scholarly journals Impact of workplace discrimination and harassment among National Health Service staff working in London trusts: results from the TIDES study

BJPsych Open ◽  
2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Rebecca D. Rhead ◽  
Zoe Chui ◽  
Ioannis Bakolis ◽  
Billy Gazard ◽  
Hannah Harwood ◽  
...  

Background Harassment and discrimination in the National Health Service (NHS) has steadily increased over the past 5 years with London being the worst performing region. There is a lack of data and research on the impact this is having on staff health and job satisfaction. Such data are necessary to inform the development of effective workplace interventions to mitigate the effects these experiences have on staff. Aims Examine the impact of harassment and discrimination on NHS staff working in London trusts, utilising data from the 2019 TIDES cross-sectional survey. Method In total, 931 London-based healthcare practitioners participated in the TIDES survey. Regression analysis was used to examine associations between the sociodemographic characteristics of participants, exposure to discrimination and harassment, and how such exposures are associated with physical and mental health, job satisfaction and sickness absence. Results Women, Black ethnic minority staff, migrants, nurses and healthcare assistants were most at risk of discrimination and/or harassment. Experiencing either of the main exposures was associated with probable anxiety or depression. Experiencing harassment was also associated with moderate-to-severe somatic symptoms. Finally, both witnessing and experiencing the main exposures were associated with low job satisfaction and long periods of sickness absence. Conclusions NHS staff, particularly those working in London trusts, are exposed to unprecedented levels of discrimination and harassment from their colleagues. Within the context of an already stretched and under-resourced NHS, in order to combat poor job satisfaction and high turnover rates, the value of all healthcare practitioners must be visibly and continuously reinforced by all management and senior leaders.

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054533
Author(s):  
Diana A van der Plaat ◽  
Rhiannon Edge ◽  
David Coggon ◽  
Martie van Tongeren ◽  
Rupert Muiry ◽  
...  

ObjectiveTo explore the patterns of sickness absence in National Health Service (NHS) staff attributable to mental ill health during the first wave of the COVID-19 epidemic in March–July 2020.DesignCase-referent analysis of a secondary dataset.SettingNHS Trusts in England.ParticipantsPseudonymised data on 959 356 employees who were continuously employed by NHS trusts during 1 January 2019 to 31 July 2020.Main outcome measuresTrends in the burden of sickness absence due to mental ill health from 2019 to 2020 according to demographic, regional and occupational characteristics.ResultsOver the study period, 164 202 new sickness absence episodes for mental ill health were recorded in 12.5% (119 525) of the study sample. There was a spike of sickness absence for mental ill health in March–April 2020 (899 730 days lost) compared with 519 807 days in March–April 2019; the surge was driven by an increase in new episodes of long-term absence and had diminished by May/June 2020. The increase was greatest in those aged >60 years (227%) and among employees of Asian and Black ethnic origin (109%–136%). Among doctors and dentists, the number of days absent declined by 12.7%. The biggest increase was in London (122%) and the smallest in the East Midlands (43.7%); the variation between regions reflected the rates of COVID-19 sickness absence during the same period.ConclusionAlthough the COVID-19 epidemic led to an increase in sickness absence attributed to mental ill health in NHS staff, this had substantially declined by May/June 2020, corresponding with the decrease in pressures at work as the first wave of the epidemic subsided.


2021 ◽  
Author(s):  
Diana van der Plaat ◽  
Rhiannon Edge ◽  
David Coggon ◽  
Martie van Tongersen ◽  
Rupert Muiry ◽  
...  

Abstract Objective: To explore the patterns of sickness absence in National Health Service (NHS) staff attributable to mental ill health during the first wave of the Covid19 epidemic in March to July 2020 Design: Case-referent analysis of a secondary data set Setting: NHS Trusts in England Participants: Pseudonymised data on 959,356 employees who were continuously employed by NHS trusts during 1 January 2019 to 31 July 2020 Main Outcome Measures: Trends in the burden of sickness absence due to mental ill health from 2019 to 2020 according to demographic, regional and occupational characteristics. Results: Over the study period, 164,202 new sickness absence episodes for mental ill health were recorded in 12.5% (119,525) of the study sample. There was a spike of sickness absence for mental ill health in March-April 2020 (899,730 days lost) compared with 519,807 days in March and April 2019; the surge was driven by an increase in new episodes of long-term absence and had diminished by May and June 2020. The increase was greatest in those aged >60 years (227%) and among employees of Asian and Black ethnic origin (109%-136%). Among doctors and dentists the number of days absent declined by 12.7%. The biggest increase was in London (122%) and the smallest in the East Midlands (43.7%); the variation between regions reflected the rates of Covid19 sickness absence during the same period. Conclusion: Although the Covid19 epidemic led to an increase in sickness absence attributed to mental ill health in NHS staff, this had substantially declined by May and June 2020, corresponding with the decrease in pressures at work as the first wave of the epidemic subsided.


2020 ◽  
pp. 095148482091851
Author(s):  
Deborah Roy ◽  
Andrew Keith Weyman ◽  
Reka Plugor ◽  
Peter Nolan

Because of a perceived decline in staff morale, the UK National Health Service has begun to routinely assess the extent to which commitment to the National Health Service may aid staff retention. While a number of studies have investigated the role of employee commitment in relation to staff turnover, no research to date has empirically tested if staff commitment to the NHS could protect job satisfaction from the effects of high job demands, and if this varies according to age. Using latent variable path analysis, this novel study examined this question among a national sample of Healthcare Professionals Allied to Medicine in the National Health Service. The results indicate that the negative effects of high job demands on job satisfaction were fully mediated by commitment to the National Health Service, but age mattered. Among the over 45s and over 55s, commitment to the National Health Service acted as an effective buffer against the negative effects of job demands on job satisfaction, but this effect was not as strong among the 35–44 age group. The broader policy implications of these findings are that age sensitive policies to support NHS workforce retention are needed. Also, pro-social institutions who employ Healthcare Professionals Allied to Medicine should develop policies for inspiring commitment to that institution, as it could help them with the demands of the job, and may even encourage more skilled workers to work longer.


2020 ◽  
Vol 20 (3) ◽  
pp. 183-200
Author(s):  
Elizabeth Chloe Romanis ◽  
Anna Nelson

COVID-19 has significantly impacted all aspects of maternity services in the United Kingdom, exacerbating the fact that choice is insufficiently centred within the maternity regime. In this article, we focus on the restrictions placed on homebirthing services by some National Health Service Trusts in response to the virus. In March 2020, around a third of Trusts implemented blanket policies suspending their entire homebirth service. We argue that the failure to protect choice about place of birth during the pandemic may not only be harmful to birthing people’s physical and mental health, but also that it is legally problematic as it may, in some instances, breach human rights obligations. We also voice concerns about the possibility that in the absence of available homebirthing services people might choose to freebirth. While freebirthing (birthing absent any medical or midwifery support) is not innately problematic, it is concerning that people may feel forced to opt for this.


2019 ◽  
Vol 37 (2) ◽  
pp. 199-217
Author(s):  
Martin Powell

There have been recent calls for a royal commission (RC) on the British National Health Service (NHS). This article focuses on the impact of RCs and similar advisory bodies, particularly on finance recommendations, of three inquiries with broad remits across the whole of the NHS from very different periods: Guillebaud (1956); Royal Commission on the National Health Service (1979); and House of Lords Select Committee on the Long-term Sustainability of the NHS (2017). These inquiries appear to have had rather limited impacts, especially on NHS funding. First, there appears to be some hesitancy in suggesting precise figures for NHS expenditure. Second, the reports are advisory, and governments can ignore their conclusions. Third, governments have ignored their conclusions. In the 1950s and the 1980s, contrary to the recommendations of the inquiries, NHS expenditure subsequently grew only slowly, and charges were increased. In short, asking an independent RC to provide answers on NHS expenditure is perhaps the unaccountable in pursuit of the unanswerable.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e035957
Author(s):  
Shannon Cheng ◽  
Jeremy Dawson ◽  
Julie Thamby ◽  
Winston R Liaw ◽  
Eden B King

ObjectivesTo examine the prevalence of aggression in healthcare and its association with employees’ turnover intentions, health and engagement, as well as how these effects differ based on aggression source (patients vs colleagues), employee characteristics (race, gender and occupation) and organisational response to the aggression.DesignMultilevel moderated regression analysis of 2010 National Health Service (NHS) survey.Setting147 acute NHS trusts in England.Participants36 850 participants across three occupational groups (14% medical/dental, 61% nursing/midwifery, 25% allied health professionals or scientific and technical staff).Main outcome measuresEmployee turnover intentions, health and work engagement.ResultsBoth forms of aggression (from patients and colleagues) have significant and substantial effects on turnover intentions, health and work engagement; however, for all three outcome variables, the effect of aggression from colleagues is more than twice the size of the effect of aggression from patients. Organisational response was found to buffer the negative effects of aggression from patients for turnover intentions and the negative effects of aggression from patients and colleagues for employee health. The results also demonstrated that nurses/midwives, women and Black employees are more likely to experience aggression; however, no clear patterns emerged on how aggression differentially impacts employees of different races, genders and occupations with respect to the outcome variables.ConclusionsAlthough aggression from patients and colleagues both have negative effects on healthcare employees’ turnover intentions, health and work engagement, these negative effects are worse when it is aggression from colleagues. Having an effective organisational response can help ameliorate the negative effects of aggression on employees’ health; however, it may not always buffer negative effects on turnover intentions and work engagement. Future research should examine other approaches, as well as how organisational responses and resources may need to differ based on aggression source.


2009 ◽  
Vol 25 (03) ◽  
pp. 262-271 ◽  
Author(s):  
Eva Susanne Dietrich

Objectives:The aim of this study was to examine the impact of the National Institute for Health and Clinical Excellence's (NICE's) negative and restricting technology appraisals on the number of prescription items dispensed and the corresponding total net ingredient costs for drugs from 2000 to 2004 in the ambulatory care of the National Health Service (NHS) in England and Wales. In addition, it is discussed whether the NICE approach could be a role model for Germany.Methods:The number of prescription items dispensed and the net ingredient costs of thirty-one drugs reimbursed by the NHS were analyzed, thereof thirteen drugs descriptively and twenty-one drugs with regression analyses. Data were extracted from the “Prescription-Costs-Analysis-Statistics” for the ambulatory care of the British Department of Health (England 1993–2005). In the case of the twenty-one drugs analyzed by regression analyses, predictions were established how the prescribing and the costs would have developed without NICE's drug appraisal. Finally, conclusions were drawn whether NICE's negative and restricting drug appraisals had a decreasing effect or not.Results:For 97 percent of the drugs analyzed in this study, the publication of NICE's fourteen negative and restricting technology appraisals of drugs between 2000 and 2004 did not reduce the number of prescription items dispensed and net ingredient costs in the ambulatory care of the NHS in England and Wales.Conclusions:Cost-effectiveness appraisals as performed by NICE or the German Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) are a useful and important tool to enhance the discussion about methods and acceptance of evidence-based medicine in general.


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