Secret aid worker: Is the NHS really comparable to a humanitarian crisis?

In 2015 I left the UK to provide humanitarian medical care to a refugee camp stuck in the midst of a civil war. The camp’s population quadrupled in the space of four months while I was there and the onset of the rainy season led to a demand for care that exceeded all expectations.

Hundreds queued to the door of the hospital with an official capacity of 90. Patients shared mattresses and sat in corridors. Where else could they go? They were sick and needed treatment and sending them home without medical care would often have been a death sentence – there were no other hospitals within hundreds of miles.

As the death toll rose in our camp, an emergency was declared. Last week the British Red Cross declared that the NHS is facing a “humanitarian crisis” too. Dr Mark Holland, president of the Society for Acute Medicine, admitted that this was strong wording but “not a million miles away from the truth”. We may not have thousands of people suffering on shared mattresses, but we do have thousands of our sick and our elderly and our children needlessly suffering in corridors around the country.

We have intensive care units that have to ship patients to distant hospitals in search of capacity. One month ago we ran out of intensive care beds for children throughout Leicester and the whole of London.

It may not be a civil war, epidemic or earthquake causing this crisis, but a hurricane of political ineptitude, denial and poor funding. There is an over-reliance on the compassion, blood, sweat and tears of NHS staff around the country. Staff that are already working 24/7, despite the suggestions we need a seven day NHS.

The symptoms are already visible, NHS workers are stretched. In a humanitarian crisis, people work to breaking point, burning themselves out in their endeavour to save people, often in the knowledge that they will go home to recuperate and resume their “normal” job. In the UK, NHS staff don’t have that luxury. This is their life and they are at breaking point.

The mantra we repeat to drivers that “tiredness kills” seems to be easily forgotten. Mistakes will happen. In Worcestershire, two poor souls died waiting for beds in a corridor, forgotten and lost amid the tsunami of other people waiting to be admitted.

I challenge any nurse or doctor to maintain that in the current environment the same could not happen in their own A&E department. From our state-of-the-art trauma centres to our small district general hospitals, we are overwhelmed. Suggestions by the health secretary that 30% of people attending A&E do not need to be seen in A&E does not solve the fact that 18,000 people in one week required A&E and waited over four hours to be admitted to a ward.

When the death toll in our refugee camp exploded, my organisation responded by providing more resources and staff. The levels of death and suffering began to drop. We know the costs of not responding quickly to a medical crisis. In 2014 the initial alarms raised by health professionals in response to the number of reported cases of Ebola in west Africa went largely ignored. They were further downplayed for months. This delay ultimately led to the unwarranted death of thousands of people and a panic on a global scale.

The problems faced by the NHS are complex and there is no easy solution, but perhaps the British Red Cross’s recent declaration is not wholly inappropriate. A humanitarian crisis is defined as a singular event, or a series of events that are threatening in terms of the health, safety or wellbeing of a community. This isn’t some faraway country seeing a civil war, epidemic or flood. But a slow-burning, manmade disaster of our own governing. The death toll I pray will not go in the thousands, but thousands are already suffering.

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Secret aid worker: Is the NHS really comparable to a humanitarian crisis?

Hospital worker stabbed to death on ward

”The full facts of this unhappy incident are nonetheless getting established and therefore it is inappropriate for us to comment further at this time.”

The spokesman was unable to verify the role of the employees member, but it is understood the female was not a nurse.

The 2gether web site says Wotton Lawn Hospital is an 88-bed acute psychological health hospital near the centre of Gloucester which gives inpatient companies for the county of Gloucestershire.

The hospital has four admission wards, a nurse-led psychiatric intensive care unit (PICU) and a low safe unit (LSU).

It says services end users are supported by a selection of healthcare staff which includes nurses, doctors, psychologists, artwork therapists, physiotherapists, occupational and sports exercise therapists.

Hospital worker stabbed to death on ward

Marks & Spencer admits exposing worker to asbestos

Janice Allen says she feels betrayed by her former employer Marks &amp Spencer. Photograph: Graham Turner for the Guardian

Marks &amp Spencer has admitted negligently exposing to asbestos a female who worked in two of its stores.

Janice Allen, 53, who was a supervisor in the men’s and women’s garments sections of M&ampS from 1978-87, initial at its principal Oxford Street retailer in London and then in Uxbridge, has been diagnosed with mesothelioma, a lethal type of lung cancer caused by inhaling asbestos fibres. There is no cure, and she has been given months to dwell. M&ampS has agreed in the large court to pay “significant” damages soon after judgment in her favour in Might. M&ampS admitted breaching its legal duty of care .

Allen’s attorney, Harminder Bains, of Leigh Day, stated there could be numerous people suffering asbestos-relevant ailments brought on by owners of premises failing to comply with legal safety procedures.

Mesothelioma, cancer of the lung’s outer lining, can get decades to develop and leads to a drawn-out, agonizing death.

Allen, married with two children in their 20s, said she was “devastated and distraught” that she was dying from a cancer she had in no way heard of, from inhaling asbestos that she did not know existed in the retailers.

“I feel betrayed by Marks &amp Spencer. The firm employed to portray itself like a loved ones they engendered loyalty. I worked very hard, I met my husband there. But to believe beneath the surface they have been exposing folks to deadly dangers, to asbestos, it really is so cynical. We have been searching forward to enjoying life in the coming many years alternatively I have to face the truth I will not dwell to see my grandchildren.”

Asbestos was regarded as a miracle fire-proof developing materials and widely utilized in construction right after the second globe war right up until the 1970s, when it was recognised to be lethal. Successive legislation has considering that essential the elimination of asbestos.

In 2013 Steve Rowe, an M&ampS executive director, advised a BBC documentary: “If you seem back into the 60s, 70s and 80s, it is feasible that workers have been exposed to asbestos in our shops.” But M&ampS’s policies relating to asbestos had grow to be “market foremost” because then.

In 2011, M&ampS was fined £1m, for unsafe managing of asbestos at its Studying keep. The judge Harvey Clarke QC said managers had been cavalier in not closing the retailer even though the perform was ongoing, “to maintain the trading profit as large as reasonably attainable”.

Allen worked in the Marble Arch shop and then at Uxbridge for a complete of 9 many years following leaving school at 18. In the summer time of 2012, 25 many years soon after leaving Marks and Spencer, she felt agonising discomfort close to her ribs, and in April 2013 she was diagnosed with mesothelioma. Given M&ampS’s background, her attorney Bains believed it was most likely that Allen had been exposed to asbestos while operating there.

William Wallace, a well being and safety officer who worked at the Reading retailer in 2006, informed the HSE of the criminally unsafe perform there and grew to become a witness in the Studying prosecution, had worked at the Marble Arch store in 1998 and acted as a witness in Allen’s legal declare.

Wallace offered inside information of massive quantities of asbestos in the Marble Arch keep, in fire doors, pillars, ceiling voids and insulation board. He mentioned the air-conditioning was most likely to have circulated asbestos dust, and workers and the public could have been exposed in other methods unless stringent measures had been followed.

Steve Rotheram, a Labour member of the all-party parliamentary group on asbestos, said: “Right now I am creating to the chief executive of the HSE [Health and Safety Executive] to create quick clarification on the procedures deployed by Marks &amp Spencer in relation to asbestos. I want assurances that the public can be confident that they were not put in any danger while purchasing in these merchants.”

M&ampS declined to comment on its breach of duty to Allen, but stressed it took spot in the 1970s and 80s.

In a statement the business explained: “We are confident that we now have the most rigorous policy we can have in spot and that M&ampS stores are safe for our staff and our clients.”

Marks & Spencer admits exposing worker to asbestos

Activity shifting explained: a viable solution to health worker shortage?

Training community members to give HIV treatment method delivers a treatment to a shortage of educated wellness workers. Photograph: Siphwe Sibeko/Reuters

Job shifting is a lower-value solution to tackling gaps in well being providers in the developing world, for instance individuals in HIV and mental overall health treatment. The need to have for each is ever present.

Last month, a report showed that South Africa has the highest price of new HIV infections in the world, with in excess of 400,000 happening in 2012 – and only a third of people becoming handled with antiretroviral treatment (Art).

Meanwhile, the variety of folks impacted by mental illness globally is increasing, as humanitarian crises from conflict and natural disaster multiply – in Syria, South Sudan and the Philippines – but funding is hardly ever allocated to treat them. The WHO reviews that humanitarian emergencies enhance mild or reasonable mental ailments ( such as depression) by 5% to 10% and a lot more serious mental health issues such as schizophrenia by 2% to 3%.

“Funding is typically tough, as mental well being is not on the radar for donors,” says Inka Weissbecker, global psychological wellness and psychosocial adviser at Global Medical Corps.

What is task shifting?

Alternatively of lamenting the lack of qualified healthcare experts, activity shifting starts with a useful “we are are the place are” technique and helps make the most of the sources in the country. The WHO defines it as as “the rational redistribution of duties amid health workforce teams” including – in worldwide guidelines issued in 2008 – “particular duties are moved, the place appropriate, from hugely qualified overall health staff to wellness employees with shorter education and fewer qualifications”. Margaret Chan, director standard of the WHO, says she sees task shifting as “the vanguard for the renaissance of major overall health care”.

What is the downside?

A review of activity shifting in Mozambique and Zambia identified unhappy and overworked workers. The report concluded “process shifting alone cannot reply to the demands of poor countries, particularly if other problems are not addressed at the exact same time … staff have clear concepts about how to improve the availability of solutions it stays to be observed if choice-makers will listen to them.”

What do improvement groups say about it?

Weissbecker says activity shifting is an revolutionary answer to the scarcity of trained psychiatrists and psychologists in reduced cash flow countries. “The truth that a community well being worker can deal with an individual with depression successfully offers us a great deal of hope and encouragement,” she says. “Task shifting presents a sensible and sustainable solution to most African countries’ critical wellness worker shortage,” says African wellness NGO Amref.

A systematic evaluation of task shifting identified that it delivers “high-quality, cost-effective care to a lot more patients than a physician-centered model”. The study warned that the issues are “adequate and sustainable coaching”, but advisable that the approach must be regarded for “careful implementation” in which a shortage of healthcare human resources threatens programmes.

Read far more stories like this:

• How Africa’s researchers are solving Africa’s overall health troubles

• Energy to the folks: how open information is enhancing wellness service delivery

• Mental overall health demands sensible remedy – or we encounter decades of wasted time

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Activity shifting explained: a viable solution to health worker shortage?

Essex care property worker arrested on suspicion of assaulting elderly resident

A nonetheless from the Panorama investigation into the Previous Deanery care residence in Braintree, Essex. Photograph: Bbc/PA

A female has been arrested on suspicion of assaulting a resident at a care house that was the topic of an undercover investigation by the BBC’s Panorama.

The female, in her 40s, was arrested on Friday by detectives probing abuse at the Outdated Deanery care home in Braintree, Essex police mentioned.

Anglia Retirement Homes Ltd, which runs the property, sacked seven members of employees there right after Panorama showed an elderly woman with dementia becoming bullied and slapped by a worker.

The woman arrested has been released on bail until finally later on this month pending additional inquiries, police additional.

An Essex police spokesman mentioned on Saturday the female had been arrested after police watched the Panorama broadcast.

He extra: “The documentary highlighted the remedy of residents within the Previous Deanery care house.

“Essex police have been denied an advance viewing of the programme so have been only able to commence an investigation following its nationwide broadcast on Wednesday April thirty.

“On Friday evening officers arrested a lady in her 40s at her property in Braintree on suspicion of assaulting a resident at the care property just before being launched on police bail until later this month pending more inquiries.”

The force urged anybody else wanting to report abuse or neglect at the residence to come forward.

The programme showed residents becoming taunted, approximately dealt with, ignored and left in their personal excrement for hrs at the 93-bed property, which charges up to £700 a week.

Anglia released a statement right after the documentary was aired in which it insisted the incidents involved only a small variety of staff and said the company did not tolerate this variety of behaviour.

It stated that after at first suspending eight members of staff when the allegations came to light, six had been dismissed and a further case was currently being urgently reviewed, although the care employee who slapped the resident had been summarily dismissed.

The Care High quality Commission visited the web site although Panorama was filming undercover in November and gave the house a clean bill of wellness.

But the regulator returned two months ago after it was informed about the Panorama findings and located shortcomings such as too couple of workers and some residents having to wait also extended for support.

Essex care property worker arrested on suspicion of assaulting elderly resident

Worker engagement need to be a priority for NHS trusts

It is difficult for organisations to ignore the positive impact that a properly-motivated workforce can have on the delivery of top quality healthcare, says Nicola Bullen. Photograph: John Robertson

Workers inside the healthcare system are creating essential choices primarily based on the reputations and brand names of person service suppliers and NHS trusts, study suggests.

The reputation of an NHS believe in as an employer is the very first consideration for one particular in 5 nurses when they are looking for a new role, with other key concerns such as a great function/life stability, great possibilities for job progression, an superb salary and investment in personnel.

Three in four nurses in the healthcare sector said they would actively stay away from operating for a trust seen as getting a poor track record in worker engagement, in accordance to the examine, Nursing a Healthful Popularity, which surveyed 1,600 nurses.

As the United kingdom economy recovers, employees who deferred a job move in the course of the recession are beginning to get restless. This trend is prevalent inside of the healthcare sector with the analysis exhibiting that only 14% of nurses surveyed are happy in their recent position, with 57% thinking about a new role and 21% actively seeking a modify. Healthcare organisations with minimal amounts of worker satisfaction are most likely to endure the most from resignations and sluggish recruitment, even though those with good reputations will appeal to and retain the best personnel.

The considerable nursing shortfall in the Uk has large implications for the two the NHS and the private healthcare sector. In the quick phrase, organisations are plugging the gap with bank and company staff but at a large price tag. With employees constituting the lion’s share of an organisation’s costs, there are evident pressures for value containment through successful staff engagement and retention. It is also hard for organisations to ignore the hugely positive effect that a stable, properly-motivated workforce can have the two in the consistent delivery of quality healthcare and in the avoidance of long term scandals.

Popularity will also be a critical factor in stopping a likely talent exodus to other countries and care sectors, with more than half of nurses in the survey saying they have regarded either functioning outside the Uk or moving to a distinct care profession, outside the NHS.

Another essential finding from Nursing a Healthy Reputation is that nurses are responding positively in direction of aligning employment behind the “6C” values of patient support – care, compassion, competence, communication, courage and dedication. With 71% of nurses supporting the values of the 6Cs, the findings suggest that the current concerns of employees shortages and disengaged workers can be conquer by imaginative leaders inside of the NHS proactively working with the 6Cs ideas, and that talent is ready to get behind initiatives that will flip close to the existing poor perception of public sector healthcare.

Employees make the best ambassadors for any organisation, and, in a culture in which the credibility of messages from prime executives is under important scrutiny, word-of-mouth and social media channels among NHS personnel are enjoying a essential position in choice producing for jobseekers. Constructive internal stakeholder engagement is as a result not only the appropriate point to do on its own merits, but a essential part of the management of external reputation.

The message for healthcare support companies and NHS trusts is a basic one. Reputational threat and powerful communications – and in specific positive worker engagement – now require to be leading of the agenda for any board that hopes to attract and retain the greatest employees.

Nicola Bullen is strategic lead for well being at TMP Worldwide Uk

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Worker engagement need to be a priority for NHS trusts