How do Patient Safety Partners feel about their role? Analysis of online survey results

Summary

In this blog, Patient Safety Partners Anne Rouse and Chris Wardley and Patient Safety Learning’s Chief Executive, Helen Hughes, examine the results of a recent survey of Patient Safety Partners (PSPs). The results reveal significant variation in how the PSP role is being implemented in NHS organisations in England and highlight frustration, barriers and successes that people in the role are experiencing.

Content

The new role of Patient Safety Partner (PSP) was introduced in 2022 by NHS England as part of its Framework for involving patients in patient safety. Trusts across England must recruit at least one PSP—they can be patients, carers or members of the public who want to support and contribute to an organisation’s governance and management processes for patient safety.

Many Patient Safety Partners have joined the Patient Safety Management Network (PSMN) to connect with collegues in the patient safety community and other PSPs. In discussion, many felt that as well as enjoying the wider community, knowledge sharing and peer support, there would be value in creating a separate community of interest just for PSPs. Patient Safety Learning was very supportive of this idea, and in September 2023, we set up the Patient Safety Partners Network (PSPN).

The aim of the network is to bring together PSPs working in different organisations, some of whom have no local PSP networks or communities that they are invited to engage with. Recognising that PSPs often work alone in this new and evolving role, the network provides a supportive space to discuss the issues we face, share successes and discuss how we can use our collective voice to make a difference for patient safety. We meet once a month on MS Teams and all PSPs are welcome to join, whether they are PSPs in NHS organisations, Regional or National PSPs.

One theme that keeps recurring in our discussions is the fact that there is significant variation between trusts in how PSPs are employed, the hours they work and the areas they are involved in. We wanted to find out more, so with the help of the Patient Safety Learning team, we put together a short survey to find out more about some of these issues. 43 PSPs responded to the survey, nearly half of the current network, and the results give us some insight into how PSPs are employed, what they are doing in their role, and some of their challenges and frustrations.

What do the survey results tell us?

The results reflect the conversations we have had in our meetings and show that trusts are taking a wide range of approaches to employing and inducting PSPs. Respondents reported being involved in significantly varied areas of work—some attend board, PSIRF, quality and safety committee meetings while others input on specific patient safety incident learning reviews and investigations. Some reported not being asked for input in any of these areas, which is a frustration we have also heard expressed in the network meetings.

Contracts, pay and training

The survey found that 40% of survey respondents work for an Acute Trust, 16% for an Integrated Care System (ICS) and the rest for a Community and Mental Health Trust, NHS England, a Mental Health Trust or an Ambulance Service.

The results show that there is significant variation in whether and how PSPs are paid:

• 49% respondents were recruited as volunteers, 14% are paid contracted days per month by the trust, while 7% are on a zero-hours contract. The rest of the cohort was remunerated in a variety of ways, including receiving an honorarium, being a PAYE employee of the trust and being paid expenses only.
• 42% respondents said they work more hours than contracted and 16% work twice the number of hours they are contracted for.

The results also reveal that PSPs receive a varied range of induction and training across different organisations.

• 54% of respondents had received PSIRF training alongside staff.
• Only 42% received bespoke training for their role as a Patient Safety Partner, and it is slightly concerning that only just over half of PSPs had received a basic HR induction at their trust.

Areas of involvement

PSPs reported being involved in many different activities; some said they had been invited into high level governance meetings, while others were taking a more operational focus, looking at specific incidents of unsafe care or having input into patient and family communications. A relatively low percentage (33%) of PSPs said they had been involved in contributing to PSIRF plans and policies. 14% respondents said the only meetings that they had attended had been to discuss their role or performance.

Chris highlighted that some of the feedback PSPs said they have received about the impact of their work was very positive:

• 49% of respondents said that frontline staff have expressed enthusiasm about their role.
• 47% had received feedback from trust management that their role is having a positive impact on patient safety.

Challenges and frustrations

The survey also identified several barriers that PSPs perceive as preventing them from fulfilling their role effectively. 42% of respondents said they were unsure of the expectations for their role. This suggests a significant number of PSPs are trying to work without clarity on what they should or could be doing. Only 21% of PSPs said they perceived no barriers to them fulfilling their role. These findings were borne out in some of the free text comments at the end of the survey.

In Chris’s view, the most telling comment was "I don't feel confident at the moment that my role will make a difference to patients who access services." This summarises a major concern for many PSPs, that they currently feel unable to fulfil the core purpose of their role.

Linked to this, several respondents raised concerns about a lack of clarity in what PSPs should be doing and how the role of PSP should be viewed by the trust. One wrote, “We've seen what a lack of firm guidance looks like in some dysfunctional trusts.” However, some respondents noted that the flexibility in how the role is used could be helpful for trusts, allowing organisations to use PSPs in whichever way is most effective for their setting.

Some respondents expressed frustration that trusts were taking a long time to complete HR processes and induct PSPs into their role. Some reported not being given the equipment and information they needed to start work. One person commented, “My trust has not thought through the introduction of PSPs and is nowhere near ready to embrace the changes required to introduce new processes. What a missed opportunity!”

In turn, this has led to some PSPs feeling that their role is not seen as important or valuable by trust leaders. 37% said they were unsure if their views are being taken seriously or leading to action. Several respondents commented that they felt frustrated that their skills weren’t being used effectively, or that they did not have permission from the trust to engage in areas where they felt it would be helpful.

Other concerns highlighted included the need to be sensitive and ensure that existing patient representatives don’t feel undermined by the involvement of PSPs.

What next for the Patient Safety Partners Network?

The data from this survey gives us a clearer picture of the different ways in which PSPs are working around the country, and some of the challenges they face in fulfilling their role effectively. It highlights some key issues that we can look at as a network and gives us some data to demonstrate that PSPs need to be given the clarity and authority to represent and champion patients at every level of an organisation's approach to patient safety. PSPs have commented that the survey results will be helpful to them in their discussions within their organisations and will provide insights for the wider patient safety community too.

Would you like to join the Patient Safety Partners Network?

If you are a Patient Safety Partner and would like to join the network, you can join by signing up to the hub today. When putting in your details, please tick ‘Patient Safety Partners Network’ in the ‘Join a private group’ section. If you are already a member of the hub, please email support@PSLhub.org to apply to join the PSPN.

Related reading

• The voice of the patient safety frontline—An introduction to the Patient Safety Partners Network
• Patient Safety Partners - A workshop at Kingston Hospital