Developing the Patient Safety Partner role: Imperial College Healthcare NHS Trust share their approach

Summary

In this interview, we talk to Lea Tiernan, Patient Safety Engagement Manager at Imperial College Healthcare NHS Trust, about how they have developed and embedded the Patient Safety Partner role. Lea explains what they have done practically to support those starting out in the role and to integrate them at a strategic level. She shares her personal learning along the way and ends by offering advice to anyone else seeking to embed the Patient Safety Partner role within their organisation. 

Content

Can you tell us a bit about yourself?

My name is Lea Tiernan, and I have worked at Imperial College Healthcare NHS Trust since 2018. I am responsible for leading the development and implementation of our Trust’s strategy to involve patients in patient safety. I have a background in quality improvement (QI), which has been invaluable when designing this programme of work alongside our Patient Safety Partners, local community and staff.

How did you go about planning and preparing for the Patient Safety Partner role?

We have been fortunate that at the Trust our senior leadership were bought into the idea of the Patient Safety Partner role early on. They supported its implementation and created a Patient Safety Partner policy, prepared for an inclusive recruitment process and planned for a thorough induction once they came into post. Their induction included a pack providing key information, attendance at our corporate induction session, meeting key colleagues and codesigning an agreement for how we would work together.

Our senior leadership team quickly realised that we needed more resources to manage the Patient Safety Partners in a meaningful way and meet the ambitions of the framework to involve patients in patient safety. The Patient Safety Engagement Manager role was conceived, and I was recruited into the role in February 2023.

How did you approach the recruitment stage?

Our Trust Medical Director’s office was responsible for the recruitment process and were supported by the Recruitment Team. We set out with the aim of having a group of Patient Safety Partners that were as diverse as our community, so we knew we needed to actively promote and support applications from all parts of our local area. This meant that whilst we advertised the role through regular channels like our website and NHS jobs, we also worked with our internal Involvement Team to share more widely. This included promoting the role through:

• social media channels
• the Black and Minority Ethnic health forum
• charity volunteer contacts
• Nextdoor website
• local Healthwatch
• local authorities
• maternity voices group
• other community contacts.

Once we opened to applications, we continued to follow an inclusive recruitment approach to avoid limiting applications, for example offering informal discussions during the process.

Can you tell us about the Patient Safety Partners that you have in post?

We have five Patient Safety Partners, and their day-to-day lives all look very different. We have a mix of professionals working in accounting, community leadership and other patient partnership roles. We also have two Patient Safety Partners that are students, one in law and one in medicine.

Their skills and experience with the NHS are varied too. Some Patient Safety Partners have extensive experience as patients, and bring this to the role. Whereas others are focused on how they can make healthcare safer for their local community by looking at language and cultural barriers. Our Patient Safety Partners also represent a wide range of ethnic backgrounds and ages, which greatly adds to cognitive diversity, especially when carrying out group work. It means that we have a broad agenda, and our Patient Safety Partners are great at taking a strategic view to how we deliver our work.

A shared love of food has been a great way to bond as a group and when we meet in person, Patient Safety Partners bring their favourite snacks. When the Patient Safety Partners were still new to the Trust, I would often run ‘icebreakers’ in our meetings to learn more about them and help the group gel. At the start of one meeting, I noticed we all had a cup of tea or coffee – so we chatted about where our mugs had come from, and we were surprised that everyone had a tale to tell!

How have you made sure the Patient Safety Partners are strategically involved?

Some of the infrastructure for involving the Patient Safety Partners at a strategic level was already in place when we recruited them. At the Trust we have safety improvement leads, which each look after a portfolio of safety improvement projects. I work with the leads to understand their projects, whether they are ready for patient involvement, what they require of a Patient Safety Partner and how they would support them.

The national framework describes a ‘task profile’ which we found helpful to adopt. With the help of a Patient Safety Partner, I designed a request form for anyone interested in working with them. I manage the process, checking the request and partnering people with Patient Safety Partners based on their interest and capacity.

In tandem with their involvement in the safety improvement priorities, we recognise that there is more to be done to drive the ambitions of the framework forward. Early in their tenure, the Patient Safety Partners and I met fortnightly to design our initial strategy for involving patients in patient safety. We used the model for improvement to approach this, and after generating a driver diagram, we broke the work down into five workstreams. These include:

• Patient Safety Partner programme.
• Community engagement.
• Staff engagement and training.
• Learning response engagement.
• Equity and inclusion.

The Patient Safety Partners expressed an interest in the workstreams and we have at least two partnered with each. Whilst the Patient Safety Partners are involved in lots of work, we are reviewing this to ensure that their participation is meaningful and that they are empowered decision makers. We have recently set up a project team to drive forward improvements in this area.

How have you helped the Patient Safety Partners settle in?

When I first came into post, I ran a series of sessions to understand how the Patient Safety Partners wanted to work together. We settled on a monthly team meeting and 1:1s. We also drew up an agreement which serves as an agreement between the Patient Safety Partners and any project teams or committees they are working with.

When they are partnered with a project or committee, I attend any introductions and their first meeting to ensure their questions are answered and to raise their profile.

We have also recently initiated a network of Patient Safety Partners across the Acute Provider Collaborative in north-west London. Some of the Patient Safety Partners at other organisations are working alone, so this has helped them to feel more connected.

Have you started to see the impact of the Patient Safety Partner role?

One of the places we have seen Patient Safety Partner impact is within our work to engage with patients and families compassionately during learning responses. They co-designed a guide for patients and families and a set of steps for staff to follow. They referenced the PSIRF steps for this but made it more patient-centred. This is then linked to all the resources (eg interpreters) that staff might need to access to support patients and families involved.

More recently we have set up a project team to continue driving this work forward and two of our Patient Safety Partners are involved. They’ve already had a huge impact – challenging us to think about learning responses as less of a process and more of the right way to do things.

What’s next for the Patient Safety Partners?

We have a set of clear routines and ways of working with the Patient Safety Partners and we now need to get to the point where Patient Safety Partners are empowered decision makers, alongside the teams they are working with. To do this we have set up an improvement project and team, meeting fortnightly. We have explored the barriers to being involved meaningfully (eg contributions not being explicitly celebrated, being brought into a project too late, not receiving meeting papers far enough in advance). Most recently, we started generating ideas to address these problems and will be testing them out in the coming months.  

What have you personally learnt along the way?

Personal and professional development of the Patient Safety Partners has been more important than I thought it would be. They are all knowledgeable, skilled individuals, but have areas where they want to build their confidence. For example, one of our Patient Safety Partners has extensive experience with the healthcare system and is keen to tell her story to help others. I found a story-telling workshop for her to attend so she could hone this skill. Another of our Patient Safety Partners has an interest in communications, so we set up a half-day of shadowing with our Communications team. This has been a worthwhile activity and means they can bring even more to the role.

What advice would you give someone who is looking to embed the Patient Safety Partner role?

• Spend time on their personal and professional development. Building on the skills they already have means they feel valued and confident.
• Be flexible and try to make things work around their schedules. Patient Safety Partners often have other jobs, and this supplements their skills and knowledge, so it’s important we make their involvement easy.
• Explore a dedicated resource for managing the Patient Safety Partners. This has meant that we’ve done the basics well (eg regular meetings) but are now able to challenge ourselves to make their involvement even more meaningful.
• Get them involved early on and wherever you can. Even if they don’t have a lot to contribute straight away, they’ll get the context of the work, and it’ll make it easier for them in the long run.
• Remunerate your Patient Safety Partners. This will ensure the role is inclusive, attracting a diverse group of people and make it so that people can commit their time.  

If you'd like to hear more about our approach to developing the Patient Safety Partner role, please get in touch with Lea at [email protected].

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