Prof Alison Leary 💙#ProtectNurse
@alisonleary1
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Safety thru maths. Professor of healthcare & workforce modelling. Director ICNO @theQNI Consultant @WHO HRH MBE modelling safety in football Ex @MillwallFC
London & Norfolk
Joined October 2012
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Pinned Tweet
After 23 wonderful years at The Den I've finally hung up my hi viz!
Thank you so much for all of the support to the
@MillwallFC
medical team. It means so much.
No one likes us but we do care 🦁
I'm still a trustee of
@BASICS_HQ
so hopefully more to contribute!
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Found on the sofa this morning.
We don't have a cat...
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I see Nightingale Hospitals is trending as a solution to the current ED/bed shortage.
They could not be staffed during the pandemic, they cannot be staffed now.
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My husband who had no pre existing health problems spent January on a ventilator. He is only just starting to walk now.
It is not the flu.
We are going to have to learn to live with Covid and find ways to cope with it – just as we already do with flu.
Please read my piece in the Mail on Sunday.
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#questiontime
Jacob Reese Mogg saying nurses get 40k after five years? What is that based on?
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There are not 30,000 extra ICU beds because there are not 30,000 extra ICU registered nurses.
Providing furniture and ventilators is not the same as providing intensive care.
Government Minister, Robert Jenrick
"today 30,000 ICU beds as a result of the work of the private sector........ businesses coming forward to create that capability"
News to the NHS !
BBC 5 Live at 2:56:20
@ShaunLintern
@BACCNUK
@credland_nicki
@NursingTimes
@unisontheunion
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Staffed beds, the NHS is short of STAFFED beds.
The problem isn't lack of furniture, its lack of staff.
I don't know why this is so difficult to understand.
#Nursingstrike
We hear how the NHS is short of beds. Why don’t managers put more in?
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Just been sent another advert for a Deputy Chief Nurse open to those without registration qualifications of experience as a nurse.
I would not recommend working in an organisation that did not value professional knowledge (of any professional group)
Its a red flag 🚩🚩🚩🚩
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Public Health England did not fail.
Public Health England were failed.
The last thing any sensible government would do in the middle of a pandemic is axe public health.
Hancock axes ‘failing’ Public Health England
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I'm concerned that a number of nurses have contacted me today to say their employers are trying to police their free speech on here.
Raising concerns about
#fuelshortages
, working conditions, staffing or safety is not unprofessional.
Censoring people with genuine concerns is.
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The NHS workforce is not inefficient
A lot of the work they are asked to do is inefficient.
⚠️Poor IT
⚠️Loss of admin staff
⚠️Loss of domestic staff
⚠️Redundant data collection
⚠️Division of labour/skill dilution
⚠️Poor working conditions
Them working harder is just burnout
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If you have eyesight problems you should seek medical advice. You should not take a 4 year old for a drive.
You should not drive at all
#DominicCummngs
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Who
Is
Going
To
Staff
Them?
Without staff extra beds are just furniture.....
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A lot of comms about risk to patient safety/taking the moral high ground during
#NursesStrike
by some NHS Trusts, leaders, NHS membership bodies & politicians seems performative.
Where is the concern for
#patientsafety
the rest of the time?
Your workforce is watching.
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What qualifies a man who used to run a phone shop to be an expert in public health?
#bbcqt
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Best placard of the day!
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Thank you to
@Ldn_Ambulance
crew and
@KingsCollegeNHS
ED particularly Rochanda Mike
@duncanbew
and in particular SN Matt who took care of my mum today.
I'm grieving her death but comforted by their skill care and compassion.
Don't ever doubt it makes a difference 💕💕💕
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Four times as many ventilators without four times as many skilled registered nurses to operate them means no gain in capacity to provide care.
It does demonstrate how poorly this is understood particularly by those making such decisions.
Hospitals in England now have four times as many ventilators compared to when the pandemic started.
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Feeling so grateful to be reunited with my husband today after 76 days thanks to
@GSTTnhs
@GSTT_ICU
#HowardWard
@avey_bhatia
and the whole team
Very grateful indeed and really feel very deeply for those who did not make it 💕
#NationalDayofReflection2021
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Anyone in the UK can call themselves a nurse. Even if they have no nursing qualifications or experience. They can even call themselves a nurse if they have been struck off. This is a
#PatientSafety
issue
If you are concerned too please sign
#ProtectNurse
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Many think its better to be in the tent/at the table at any cost.
Thats not been my personal experience.
I for one, have learnt to walk away.
Walk away from disrespect, from tokenism, from aggression, from wasting energy and time.
And dont look back.
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Its not furniture and vehicles we are short of, its staff.
A extra bed is useless without extra registered nurses.
In my time in the NHS I've never seen this level of pressure, staff are treating more people than ever, whether that’s GP appointments, A&E attendances or category one ambulance call outs.
We’ve launched a plan to help, including more beds and ambulances across the country.
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Every time I hear the term "empowering nurses" it makes my skin crawl.
#Nurses
dont need empowering. They need people to start valuing their work & stop excluding them from conversations.
Same with patients and families. Stop "empowering" start recognising.
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Timely reminder In the UK, "nurse" is not a protected title. Literally anyone can call themselves a nurse.
Literally anyone.
I dont know any Registered Nurses that would support this view or this anti NHS march
They have been through too much
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Caring is not valued. Its not seen as heroic or noble, it attracts little money, its seen as a predominately female activity thats is innate & does not require much knowledge. This is incorrect.
Caring is a vital & we only see it when its not there.
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Beds without staff are no use at all. Its just furniture
And most people in the community already have a bed but not the staff.
If you want safe care:
Invest in workforce.
Invest in workforce.
Invest in workforce.
Invest in workforce.
Invest in workforce.
Invest in workforce.
Today I am asking the Health Secretary to put in some more hospital beds so we have more NHS capacity. That would be a good use of the extra money.
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Good to see
@CNOEngland
support and call for a resolution
#FairPayforNursing
England’s chief nurse Dame Ruth May has just turned up on the picket line here outside St Thomas’s hospital.
She says she supports striking nurses and ministers must reach an “urgent resolution” with the nursing union over pay.
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@DrRobgalloway
@Keir_Starmer
This is the man who told me there is no relationship between staffing and patient safety. I sincerely hope he has changed his mind
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Really appalled to see
@MSEHospitals
advertise a cancer CNS role, an advanced practice role, at a band 5.
This is not valuing nursing
#valuenursing
#CNSvalue
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Unbelievable that
#SackChrisWhitty
is trending.
The day we start to silence experts because we don't like what they have to say is a bad day for all of us.
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Every part of the system we work is is reporting large parts of care left undone and safety concerns. The workforce isn't there. They have left or are off sick. Those that are left seem unhappy and tired.
The NHS and the workforce have not failed, they have been failed.
Thousands of people could be dying waiting for ambulances or because of long waits on trolleys in A&E. While
@sajidjavid
talks about elective backlogs, emergency care in the NHS is collapsing. Today's
@thesundaytimes
report here:
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Who
Is
Going
To
Staff
Them?
Health trusts have been advised to create areas for
#elderly
patients to prevent long waits in ambulances ⏳
@MLChealth
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I feel the need to retweet this excellent tweet today.
#nursing
Slice up the tennis balls and you can get more in the tube - efficient use of space and increased productivity. But you won't be able to play tennis! Be efficient, be productivity but more importantly be effective - do not forget your purpose...
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Nursing is a safety critical profession
Nursing is a safety critical profession
Nursing is a safety critical profession
Nursing is a safety critical profession
Nursing is a safety critical profession
Nursing is a safety critical profession
In case you didn't know that.
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There
Are
Not
Enough
Staff
To
Safely
Run
Extra
Beds
(or the ones there are for that matter)
Its really not difficult.
Why not open and staff all the Nightingale hospital capacity they need for CV 19 cases and get the rest of the NHS back to full capacity for everything else? No need to scare us with the idea the NHS will not cope.
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The thing that nursing leaders and policy makers said would never happen has happened....
This was always going to be an exploited role and a patient safety issue as RNs are lost from the workforce.
Cards on the table; I’m a Band 4 Nursing Associate registered with the NMC. I often have up to 12 patients assigned to me. I do medications, IV’s, syringe drivers and more. I’m a lone parent so I do no unsocial = no enhancements. This is my take home. This is why there’s strikes.
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My husband is still in
@GSTTnhs
ITU and its very difficult not being able to visit. They are doing a great job.
Fortunately we live nearby and its very easy to socially distance in the garden.
Often have the company of these two!
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I saw some journalists giving
@wesstreeting
a hard time for saying this but its what people who work in and use the services tell me everyday.
The "nothing to see here" approach of the last government and NHS England caused far more distress IMO.
It is now the policy of the Government that our NHS is broken.
It will be the mission of my department, every member of this government, and the 1.4 million people who work in the NHS, to turn our health service around.
That work starts now.
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There has not been spare ITU capacity.
There has been "stretch" capacity of beds with ventilators, not ITU beds.
ITU beds require qualified ITU nurses to be ITU beds.
Stretch capacity has come at the cost of other services such as elective surgery & cancer care.
Nothing to spare
Stephen Powis says NHS capacity has "always been there" for surge of coronavirus patients.
"We always had spare capacity - there were always large amounts of intensive care beds available if needed."
He says the public must continue to comply with social distancing measures.
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I'm in one of those depressing "nurses don't need degrees" conversations.
For all the people who were (rightly) enraged about the
#hardmaths
stuff yesterday-this comes from the same place.🙄
When will this nonsense stop?
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If you do nothing else today give yourself 5 mins to hear & watch this. Her face is just lit up with joy. Its beautiful.
Fast Car a hit again 36 years after it was released.
I had a feeling that I belonged❤️
I had a feeling I could be someone ❤️
#TracyChapman
In case you didn’t get to see it, here is the full video of Tracy Chapman and Luke Combs singing “Fast Car” at the Grammys
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Blowing out another's candle doesn't make yours burn brighter.
We all just end up sitting in the dark.
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What do I think of the pay offer to
#nursing
?
5% is too low to retain or attract returners.
Its worth noting that retention and patient safety is not the ambition of government reflected in the deprofessionlisation we have seen across the public sector
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Delighted to say I've been appointed as a senior associate
@NuffieldTrust
and look forward to contributing going forward
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What unsafe registered nurse staffing looks like (from tweets this week)
Un-coordinated care
Deterioration not seen/acted upon
Deconditioned patients
Poor communication
Symptoms not eased
Worries not addressed
Call bells unanswered
Wounds not dressed
Drug errors
#ValueNursing
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A lot of people ask me if the
#NHS
is collapsing. I reply, it wont be with a big bang, its your gran being left in a cupboard on a ward without nursing care, its waiting too long for a cancer diagnosis, its the increasingly burned out staff and its this
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Today I have heard from
A doctor who has waited four hours for a PC to restart (has used own phone in meantime)
A community nurse that needs FORTY(!) passwords
Numerous issues with connectivity, wifi, slow and old hardware, unfit platforms
Perhaps invest in the basics first?
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Happy
#InternationalNursesDay2023
!
Things are difficult but don't ever doubt your worth. You are part of the larger safety critical profession and you make a difference every day
#valuenursing
#PatientSafety
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Was just talking to a lady in the local shops as she was reading one of
@MichaelRosenYes
books. She is learning to read at the age of 52 so she can read with her grandkids. She is so enthusiastic and lovely. We forget what we take for granted 💕💕💕
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To everyone who messages me about working in health and social care.
This is the best advice I can give you.
Monday 15th April 2024 Thought Of Early Evening From Morden Underground Station
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@wesstreeting
Dan Poulter told me there is no evidence between staffing in hospitals and patient safety (despite 1000+ peer reviewed papers suggesting there is). I would not recommend his advice in that respect.
He was junior health minister at the time & could have influenced policy then
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Covid and sexual health advice all in one poster!
I see the poster spellcheckers in Bristol have been furloughed
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Who
Is
Going
To
Staff
Them?
6. Putting patients first.
- Build or modernise 250 GP surgeries.
- Expand Pharmacy First to free up a total 20 million GP appointments.
- Build 50 new Community Diagnostic Centres.
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Another DM from an experienced
#nurse
having to drop banding from 7 to a 5, to get the hours/flexibility they need. They are resigning to work agency.
⚠️Demotion is not a retention strategy⚠️
#ValueNursing
@KateBurkeNHS
@FlexNHS
@NavinaEvans
@AmandaPritchard
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I tweeted it earlier but im tweeting it again because its worth it. 👏👏👏
Exclusive: Chief nurse
@CNOEngland
was dropped from No.10 coronavirus briefings after refusing to back Dominic Cummings
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I think more than anything this shows how poorly the safety critical work of professional registered nurses is not understood by people who lead healthcare.
Could nursing shortages be filled with airline staff?
Chief Executive of NHS England Simon Stevens tells MPs the NHS had been losing nurses to airlines in the early 2000s, but that “perhaps we can think about recruiting back the other way”
Latest:
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Had a lovely day
@RoyalFamily
investiture.
Thank you to everyone who has supported the
@MillwallFC
medical team.
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#nursing
is highly skilled professional work.
It's not unusual to see these views in public, its increasingly disturbing to see them in workforce policy & even from the regulator
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NHS employers please please please STOP doing "workforce reviews" & making your staff (particularly the specialist nurses) have to keep proving their worth.
They have already proven their worth and this will not help you retain frontline risk managing expertise!!!
#PatientSafety
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@trishgreenhalgh
Jan 8th 2021 I sat in the snow alone outside St Thomas my husband was inside on a ventilator. 11th of Jan I buried my mum with a few family members. Went home to an empty house. Don't regret sticking to the rules but "move on" is hurtful. It still hurts.
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Need to stop talking about not having enough beds-what we really dont have is the staffing for the beds.
The problem is not a lack of furniture. Its a lack of skilled people.
The government has announced funding to upgrade wards, redevelop A&E and provide an extra 900 beds to prepare for winter pressures. It described last winter as ‘challenging’. How can we learn from last winter? Will the £145m fund address the pressures?
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First contact physios are great and meet demand
but please
@NHS_HealthEdEng
STOP describing every health professionals value as their ability to save doctors time. They have unique skills that in many case might better meet that persons need.
First contact physios in GPs will free up GP time, improve patient satisfaction, and reduce referrals. Our new guide outlines key steps, support and guidance for the introduction of local
#firstcontactphysio
#primarycare
@thecsp
@NHSEngland
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Of all the professional groups we work with I am constantly surprised at how nurses undermine the value of nursing. This includes some leaders.
Other professions dont do this.
If nurses dont value nursing, no one else will either.
#ValueNursing
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Nursing is the largest safety critical profession in healthcare
No longer tolerating poor working conditions & safety compromises means you are in the right job.
Nurse is going on strike!! Surely if you want to do that you are in the wrong job?
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Just seen a senior job advertised at
@SurreyHeartland
ICS Nursing and Midwifery Strategic Lead-to lead nursing across an ICB for which no nursing qualifications or experience are necessary.
The devaluation of
#nursing
is a serious retention issue and this is a red flag.
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Why does
@BBCBreaking
& the experts they interview keep equating
#Nightingale
hospitals with increased capacity?
The supply of staff is finite, it is not substantially growing and the ones we have can't meet a massive sustaned surge in demand
#COVID19
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I know this is going to be unpopular but I have to say it.
Why are people with no knowledge of workforce, no understanding of safety critical work, no training/underpinning knowledge doing workforce planning in the
#NHS
?
Do they not realise how much damage they can do?
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Its not furniture we are short of.
Its staff
We are short of staff.
Id be impressed with a headline saying 4,000 extra qualified staff.
#shedswithbeds
dont take care of people.
GUARDIAN: Hospitals urged to find space for 4000 extra beds as cases surge
#TomorrowsPapersToday
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Happy
#InternationalNursesDay
to the biggest safety critical profession in healthcare
Let's hope for a world where you no longer have to
#ProveYourWorth
#ProtectNurse
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⚠️Top retention tip for NHS Trusts!⚠️
Closing down bank options in the hope your staff will move to substantive vacant poorly paid roles with terrible shift patterns/working conditions is unlikely to work.
There is a reason people have left those jobs in the first place. 🔥🔥🔥
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England has lost half of its district nurses in ten years.
I wonder if that's a factor.
A&E rising demand isn't driving long waits in A&E. Attendance rates are not dramatically up from pre-pandemic levels. The real issue is collapse of social/community care provision & some increased acuity. This is driving longer stays & means fewer open beds for ppl to go into
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This is my husband. This time last year he was admitted to
@GSTTnhs
@GSTT_ICU
with
#Covid19UK
before vaccines were available.
You really don't want to go through what we went through & he is still going through. Please get your vaccine or talk to someone if you are worried
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Not angels not heros, educated people who work in a safety critical profession......
Well said
@credland_nicki
@BBCNewsnight
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Sitting in a coffee shop in
#Melbourne
my husband is visiting family
This is only possible thanks to
@GSTTnhs
@GSTT_ICU
@EvelinaLondon
#HowardWard
saved his life 2 years ago
#COVID19
.
I know it feels like your work isn't valued but it really is.
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No. We do not suffer from a shortage of applicants. We must not give even more students and newly qualified poor experiences of the workplace.
We must put much more effort into retention and stop filling the leaky workforce bucket.
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This approach to workforce is a red flag. Putting system resilience on individuals is a worrying practice but a culture that can think this is acceptable should be avoided
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"Sorry if you felt" is a term one should never use.
If you are sorry say sorry, if are not then best to say nothing.
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The NHS is under-managed. Necessary & unnecessary administrative work, is now pushed to clinical staff. Better to hire a good mix of skilled professionals including admin staff
NHS to slash bureaucracy by recruiting doctors and nurses over pen-pushers
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Thanks to everyone who has sent me this.
Patient discharge is a clinical procedure. There is risk if its not done well/completely. The focus on "flow" means its simply seen as part of a logistics chain now.
Turning into a competition I really dont know where to start with. 😬🚩
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Been scraping NHS Jobs for a while and looking at gendered pay.
Here is a nice example a Sister for paeds ward including people management Band 6
Estates specialist officer Band 7 at same Trust
Similar pattern observed over a number of years.
Worth a paper
@maxwele2
?
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As its
#NHS75
I thought id celebrate five
#nurses
who have made a massive contribution over the last 75 years but who you might not have heard of (not all NHS but impacted care in the NHS)
#NHS75Women
🧵1/6
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Had several concerning DMs about
#safestaffing
this weekend.
There is an agency/bank ban currently in England and I have reports of wards without registered nurse cover.
This is dangerous and also unlikely to force people into poor substantive contracts. False economy
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This makes me so angry. We have a retention crisis in
#Nursing
yet people with great skill and expertise-our primary risk managers in the system, our teachers of the next generation-are only rewarded if they manage people and budgets.
We need to stop saying this is OK.
Been asked again why 13 yrs in the same job I haven't progressed up from band 5... I have progressed but just not gone into a management role... in that 13 yrs I've developed a true passion for palliative care and gained a wealth of knowledge & experience I want to be hands on
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A 1000 deaths a week is "mercifully low"
No words.
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No, it really isn't. Its disgraceful.
Trump says it's 'beautiful' to see 'nurses running into death just like soldiers running into bullets
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Advertisng
#nursing
jobs particularly senior ones, where nursing qualifications and experience are optional,
sends a message to the workforce that it's not valued. I know this because they contact me!
⚠️It's not a good retention strategy ⚠️
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If you are a registered healthcare professional in the UK, I would urge you to understand the difference between what the regulator requires of you, what the law requires of you and what your employer requires of you as part of an employment contract
They do not always align.
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The vigilance of nursing care is something very few, other than those who have experienced it, understand.
It isn't only what nurses do that makes them safety critical, its the bad outcomes they prevent that matter.
We need to retain experienced nurses
#FairPayForNursing
When I was in an induced coma, night after night nurses watched over me to see that I didn't need emergency attention. In the morning they wrote me a 'letter' which went into a 'Patient Diary' which they gave me when I came round. This is only worth 1%?
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Just spoken to a chief nurse who is building a workforce model based on outcomes, understands the relationship between workforce and safety, values experienced RNs, just culture & aiming to lead a high reliability organisation.
I cannot tell you how happy this has made me.
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Why do we have a retention problem?
How many other professional groups at
@LandDHospital
are going to be asked to do the cleaning?
And patients with long term conditions will go without specialist nursing care.
Now more than ever we need to
#ValueNursing
#nursing
#PatientSafety
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Just raised some fairly serious safety concerns with an NHS service. Appreciate pressure they are under so offered to help.
Only response is to make a formal complaint.
We are so far away from safety culture.
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Its possible to speak out against front-line skill dilution, deprofessionalisation, the substitution of roles, un-evidenced based workforce policy etc without being nasty to the people who are doing those jobs.
They did not introduce the policies.
The government did.
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Thank you to everyone who has taken the time to show their support to us in the last 24 hours. Have been overwhelmed.
Twitter can be a harsh place sometimes but times like these really show how good people are 💕
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CNS job, prescribing etc
Band 6. If you want to keep people out of hospital this exploitation has to stop (and its not just this trust)
Within Luton we are currently developing an innovative respiratory Virtual Ward. This brings an exciting opportunity for an experienced and skilled Respiratory Nurse to join the team.
#NHS
#NHSJobs
#Nursingjobs
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When I was young I worked in the
#NHS
as an engineer and learned to fix one of the most vital pieces of equipment there is-the NHS Dualit toaster!
My broke this week-just fixed it, 40 years on, still got it 😉
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⚠️"Someone is better than no one" is not a workforce plan
⚠️Pressuring those who raise concerns is bullying
⚠️Public hand wringing when things go wrong but not changing anything to stop them going wrong again is beyond poor practice.
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There have been several celebrity reviews of hospital food.
Feeding ill people well on less than £3 a day is a tall order.
Health service already has many experts who can help with this
But none of it matters if we dont have the staff to help people eat, monitor intake & act
Today we’ve launched a review into hospital food to ensure patients have delicious, nutritious food to help them recover as quickly as possible. Delighted to have
@PrueLeith
on board as an adviser
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