and is now used in three countries. In the UK we work with 600 health and social care organisations, and are visited by 100,000 people each week.

Our mission is to provide an online platform so that:

  • people can share honest feedback easily and without fear
  • stories are directed to wherever they can help make a difference, and
  • everyone can see how and where services are listening and changing in response

Our values are innovation, transparency, inclusivity, positivity and humanity.

(More details: https://www.careopinion.org.uk/info/mission )

Listening to what an emerging ACO/ACS wants

New systems of care require new thinking on the possibilities and potential of feedback, going far beyond the limited value of the NHS Friends and Family test. Increasingly, people want to see an approach which:

  • is clearly aligned with NHS values
  • serves the needs of both patients and staff
  • enables authentic voices to be heard
  • is transparent and accountable
  • is as real-time as possible, to support rapid resolution/improvement
  • can work across multiple organisations
  • engages and motivates staff
  • is both effective and cost-effective
  • avoids onerous data entry, paperwork, or copying and pasting
  • makes a genuine difference to care, culture and morale

Our experience over more than a decade of research, development and learning is that Care Opinion meets all of these challenges.

Why Care Opinion is a good fit for the new ACO/ACS landscape

Care Opinion has a number of attributes which set it apart from traditional, organisation-centric approaches to feedback. These include:

Person-centred Care Opinion starts from what people want to say, not from what organisations want to ask. So you learn about things you didn’t realise were important. And a feedback donor need tell their story just once: we share it will all the relevant organisations. Feedback is person-centric, not organisation-centric.
Accessible Care Opinion is online and accessible to people with a range of sensory impairments. BSL videos are linked from every page, and we recently added our innovative “picture stories” feature to help people with cognitive impairments tell their stories too.
Integrated Care Opinion works across all the organisations in an ACO/ACS. It spans commissioners and providers, health and social care. You can include the healthwatch, PPGs and local patient voice groups too.
Flexible As the ACO/ACS evolves, Care Opinion evolves too. We remain endlessly flexible as the world changes.
Two-way Almost every current health/care feedback system is one-way: so there is no room for resolving concerns, clarifying issues or making connections. Care Opinion is safe, simple and two-way.
Transparent Every Care Opinion post is moderated by an expert human, prior to publication. Responses are published too. The transparency that results spreads trust, understanding and learning among staff and patients alike.
Built for learning and change Simply collecting data won’t improve services or change culture. Feedback has to be shared, understood and acted on to make a difference. At Care Opinion, encouragement for change and learning is built into the platform.
Fully supported Care Opinion is more than a feedback platform: it’s also a journey which requires vision, courage and persistence. We provide unlimited phone and email support to keep you on track.

 

How Care Opinion works, in a nutshell

Care Opinion is an online feedback platform, and can also accept feedback by post and phone.

  1. People post their stories on the site, saying what was good and what could have been better. Each story is linked to the services it relates to.
  2. Every story is moderated by Care Opinion, before publication.
  3. On publication, relevant staff across multiple organisations can be alerted. Staff can control their own alerts.
  4. Authorised staff can respond online, as often as needed to resolve an issue. The story author may also respond. Everyone learns from the exchange.
  5. Over time, trust is built and culture becomes more open to feedback and learning.

Here are examples of effective responding creating change and building trust:

https://www.careopinion.org.uk/opinions/294974

https://www.careopinion.org.uk/opinions/126866

In addition, Care Opinion includes built-in flexible tools for

  • Searching
  • Reporting
  • Alerting
  • Blogging
  • Data visualisation
  • Service page customisation

Flexible, right across the health economy

Care Opinion works right across the health economy in a flexible way to suit local circumstances. This means that we can involve and work with

  • ACOs of any shape
  • Commissioners (including local authorities)
  • Healthwatch
  • Local patient voice organisations
  • General practices, individually as well as in federations
  • Practice participation groups

James Munro, 4 January 2018

Find out more

This is just the start: we have much more we can share with you! To find out more:

Visit www.careopinion.org.uk

Call us on 0114 281 6256

Or email Miriam.rivas-aguilar@careopinion.org.uk

 

Top dementia research charity calls on pharma to stay the course

Posted by on Jan 9, 2018 in Blog, NHS | 0 comments

Alzheimer’s Research UK is calling for a recommitment from pharmaceutical companies to continue efforts to fund research into dementia, the leading cause of death in the UK.

Recent news that Pfizer will refocus efforts away from dementia research is a reminder of one of the barriers that stands in the way of bringing about the first life-changing treatment for dementia.

Investment in research comes with risks, and a number of initiatives are now in place to allow companies to spread this risk and continue investing in dementia. This includes collaborative efforts such as the Dementia Discovery Fund (DDF), which Alzheimer’s Research UK has invested in alongside Pfizer. The DDF works internationally with universities, pharmaceutical industry and biotechnology companies to identify and fund innovative early stage drug discovery research.

Dr Matthew Norton, Director of Policy at Alzheimer’s Research UK, the UK’s leading dementia research charity, said:

“We must continue to encourage companies to invest in research in dementia and neuroscience. We still lack life-changing treatments for dementia and the continued investment of pharmaceutical companies, which bring resources and expertise in drug discovery and clinical trials, is vital to improve the outlook for the 46 million people living with dementia worldwide.

“Although neuroscience research is high risk in that failure for pharmaceutical companies comes at a high price, the potential benefits of success to the millions of people around the world living with dementia are too great to ignore.

“Dementia is caused by diseases, which means it can be treated through advances in research. The UK is now a world leader in dementia research, and we hope that pharmaceutical companies will look at the long-term potential when deciding whether to participate in this effort. It is vital that all of us – charities, government and industry alike – make long-term commitments to dementia research if we are to bring an end to the fear, harm and heartbreak of dementia.”

Figures show pressures are “becoming intolerable” says NHS Confederation

Posted by on Jan 5, 2018 in Blog, NHS | 0 comments

Responding to today’s NHS England performance figures, Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said:

“Staff are working at full capacity to deliver the right care, but the pressures are becoming intolerable.  

“Figures from the last six weeks show the number of people arriving at A&E has remained fairly consistent – but today’s results highlight the increasing number of people experiencing delays in ambulances as they arrive.

“The stats also mask the pressures which can be seen across all parts of the system – in social care, community and mental health services, as well as at the hospital front door and in our ambulance services.

“These delays cause distress to patients and their families but emergency departments are seen as a litmus test for the rest of the system. If the health service cannot cope at its front door, what lies behind it will also be struggling.”

Stillbirths: Will independent NHS investigations mean a fairer outcome for parents?

Posted by on Jan 4, 2018 in Blog, Public Health | 0 comments

The news that the Government is to invest more money to help reduce the rate of stillbirths, neonatal deaths and maternal deaths in England by 50% by 2030 is extremely welcomed. It will allow for independent reviews of all stillbirths to be carried out, which will hopefully provide a speedy response and give the families involved hope that they will find the answers as to why it happened.

The only question that families feel they can ever really ask is “why did this happen?” But, all too often, bureaucracy gets in the way and the process to answer this simple question takes too long for the mother and her family. It creates doubt and mistrust, leaving the parents feeling as if they are not being told the whole truth, and in desperation to find answers, families will often turn to the law to help get the facts. This creates anxiety for any future pregnancies the family may later experience.

In a recent case I dealt with, a mother, who had a family history of diabetes, sadly lost her baby just before the due date. She had done all she could have done in preparing for her pregnancy, but there were missed opportunities for staff to carry out further investigations to check the health of the baby, which may have allowed for a better outcome during the birth.

Encouragingly, in 2016 the Office for National Statistics indicates that the stillbirth rate in the UK decreased to 4.4 per 1,000 total births – the lowest rate since 1992. The figures are reassuring but there is no room for complacency. The main focus of maternity care is to make childbirth as safe as possible, and this can only be done with continued investment into the maternity services to ensure units are adequately staffed and equipped for purpose.

It is hoped that the proposed investment by the government will go a long way towards making sure that each and every stillbirth is properly investigated, and it is vital that lessons are then learned in respect of these often avoidable and tragic deaths.

For more information, please visit www.fletcherssolicitors.co.uk

Health leaders warn against removal of Working Time Regulations

Posted by on Dec 21, 2017 in Blog, NHS | 0 comments

Following reports that there is support within government for the removal of the Working Time Regulations (WTR), the British Medical Association, alongside 12 royal colleges and trade unions, has today written to the Prime Minister urging caution against removing them from law following Brexit.

In a letter to Theresa May, the BMA’s chair of council, Dr Chaand Nagpaul, and the other signatories, stress that the Working Time Regulations protects medical staff from the dangers of overwork whilst protecting patients from overtired doctors and nurses.

Dr Chaand Nagpaul, BMA council chair, said:

“The Working Time Regulations are not only vital for the wellbeing of staff but also because, as medical professionals, the safety of our patients is our number one priority. We can all agree that no one wants a return to the days where doctors and nurses were working 90 hour weeks – it would be bad for patient safety, bad for staff and bad for the NHS.

“With unprecedented staff shortages and pressure currently facing the health service, it is crucial that doctors’, nurses and midwives’ concerns over unsafe working conditions are heard.”

The full text of the letter is below:

Dear Prime Minister,

As the representatives of doctors, nursing staff and midwives in the UK, we are deeply concerned by reports that there is support within government for the removal of the Working Time Regulations (WTR) from UK law following the UK’s departure from the European Union.

Dealing with and preventing the effects of excessive working is crucial not only because of the impact on individuals and their families, but also because of the wider consequences it poses to patient safety.

Twenty-five years ago, the phenomenon of health professionals working 90 hour weeks, and the attendant risks this posed, was all too common in the NHS. The worst excesses of these working arrangements were only curtailed following the arrival of EU-derived legislation limiting hours in the form of the WTR.

It is not in the interests of either staff or patients to relax or move away from the safeguarding protections introduced by the WTR, namely the limit of an average 48 hour working week, rest breaks and statutory paid leave, especially when there is, of course, the existing option for all workers to voluntarily opt out of these regulations.

Even with these regulations, we know that fatigue caused by excessive overwork remains an occupational hazard for many staff across the NHS, with tragic and not uncommon reports of road accidents after falling asleep at the wheel.

With health and care services under more pressure than ever before, and staff being called upon to work ever longer hours, what is needed is proper resourcing and investment to increase our workforce, not the removal of safeguards. We noted the commitment in your speech to the Conservative Party Conference, and in recent days, that not only would existing workers’ legal rights be guaranteed in law, but that they would be enhanced under your Government. We urge you not to renege on this commitment: Brexit must not be used as an excuse to overwork any staff group.