Self-determining medical leadership needs of occupational health physicians

Purpose: Medical leadership is seen as crucial to the transformation of healthcare services, yet leadership programmes are often designed with a top-down and centrally-commissioned 'one-size-fits-all' approach. In the UK the Smith Review (2015) concluded that more decentralised and locally-designed leadership development programmes were needed to meet the healthcare challenges of the future. However, there is an absence of an evidence-base to inform the design of effective strategies to motivate doctors to take up leadership roles, while at the same time the development of clinical leadership roles is becoming an increasingly popular strategy in order to secure formal leadership roles for doctors in healthcare organisations. The problem is further compounded by a lack of validated leadership qualities assessment instruments which support researching this problem further. The purpose of this national study was to frame an inquiry of medical leadership self-assessment within Self Determination Theory (SDT) in order to identify the extent to which a group of Occupational Health physicians (OHP) were able to self-determine their leadership needs, accurately and reliably using a National Health Service (NHS) England competency approach promoted by the NHS England Leadership Academy as a self-assessment leadership diagnostic. Design/Methodology/approach: The analysis draws on a sample of about 25% of the total population size of the Faculty of Occupational Medicine (n=250). The questionnaire used was the Leadership Qualities Framework tool as a form of online self-assessment (NHS Leadership academy, 2012a). The data were analysed using descriptive statistics and simple inferential methods. Findings: OH Physician Consultants are open about reporting their leadership strengths and leadership development needs and recognise leadership learning as an ongoing development need regardless of their level of personal competence. This study found that the single most important factor to affect a doctor’s confidence in leadership is their experience in a management role. Management experience accounted for the usefulness of leadership training, suggesting that doctors learn best through applied 'leadership learning' as opposed to theory-driven programmes. Drawing on Self Determination Theory (SDT) this article provides a theoretical framework that helps to understand those doctors who are likely to engage in leadership and management activities in the organisation. More choice and self-determination of medical leadership programmes is likely to result in more relevant leadership learning that builds on doctors' previous experience in this area. Research Limitations and Implications: While this study benefitted from a large sample size, it was limited to the use of purely quantitative methods. Future studies would benefit from the application of a mixed methodology. Practical Implications: This study suggests that doctors are able to determine their own learning needs reliably and that they are more likely to increase their confidence in leadership and management if they are exposed to leadership and management experience. Originality Value: This is the first large scale study of this kind with a large sample within a single medical specialty. The study is considered as insider research as the first author is an Occupational Health Physician with knowledge of how to engage OH Physicians in this work

Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020.

Healthcare workers (HCW) are potentially at increased risk of infection with coronavirus disease (COVID-19) and may transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to vulnerable patients. We present results from staff testing at Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom. Between 16 and 29 March 2020, 1,533 symptomatic HCW were tested, of whom 282 (18%) were positive for SARS-CoV-2. Testing HCW is a crucial strategy to optimise staffing levels during this outbreak

Deprivation and Early Involuntary Retirement: Area-Level Analysis across English Local Authorities

AbstractIntroductionRetirement is a major transition point in life. Falling economic support ratios in many countries have led to a rise in the state retirement age and impending changes to eligibility for state and occupational benefit schemes such as pensions as Governments seek to curb expenditure. Permanently incapacitated individuals from work may face increasing challenges in accessing financial support. Such difficulties may impact those most deprived differentially with potentially significant consequences for morbidity and mortality. Few studies thus far have examined early retirement from a societal perspective. This study explores involuntary retirement in this regard.MethodsA retrospective analysis of the association between deprivation with IHR success rates for Local Authorities (LA) in England between 2015-18 was conducted. Deprivation status was assigned according to the proportion of Lower-Layer Super Output Areas in the most deprived 10% nationally using data from the National Statistics SocioEconomic Classification 2015. Freedom of Information Requests were sent to all 326 LAs in England to obtain data on successful IHR applications, number of active members of respective pensions schemes and numbers of applications.Results131 LAs provided complete data for IHR applications, numbers of approved applications and eligible members. Several others provided data on application numbers but not those awarded. he national IHR approval rate was 2.16 per 1000 members, with a range of 0.16 to 8.96. There was a trend towards a greater proportion of approved application per 1000 eligible members in more affluent LAs.ConclusionThe results from this brief analysis suggest that there is an association between increasing rates of ill-health retirement and higher area-level deprivation. Policy should note that those in more deprived areas face a quadruple whammy; a greater risk of becoming incapacitated from public health and occupational exposures, more limited access to medical support, less opportunities for alternative work and potentially disproportionate disadvantage from stringent pension eligibility criteria.</jats:sec

Surveillance and return to work of healthcare workers following SARS-CoV-2 Omicron variant infection, Sheffield, England, 17 January to 7 February 2022

The SARS-CoV-2 Omicron variant has challenged demands to minimise workplace transmission in healthcare settings while maintaining adequate staffing. Policymakers have shortened COVID-19 isolation periods, although little real-world data have evaluated the utility. Our findings from surveillance of 240 healthcare workers from Sheffield Teaching Hospitals, England, show that 55% of affected staff could return before day 10 of isolation with over 25% eligible on day 6, pending two successive negative antigen tests. This outcome is favourable for continuity of healthcare services.</jats:p

Lived experience and the social model of disability: conflicted and inter-dependent ambitions for employment of people with a learning disability and their family carers

1.1 Background Only 5.9% of working adults with a learning disability are in paid employment and their family-carers are similarly likely to be unemployed, as they continue to take on an extended caring and advocacy role as the welfare state retreats. Despite social policy efforts to stimulate employment for people with a learning disability, there has been little or no progress. Changes in the language of welfare benefit departments seek to use the words once heralded as success for the Disability rights activists and proponents of the social model: such as Inclusion, independence and citizenship. A new definition of the social model of disability utilising Hannah Arendt needs to redefine the “private” sphere of the lived experience of people with a learning disability to allow for a better understanding of the inter-dependencies that exist between people with a learning disability, their family carers and a wider support network. 1.2 Materials and Methods Empirical data were collected in a mixed methods study while undertaking a consultation on the future of day services for people with a learning disability in a Local Authority in the north of England, UK. 1.3 Results The results reveal high levels of inter-dependence between people with a learning disability and their carers, combined with the continued financial struggle as a lived experience of caring. The study found that barriers in providing care and support restrict the rights of people with a learning disability and their carers to secure employment. 1.4 Conclusions There is a need to reconceptualise the social model of disability to more closely resonate with the lived experiences of people with a learning disability and their carers. A newly revised theoretical approach should incorporate the "private" sphere of live acknowledging the inter-dependent, co-produced relationships, between people with a learning disability and their carers to support and enable employment for both people with a learning disability and their carers under the Care Act 2014 (Department of Health, 2014)

Approximating geometric bottleneck shortest paths

AbstractIn a geometric bottleneck shortest path problem, we are given a set S of n points in the plane, and want to answer queries of the following type: given two points p and q of S and a real number L, compute (or approximate) a shortest path between p and q in the subgraph of the complete graph on S consisting of all edges whose lengths are less than or equal to L. We present efficient algorithms for answering several query problems of this type. Our solutions are based on Euclidean minimum spanning trees, spanners, and the Delaunay triangulation. A result of independent interest is the following. For any two points p and q of S, there is a path between p and q in the Delaunay triangulation, whose length is less than or equal to 2π/(3cos(π/6)) times the Euclidean distance |pq| between p and q, and all of whose edges have length at most |pq|