Patient Safety Partners - A workshop at Kingston Hospital

Summary

Melanie Whitfield, Associate Director of Patient Safety at Kingston NHS Foundation Trust, and Helen Hughes, Chief Executive of Patient Safety Learning, recently ran a workshop for Patient Safety Partners (PSPs) at the Kingston Trust. Here is a summary of the workshop.

Content

PSPs are vital in bridging the gap between healthcare providers in the UK and the patients who use these services. They are the patient’s voice and enable us, as providers, to ensure we are putting our patients first, challenging us when things go wrong and asking the difficult questions. But what is their role and why are they so important?

In July 2019, the NHS Patient Safety Strategy was released with a framework for PSP involvement in healthcare organisational safety. This relates to the role that patients, carers and other lay people can play in supporting and contributing to a healthcare organisations’ governance and management processes for enhancing and improving patient safety. This is a voluntary role with the official allocated time given to PSPs to complete their work at Kingston being 1.5 days per month. The role for PSP’s was outlined as follows:

• Membership of safety and quality committees whose responsibilities include the review and analysis of safety data.
• Involvement in patient safety improvement projects.
• Working with organisation boards to consider how to improve safety.
• Involvement in staff patient safety training.
• Participation of investigation oversight groups.

We know that the opportunity and benefit of PSPs is so much more than this. So Melanie and Helen developed the idea of a workshop for PSPs, the patient safety team, the staff wellbeing chaplain and PEPI lead to share experiences of the first year of PSPs, to learn from each other from this experience, celebrate achievements and impact, and to discuss opportunities to promote listening and learning from patients to shape the future journey. Helen facilitated the workshop and the discussions and outcomes of this are outlined below.

The session started with what do we want from PSPs. Reflections included:

• Take us out of our comfort zone; challenge us on our actions and evidence and ‘bring us back to reality’ of what it’s like to be a patient or family member.
• Help us look at systems and culture and for PSPs to ask difficult/challenging questions – ‘lift the rocks and see what’s underneath’.
• Remind us that following up when things go wrong isn’t just about incident reviews and report writing, there are patients involved.
• Help us close the gap between patients and staff and build the interaction between patients, staff and patient and staff safety. Bridging the gap between patients and clinicians responsible for them.
• Leadership and insight by doing together.
• Patient safety improvement and prevention by providing information to patients sooner.
• Improving communication by being more visible.
• Raising PSP profile for staff and patients.
• Access to networks within the community.
• Real time listening rather than delayed Duty of Candour.
• Usefulness of speaking up and the consequences of not wanting to.

Everyone agreed this is a huge and challenging agenda but it’s what’s needed. There was huge energy in the room and motivation to work collaboratively to address these issues.

During the workshop

Three of the PSPs were then asked for an insight into their role, what they want to achieve from the role and what barriers they face. This was a rich session with much insight, including these issues highlighted by PSP colleagues:

• We’re all passionate about patient’s voice being heard; what can we do to help the NHS and give back. There’s a real desire to fix things and it make better and to implement ideas that can be easily rolled out.
• It’s still an evolving role – by the time we’ve got the skills and knowledge to do a good job our time in the role may be at an end, so we need to create longevity in the role, including succession planning. There are huge amounts of learning to be done.
• Opportunity to be more effective by being project based and utilising volunteers.
• Feeling really welcomed and accepted; feeling lucky to be a part of the team.
• The value of PSPs being outside ‘experts’ who may have access to other networks, e.g. in voluntary sector, children’s services
• How do we best use PSP individual experience and knowledge?
• Awareness of staff pressures.
• There’s a huge opportunity for PSPs but do we have sufficient numbers and time? Opportunity to demonstrate value and create the business case for more resourcing.
• Meetings are often fast paced meetings with no time to ask questions; if decisions are already made, what’s the value that PSPs can bring? And it’s a real struggle to understand NHS terminology and jargon.
• There is a need for improved visibility of PSPs, with staff and patients; comms and engagement strategies needed. Demonstrate the credibility of the role.
• Difficulties of families having their voice heard. How can patients be signposted, what are the communication pathways?

“I’ve attended meetings where Trust colleagues didn’t understand who we were or what our role entailed. We need clear guidance on our job description and need better visibility to Trust colleagues, so they know who we are. I would love for us to be involved in policy writing and attend formative discussions on major transformation project with high impact on patient safety.” Michelle Deans – Hounslow and Richmond Community Healthcare.

“Patients need to have their voices heard; therefore, a clear communication pathway is essential. The language used by clinicians in incident reports is far too complex for the average reader to understand and often implies negative connotations. We need to be fully visible for both staff and patients, but we only have so much time.” Sue Strudwick – Kingston Hospital Foundation Trust.

“I’ve struggled with understanding NHS terminology having had no clinical or NHS experience in my life. The meetings we are asked to attend can often be fast paced with no time to ask questions. I would love this role to be more project based utilising hospital volunteers.” Chloe Scott – Hounslow and Richmond Community Healthcare.

As you can see, the PSPs have challenges within their roles which is no doubt reflected across the country. The workshop provided an opportunity for the PSPs and staff to come up with ways to work together to improve patient safety. Everyone agreed the biggest opportunities would come from visibility, education and direct engagement with patients. Here are some of the ideas that came up:

• Use of social media channels to publicise the role of the PSP at the Trust, including visibility on our internet and intranet page.
• Frontline patient engagement, including ward walkabouts, pop-up desks and drop-in sessions.
• PSPs to hold us to account when things have gone wrong ensuring constructive follow up on action plans and improvements.
• Spreading the word through patient stories and experiences.
• PSPs to have regular interaction/involvement with quality improvement to influence what projects are completed and how the patients are involved.
• Collaborative/cross organisational working.
• More thinking is needed on how we recruit PSPs that reflect the diversity of the community we serve.
• Involvement in the new Patient Safety Incident Response Framework (PSIRF) and patient safety incident investigations (PSIIs).

It is important we highlight to the staff and patients that patients and families need to be able to speak to the right people in real time. We don’t want something to go wrong and then people pick up on it afterwards; we want to encourage staff and patients to speak up when they have questions that need answering and to be able to be listened to when they recognise that something is about to go wrong.

We know we can’t stop things from going wrong, but prevention and learning from incidents is well within our control. With the help of our PSPs and educating patients and staff, we can make the necessary improvements to ensure our patient’s safety is always our priority.

We hope that by sharing this blog with colleagues in the NHS in England, others can learn from the ambition, excitement and opportunity at Kingston for the PSP role. As we develop, we’re keen to share our journey and collaborate with colleagues, through the newly established Patient Safety Partnership Network and with Dr Henrietta Hughes, the Patient Safety Commissioner.