2020: Encouraging staff to speak up (Patient Safety Learning)

Summary

So far in our 2020 overview series, we’ve heard an introduction to how the year has gone from our Chief Executive Helen Hughes, and looked at the impact of the COVID-19 pandemic on patient safety, as well as the work we’ve done in the areas of Long COVID and painful hysteroscopies. In our penultimate blog of the series, we turn our attention to the work we’ve done in staff safety.

Content

As an additional option to the text below, you might like to watch the following short video from Claire Cox, Patient Safety Learning's Associate Director of Patient Safety, and Clive Flashman, Chief Digital Officer.

Making the case for staff safety and its impact on patient safety

COVID-19 has resulted in unprecedented levels of focus on the issue of staff safety in health and social care, showing the important role it has in keeping patients safe. The pandemic has exposed risks to staff physical and mental wellbeing, with inadequate Personal Protective Equipment, intensely difficult physical and psychological working conditions, and inadequate infection control, which tragically has resulted in deaths from exposure to the virus.

At Patient Safety Learning, we believe that staff safety is intrinsically linked to patient safety. To improve the safety of patients, we need to ensure that staff are safe, both physically and psychologically.

Psychological safety involves providing the conditions where staff feel able to speak up about patient safety risks and mistakes, moving away from a culture that seeks to simply assign blame when things go wrong. Blame culture incentivises people to cover up mistakes, rather than reporting them, and often singles out individuals rather than tackling the systemic causes of errors.

Health and social care needs to move towards a just culture approach – one of Patient Safety Learning’s six foundations of safe care – a working culture that fosters learning and where all staff feel able to raise concerns.

Working directly with staff to understand the issues they face

Through conversations we have had with staff – both via our patient safety platform, the hub, and directly with them – it is clear to see that a just culture does not exist widely across the health and care system, and that many staff generally do not feel able to speak up about risks to patient safety. For example:

• New members of the hub are often not willing to publicly disclose their organisation or role.
• People are hesitant to comment on articles or in Community discussions on the hub at the risk of identifying themselves. This leads to lots of viewing activity but less sharing of experiences and interaction than we would like.
• Members of the hub from NHS organisations are not willing to share information that might be sensitive or controversial. Staff express their fear that they will be ‘found out’ and do not have permission to share good practice.

Encouraging staff to speak up

We have taken various measures this year to raise awareness about the importance of staff safety and its impact on patient safety.

On the hub, we’ve worked with members to enable them to post their stories anonymously. We are continuously developing and improving the hub, based on user feedback and the trends we are seeing. Some of these future updates will include allowing members to anonymously post comments on articles and in Community discussions, and creating private areas for NHS organisations to share and collaborate in safety.

Raising awareness about the importance of staff safety

Staff safety was the theme for this year’s World Patient Safety Day (17 September 2020). We interviewed staff from across the health and care system, sharing their unique insights and experiences on the hub. By doing so, we were able to highlight the key issues in staff safety, draw on common themes, share and promote good practice, and gain a clearer idea of the kind of change that is needed to keep staff, and ultimately patients, safe.

Also in September, we held a small, interactive workshop-style event, exclusively for staff. Within two hours of promoting the event to members of the hub, places to the event were fully booked. We worked with Gill Phillips, creator of the innovative Whose Shoes© model, which the workshop was based on. The intimate, highly participative event gave staff the chance to talk openly about their personal experiences around key issues in staff safety and how they impact patient safety. On World Patient Safety Day, we shared a glimpse into the event for all to see the main points of discussion and the learning that came out of it.

During September, on our social media channels, we asked the public to share with us the three things they thought were most needed for staff to be safe. We gathered these responses, identified the most common themes and shared our learning on the hub.

Looking ahead to 2021

We will continue to work with staff, both directly and via the hub, giving them a platform so they can raise their concerns or perceived risks to staff and patient safety. We will also continue to share their stories with the public more widely. We will use what we learn to engage with leaders in health and care so that staff, and therefore patients, are kept safe from harm.