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[email protected] · Thu Dec 14 2023

reword: I hope you are both well, our current dual workforce Lead across the workforce efficiencies programme has asked if the people partners have some specific information (below tables) that they could share for their inpatient wards, this information will form part of conversations with senior clinical managers around their agency usage. I have attached a template for one unit to show you the format of the data we will be producing to the inpatient unit, if this information is something your people partners could provide across their inpatient units, that would be fantastic.

I trust you are both doing well. Our current dual workforce Lead for the workforce programme has inquired whether the people partners have specific information, detailed in the tables below, that they could share regarding their inpatient wards. This data will contribute to discussions with senior clinical managers regarding their agency usage. I have included a for one unit to illustrate the format of the data we will be presenting to the inpatient unit. If your people partners are able to provide this information across their inpatient units, it would be greatly appreciated.

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england.nhs.uk

Guidance to support the commissioning and delivery of timely access to high quality therapeutic inpatient care, close to home and in the least restrictive setting possible. Summary In 2019, the NHS Long Term Plan was published, together with the NHS Mental Health Implementation Plan, which set out ambitious, funded plans, to transform mental health services. Shortly after this, the COVID-19 pandemic began, which had a major impact across the health system, including mental health services. As a result of pandemic pressures and the increases in cost of living currently facing households, inpatient mental health services have experienced sustained rises in demand and acuity, which have been particularly challenging due to the current workforce pressures across the NHS. While adult and older adult acute inpatient mental health teams continue to work hard to deliver high quality care in line with the commitments set out in the NHS Long Term Plan and NHS Mental Health Implementation Plan, feedback from those who work in and access these services indicates that while some people have positive experiences, others can experience issues accessing care that truly meets their needs and supports their recovery. This can include delays to accessing inpatient care and to being discharged, people being placed out of area where it can be challenging for friends and family to visit and disproportionate use of restrictive interventions. Furthermore, issues with the quality of care disproportionately affect certain groups of people, including people from ethnic minorities, people who have a learning disability, and autistic people. It is vital that every person who needs acute inpatient mental health care receives timely access to high quality, therapeutic inpatient care, close to home and in the least restrictive setting possible.To support this, NHS England has produced this guidance to set out its vision for effective care in adult and older adult acute inpatient mental health services, togetherwith resources and suggestions to support delivery. In this vision: Care is personalised to peoples individual needs, and mental health professionals work in partnership with people to provide choices about their care and treatment, and to reach shared decisions. Admissions are timely and purposeful When a person requires care and treatment that can only be provided in a mental health inpatient setting and cannot be provided in the community, they receive prompt access to the best hospital provision available for their needs, which is close to home, so that they can maintain their support networks and community links. The purpose of the admission is clear to the person, their carers, the inpatient team and any supporting services. Hospital stays are therapeutic People receive timely access to the assessments, interventions and treatments that they need, so that their time in hospital delivers therapeutic benefit. Care should be delivered in a therapeutic environment and in a way that is trauma-informed, working with people to understand any traumatic experiences they have had, and how these can be supported in hospital, in a way that minimises retraumatisation. Discharge is timely and effective People are discharged to a less restrictive setting as soon as their purpose of admission is met and they no longer require care and treatment that can only be provided in hospital. For this to happen, there needs to be discharge planning from the very start of a persons admission. There also needs to be a range of community support available and supported living options which meet different needs and enable people to maintain their wellbeing and live as independently as possible after discharge. Care is joined up across the health and care system inpatient services work in a cohesive way with partner organisations, at admission, during a persons inpatient stay and to support an effective discharge, so that people are supported to stay well when they leave

england.nhs.uk

Access to health records This section looks at your right to see your health records and how to do this. It explains what to do if you think the information on your health records is wrong. In this section, when we say record or records, we mean your health record. This section is for people who live with mental illness and their carers. If you would like more advice or information you can contact our Advice and Information Service by clicking here. Overview My records Why & How Accessibility Other people Incorrect information & complaints Useful Contacts Overview When an NHS professional sees you, they will update your record with information about your illness and treatment. Records are kept in different places. If you have seen mental health services, your record is kept there. Your GP wont have the information. You can see your records. But your doctor can withhold information if it may harm your physical or mental health. You should be able to see a copy of your record within 1 month. Other people, such as an employer or insurer, can only see your records if you agree. If you feel something on your records is wrong, you cant usually delete it. You can ask your doctor to add a note to show that you disagree. You should be able to see your records online if you sign up for Patient Online. You can have a summary care record which gives the NHS important information about your health. This helps them to deal with emergencies. You dont have to have one if you dont want to. Need more advice? If you need more advice or information you can contact our Advice and Information Service. My records What are my records? When you see a health professional, they will update your health records with information about your condition and treatment. These records may be on a computer or handwritten. Your records have information about things like your: diagnosis, reports, letters, and test results. Health records in mental health teams may have information about your care plan and time spent in hospital. The NHS keeps detailed records locally so the person in charge of your treatment can see it. This means your GP surgery will hold records of your GP visits. Your mental health team will keep records of your contact and appointments with them. Local NHS services must have a data protection officer. This is a professional who is responsible for processing all the data they record. Your GP records and mental health team records arent kept together. But specialist services and your GP may share some important information about your care. This may include: referral letters, your diagnosis, reports, and results. Summary Care Records When you are treated outside your GP surgery, healthcare professionals cant access your GP records. They may be able to see a summary care record instead. This holds important information about your health. Your GP will automatically start a summary care record. The record will have information about: your medication, your allergies, any bad reactions to medications you have tried, and your name, address, date of birth and NHS number. For example, in an emergency doctors could look at the record to see if you are allergic to any medications. This can help them treat you properly. Professionals can put additional information on your summary care record, unless you tell them not to. This additional information can include: significant medical history reasons for medication information about the management of long-term conditions end of life care information immunisations. Specific sensitive information wont be automatically included when additional information is added. This includes things like fertility treatments, sexually transmitted infections, pregnancy terminations and gender reassignment. Health professionals must ask you before looking at your record. But if you are unconscious or cant give consent, they can look at your record without your permission. If they do this, they must make a note on your record to ex

rethink.org

what is another word for a reasonable request

A synonym for a reasonable request is a "reasonable demand" or an "appropriate petition."

reasonable request collocation in English meanings of reasonable and request reasonableadjectiveuk Your browser doesn't support HTML5 audio /ri.zn..bl/us Your browser doesn't support HTML5 audio /ri.zn..bl/ based on or using good judgment and therefore fair ... requestnounuk Your browser doesn't support HTML5 audio /rkwest/us Your browser doesn't support HTML5 audio /rkwest/ the act of politely or officially asking ... Examples of reasonable request These examples are from corpora and from sources on the web. Any opinions in the examples do not represent the opinion of the Cambridge Dictionary editors or of Cambridge University Press or its licensors. As we are looking to the future and pursuing legislation, we cannot, unfortunately, find time for all debateseven when there is a reasonable request. It seems to me a very reasonable request. It will only cost 30,000, and since they have increased their output by over 30,000 tons a year, surely it is a reasonable request to make. This is a reasonable request, which we need to meet at the earliest opportunity. This surely is a reasonable request when one bears in mind the rising unemployment figures in my constituency. I cannot think of a more reasonable request. I thought it was a reasonable request that they made. This seems to me to be a perfectly reasonable request. That seems to me to be a perfectly reasonable request. I think that is a very reasonable request. I think that that is a very reasonable request. It is a fair and reasonable request from these villagers that 30 mph should be the limit. That seemed to be a logical and reasonable request on the face of it. It was in my view a reasonable request to which a reasonable authority would have responded positively. Could he define who decides what is a reasonable request? That would have been a very reasonable request in the circumstances. It is a reasonable request and a modest amendment. We have the further complication that any reasonable request might well be interpreted by a court as including the fact that it is economical. It might well be said that you cannot have a reasonable request if you are asking for something which is wholly uneconomic. We think that that is a reasonable request. These examples are from corpora and from sources on the web. Any opinions in the examples do not represent the opinion of the Cambridge Dictionary editors or of Cambridge University Press or its licensors.

dictionary.cambridge.org

adjective as in moderate, tolerableadjective as in intelligent, practicalDiscover MoreExample SentencesPay attention to whats happening and make reasonable adjustments based on your personal experience.After years of hearings, and by my unofficial count, five short-term vacation rental proposals, we finally have an opportunity to pass reasonable regulations that deliver 90 percent of what both sides are looking for.She doesnt recall whether her payments or interest rate dropped as a result but said she found the $130 bimonthly payments on her most recent $6,000 loan reasonable.It feels to me that a reasonable person looking at the situation will say the thing has only gotten worse.Both will fit groceries from a reasonable Costco run or one to two human passengers, not including the pilot.Again, the reasoning sounds, well, reasonable, and is sourced to a respectable organization, the Samaritans.The advisor would cite reasonable-sounding sources like haltabuse.org and the FBI.Expectations, reasonable or unrealistic, remain so even if we impose them on ourselves.Going at a reasonable clip, my husband and I travel the trails and side roads near our house.But these must be proven under a signed and sworn statement and judged reasonable by the DOH.That it is a reasonable and proper thing to ask our statesmen and politicians: what is going to happen to the world?Few people, I think, realize that, and fewer still realize the reasonable consequences of that.It is something which takes side in the child's breast with the reasonable governor and the laws which he or she administers.The charges in general are quite reasonable, though I have paid one or two absurd bills.But these were to him things so obvious that he could not conceive any reasonable person doubting them.On this page you'll find 238 synonyms, antonyms, and words related to reasonable, such as: acceptable, cheap, equitable, fair, feasible, and honest.From Roget's 21st Century Thesaurus, Third Edition Copyright 2013 by the Philip Lief Group.

thesaurus.com

1 as in to survey to go around and approach (people) with a request for opinions or information solicited several opinions about which job he should accept 2 as in to seek to make a request for always ready to solicit donations for a charity 3 as in to ask to make a request of solicited him to join the team 4 as in to beg to make a request to (someone) in an earnest or urgent manner solicit the President for relief funds 5 as in to tempt to lead away from a usual or proper course by offering some pleasure or advantage how many men have been solicited into purchasing bogus aids for "male enhancement" by shameless appeals to their vanity? Synonym Chooser How is the word solicit distinct from other similar verbs? The words ask and request are common synonyms of solicit. While all three words mean "to seek to obtain by making one's wants known," solicit suggests a calling attention to one's wants or desires by public announcement or advertisement. a letter soliciting information When is ask a more appropriate choice than solicit? The words ask and solicit can be used in similar contexts, but ask implies no more than the statement of the desire. Where would request be a reasonable alternative to solicit? The words request and solicit are synonyms, but do differ in nuance. Specifically, request implies greater formality and courtesy. requests the pleasure of your company Thesaurus Entries Near solicit Cite this Entry Solicit. Merriam-Webster.com Thesaurus, Merriam-Webster, https://www.merriam-webster.com/thesaurus/solicit. Accessed 14 Dec. 2023. Share More from Merriam-Webster on solicit Subscribe to America's largest dictionary and get thousands more definitions and advanced searchad free! Merriam-Webster unabridged

merriam-webster.com

what is another work for appropiate

Some synonyms for "appropriate" are suitable, proper, fitting, apt, relevant, connected, pertinent, apposite, applicable, deserved, fitting, relevant, and congruous.

2 days ago Related Words acceptable allowed applicable appropriate concedable fair fitting just justifiable lawful legal legitimate...Which word is most appropriate synonym?What is a better word for appropriately?What is a word for better than appropriate?What are the word forms of appropriate?Synonyms for APPROPRIATE: suitable, proper, fitting, fit, fitted, good, applicable, right; Antonyms of APPROPRIATE: inappropriate, improper, unsuitable,...appropriate 1 (verb) in the sense of seize. Synonyms. seize commandeer confiscate. impound. take possession of. usurp 2 (verb) in the sense of steal.6 Dec 2023 Antonyms and examples. unsuitable. The venue is unsuitable - far too small for our needs. inappropriate. That sort of language is inappropriate...advisable appropriate apt commendable desirable expedient fit fitting judicious politic prudent seemly sensible sound suggested...On this page you'll find 49 synonyms, antonyms, and words related to most appropriate, such as: relevant, useful, convenient, applicable, apt, and fitting.What is another word for appropriate? ; favorable favourable ; auspicious propitious ; opportune felicitous ; well judged seemly ; befitting becoming.antonyms for appropriate evil improper inappropriate incorrect inopportune irrelevant misbehaving unfitting unreal unskilled unsuitable...On this page you'll find 34 synonyms, antonyms, and words related to more appropriate, such as: exceptional, improved, superior, choice, exceeding, and fitter.1, befitting, apt, felicitous, suited, proper, due, becoming, pertinent; meet ; 3, apportion, allocate, assign...

google.com

what does pertinent mean

Pertinent means having a clear and decisive relevance to the matter at hand. It implies a strong connection and applicability, suggesting that the information or topic in question is directly and significantly related to the current situation or discussion.

: having a clear decisive relevance to the matter in hand Synonyms Choose the Right Synonym for pertinent found material relevant to her case germane may additionally imply a fitness for or appropriateness to the situation or occasion. a point not germane to the discussion material implies so close a relationship that it cannot be dispensed with without serious alteration of the case. facts material to the investigation pertinent stresses a clear and decisive relevance. apposite suggests a felicitous relevance. add an apposite quotation to the definition applicable suggests the fitness of bringing a general rule or principle to bear upon a particular case. the rule is not applicable in this case apropos suggests being both relevant and opportune. Examples of pertinent in a Sentence At the dawn of the common-law court system, jurors took their places as residents of the neighborhood where the pertinent events had occurred, who were assumed to possess special knowledge of the facts and, more important, of every witness's credibility. Hiller B. Zobel, American Heritage, July/August 1995 A more pertinent question than "What am I?" is "How can I be who I am and still hack it in America?" C. Eric Lincoln, Lure and Loathing, 1993 But as my moment of fame ticks by, a more pertinent issue persists: What hath CNN wrought in the worlds of communications, of diplomacy, of politics? Peter Arnett, Washington Post, 25-31 Mar. 1991 No recurrent symbolism in the Odyssey is more pertinent than the long and deliberate stripping its hero undergoes: of his ships, of his men, of his hopes, of his clothes, even of his very skin on the cliffs of Corfu. John Fowles, Island, 1978 he impressed the jury with his concise, pertinent answers to the attorney's questions Recent Examples on the Web Finding answers to these questions has fallen mainly to HR teams, who are grappling with how to upskill employees, what skills will be most relevant, and pertinent AI use cases for their business. Trey Williams, Fortune, 2 Nov. 2023 This is especially pertinent amongst Black women who are often held to harsher standards regarding the appearance of their hair. Tayler Adigun, Essence, 31 Oct. 2023 The study revealed that one of the most pertinent needs in the sheriff's office is funding for 38 new positions. Paige Eichkorn, Arkansas Online, 4 Sep. 2023 Anyone with pertinent information on the missing persons including knowing the person to be safe or any additional information that may help locate them is encouraged to call the FBI at 808-566-4300. Timothy Nerozzi, Fox News, 26 Aug. 2023 These are pertinent questions to consider in this particular space, since J. Pierpont Morgans fortune built the mansion the museum occupies. Teresa Nowakowski, Smithsonian Magazine, 20 Nov. 2023 The brief did not break out the performance of students who received subsidies to take A.P. exams, arguably the most pertinent group for policymakers. Dana Goldstein, New York Times, 18 Nov. 2023 But the first question is pertinent to what is emerging as a sort of billionaires cancel campaign against the Ivy League universities and other institutions that have enjoyed their patronage for about as long as America has had billionaires. Michael Hiltzik, Los Angeles Times, 18 Oct. 2023 The lighting is the most pertinent thing to be updated. Cynthia Howell, Arkansas Online, 7 Nov. 2023 See More These examples are programmatically compiled from various online sources to illustrate current usage of the word 'pertinent.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples. Word History Etymology Middle English, from Anglo-French, from Latin pertinent-, pertinens, present participle of pertinre see pertain First Known Use 14th century, in the meaning defined above Time Traveler The first known use of pertinent was in the 14th century Dictionary Entries Near pertinent Cite this Entry Pertinent. Merriam-Webster.com Dic

merriam-webster.com

pertinentadjectivepertaining or relating directly and significantly to the matter at hand; relevant: pertinent details.Origin of pertinent1First recorded in 13501400; Middle English, from Latin pertinent- (stem of pertinns ), present participle of pertinre to be applicable, pertain; see pertain, -entsynonym study For pertinentOther words for pertinentOpposites for pertinentOther words from pertinentpertinence [pur-tn-uhns], /pr tn ns/, pertinency [pur-tn-uhn-see], /pr tn n si/, nounpertinently, adverbnonpertinent, adjectivenonpertinently, adverbunpertinent, adjectiveunpertinently, adverbWords Nearby pertinentperthitePerthshirepertinaciouspertinacitypertinencepertinentperturbperturbateperturbationperturbation theoryperturbativeDictionary.com Unabridged Based on the Random House Unabridged Dictionary, Random House, Inc. 2023How to use pertinent in a sentenceHosts can enter takeout orders in the app, along with pertinent information such as whether the order was submitted online or over the phone, and the type of car to facilitate curbside pickup.She also suggested the revelations arent pertinent because they came before she ran for Congress.As children, I think things can be around you, but you really just retain the information that feels pertinent or important to you.They usually also display a pertinent image alongside or above the text.The histories of slavery and racism in the United States have never been more pertinent.Usually Mom would doze off at this point, opening an eye to catch only what she found pertinent.Cesar Chavez touches on a lot of issues that are still pertinent today, like labor unions, nonviolent protest, etc.The Dalai Lama regaled the crowd with stories, not all pertinent to the subject at hand.And there is, by pure chance, a very pertinent and current comparison to be made between two Boeing models, the 787 and the 777.Your novel spans 150 years, but given the drawdown in Afghanistan it feels particularly pertinent to the present day.Barrington's perceptions seemed to grow clearer, and he asked a few pertinent questions before he nodded approbation.I gave my mother the lower berth, and then the question became pertinent how was I to scramble into the upper one.But the case of Terrett v. Taylor, before cited, is of all others most pertinent to the present argument.I wave, as not pertinent in this place, all that could be said in qualification of the alleged excellence of paternal government.Such extravagance of expression and relaxation of official tone has no pertinent cause, and is at least noteworthy.British Dictionary definitions for pertinentadjectiverelating to the matter at hand; relevantOrigin of pertinent1C14: from Latin pertinns, from pertinre to pertainDerived forms of pertinentpertinence, nounpertinently, adverbCollins English Dictionary - Complete & Unabridged 2012 Digital Edition William Collins Sons & Co. Ltd. 1979, 1986 HarperCollins Publishers 1998, 2000, 2003, 2005, 2006, 2007, 2009, 2012

dictionary.com

pertinent (ptnnt ) adjective Something that is pertinent is relevant to a particular subject. [formal] She had asked some pertinent questions. Pertinent information will be forwarded to the appropriate party. ...knowledge and skills pertinent to classroom teaching. [+ to] pertinently graded adverb [ADVERB with verb, ADVERB with cl] 'If we pay players, how far do we go?' Gresson asked pertinently. Where had they learned all this, or, more pertinently, why had they remembered it? pertinence uncountable noun I do not see the pertinence of most of this material. Collins COBUILD Advanced Learners Dictionary. Copyright HarperCollins Publishers Video: pronunciation of pertinent British English pronunciation American English pronunciation pertinent in British English (ptnnt ) Collins English Dictionary. Copyright HarperCollins Publishers Derived formspertinence (pertinence) or pertinency (pertinency)noun pertinently (pertinently)adverb Word originC14: from Latin pertinns, from pertinre to pertain pertinent in American English (prtnnt ) adjective having some connection with the matter at hand; relevant; to the point SIMILAR WORDS: relevant Websters New World College Dictionary, 4th Edition. Copyright 2010 by Houghton Mifflin Harcourt. All rights reserved. Derived forms pertinently (pertinently)adverb Word originME < MFr < L pertinens, prp. of pertinere: see pertain pertinent in American English (prtnnt) adjective pertaining or relating directly and significantly to the matter at hand; relevant pertinent details SYNONYMS appropriate, fitting, fit, suitable, applicable. See apt.ANTONYMS irrelevant.Most material 2005, 1997, 1991 by Penguin Random House LLC. Modified entries 2019 by Penguin Random House LLC and HarperCollins Publishers Ltd Derived formspertinence or pertinencynoun Word origin [13501400; ME L pertinent- (s. of pertinns), prp. of pertinre to pertain; see -ent] Examples of 'pertinent' in a sentence pertinent These examples have been automatically selected and may contain sensitive content that does not reflect the opinions or policies of Collins, or its parent company HarperCollins. He was one of the most pertinent and poetic artists of this age.All of which begs a few pertinent questions.But surely it has rarely been so pertinent as now.Maybe more pertinent to the age you wish to attain is where you are born.The picture has an apocalyptic air that seems uncomfortably pertinent.This is particularly pertinent when it comes to credit cards.There are just a few more pertinent points.They are particularly pertinent in the company which has undergone a period of rapid growth.Then came the manipulation that is pertinent to the point being made here.But his most pertinent point was that this was no excuse for inaction. COBUILD Collocations pertinent

collinsdictionary.com

does this sentence make sense: ACS and RCH currently have a supernumerary period of 2 weeks for new starters and therefore it would be a pertinent to align mental health international nurses to this process.

Yes, the sentence makes sense. It indicates that ACS and RCH currently have a supernumerary period of 2 for new starters and suggests that aligning mental health international nurses to this process would be relevant and.

2 days ago Related Words acceptable allowed applicable appropriate concedable fair fitting just justifiable lawful legal legitimate...Which word is most appropriate synonym?What is a better word for appropriately?What is a word for better than appropriate?What are the word forms of appropriate?Synonyms for APPROPRIATE: suitable, proper, fitting, fit, fitted, good, applicable, right; Antonyms of APPROPRIATE: inappropriate, improper, unsuitable,...appropriate 1 (verb) in the sense of seize. Synonyms. seize commandeer confiscate. impound. take possession of. usurp 2 (verb) in the sense of steal.6 Dec 2023 Antonyms and examples. unsuitable. The venue is unsuitable - far too small for our needs. inappropriate. That sort of language is inappropriate...advisable appropriate apt commendable desirable expedient fit fitting judicious politic prudent seemly sensible sound suggested...On this page you'll find 49 synonyms, antonyms, and words related to most appropriate, such as: relevant, useful, convenient, applicable, apt, and fitting.What is another word for appropriate? ; favorable favourable ; auspicious propitious ; opportune felicitous ; well judged seemly ; befitting becoming.antonyms for appropriate evil improper inappropriate incorrect inopportune irrelevant misbehaving unfitting unreal unskilled unsuitable...On this page you'll find 34 synonyms, antonyms, and words related to more appropriate, such as: exceptional, improved, superior, choice, exceeding, and fitter.1, befitting, apt, felicitous, suited, proper, due, becoming, pertinent; meet ; 3, apportion, allocate, assign...

google.com

recommendations for using international nurses into HCA numbers

Based on the provided information, integrating international nurses into HCA (Health Care Assistant) numbers involves a code of practice for recruiting internationally for health and social care organizations in England. This code aims to ensure ethical and responsible recruitment practices. The code also addresses concerns regarding fairness and consistency in employment contracts, escalation routes for concerns about exploitative practices or breaches of the code, and the application of the code to different international recruitment models.

To effectively integrate international nurses into HCA numbers, consider the following recommendations:

Ethical Recruitment: Ensure that the recruitment of international nurses aligns with the principles of ethical recruitment as outlined in the code of practice. This includes avoiding active recruitment from countries facing severe health and care workforce-related challenges unless there is a government-to-government agreement to support managed recruitment activities.
Collaboration and Bilateral Work: Engage in effective bilateral work and partnership with the governments of countries from which international nurses are being recruited. This can involve establishing memorandums of understanding to support well-managed migration pathways that benefit both the recruiting organization and the sending country.
Fair Employment Contracts: Strengthen best practice benchmarks to ensure fairness and consistency in employment contracts for international nurses. This includes setting out principles on the use of repayment clauses in employment contracts and addressing concerns related to exploitative recruitment or employment practices.
Clarity and Transparency: Provide clarity on how the code of practice applies to different international recruitment models. This can involve a knowledge test for recruiting organizations applying to recruit international nurses.
Regular Updates and Compliance: Commit to regularly updating the code of practice to address emerging concerns and ensure compliance with the established principles and benchmarks.

By following these recommendations and aligning the integration of international nurses into HCA numbers with the code of practice, organizations can promote ethical and responsible recruitment practices while effectively addressing the healthcare workforce needs.

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radar.brookes.ac.uk

Foreword We are pleased to introduce the revised code of practice for recruiting internationally for health and social care organisations in England. With a projected global shortage of 10 million health workers to achieve universal health coverage in low and lower-middle income countries by 2030, we remain committed to be a force for good in the world, and support better health and care both within and beyond our shores. We recognise the important role that international health and care workers play in health and care service delivery in the UK and we are committed to ensuring that we recruit from overseas in an ethically responsible manner. Heath and social care organisations in England do not actively recruit from those countries the World Health Organization (WHO) recognise as having the most pressing health and care workforce-related challenges unless there is government to government agreement to support managed recruitment activities. Through effective bilateral work - such as our memorandums of understanding with the governments of India, Kenya, Malaysia, Nepal, the Philippines and Sri Lanka - we are working in partnership to support well managed migration pathways that deliver benefits to the NHS, the health or care professionals, and the sending country. We are committed to regularly updating the code. In this edition, you will see that we have responded to concerns that have arisen over the last year, including: strengthening the best practice benchmarks to ensure fairness and consistency in employment contracts, and set out principles on the use of repayment clauses in employment contracts setting out the routes of escalation for concerns about exploitative recruitment or employment practices and breaches of the code providing more clarity on how the code applies to different international recruitment models introducing a knowledge test for recruiting organisations applying to be on the ethical recruiters list expanding the scenario examples In actively addressing emerging issues of concern we aim to maintain the highest ethical standards in all international recruitment activity undertaken in the UK. Maria Caulfield MP, Minister of State for Health, Department of Health and Social Care Amanda Milling MP, Minister of State (Minister for Asia and the Middle East), Foreign Commonwealth and Development Office Definitions Active international recruitment Active international recruitment in the code is defined as the process by which UK health and social care employers (including local authorities), contracting bodies, recruitment organisations, agencies, collaborations and sub-contractors target individuals to market UK employment opportunities, with the intention of recruiting to a role in the UK health or social care sector. It includes both physical or virtual targeting, and whether or not these actions lead to substantive employment. This can include (but is not limited to): advertising to candidates through any medium incentivisation activities such as referral bonus schemes referring candidates to specific vacancies in the UK in return for a fee from the employing organisation - it is illegal under section 6(1) of the Employment Agencies Act 1973 for recruitment organisations of any type to charge fees to the individual applicant for job-finding services The only exception to this definition is where a candidate has already been appointed by a UK employer following an independent direct application and selection without the support of a recruitment organisation, agency or collaboration (defined below). In this case, if required, these organisations can support and facilitate the employees passage to the UK. In such cases, it is the responsibility of the recruitment organisation, agency or collaboration, if challenged, to provide evidence that the services they are providing are permitted under this exception. Direct application For the purpose of this code of practice, a direct application is when an individual

gov.uk

Nurses and midwives who wish to work in the UK but trained overseas must gain professional registration with the Nursing and Midwifery Council (NMC). Applicants are tested for competence through a two-part process to gain registration: the Test of Competence (ToC). Part one - computer-based test (CBT) multiple-choice examination which is accessible around the world for applicants to access in their home countries. Part two - practical objective structured clinical examination (OSCE), held in the UK in one of the five test centres. To pass the ToC and join the register, applicants will also have to pass an English language exam. The tests can be taken in any order. The objective structured clinical examination (OSCE) The OSCE is based on UK pre-registration standards. Candidates are required to act out scenarios that nurses or midwives are likely to encounter when assessing, planning, delivering and evaluating care. An individual entering the UK to take a nursing role has up to three months (12 weeks) from the employment start date noted on the certificate of sponsorship to sit their first attempt at an OSCE exam. During this period they can be legally employed as a pre-registration candidate. Applicants must complete the OSCE in the UK at an approved test centre. What is involved in the OSCE? The OSCE (as part of the new ToC) is made up of ten stations separated into four skills-based, four stations designed to test the candidates knowledge and understanding of assessment, planning, implementation and evaluation of care (APIE), and two silent skills. TheNHS constitutional valuesand the 6Cs of nursing are assessed throughout the OSCE at all stations. Information on how to book a test can be found on the NMC website. Applicants review all course/module information to ensure they sit the correct exam, an overview of modules are available. If an incorrect CBT has been sat, applicants will be required to re-sit and pass the correct CBT. The Nursing and Midwifery Council (NMC) has launched awebsite hubwhich contains all the information candidates, recruiters and employers prepare for the new ToC.The hub includes: candidate handbooks test specifications blueprints practice tests for the new CBTs an OSCE prep resource pack. Approved OSCE test centres There are five approved OSCE test centres, providing a choice ofsix locations to sit the OSCE. Please visit the links below for more information: University of Northampton Oxford Brookes University(Oxford campus and Swindon campus) Ulster University(Northern Ireland) Leeds Teaching University Hospitals NHS Trust Northumbria University. OSCE bookings and capacity We are aware that capacity remains limited at OSCE test centres, so in order to release test centre capacity across the system, the NMC is asking that trusts: be flexible around dates for booking tests and book the first availability. If this is outside of the 12-week period from arrival, speak with your NHS England IR lead look to all test centres when booking book tests in advance (iewhen the CoS has been issued or the flights have been booked, well before candidates begin their training), but avoid overbooking block tests and keep track of what has been booked dont cancel bookings at existing test centres to rebook at new ones confirm candidate details with test centres at least eight weeks before the test; these include the candidates name, personal registration number, application type, and confirmation of which exam they will be sitting, especially if booking tests before candidates arrive take time to ensure candidates who have failed their first attempt are fully ready to re-sit the test of competence. OSCE preparation To ensure candidates have adequate time to prepare for the OSCE, they are given up to 12 weeks from the start date on their certificate of sponsorship (CoS) to complete the first attempt of their exam. In the run-up to the exam, candidates should be given support and the opportunity to practice and prepare f

nhsemployers.org

summarise: International Nurse academic time and working time. Introduction Using agency comes at a high cost and can present drawbacks to our NHS, staffing inconsistencies do not make our current staff feel valued and therefore it would be beneficial to utilise our current resources within our international nurse’s cohort which can lead to cost savings by reducing the need for agency and providing a more sustainable workforce.

Opening information Utilising International Nurses to work 1 x HCA LD/Night shift per week or 4 shifts per roster period:

Benefits: 1: Cost savings; utilising international nurses can lead to cost savings by avoiding using agency 2: Continuity of care; international nurses are already familiar with their wards and can provide continuity of care. 3: Enhanced team cohesion; having international nurses cover shifts can contribute to better team cohesion, ensuring a feeling of inclusion. 4: Skill development; this allows additional clinical experience and exposure to a wider range of patient care, fostering their professional development 5: Cultural Diversity; this will contribute to cultural diversity, which can enhance the overall patient experience and promote a more inclusive working environment. 6: Recruitment and Retention; involving international nurses can contribute to their professional development, retention and overall engagement within the organisations, contributing to a more stable and committed workforce.

These benefits will support the overall goal of reliance on HCA agency staff while optimising the use of internal resources within our organisations.

Current position To determine the feasibility of deploying international nurses across the organisations during their training and mentoring time, it was appropriate to consult with the relevant practice educators & clinical managers to review the specifics of the training programme and ensure that all necessary permissions and guidelines are followed to maintain the quality of patient care and the professional development of International Nurses.

RCH: International Nurses across RCH attend OSCE skills training at the knowledge spa for part of their contracted hours, around their OSCE skills course, mock exam time, study time and OSCE exam international nurses are assigned to shifts as a Band 4 or lower based on their skill levels until they have completed their OSCE exam and receive their PIN. There are current inconsistencies across the inpatient wards with allocation of working times. Considerations: Ward managers would like the discretion to retain international nurses as supernumerary if they deem it necessary to provide additional support to staff.

CFT: Mental Health; International nurses join Mental Health wards after they have completed their OSCE exam but work in supernumerary capacity for 3-6 months due to skills and experience within this speciality. Considerations: ACS and RCH currently have a supernumerary period of 2 weeks for new starters and therefore it would be a pertinent to align mental health international nurses to this process. Ward managers would like the discretion to retain international nurses as supernumerary if they deem it necessary to provide additional support to staff.

ACS; International nurses across ACS attend OSCE skills training either at Cardew House or on their base unit. While International Nurses at times may occasionally contribute to the staffing numbers, there is no official process governing this agreement. Considerations: Ward managers would like the discretion to retain international nurses as supernumerary if they deem it necessary to provide additional support to staff.

Current numbers of International Nurses as of the 1st December 2023 Number of International Nurses booked for OSCE exam as of the 1st December 2023 RCH 67 21 arriving on the 4/12/23 29 (end of January 2024) ACS 52 16 (end of January 2024) Mental Health 60

Options / considerations

International Nurses may need a longer period of supernumerary at managers discretion if they require additional support.

International nurses working in RCH Theatres, A&E and ITU require blood tests before they can undertake working shifts and therefore will be required to be supernumerary for a longer period.

Conclusion The utilisation of international nurses into clinical numbers as AP’s/HCA’s whilst they are undergoing OSCE skills training depends on various factors but is mainly based on their skills and experience around specific duties and responsibilities involved in their training.

Recommendations 1 x HCA Long Day/Night shift per week with flexibility for managers/roster creators to assign 4 shifts per roster period.

Set up processes and cascade information to Practice Educators, HON’s/HIP’s, Ward Managers/deputies and eRoster teams.

Set up drop-in team sessions to offer support.

Appendix 1; outlines the process for rostering International Nurses.

The document addresses the potential benefits and considerations of utilizing international nurses within NHS to curtail the dependence on agency staff and promote a sustainable workforce. It emphasizes the cost savings, continuity of care, team cohesion, skill development, cultural diversity, and recruitment and retention benefits of integrating international nurses into clinical positions. Additionally it discusses the current positions of international nurses at RCH, CFT, and ACS, including their training, allocated working times, and the discretion of ward managers to retain them as supernumerary if necessary. The current numbers of international nurses and their bookings for the OSCE exam are also provided. Considerations include the need for longer supernumerary periods for certain international nurses, such as those in RCH Theatres, A&E, and ITU, depending on their specific requirements. The conclusion highlights that the utilization of international nurses into clinical numbers is primarily based on their skills and experience. Recommendations proposing 1 x HCA Long Day/Night shift per week flexibility for managers/roster creators to assign 4 shifts per roster period, setting up processes, cascading information, and offering support through drop-in team sessions.

Appendix 1 outlines the process for rostering international nurses.

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hee.nhs.uk

Journal List Lippincott Williams & Wilkins Open Access PMC4196798 Med Care. 2014 Nov; 52(11): 975981. The Association With Perceived Quality of Care and Patient SafetyPeter Griffiths, RN, PhD,* Chiara DallOra, MSc,* Michael Simon, RN, PhD, Jane Ball, RN, MSc, Rikard Lindqvist, RN, PhD, Anne-Marie Rafferty, RN, DPhil, Lisette Schoonhoven, RN, PhD, Carol Tishelman, RN, PhD, and Linda H. Aiken, RN, PhD#, For the RN4CAST ConsortiumAbstractBackground:Despite concerns as to whether nurses can perform reliably and effectively when working longer shifts, a pattern of two 12- to 13-hour shifts per day is becoming common in many hospitals to reduce shift to shift handovers, staffing overlap, and hence costs.Objectives:To describe shift patterns of European nurses and investigate whether shift length and working beyond contracted hours (overtime) is associated with nurse-reported care quality, safety, and care left undone.Methods:Cross-sectional survey of 31,627 registered nurses in general medical/surgical units within 488 hospitals across 12 European countries.Results:A total of 50% of nurses worked shifts of 8 hours, but 15% worked 12 hours. Typical shift length varied between countries and within some countries. Nurses working for 12 hours were more likely to report poor or failing patient safety [odds ratio (OR)=1.41; 95% confidence interval (CI), 1.131.76], poor/fair quality of care (OR=1.30; 95% CI, 1.101.53), and more care activities left undone (RR=1.13; 95% CI, 1.091.16). Working overtime was also associated with reports of poor or failing patient safety (OR=1.67; 95% CI, 1.511.86), poor/fair quality of care (OR=1.32; 95% CI, 1.231.42), and more care left undone (RR=1.29; 95% CI, 1.271.31).Conclusions:European registered nurses working shifts of 12 hours and those working overtime report lower quality and safety and more care left undone. Policies to adopt a 12-hour nursing shift pattern should proceed with caution. Use of overtime working to mitigate staffing shortages or increase flexibility may also incur additional risk to quality.Key Words: shift work, quality, safety, nurses, workforce, efficiency, EuropeBACKGROUNDTraditionally, shift work was organized by dividing the day into three 8-hour shifts. This pattern was the norm in nursing for many years. In common with other industries, there is now a trend for some health care employers to adopt longer shifts, typically 2 shifts per day each lasting 1213 hours. Employees work fewer shifts each week.1 Changes are driven by perceived efficiencies for the employer, and improved work life balance for employees because they work fewer days per week.13 However, persistent concerns have been raised about negative impacts on the quality of care associated with working longer hours.From an employers perspective, a move from 3 to 2 shifts per day reduces periods of shift overlap and the number of handovers, thus reducing costs by reducing total workforce requirements.4 Because handovers and overlaps between shifts are regarded as unproductive, the aim is to improve efficiency with no detrimental effect on quality. Indeed a reduced number of handovers might have beneficial effects as handovers are associated with discontinuity and errors.5,6 From an employee perspective, there are reports that many nurses prefer the compressed working week that results from working fewer shifts.710Nonetheless, the introduction of 12-hour shifts has raised concerns. Long working hours are correlated with fatigue and decreased levels of alertness, potentially resulting in more adverse events.11,12 However, the point at which longer shifts adversely affect performance is likely to be industry, context, and task specific,1 and studies in health care have given mixed results.13 A recent study based on a survey of 22,275 registered nurses (RN) in 4 US states found that nurses who worked shifts of 12 hours were significantly more likely to report poor quality of care and poor patient safety when compared wit

ncbi.nlm.nih.gov

Working time and breaks You are here: Royal College of Nursing / Get Help / Advice Guides / Working time and breaks Overview The Working Time Regulations 1998 and Working Time Regulations (NI) 2016 ("the regulations") govern the number of hours an employee can work per week as well asthe rest breaks the employee is entitled to; this includes breaks between shifts, annual leave and days off. The key aim of the regulations is to ensure standards of health and safety in the workplace. The regulations apply to most workers. 'Workers' is a wider category than employees (employees work under a contract of employment) so the regulations will apply to most agency workers. There are certain exceptions to the application of the regulations,for exampleactive membership of the armed forces. This area is complex and if you are in dispute with your employer over whether the regulations apply to you, please contact usfor advice. If your employer is planning on changing your shift patterns, you can also read our guidance, changes to your shifts. RCN Nursing Workforce Standards The RCN Nursing Workforce Standardsaredesigned to support a safe and effective nursing workforce alongside each nations legislation. They include guidance on workforce planning and rostering, as well as staff health, safety and wellbeing. If you have concerns If you have concerns about your working time speak to your line manager in the first instance. This may also include working under unsustainable pressures meaning that you cannot take your breaks or annual leave. You can raise your concerns in writing, following our raising concerns guidance. If your concerns are not addressed, please contact us. What is working time? Gov.ukdefine working time as including: job-related training time spent travelling for workers who have to travel as part of their job, for example, travelling sales reps time spent travelling between home and work at the beginning or end of your working day (if you do not have a fixed work base or you are asked to work from somewhere other than your normal base) paid and unpaid overtime where it has been requested time spent on call at the workplace, and any other time that is treated as working time under a contract. The following are generallynotregarded as working time: breaks when no work is done normal travel to and from fixed or habitual workplaces time on call away from the workplace evening and day-release classes not related to work travelling outside of normal working hours unpaid overtime a worker has volunteered for, such as staying late to finish something off paid or unpaid holiday. Check your contract and your employer's policies if you are unsure about what is treated as working time in your workplace. The ACAS guidance on working hours may also be useful. The 48 hour weekly limit You cannot be forced to work over 48 hours a week over a standard reference period of 17 weeks. Hours are normally averaged over this reference period by taking actual hours worked divided by the number of weeks. If the reference period includes any 'excluded' days, then the hours worked in the equivalent number of days following the reference period must be included. 'Excluded' days include paid annual leave, sick leave and maternity leave. You can opt out of the 48 hour weekly limit if you agree this with your employer in writing. The decision to opt-out is an individual and voluntary one, and you should not be under any pressure to take that option. Any agreement made could relate to a specified period or may apply indefinitely ensure this is clear in the agreement itself. If you make the agreement and then wish to end it, you must give written notice to your employer. Unless agreed otherwise, you will need to give a minimum of 7 days notice to your employer in writing. The maximum notice should not exceed three months. Breaks, daily rest and weekly rest Rest breaks during a shift You are entitled to a minimum break of 20 minutes when your daily working

rcn.org.uk