staff shortages – The NEN – North Edinburgh News

Persistent understaffing of NHS a serious risk to patient safety, warns Westminster committee

‘We now face the greatest workforce crisis in history in the NHS and in social care’

The NHS and social care face the greatest workforce crisis in their history, compounded by the absence of a credible government strategy to tackle the situation, say MPs in a new Health and Social Care Committee report.

In the NHS, persistent understaffing poses a serious risk to staff and patient safety in routine and emergency care.

The Workforce: recruitment, training and retention report outlines the scale of the workforce crisis: new research suggests the NHS in England is short of 12,000 hospital doctors and more than 50,000 nurses and midwives; evidence on workforce projections say an extra 475,000 jobs will be needed in health and an extra 490,000 jobs in social care by the early part of the next decade; hospital waiting lists reached a record high of nearly 6.5 million in April.

The report finds the Government to have shown a marked reluctance to act decisively. The refusal to do proper workforce planning risked plans to tackle the Covid backlog – a key target for the NHS.

The number of full-time equivalent GPs fell by more than 700 over three years to March 2022, despite a pledge to deliver 6,000 more. Appearing before the inquiry, the then Secretary of State Sajid Javid admitted he was not on track to deliver them. The report describes a situation where NHS pension arrangements force senior doctors to reduce working hours as a “national scandal” and calls for swift action to remedy.

Maternity services are flagged as being under serious pressure with more than 500 midwives leaving in a single year. A year ago the Committee’s maternity safety inquiry concluded almost 2,000 more midwives were needed and almost 500 more obstetricians. The Secretary of State failed to give a deadline by when a shortfall in midwife numbers would be addressed.

Pay is a crucial factor in recruitment and retention in social care. Government analysis estimated more than 17,000 jobs in care paid below the minimum wage.

A separate report by the Committee’s panel of independent experts (Expert Panel) published today rates the government’s progress overall to meet key commitments it has made on workforce as “inadequate”.

Health and Social Care Committee Chair Rt Hon Jeremy Hunt said: “Persistent understaffing in the NHS poses a serious risk to staff and patient safety, a situation compounded by the absence of a long term plan by the government to tackle it.

“We now face the greatest workforce crisis in history in the NHS and in social care with still no idea of the number of additional doctors, nurses and other professionals we actually need. NHS professionals know there is no silver bullet to solve this problem but we should at least be giving them comfort that a plan is in place.

“This must be a top priority for the new Prime Minister.”

Lothian announces timetable changes due to staff shortages

On Sunday 24 July, we will introduce a short notice timetable change to some of our services on the Lothian network.

With recruitment issues across our industry still causing major resourcing issues for our business, we have taken the decision to introduce these measures to ensure that we can operate our services as advertised for our customers.

This change will see some minor timetable changes and alterations to frequencies on some of our services. There will be bus stop changes to Lothian Country.

There will be no changes to EastCoastbuses, Airport or Nightbus services.

Details of the service change and links to timetables can be found below.

If you need any assistance, please reach out on our social media channels – Twitter, Facebook and Instagram – or phone bus information on 0131 555 6363.

Lothian Buses

Lothiancountry

Police Scotland reorganises staff to tackle Omicron challenge

Police Scotland is increasing the number of officers deployed in local policing divisions to support communities during the latest phase of the COVID pandemic.

More than 300 officers from specialist functions throughout Scotland will move to support colleagues in local policing divisions temporarily from Monday, 10 January, 2022.

At the same time, 258 probationary constables currently undergoing training at the Scottish Police College will also be deployed to local policing divisions.

The use of probationers and officers from specialist functions was successful both earlier in the pandemic and during the COP26 climate conference.

Assistant Chief Constable Alan Speirs said “We are working hard to maximise the availability of officers and staff in frontline duties to ensure that we continue to provide a highly effective policing service to our local communities.

“Omicron is having a significant effect on the country and Police Scotland is included in that. The welfare of our officers and staff is paramount and has been throughout the pandemic.

“As a national service we can quickly flex resources and move people to where they are needed and respond to increased demand and high absence levels.

“By deploying these extra resources we can support local policing and keep people safe during this critical time.”

RCEM: Current A&E performance trend is ‘extremely worrying’

In October 2021 there were 108,279 attendances to major Emergency Departments across Scotland, the number of attendances dropped by 5,719 patients (5%) compared to the previous month, September 2021.

Despite this, data show that four-hour performance in major departments has once again reached a new record low, with 70.9% of patients being seen, transferred or discharged within four-hours – 2.5 percentage points lower than the previous month, September 2021.

In October 2021 2,533 patients spent 12-hours or more in a major Emergency Department, this is an increase of 30% compared to the previous month, September 2021, and the highest number on record.

Data also show that 8,181 patients spent eight hours or more in a major Emergency Department. This is an increase of 21% compared to the previous month, September 2021 and is also the highest number on record.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine Scotland, said: “Yet again we are reporting on the worst performance figures on record. 1 in 13 patients are now delayed by eight hours are more.

“This trend is extremely worrying and, most of all, dangerous for patients. Each month, the number of patients that have come to avoidable harm grows. So far in 2021, 387 excess deaths have occurred as a direct result of crowding.

“This number will continue to increase unless patient flow is prioritised this winter; this means freeing up beds where possible by ensuring that patients have timely access to social care, utilising the Discharge to Assess model, and avoiding admission when appropriate by maximising the use of Same Day Emergency Care.

“Every winter we know that the increase in demand for unscheduled care, and therefore beds, disrupts elective surgery – this is not a new phenomenon by any means.

“However, with a record number of patients awaiting surgery, ensuring that unscheduled care does not derail progress on the backlog is more crucial than ever. This requires a whole system approach and cannot be tackled in isolation. If poor patient flow in emergency departments is addressed successfully, this will go some way in mitigating the risk of further disrupting elective care.

“We are very keen to work with the Scottish government on what can be done in the short term to alleviate the immense pressures EDs are currently facing.

“Accompanying this, we continue to call on the Scottish government to set out a long-term workforce plan. The required expansion in capacity cannot be safely achieved without both recruiting new and retaining existing staff.

“At present we need an additional 130 EM consultants along with sufficient numbers of both junior and supporting staff and nurses.”

Scottish business confidence climbs as restrictions ease

Bank of Scotland’s Business Barometer for August 2021 shows:

Scottish business confidence rises six points in August to 34%

Firms’ hiring intentions jump 13 points with 34% planning to create jobs in the next 12 months
Overall UK business confidence reaches 36% – the highest reading since May 2018 – as all regions and nations report positive confidence levels

Business confidence in Scotland rose six points during August to 34%, according to the latest Business Barometer from Bank of Scotland Commercial Banking.

The full easing of lockdown restrictions in Scotland in August was a clear boost for businesses, with overall confidence in the economy also rising by 20 points to 43%.

Companies in Scotland reported marginally lower confidence in their own business prospects month-on-month, down eight points at 25%. When taken alongside their optimism in the economy, this gives a headline confidence reading of 34%.

The Business Barometer questions 1,200 businesses monthly and provides early signals about UK economic trends both regionally and nationwide.

A net balance of 20% of businesses in Scotland expect to increase staff levels over the next year, up seven points on last month.

Overall UK business confidence rose six points in August, reaching 36%, the highest level recorded since May 2018. When asked about their overall trading prospects businesses reported a six-point increase on July’s reading at 34% and firms’ confidence in the economy also increased six points to 39%.

All UK nations and regions had a positive confidence reading in August. The most confident regions were the North West (64%), North East (46%) and London (41%). All bar three areas reported a growth in confidence in August, with the East Midlands (down 10 points to 28%), West Midlands (down three points to 27%) and Yorkshire and Humber (down two points to 26%) reporting marginal falls.

Fraser Sime, regional director for Scotland at Bank of Scotland Commercial Banking, said: “With most of the Covid-19 restrictions easing in August, businesses across Scotland were able to return to normal trading for the first time in 18 months and are feeling optimistic about what this means for the economy.

“With confidence on the up and even more firms are now planning on making new hires, the country is taking great steps towards recovery and growth. We’ll continue to support businesses through the coming months as they aim to capitalise on this positive momentum.”

In sector terms, there was notable strength in sectors benefiting from the further easing of Covid restrictions. Services confidence saw the greatest month-on-month increase, rising by 8 points to 36%, the highest level since January 2018.

Confidence in both manufacturing and construction also picked up (both up 7 points to 40%), led by rises in trading prospects for the year ahead.

The increase in manufacturing confidence came despite ongoing supply disruptions, although the level remains below the high in May. Retail confidence posted a smaller 2-point rise to 34%, remaining below the recent peak in May.

Gareth Oakley, Managing Director for Business Banking, Lloyds Bank, said: “Since the start of the year business confidence has been increasing, and August has been a particularly strong month. Many of the regions have seen significant upticks in confidence and it’s encouraging that Northern Ireland has moved back into positive territory.

“It is clear there is still some level of uncertainty on inflation and the impact of price pressures, but with further boosts to confidence in the services, manufacturing and construction sectors we can be hopeful that demand across all sectors will drive consumption throughout the rest of the year. The last few months of the year will be pivotal to the future of UK economic growth and we remain by the side of businesses as the country continues to reopen.”

Hann-Ju Ho, Senior Economist Lloyds Bank Commercial Banking, said: “Business confidence reaching its highest level in over four years tells a positive story about the country’s economic recovery.

“This confidence is driven by the continued success of the vaccine ollout, the removal of lockdown restrictions and adjustments to self-isolation rules.

“Staff shortages remain a challenge, but as the economy moves back towards pre-pandemic levels we can be optimistic that the momentum for business confidence and economic optimism can be sustained in the months ahead.”

Scotland’s Emergency Departments experience worst ever May performance

The latest data released yesterday by the Scottish Government for May 2021 show that attendances at Emergency Departments have risen significantly.

In May 2021 there were 112,563 attendances to major Emergency Departments across Scotland. This is a 12% increase compared to April 2021, a 24% increase when compared to March 2021, and a 45% increase compared to May 2020.

Following this increase, four-hour performance deteriorated, 86% of attendances to major Emergency Departments in Scotland were seen within four hours. 15,706 patients were delayed by four-hours or more in an Emergency Department, this is the highest figure since January 2020, and it is the highest figure ever recorded for the month of May. This means one in seven patients were delayed by four hours or more before being seen.

In May 2021, 393 patients spent 12 hours or more in an Emergency Department, this is double the figure for April 2021. This is the highest number of 12-hour delays for the month of May ever recorded, and it is more than double the previous highest May figure of 189 12-hour delays that was recorded in 2019.

Data also show that 1,680 patients spent eight hours or more in a major Emergency Department, this is an increase of nearly 50% compared to April 2021 and it is the highest figure ever recorded for the month of May.

Dr John Thomson, Vice President of the Royal College of Emergency Medicine, said: “The data is deeply concerning and very much reflects what is happening on the ground. Departments are busier than ever, especially for the summer period with some record-breaking figures for the month of May, and it is becoming increasingly challenging.

“These figures come at a time when reports suggest Scotland has the highest covid infection rate in Europe. We are battling community admissions, elective care patients seeking treatment, as well as increasing covid patients attending our departments, all within the context of reduced bed-stock.

“Departments are filled with patients, some who may have covid, waiting to be seen. While long-stays alone can put patient safety at risk. This risk is increased as some patients could contract the disease in a busy Emergency Department.

“The College’s recent Emergency Medicine workforce census in Scotland revealed an Emergency Medicine workforce that was not adequately staffed to deliver the highest quality patient care in Emergency Departments in Scotland.

“We have shortages across the board, but particularly among consultants and senior decision-making clinicians. These shortages are currently exacerbated by the soaring covid infection rate, meaning there are a large number of absent NHS staff due to covid in Scotland.

“We are doing all we can to maintain flow and maximise patient safety, but the pressures are increasingly intense and are faced by the existing but short-staffed workforce that are facing continued burnout and exhaustion.

“The data show the growing demand for urgent and emergency care, Emergency Departments are where people turn to for treatment when there is nowhere else to go, so they must be adequately staffed with trained Emergency Medicine staff, properly funded, and equipped with enough capacity and resources to cope with severe demand.”

“We urgently need the Scottish Government to support the urgent and emergency care system to cope with these pressures.”

Two NHS Grampian hospitals have announced this week that they are at capacity as Covid cases rise.

Scotland was expected to move to level zero on 19 July, with remaining legal restrictions lifted on 9 August, but First Minister Nicola Sturgeon conceded yesterday that th planned dates are not “set in stone”.

She will be holding a media briefing at lunchtime today:

Emergency! Key staff shortages are increasing the pressure on struggling ED workforce

Census by RCEM Scotland shows a shortage of key senior decision-making clinicians and a workforce below adequate staffing levels

A census of the Emergency Medicine workforce in Scotland by the Royal College of Emergency has found shortages of key senior decision-makers, and a workforce that is below adequate staffing levels to deliver the best and most effective care to patients.

When asked for immediate staffing needs, Emergency Departments across Scotland reported they needed an increase of:

25% in consultants
45% in Advanced Clinical Practitioners/Advanced Nursing Practitioners/Physician Associates
16% in Emergency Nurse Practitioners
22% in Higher Specialist Trainees/Non-consultant Senior Decision-Makers
21% in Junior Doctors

RCEM analysis shows that to resolve the shortages of senior decision-makers and to achieve adequate staffing and aspirational staffing levels by 2026 the current workforce in Scotland needs a total of 405 more health care staff broken down as:

113 more consultants
74 more Higher Specialist Trainees/Non-consultant Senior Decision-Makers
38 more Advanced Clinical Practitioners/Advanced Nursing Practitioners/Physician Associates
180 more Junior Doctors

RCEM’s Scotland workforce census consisted of a 64-question survey and was sent to Emergency Department Clinical Leads across Scotland.

Responses were received from 24 Emergency Departments, including all 20 consultant-led Emergency Departments, one Minor Injury Unit, and three Remote and Rural Hospitals.

Commenting on RCEM’s Scotland workforce census, Dr John Thomson, Vice President (Scotland) of the Royal College of Emergency Medicine, said: “The census clearly shows that the Emergency Medicine workforce in Scotland is not adequately staffed to deliver the highest quality patient care.

“This has led to an increase in intense pressures on the existing workforce and is very likely to be a contributing factor to the continued deterioration in performance.

“We have always been proud of Scotland’s performance in Emergency Medicine, ensuring quick and effective care that outperformed the rest of the United Kingdom. But, even before the pandemic, the increase in demand put severe pressure on staff, and departments began to struggle to meet the four-hour access standard, but more seriously began to struggle to deliver appropriate treatment to patients, resulting in more delays and longer stays.

“The pandemic certainly exacerbated these issues and now there are some major challenges that face Emergency Medicine in Scotland. Emergency Medicine can be relentless; a service delivered 24 hours a day, seven days a week, will always take its toll, and the pandemic has highlighted the severe burnout that Emergency Medicine staff, especially face.

“Departments must be staffed with a workforce trained and qualified in Emergency Medicine. Shortages in senior decision-making staff groups can lead to Emergency Departments over-depending on junior staff. The census shows that we need considerable expansion of funded consultant and senior decision-maker posts in order to prioritise patient safety and quality of care.

“We managed to survive the first two waves of pandemic with an insufficient workforce, but now these existing staff are facing burnout and exhaustion – with some clinicians reporting they are planning on retiring early. This census clearly shows that we must act and address these problems without delay.

“The Scottish Government must work with the specialty to devise an adequate workforce plan for the emergency care system, taking into account population needs and rising demand on the service. Plans must ensure sustainable and fulfilling careers for all staff, allowing for the delivery of quick, safe, and effective care for patients.

“Without a sufficient workforce plan that addresses the findings of the census, it is likely that there will be continued deterioration in Emergency Department performance and rates of burnout will continue to increase amongst Emergency Medicine staff.”

Tonight’s West Pilton youth discussion goes ahead as planned

Tonight’s West Pilton West Granton Community Council meeting is going ahead, West Pilton Neighbourhood Centre have confirmed.

It was feared that the discussion on youth issues would have to be cancelled due to staff sickness but janitorial cover has been found and the meeting will go ahead as planned.

The meeting starts at 7pm – all welcome.