Workforce and patient safety: temporary staff - integration into healthcare providers — HSSIB — HSSIB Investigation

Summary

1 recommendation 2 observations 8 learning prompts 1 of 1 responded

Safety Recommendations

1 total

R/2024/036 National Guardian's Office

HSSIB recommends that the National Guardian’s Office, working with relevant stakeholders, identify the barriers that prevent temporary staff from speaking up and develops mechanisms to address those barriers. This will build on their work to explore barriers for other staff groups and enable all workers to contribute to patient safety improvements without fear of reprisal.

The National Guardian’s Office committed to identify barriers for temporary staff speaking up and develop addressing mechanisms in 2025/26, subject to funding. HSSIB was subsequently notified that all actions have been completed.

Response received 5 November 2024

We will implement HSSIB’s safety recommendation that the National Guardian’s Office will work with stakeholders to identify the barriers that prevent temporary staff from speaking up and develop mechanisms to address those barriers. This builds upon our work exploring the barriers to speaking up to improve workplace cultures so that all workers – no matter what their contract terms – are confident to speak up. Given the critical role which temporary workers play in the NHS, it is vital that we ensure that they feel confident to speak up about patient safety and not fear they will lose future opportunities to work in that organisation. Temporary workers can offer valuable insights into practices and quality of care. Freedom to Speak Up guardians are available to all workers – this includes temporary, agency and bank staff. I echo HSSIB’s recommendation for local level learning and for leaders to ask themselves: How do you ensure that temporary staff know how to speak up and that they feel safe to raise concerns? We are planning on taking this action forward in 2025/26, subject to funding. Response received on 5 November 2024. -------------------------------------------------- May 2026: HSSIB has been notified by the National Guardian’s Office that all actions have been completed.

Safety Observations

2 total

Observation 1 Observation National bodies can support patient safety by developing credentialing systems which enable staff to verify their competencies when moving between NHS organisations.

Observation 2 Observation Organisations that provide temporary staff to the NHS can improve patient safety by including information about the NHS England Learn from Patient Safety Events service to temporary staff as part of their onboarding process. This is to enable temporary staff to record patient safety risks if they do not have access to a healthcare provider’s reporting system.

Learning Prompts

8 total

Prompt 1 Learning prompt How do you enable temporary workers to feed back on their experiences of working in your organisation, to understand the organisational culture in relation to this group?

Prompt 2 Learning prompt How do you ensure that temporary staff know how to speak up and that they feel safe to raise concerns?

Prompt 3 Learning prompt How do you ensure that you are clearly advertising the skills required of a temporary worker to fill a rota gap?

Prompt 4 Learning prompt How do you ensure that the skills and experience of temporary workers are taken into account when redeployments are being considered?

Prompt 5 Learning prompt How do you work with providers of temporary staff to understand the skills and experience of temporary workers so they can be used most effectively?

Prompt 6 Learning prompt How do you ensure that temporary workers can access electronic systems and physical environments that are vital to providing safe care?

Prompt 7 Learning prompt How do you ensure that inductions are carried out and that the time needed to complete local inductions is factored into the workload of staff?

Prompt 8 Learning prompt Do you have a dedicated and accountable professional lead for ensuring that local inductions are carried out?