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Nursing crisis sweeps wards as NHS battles to find recruits

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0crisis sweeps wards as NHS battles to find recruits

Ministers are being warned of a mounting workforce crisis in England’s hospitals as they struggle to recruit staff for tens of thousands of nursing vacancies, with one in five nursing posts on some wards now unfilled.

Hospital leaders say the nursing shortfall has been worsened by a collapse in the numbers of recruits from Europe, including Spain and Italy.

The most recent NHS figures reveal there are about 39,000 vacancies for registered nurses in England, with one in 10 nursing posts unfilled on acute wards in London and one in five nursing posts empty on mental health wards in the south-east.

The number of nurses from the European Economic Area joining the Nursing and Midwifery Council register has fallen more than 90%, from 9,389 in the year to 31 March 2016 to 810 in the year to 31 March 2021.

Thousands of nursing shifts each week cannot be filled because of staff shortages, according to hospital safe staffing reports seen by the Observer.

The prime minister, Boris Johnson, is already under pressure over worker shortages in the UK after Brexit, from lorry drivers to farm workers. Concerns among health bosses about the impact on patient care of acute staff shortages are revealed as experts warned last week that flu could kill up to 60,000 this winter.

NHS trusts are being paid by NHS England up to £7,000 for each vacant post to try to recruit nurses from overseas countries including India and the Philippines.

Patricia Marquis, England director for the Royal College of Nursing (RCN), said: “There just aren’t enough staff to deliver the care that is needed, and we now have a nursing workforce crisis. We should never have got into a position where we were so dependent on international nurses. We are on a knife-edge.”

Hospital trusts struggling to fill nursing posts include:

University Hospitals of North Midlands NHS trust – which runs Royal Stoke university hospital and Stafford’s county hospital – and which has reported 401 unfilled nursing posts to its board, a vacancy rate of 12%. The trust temporarily suspended non-emergency operations last month because of high demand and staff shortages. It is recruiting nurses from overseas, including from India and Ghana.

Leeds Teaching Hospitals NHS trust, which has reported nearly 700 vacancies for nurses, midwives and operating department practitioners, a vacancy rate of 13%. It postponed 287 operations in July and August and appealed last weekend for nurses to work extra shifts because of “staffing shortfalls in our critical care wards”.

Mid and South Essex NHS foundation trust, with a 17% vacancy rate for nurses, one of the highest in the country. It has 2,269 full-time clinical and non-clinical vacancies. The trust reported that over the summer up to 1,850 patients a month were waiting longer than four hours in A&E because of staff shortages.

A survey by the union Unite of 188 critical care staff at Guy’s and St Thomas’ NHS foundation trust has uncovered staff concerns of “chronic” nursing shortages and risks to patient safety. Nine out of 10 staff reported understaffing in their department on every shift.

Dave Carr, 58, a critical care nurse at St Thomas’ hospital and a Unite representative, said: “I work in intensive care for patients recovering from surgery and we need up to 11 nurses on that shift, one for each patient. We regularly only have three or four of our own nurses available and have to borrow nurses from other areas or get temporary staff. Staff are absolutely wrecked. More than 100 nurses have left the trust in the last 10 months.”

Shelley Pearce, 34, an accident and emergency nurse and RCN workplace representative in southern England, said nurses from Europe endured abuse from some members of the public after the Brexit referendum. She said: “I can quite understand why some made a decision to go home because they didn’t seem to be wanted.”

The government has pledged to increase the number of NHS nurses by 50,000 by 2025. NHS England announced £28m of funding in September last year to recruit nurses from overseas to help pay for accommodation, flights and quarantine. The upfront cost of recruiting a nurse from overseas is between £10,000 and £12,000.

By comparison, it takes three years to train a nurse in the UK and costs from £50,000 to £70,000. The government does not pay tuition fees, but provides maintenance grants worth at least £5,000 a year.

There is a global shortage of nurses, and consequently there has been criticism of trusts recruiting from overseas instead of training more UK staff. Even the new care and mental health minister, Gillian Keegan, is reported to have called it “unbelievably inefficient and also wrong and just bizarre”.

Despite this, a report by the Nuffield Trust thinktank commissioned by the NHS and published last week, said significant overseas recruitment would be required if the government nursing target was to be met. Saffron Cordery, deputy chief executive of NHS Providers, called for a fully costed workforce plan in the government’s spending review this month.

She said: “We’ve had workforce shortages for many years, and we’ve seen that exacerbated by Brexit. The workforce is the engine of any hospital and when you have shifts that aren’t filled, that’s a huge challenge.”

Danny Mortimer, chief executive of NHS Employers, part of the NHS Confederation, said: “We have experienced the pressure we would usually see in the winter months over the summer. Many staff are predicting that this will be one of the most difficult winters the NHS has ever faced.”

A survey of more than 1,000 NHS staff by the Healthcare Workers’ Foundation, a charity that supports health service employees, found 73% considered leaving in the last year. Nearly one in three frontline staff said they were likely to leave in the next year.

The total number of full-time equivalent vacancies in the NHS in England has increased from 83,203 in June 2020 to 93,806 in June 2021, according to figures from NHS Digital, the government’s health and information centre. Over the same period, nursing post vacancies rose from 37,760 to 38,952.

Hospital trusts say they are recruiting staff from overseas to help fill posts. University Hospitals of North Midlands NHS trust said it had recently hired nearly 300 extra nurses, including 93 from overseas. Leeds teaching hospitals NHS trust said staffing was an “ongoing challenge”, but it was successfully recruiting new staff. Mid and South Essex NHS foundation trust said its gaps were filled by agency and temporary staff.

A spokesperson for Guy’s and St Thomas’ NHS foundation trust confirmed 118 nurses left this year, but said 97 started and another 30 were going through pre-employment checks. They said the trust was listening to all concerns raised by staff: “The safety of our patients and wellbeing of our staff are our top priorities. We are investing in recruiting more nurses, as well as continuing to provide extensive health and wellbeing support to our staff.”

Health experts say the overall NHS workforce is growing, but not enough to keep up with demand, and the proportion of unfilled jobs across NHS England has grown over the year.

The NHS said: “The NHS is committed to reducing nursing vacancies, including through international recruitment, and increasing wellbeing support for existing staff to boost retention.

“The nursing and midwifery workforce grew by over 2.7% over the past year with over 330,000 extra full-time staff delivering care, and 80,000 people across the country applied for a nursing course this year.”

A Department of Health and Social Care spokesperson said: “We are seeing record numbers of nurses working in the NHS and applications to study nursing and midwifery have risen by 21% this year alone. We will continue to support our NHS workforce to grow to tackle the backlog, with 50,000 more nurses by the end of this parliament.

“We are working closely with Health Education England, NHS England, Skills for Care and the wider sector to make sure we have staff with the right skills up and down the country. This includes improving retention, investing in and diversifying our training pipeline, and continuing to ethically recruit from overseas.”

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Health

Covid Vaccines Saved 20 Million Lives In First Year – Study

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Covid Vaccines Saved 20 Million Lives In First Year – Study

Covid vaccines prevented nearly 20 million deaths in the first year after they were introduced, according to the first large modelling study on the topic released Friday.

The study, published in The Lancet Infectious Diseases, is based on data from 185 countries and territories collected from December 8, 2020 to December 8, 2021.

It is the first attempt to estimate the number of deaths prevented directly and indirectly as a result of Covid-19 vaccinations.

It found that 19.8 million deaths were prevented out of a potential 31.4 million deaths that would have occurred if no vaccines were available.

It was a 63 percent reduction, the study found.

The study used official figures — or estimates when official data was not available — for deaths from Covid, as well as total excess deaths from each country.

Excess mortality is the difference between the total number of people who died from all causes and the number of deaths expected based on past data.

These analyses were compared with a hypothetical alternative scenario in which no vaccine was administered.

The model accounted for variation in vaccination rates across countries, as well as differences in vaccine effectiveness based on the types of vaccines known to have been primarily used in each country.

China was not included in the study because of its large population and strict containment measures, which would have skewed the results, it said.

The study found that high- and middle-income countries accounted for the largest number of deaths averted, 12.2 million out of 19.8 million, reflecting inequalities in access to vaccines worldwide.

Nearly 600,000 additional deaths could have been prevented if the World Health Organization’s (WHO) goal of vaccinating 40 percent of each country’s population by the end of 2021 had been met, it concluded.

“Millions of lives have probably been saved by making vaccines available to people around the world,” said lead study author Oliver Watson of Imperial College London.

“We could have done more,” he said.

Covid has officially killed more than 6.3 million people globally, according to the WHO.

But the organisation said last month the real number could be as high as 15 million when all direct and indirect causes are accounted for.

The figures are extremely sensitive due to how they reflect on the handling of the crisis by authorities around the world.

The virus is on the rise again in some places, including in Europe, which is seeing a warm-weather resurgence blamed in part on Omicron subvariants.

AFP

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WHO considers declaring monkeypox a global health emergency

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WHO considers declaring monkeypox a global health emergency

As the World Health Organization convenes its emergency committee Thursday to consider if the spiraling outbreak of monkeypox warrants being declared a global emergency, some experts say WHO’s decision to act only after the disease spilled into the West could entrench the grotesque inequities that arose between rich and poor countries during the coronavirus pandemic.

Declaring monkeypox to be a global emergency would mean the U.N. health agency considers the outbreak to be an “extraordinary event” and that the disease is at risk of spreading across even more borders. It would also give monkeypox the same distinction as the COVID-19 pandemic and the ongoing effort to eradicate polio.

Many scientists doubt any such declaration would help to curb the epidemic, since the developed countries recording the most recent cases are already moving quickly to shut it down.

Last week, WHO Director-General Tedros Adhanom Ghebreyesus described the recent monkeypox epidemic identified in more than 40 countries, mostly in Europe, as “unusual and concerning.” Monkeypox has sickened people for decades in central and west Africa, where one version of the disease kills up to 10% of people. In the epidemic beyond Africa so far, no deaths have been reported.

“If WHO was really worried about monkeypox spread, they could have convened their emergency committee years ago when it reemerged in Nigeria in 2017 and no one knew why we suddenly had hundreds of cases,” said Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory groups. “It is a bit curious that WHO only called their experts when the disease showed up in white countries,” he said.

Until last month, monkeypox had not caused sizeable outbreaks beyond Africa. Scientists haven’t found any major genetic changes in the virus and a leading adviser to WHO said last month the surge of cases in Europe was likely tied to sexual activity among gay and bisexual men at two raves in Spain and Belgium.

To date, the U.S. Centers for Disease Control and Prevention has confirmed more than 3,300 cases of monkeypox in 42 countries where the virus hasn’t been typically seen. More than 80% of cases are in Europe. Meanwhile, Africa has already seen more than 1,400 cases this year, including 62 deaths.

David Fidler, a senior fellow in global health at the Council on Foreign Relations, said WHO’s newfound attention to monkeypox amid its spread beyond Africa could inadvertently worsen the divide between rich and poor countries seen during COVID-19.

“There may be legitimate reasons why WHO only raised the alarm when monkeypox spread to rich countries, but to poor countries, that looks like a double standard,” Fidler said. He said the global community was still struggling to ensure the world’s poor were vaccinated against the coronavirus and that it was unclear if Africans even wanted monkeypox vaccines, given competing priorities like malaria and HIV.

“Unless African governments specifically ask for vaccines, it might be a bit patronizing to send them because it’s in the West’s interest to stop monkeypox from being exported,” Fidler said.

WHO has also proposed creating a vaccine-sharing mechanism to help affected countries, which could see doses go to rich countries like Britain, which has the biggest monkeypox outbreak beyond Africa — and recently widened its use of vaccines.

To date, the vast majority of cases in Europe have been in men who are gay or bisexual, or other men who have sex with men, but scientists warn anyone in close contact with an infected person or their clothing or bedsheets is at risk of infection, regardless of their sexual orientation. People with monkeypox often experience symptoms like fever, body aches and a rash; most recover within weeks without needing medical care.

Even if WHO announces monkeypox is a global emergency, it’s unclear what impact that might have.

In January 2020, WHO declared that COVID-19 was an international emergency. But few countries took notice until March, when the organization described it as a pandemic, weeks after many other authorities did so. WHO was later slammed for its multiple missteps throughout the pandemic, which some experts said might be prompting a quicker monkeypox response.

“After COVID, WHO does not want to be the last to declare monkeypox an emergency,” said Amanda Glassman, executive vice president at the Center for Global Development. “This may not rise to the level of a COVID-like emergency, but it is still a public health emergency that needs to be addressed.”

Salim Abdool Karim, an epidemiologist and vice chancellor at the University of KwaZulu-Natal in South Africa, said WHO and others should be doing more to stop monkeypox in Africa and elsewhere, but wasn’t convinced that a global emergency declaration would help.

“There is this misplaced idea that Africa is this poor, helpless continent, when in fact, we do know how to deal with epidemics,” said Abdool Karim. He said that stopping the outbreak ultimately depends on things like surveillance, isolating patients and public education.

“Maybe they need vaccines in Europe to stop monkeypox, but here, we have been able to control it with very simple measures,” he said.

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NMA urges NCDC to step up fight against Monkeypox

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NMA urges NCDC to step up fight against Monkeypox

The Nigerian Medical Association (NMA) has urged the Nigeria Centre for Disease Control (NCDC) to step-up its efforts in educating and protecting Nigerians from the increasing cases of the ravaging Monkeypox disease.

It stressed that the Agency, which is saddled with the responsibility of disease prevention and control, must not lose sight of other infectious diseases like monkeypox, even as it focuses on COVID-19.

The doctors’ association, while urging Nigerians to adhere strictly to the preventive measures of personal hygiene, especially hand hygiene because like monkeypox, COVID-19 is still very much in the country, and the situation can become worse if not handled properly, implored religious institutions – churches and mosques – to take up the responsibility of sensitising their followers about the disease.

Recall that yesterday the NCDC announced that the country has recorded 21 confirmed cases of the Monkeypox disease in the last five (5) months, with one death. Also, in the month of May, a total six (6) new confirmed positive cases were reported from four (4) states – Bayelsa (2), Adamawa (2), Lagos (1), and Rivers (1).

Globally, according to reports from the World Health Organization (WHO), as of 26 May, there have been a cumulative total of 257 laboratory confirmed cases, with around 120 suspected cases reported, from 23 non-endemic countries. However, no deaths have been reported.

Speaking with The Nation, the newly elected President of the NMA, Dr Uche Ojinmah, said: “We have the Nigeria Centre for Disease Control (NCDC) that has the responsibility of not just monitoring and controlling COVID-19, but every infectious disease. Therefore, they should step up to the plate. It is the business of the NCDC; they can link up with the Ministry of Information and get people aware.

“They need to start giving us data on this Monkeypox as it happens across the country. With the current awareness coming from a reputable government institution like that, people will sit up. We need to start directing our calls to the appropriate institution, which is the NCDC. We don’t expect President Muhammadu Buhari to give us information on this. Let the NCDC step up to the plate and do their job.

“The Nigeria Centre for Disease Control needs to understand that it is not only COVID-19; it is important. It is however necessary to be combined in the sensitisation of the people. The media also have a role to play in sensitisation. The government needs to bring the will, but we all in our little ways can contribute.

“We have a bit of a problem in this country; we initiate measures, achieve a positive response, and we drop our guards. In 2015 when Ebola came, we took it on as a nation, and we got rid of it, and everybody went back to their normal lives. COVID-19 has come and with us, if you check even in flights now, you force people to wear their masks. Nigerians, therefore, need to be serious and the government needs to play a role.

“Monkeypox is here now and everybody pretends they don’t know – until it becomes a problem. I also expected that the government, civil society, and non- governmental organisations should have started spreading the message by now. Our churches and mosques should take up this course now that it has not become a disaster.

“Doctors should also start to educate patients they see that do not have it. We need to start now to prepare the minds of our people; it may not be as bad as Ebola or COVID-19, but it is still a problem. So, the earlier we start preventive measures, the better we will be.”

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