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News Article
Teaching trust reviewing decisions made under Letby CEO
Patient Safety Learning posted a news article in News
A trust which hired the former chief executive of the Countess of Chester Hospital as an interim CEO has launched a review of decisions about safety and whistleblowing taken under his leadership. Jacqui Smith, chair-in-common at Barts Health and Barking, Havering and Redbridge University Hospitals trusts, made the announcement at a board meeting, following the nurse Lucy Letby’s conviction for murdering seven babies, and attempting to murder six more, during a year-long period between June 2015 and June 2016. Tony Chambers was Countess of Chester Hospital Foundation Trust CEO for six years from December 2012 to September 2018, and resigned shortly after Letby’s initial arrest. His role – and that of fellow senior managers in Chester – in responding to concerns raised by doctors, has come under intense scrutiny since the verdicts. Mr Chambers served as BHRUT’s interim chief from January 2020 until August 2021, and Ms Smith told BHRUT’s board: “In the light of concerns, particularly around listening to staff and patients, and given the seriousness of the events, we will undertake a look at the periods of Tony Chambers’ tenure. “To see whether there are, firstly, any significant decisions taken regarding quality and safety that we need to look at again, and [secondly], checking our log of whistleblowing cases and other concerns to make sure that they have been appropriately followed up." Read full story Source: HSJ, 8 September 2023 -
News Article
Medical regulator faces questions over board members’ links to drug firms
Patient Safety Learning posted a news article in News
The UK medicines watchdog has been urged to strengthen its conflict of interest policy after it emerged that six of its board members are receiving payments from the pharmaceutical industry. Board members involved in overseeing the regulator’s “strategic direction” also have financial interests in companies including US and Saudi drug giants and firms with ambitions to break into the UK’s healthcare market. Some offer consultancy services while others help run or own shares in drug and medical device firms, according to official transparency records. There is no suggestion of wrongdoing, but the findings have led to concerns about perceived conflicts of interest among senior figures at the Medicines and Healthcare products Regulatory Agency (MHRA), an executive agency of the Department of Health and Social Care responsible for regulating drugs and medical devices and ensuring they are safe. The MHRA said that “in order to be an effective regulator” it needed to “bring together the right expertise from across industry, academia, the public and beyond”, adding that board meetings are held in public and non-executive board members – to whom the potential conflicts relate – are not involved in “any work or decisions relating to the regulation of any products”. But critics raised concerns about the potential for bias – or the perception of it – and called for stricter rules on conflicts of interest for those working in pharmaceutical regulation. Read full story Source: The Guardian, 17 April 2022 -
News Article
Trust board backs medical director who wrongly dismissed whistleblower
Patient Safety Learning posted a news article in News
A trust board has backed the medical director who oversaw the dismissal of a whistleblower in a case linked to patient deaths. Portsmouth Hospitals University Trust told HSJ John Knighton had the full support of the organisation when asked if he faced any censure over the wrongful dismissal of a consultant who raised the alarm about a surgical technique. Jasna Macanovic last month won her employment tribunal against the trust with the judge calling its conduct “very one-sided, reflecting a determination to remove [her] as the source of the problem”. The judgment found that the disciplinary process Dr Knighton oversaw was “a foregone conclusion” and as such had broken employment rules. The nephrologist was twice offered the opportunity to resign with a good reference, once during her disciplinary hearing and again on the day the outcome of that hearing was delivered. The trust told HSJ nothing in the judgment suggested Dr Knighton should face any action about his conduct and none had been taken. It said there were no reasons to doubt his credibility or probity. The trust did not respond when asked if any apology had been offered to Dr Macanovic. A spokesperson said: “We are committed to supporting colleagues raising concerns, so they are treated fairly with compassion and respect.” Read full story (paywalled) Source: HSJ, 13 April 2022 -
News Article
Chair who was ‘not always honest’ in old job gets NHSE’s ‘full support’
Patient Safety Learning posted a news article in News
An integrated care board chair is keeping her job despite complaints being upheld against her in a previous role, it has emerged. Danielle Oum left her position as Birmingham and Solihull Mental Health Foundation Trust chair last October. It later emerged that an independent investigation carried out the month before her departure, the results of which were leaked to HSJ, had upheld several complaints against her and found she did not always act with “honesty, truthfulness and clarity”. She was appointed to the ICB position in October 2021, four months before the complaints were made against her by an individual at the trust. But NHS England now says it has reviewed the matter and concluded that it “continue[s] to offer Danielle our full support in her role as chair of Coventry and Warwickshire ICB”. Following the independent investigation, which upheld 16 complaints against Ms Oum in total, NHSE carried out its own review of the issues. NHSE said its review involved a “rigorous fact-finding process” and it was grateful to those who raised “freedom to speak up” concerns. It said in a statement: “A thorough review has taken place at regional and national level, and the committee responsible for adjudicating these issues has delivered what we believe is a fair decision." Read full story (paywalled) Source: HSJ, 31 August 2023 -
News Article
‘Warts and all’ references for NHS leaders ‘may be attacked’
Patient-Safety-Learning posted a news article in News
NHS England could have gone further to insist that errors and failures by senior NHS leaders are disclosed to future employers, according to the leading barrister who reviewed the NHS’s fit and proper person test (FPPT). Tom Kark KC’s review of the FPPT was delivered to government five years ago and made public the following year, and changes were finally proposed by NHSE earlier this month. In an interview with HSJ, Mr Kark said he broadly welcomed the plans, and that the revised framework should provide greater consistency across NHS boards “if applied correctly”; and could “strengthen the hand” of chairs and chief executives. Part of the purpose of the regime is to prevent senior managers and other board members who make big errors in one role, from keeping this secret from a future employer. Mr Kark told HSJ he had heard evidence that when “someone leaves under a cloud, they pop up somewhere else, and the information is lost.” Read full story (paywalled) Source: HSJ, 16 August 2023 -
News Article
Directors to be judged on their ability to create ‘compassionate’ cultures
Patient Safety Learning posted a news article in News
NHS England has announced the first details of its ‘Leadership Competency Framework’, and revealed it will be launched this September. The LCF will underpin the annual appraisal of NHS board directors and, in turn, adherence to the revamped Fit and Proper Person Test. NHSE also revealed that leaders, including senior clinicians, who hold “significant roles” but are not board members may be subject to the FPPT in the near future. The new FPPT framework said the LCF would contain “six competency domains which should be incorporated into all senior leader job descriptions and recruitment processes”. Read full story Source: HSJ, 3 August 2023 -
News ArticleThe Joint Commission Resources (JCR) has announced the appointment of two world-class and leading healthcare experts to serve as international outside directors on its board of directors: Abdulelah M. Alhawsawi and Sangita Reddy. As international outside directors, Dr. Alhawsawi and Ms. Reddy will provide their global expertise and direction to improve safety and quality of healthcare in the United States and abroad. They will be full voting members of the 13-person board of directors, which serves as JCR’s governing body. The board includes healthcare professionals, business executives and quality experts from around the world. “Dr. Alhawsawi and Ms. Reddy have dedicated their lives to transforming healthcare globally, and we are thrilled to welcome them to Joint Commission Resources’ Board of Directors,” says Jonathan B. Perlin, president and chief executive officer, The Joint Commission. “These board appointments bring unique international expertise and perspective on healthcare policy and the challenges and opportunities to advance quality and safety worldwide.” “We are so pleased that Dr. Alhawsawi and Ms. Reddy are joining Joint Commission Resources’ Board of Directors,” says Jean Courtney, interim president and chief executive officer, and chief operating officer, JCR. “They each bring in-depth and unparalleled international healthcare expertise. This will be invaluable as JCR continues to expand its mission to improve patient safety and quality of care around the globe.” Read full story Source: Joint Commission Resources, 16 August 2022
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News ArticleA quarter of Black, Asian and minority ethnic (BAME) non-executive directors of NHS trusts have seen or experienced discrimination in the course of their work, a report reveals. While almost four out of five (79%) of these BAME non-executives said they challenged such behaviour when they encountered it, only half (50%) said that led to a change of policy or behaviour. The other half felt they had been ‘fobbed off’ or subjected to actively hostile behaviour for having spoken up,” says a report commissioned by the Seacole Group, which represents most of the BAME non-executive board members of NHS trusts in England. It adds: “This level of discrimination is unacceptable anywhere and even more so in the boardrooms of NHS organisations. Too many Black, Asian and other ethnic NEDs (non-executive directors) are being subjected to it and left to deal with it on their own.” Read full story Source: The Guardian, 21 July 2022
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News Article
Trusts told to appoint board director with responsibility for reducing racism
Patient Safety Learning posted a news article in News
Mental health trusts will be expected to appoint a board member responsible for improving racial equality and to develop individual plans to eliminate systemic racism, according to new draft NHS England guidance seen by HSJ. The draft guidance says all providers will be required to draw up their own Patient and Carer Race Equality Framework by March 2024. These blueprints will outline how trusts plan to improve access, experience and outcomes for racialised communities, covering all services from talking therapies through to secure inpatient services. PCREFs were a key recommendation in the 2018 Mental Health Act review which identified disproportionate applications of the act in racialised groups and are part of NHSE’s wider mental health equalities strategy. Black people are 10 times more likely to receive a community treatment order after being an inpatient and their rate of detention under the act is four times as high as the rate for white people. The guidance follows HSJ last month revealing the “staggering” rise in restraints of black people in NHS care. Read full story (paywalled) Source: HSJ, 5 January 2023 -
News Article
All NHS board members to get equality objectives
Patient Safety Learning posted a news article in News
Trusts and systems must draw up plans to improve the diversity of their executive and senior leadership teams over the next 12 months, and evidence progress against them by summer 2025, NHS England has announced. A new equality, diversity and inclusion (EDI) improvement plan also says every board and executive team member will have EDI objectives they will be assessed against during annual appraisals by spring 2024. The targets form part of six “high impact actions,” each with set targets that aim to address the “widely known intersectional impacts of discrimination and bias” within the NHS. Read full story (paywalled) Source: HSJ, 8 June 2023 -
News ArticleAn ‘outstanding’ trust’s Care Quality Commission rating has been dropped to ‘requires improvement’, after inspectors found potential safety risks and a disconnect between board and ward. A highly critical report on University Hospitals Sussex Foundation Trust also downgraded its well-led rating to “inadequate” and recommended the trust be placed in segment four – the bottom tier – of NHS England’s system oversight framework. Its main tertiary centre – the Royal Sussex County Hospital – was also rated “inadequate”, including for safety. Deanna Westwood, Care Quality Commission’s director of operations in the South, said “staff and patients were being let down by senior leaders, especially the board, who often appeared out of touch with what was happening on the wards and clinical areas and it was affecting people’s care and treatment”. Read full story (paywalled) Source: HSJ,12 May 2023
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Content ArticleThese system leadership behaviour cards have been designed as a practical development tool. Developed by the NHS Leadership Academy, the set of 13 double sided cards are colour coded by theme; each card describes one of the behaviours and includes three question prompts on the reverse. The aim is to consider how the key themes and behaviours ‘play-out’, from an individual, organisational and system perspective. The questions support conversation and prompt self-reflection in the context of system-level working.
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Content ArticleThe Healthcare Leadership Model (HLM) was developed to help leaders in the health service become better at their day-to-day role. The model is useful for everyone from board members to managers because it describes the things you can see leaders doing at work and demonstrates how you can develop as a leader. This webpage describes how the HLM works and provides a link to the free self-assessment tool.
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Content ArticleNHS chairs and non-executive directors play a key role in driving forward transformational change across the health and care sectors. As a vital leadership group they hold executive teams to account and in doing so build patient, public and stakeholder confidence in the NHS. The NHS North West Leadership Academy (NHS NWLA) have curated a range of development support and useful resources tailored to support those in non-executive roles. This webpage contains information on: system leadership modules NHS NWLA Executive Coaching leadership masterclasses the Non-executive Leaders Network the Next Director scheme. It also contains links to the following reports and resources: Non-executive directors and integrated care systems: What good looks like Strengthening NHS board diversity Healthcare Leadership Model (HLM) self-assessment and 360 feedback System leadership behaviours framework and conversation cards Healthy leadership framework.
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Content Article
NHS Providers board development programme
Patient-Safety-Learning posted an article in Boards
NHS Providers offers a board development programme that aims to improve the effectiveness of NHS boards and organisations through practical, interactive training and development delivered by expert trainers with extensive senior-level sector experience. This webpage contains information about the board development programme including: core training modules. in-house training. induction programmes. bespoke development programmes. -
Content Article
NHS England - Making data count (18 January 2021)
Patient-Safety-Learning posted an article in Data and insight
These practical guides from NHS England are suitable for those working at all levels in the health service, from ward to board. They provide information on how to make better use of data. Guides include: Making data count - getting started Making data count - strengthening your decisions -
Content ArticleHospital boards generally focus attention on measures to answer questions about risk, such as 'How safe are we now?' They are ultimately accountable for the quality of care delivered in hospitals, and data review is a key component of effective board governance. This editorial in BMJ Quality & Safety highlights the lack of guidance on the most effective format for presenting data to determine progress against key risks and targets. The authors argue that data must not be overly simplified and that charts prepared for boards should include monthly data points in graphic format over a longer period of time. This allows trends to be more visible and denotes whether an observed change is significant, helping hospital boards avoid erroneous conclusions tied to random variation.
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News Article
Former trust CEO and medical director cleared over surgery scandal
Patient Safety Learning posted a news article in News
A major trust’s former chief executive and medical director have been cleared, after being accused of failing to protect breast patients from a rogue surgeon. The Medical Practitioners Tribunal Service has ruled neither Mark Goldman nor Ian Cunliffe’s fitness to practise was impaired, in a case brought by the General Medical Council. Mr Goldman was chief executive of the Heart of England Foundation Trust from 2001 until 2010, while Dr Cunliffe served as HEFT medical director between 2006 and 2010. Both held roles at HEFT while Ian Paterson was there. Mr Paterson was jailed for 20 years in 2017 after being convicted of 17 offences of wounding with intent while being employed at HEFT, while a later inquiry concluded he may have conducted up to 1,000 botched and unnecessary operations over a 14-year period. Mr Goldman and Dr Cunliffe are now pursuing the GMC for the costs of the case, which is expected to be heard over five days in January 2023. Read full story (paywalled) Source: HSJ, 18 October 2022 -
Content ArticleChairs and non-executives are an important NHS leadership group. As independent board members, they hold the executive to account and in doing so build patient, public and stakeholder confidence in the NHS. This report by the Independent Taskforce on Improving Non-Executive Director Diversity in the NHS explores the steps needed to strengthen the diversity of NHS boards in England. Read a shorter summary of the report
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Content ArticleThe Safety Culture Programme for Maternity & Neonatal Board Safety Champions was commissioned by NHSE/I Women’s Health Policy team. The programme was co-designed with stakeholders including Board Safety Champions, Leaders from the Maternity and Neonatal system and Maternity Voices Partnership through March 2021. The programme is underpinned by the NHSE/I framework developed by the Maternity Transformation Programme Board. The aim of the framework and the programme (concluded on 25 March 2022) is to create the conditions for a culture of safety and continuous improvement across perinatal services to improve the quality, safety and experience of care. View the presentation slides from the recent Aqua event and an overview of the HSIB Investigation Programmes highlighting the differences between the National Investigations Programme and the Maternity Investigations Programme.
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Content ArticleDeveloping an organisational approach to improvement in healthcare is a journey that can take several years. It requires corporate investment in infrastructure, staff capability and culture over the long-term. These resources from NHS Providers explain why organisation-wide improvement in healthcare matters, and how to get started.
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Content Article
Key questions for boards: What to ask yourself and others
Patient Safety Learning posted an article in Boards
NHS Providers provide a selection of example questions boards should ask themselves in relation to their role in improvement. These aim to help guide personal reflection, conversations between board members and in quality committees, with staff and with partners locally. This list does not cover everything you may wish to or need to ask, but is intended to help provide a starting point and overview of important aspects to consider. -
Content ArticleThe composition and background of members of state medical boards, including public or citizen members, can impact the functionality and public perception of medical boards in the United States. This study from Doug Wojcieszak analysed the number of public members on each state medical board and their professional backgrounds or expertise to regulate the medical profession. The findings show that for nearly half of state medical boards public members comprise at least a quarter of their voting members; however, more than half of public members for all state medical boards have no measurable medical experience or background, including in patient safety. The need for public members to have medical expertise or background – especially in patient safety -- is discussed along with potential policy recommendations.
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Content ArticleThis maturity matrix from the Good Governance Institute is a resource designed to support organisations to self-assess whether they are appropriately applying the key principles of good governance practice in relation to quality assurance.
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Content ArticleThe NHS is in the process of changing the way it embraces patient safety, moving from a focus on individual incidents and issues to a more comprehensive look at system learning. The changes are set out in NHS England/Improvement’s Patient Safety Strategy, released in July 2019 and updated in February 2021. This was followed by the Patient Safety Investigation Framework in March 2020, due for full implementation by Spring 2022. They are important not just in relation to incident management but also because of the implications they have for strategy and board responsibilities in relation to patient safety. So they need careful attention at all levels of NHS organisations. This article from the Good Governance Institute highlights the safety roles and responsibilities of organisations and moving to a proactive approach to safety management.
