Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the "engine room" of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges; staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5's, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

Challenges of a negative work load and implications on morale, productivity and quality of service delivered in NHS laboratories in England

The National Health Service (NHS) is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United Kingdom. There are several challenges militating against the effective laboratory service delivery in the NHS in England. Biomedical scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from patients. They provide the “engine room” of modern medicine with 70% of diagnosis based on the laboratory results generated by them. This review involved the search of literature for information on working condition of biomedical scientist in the NHS in England. Laboratory service delivery in the NHS in England faces numerous daunting challenges;staffing levels in the last few years have become dangerously low, less remunerated, relatively less experienced and predominantly band 5’s, multidisciplinary rather than specialty based, associated with working more unsocial hours without adequate recovery time, de-banding of staff, high staff turnaround, profit and cost driven rather than quality. These factors has resulted in burn out, low morale, high sickness absences, increased error rate, poor team spirit, diminished productivity and suboptimal laboratory service delivery. There is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix, ensuring adequate remuneration of laboratory staff, implementing evidenced-based specialty oriented service, determining the root cause/s for the high staff turnover and implementing corrective action, identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

SYSTEMATIC EVALUATION OF THE PHYSIOLOGICAL LOAD OF MOUNTAIN CLIMBING FROM THE RELATION BETWEEN INCLINATION OF WALKING PATH, WALKING SPEED, AND BACKPACK WEIGHT; SIMULATION USING WALKING ON A TREADMILL / 体力科学

We simulated mountain climbing using walking on a treadmill in order to systematically evaluate the physical load during mountain climbing. The conditions of three types of load-(1) inclination of the walking path (walking uphill and downhill), (2) walking speed, and (3) backpack weight-were varied within the range assumed for normal mountain climbing (40 sets of conditions in total). When the three types of load were expressed as vertical work rate, energy expenditure (VO₂) during walking uphill and downhill was distributed along roughly the same curve. The following characteristics of walking uphill and downhill were observed.A. Walking uphillFor all three types of load, increase in load gave a linear increase in VO₂ and heart rate (HR). A lactate threshold (LT) appeared at an intensity of 62%VO_2max, when HR was 78% HR_max. Rating of perceived exertion (RPE) was evaluated for the “Breathlessness” and “Leg Fatigue”, and both of these increased roughly in proportion to %VO_2max.B. Walking downhillWhen walking downhill, VO₂ was 35-50% the intensity of VO₂ when walking uphill on the same slope and at the same speed. Energy expenditure did not exceed 60%VO_2max in any of the load conditions, and no LT was seen. RPE values were higher for walking downhill than walking uphill, even when %VO_2max values were the same. RPE values for the “Leg Fatigue” tended to be higher than for the “Breathlessness” at the same speed in downhill walking.Using these data, we created a table giving the intensity of exercise of mountain climbing expressed as VO₂ per unit body mass and metabolic equivalents (Mets) with vertical migration velocity and total weight (Body weight + Backpack weight) as variables. This table gives mountain climbers a systematic understanding of the physical load under various mountain climbing conditions. It is likely to be of use as a reference for mountain climbers of different levels of physical fitness when practicing mountain climbing appropriate to their individual level. The present results suggest that in downhill walking, it is insufficient to express the physical load in energy expenditure (VO₂ and Mets) alone, and the load on the leg muscles must also be judged using the RPE in the “Leg Fatigue”.