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Showing results for tags 'Clinical governance'.
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Content ArticleThis review in the Journal of Clinical and Diagnostic Research explains the basics of audit and describes in detail how a clinical audit should be performed and monitored. It includes information on the 'Audit Cycle' and 'Ten Tips for Successful Audits'.
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Content Article
What is clinical audit? (2009)
Patient-Safety-Learning posted an article in Clinical governance and audits
This guide by the University Hospitals Bristol clinical audit team provides a brief summary of what clinical audit is, and what it isn't. It outlines the main stages of clinical audit and describes how it can be used, how to engage patients in the process and which staff members should be involved.- Posted
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Content ArticleExternal clinical harm reviews aim to give assurance to patients, patient groups, commissioners and the public as to whether any patients have been harmed as a result of an incident, as well as to avoid future harm to patients. This handbook by Dr Henrietta Hughes, NHS Medical Director for London North, Central and East, outlines an approach to conducting clinical external harm reviews. It identifies the factors which make external clinical harm panels successful and provides example agendas and terms of reference for the process.
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Content ArticleThis document from NHS England offers a practical interpretation of the Managing conflicts of interest guidance, providing optional content to support organisations in amending local policies. The guidance: introduces common principles and rules for managing conflicts of interest provides simple advice to staff and organisations about what to do in common situations supports good judgement about how interests should be approached and managed Sets out the issues and rationale behind the policies.
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Content ArticleThe purpose of this guidance from the Royal College of Obstetricians and Gynaecologists (RCOG) is to urge all maternity units to consider the use of the Maternity Dashboard to plan and improve their maternity services. It serves as a clinical performance and governance score card to monitor the implementation of the principles of clinical governance on the ground. This may help to identify patient safety issues in advance so that timely and appropriate action can be instituted to ensure a woman-centred, high-quality, safe maternity care.
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Content ArticleIn this article in the Pharmaceutical Journal, Carolyn Wickware asks if liquid morphine should be reclassified. She cites research that Oramorph or oral morphine sulphate solution was directly linked to the cause of death in 13 reports since 2013.
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- Prescribing
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Content ArticleThis document by the National Institute for Clinical Excellence sets out the principles for best practice in clinical audit and includes; preparing for audit, selecting criteria, measuring level of performance, making improvements and sustaining improvement.
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Content Article
Good Governance Handbook (1 March 2012)
Patient Safety Learning posted an article in Clinical governance and audits
The Good Governance Institute (GGI) has collaborated with the Healthcare Quality Improvement Partnership (HQIP) to produce this seminal report into the foundation principles of good governance. Understanding these is key to being able to apply good governance to new and emerging organisations in healthcare, and for working through partnership and hosting arrangements. Drawn from academic study, the various governance Codes and law and established better governance practice GGI and HQIP have identified nine foundation principles. This report explains how to apply these within health and social care organisations. GGI will be taking forward these foundation principles within various developmental programmes during 2012. -
Content ArticleJoint meeting with the British Medical Journal on establishing a register of financial and non-pecuniary interests for doctors.
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Content ArticleFeldman et al. set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees. They found that, overall, recording of employees’ conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria.
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- Clinical governance
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Community Post
Can the NHS learn from healthcare systems overseas?
Steve Turner posted a topic in Organisational
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- Leadership
- Organisational culture
- Organisational development
- Organisational learning
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- Transformation
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- Benchmarking
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- Accountability
Is it time to change the way England's healthcare system is funded? Is the English system in need of radical structural change at the top? I've been prompted to think about this by the article about the German public health system on the BBC website: https://www.bbc.co.uk/news/health-62986347.amp There are no quick fixes, however we all need to look at this closely. I believe that really 'modernising' / 'transforming' our health & #socialcare systems could 'save the #NHS'. Both for #patients through improved safety, efficiency & accountability, and by making the #NHS an attractive place to work again, providing the NHS Constitution for England is at the heart of changes and is kept up to date. In my experience, having worked in healthcare for the private sector and the NHS, and lived and worked in other countries, we need to open our eyes. At present it could be argued that we have the worst of both worlds in England. A partially privatised health system and a fully privatised social care system. All strung together by poor commissioning and artificial and toxic barriers, such as the need for continuing care assessments. In my view a change, for example to a German-style system, could improve patient safety through empowering the great managers and leaders we have in the NHS. These key people are held back by the current hierarchical crony-ridden system, and we are at risk of losing them. In England we have a system which all too often punishes those who speak out for patients and hides failings behind a web of denial, obfuscation and secrecy, and in doing this fails to learn. Vast swathes of unnecessary bureaucracy and duplication could be eliminated, gaps more easily identified, and greater focus given to deeply involving patients in the delivery of their own care. This is a contentious subject as people have such reverence for the NHS. I respect the values of the NHS and want to keep them; to do this effectively we need much more open discussion on how it is organised and funded. What are people's views?- Posted
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- Duty of Candour
- Just Culture
- Leadership
- Organisational culture
- Organisational development
- Organisational learning
- Safety culture
- Transformation
- Speaking up
- Transparency
- Whistleblowing
- Change management
- Collaboration
- Hierarchy
- Staff support
- Benchmarking
- Clinical governance
- Accountability
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Content ArticleMy last blog, "Forgotten heroes" – the sequel, built upon a very moving BBC Panorama programme Forgotten heroes of the Covid front line. The BBC documentary told the sad story of healthcare workers (HCWs) who had bravely and knowingly put themselves in harm's way to care for their patients during the darkest days of the pandemic. Many lost their lives, while many more were rendered so severely injured by the disease (Long Covid) that they were (and remain) unable to work and have been unceremoniously sacked by their NHS Health Trusts/Boards. The way that an organisation manages its activities is known as 'governance'. Good governance will lead to high standards of ethics, morality, care and compassion for the people who work within it and those who may be affected by its acts and omissions. Hence, when applied to a whole country, it is known as 'Government', its departments and agencies. In this blog, I propose a possible hypothetical scenario that may have led to the tragic situation revealed by the BBC documentary. I hope this will lead you to consider the standards of 'governance' that apply to the 'duty of care' which a Government owes to its HCWs during a pandemic and what, morally and ethically, should be done to support those "forgotten heroes" if the Government’s governance should be found to be severely lacking. But is the scenario I am asking you to imagine hypothetical or is it real? I shall leave that to your judgement – and that of the Covid-19 Public Inquiry.
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Content Article
Duty of Candour for Wales
Gethin posted an article in NHS Wales (Gig Cymru)
The Duty of Candour for Wales statutory guidance.- Posted
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Content ArticleA number of serious concerns were raised about the University Hospitals Birmingham NHS Foundation Trust, relating to patient safety, governance processes and organisational culture. The Trust has been under review by the Birmingham and Solihull Integrated Care Board (ICB), following a junior doctor at the trust, Dr Vaishnavi Kumar, taking her own life in June 2022. In response to these concerns, a series of rapid independently-led reviews have been commissioned at the Trust. A follow up report into concerns raised about University Hospitals Birmingham NHS Foundation Trust has now been published showing the progress made against the recommendations made in the clinical safety (phase 1) report. It also collates the evidence from phase 2 and 3 of the review and assesses how the lessons learned can at this point be incorporated into the recovery and development plan that the Trust is already progressing. It also takes account of any other concerns that have arisen or been communicated to the review team.
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Content ArticleReport from the Council for Healthcare Regulatory Excellence (now the Professional Standards Authority). The CHRE was commissioned in July 2011 to advise the Secretary of State for Health on standards of personal behaviour, technical competence and business practices for members of NHS boards and Clinical Commissioning Group (CCG) governing bodies in England. This report presents their findings and advice.
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Content ArticleThis policy paper from the Department of Health and Social Care sets out the Government’s response to the recommendations of the investigation into the death of Elizabeth Dixon in respect of the failures of care she received from the NHS.
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News Article
NHS England reinstates central control powers as covid risk rating is increased
Patient Safety Learning posted a news article in News
The NHS has been returned to the highest level of risk on its emergency preparedness framework, a move which allows national leaders tighter control over local resources and decision making. NHS England chief executive Sir Simon Stevens announced the decision at a press conference this morning. He said: “Unfortunately, again we are facing a serious situation [due to rising coronavirus infections and hospital admissions]. That is the reason why at midnight tonight the health service in England will be returning to its highest level of emergency preparedness, EPPR level 4, which of course we had to be at from the end of January to the end of July.” Placing the NHS on level 4 of Emergency Preparedness Reslience and Response framework allows system leaders to take control of decisions over mutual aid and other local priorities. Sir Simon was joined by NHSE/I medical director Steve Powis and Alison Pittard, dean of the Faculty of Intensive Care Medicine. They used the press conference to stress the threat the NHS faced from the second covid peak, but also set out more positive news on the covid vaccine programme. Read full story Source: HSJ, 4 November 2020 -
News ArticleNHS hospitals have been forced to pay millions of pounds to regulators after wrongly claiming their maternity units were among the safest in the country. Seven NHS trusts, including some now at the centre of major care scandals, will have to pay back a total of £8.5m after self-assessments of their maternity services were found to be false. Families whose babies died as a result of avoidable errors at some of the hospitals told The Independent it was further evidence of poor governance and management failings. NHS Resolution, which acts as the health service’s insurer for clinical negligence, launched the maternity incentive scheme in 2018 in an effort to focus action on 10 key safety areas in maternity, including ensuring they have systems in place to review deaths, monitor women and plan staffing levels as well as reporting incidents to the Healthcare Safety Investigation Branch which investigates maternity incidents in the NHS. Among the trusts forced to give money back over the first two years of the scheme include Shrewsbury and Telford Hospital Trust, which paid back £953,000. An inquiry into its maternity service found a dozen women and more than 40 babies died as a result of poor care in one of the largest maternity scandals in NHS history. East Kent Hospitals University Trust, which is facing an inquiry into baby deaths and a criminal prosecution by the Care Quality Commission over the death of baby Harry Richford in 2017, face paying back £2.1m over two years. Derek Richford, who helped expose failings at East Kent after the death of his grandson, told The Independent it was “abhorrent” that the trust claimed “vital NHS funds by falsely claiming that they had achieved 10/10 for maternity safety when the truth was in fact 6/10. East Kent Trust did this two years running and even when asked to check their submission, reconfirmed the erroneous data to NHS Resolution.” An evaluation of the scheme by NHS Resolution said it was “recognised that recent examples of poor governance from trusts in relation to the certification of submissions require further action”. Read full story Source: The Independent, 7 March 2021
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Event
Reinvigorating clinical governance
Patient Safety Learning posted an event in Community Calendar
This day will explore what clinical governance means for frontline clinicians. Based on experiential learning techniques, drawing on live case studies and shared experiences of the participants, it looks at the challenges that colleagues working in healthcare settings encounter as part of their journey into patient safety and overall clinical governance and what needs to happen to the system safer for the staff and the patients. Working in partnership, this day draws on expertise from the healthcare leaders and front line clinicians from BAPIO. It is grounded in principles of clinical governance which will be brought to life by the diverse experience and skills of the delivery team. The conference is open to anyone working in a health care setting who is involved in leadership role or providing care to patients. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/reinvigorating-clinical-governance or email kerry@hc-uk.org.uk. hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #ClinGov -
EventThis national conference looks at the practicalities of Serious Incident Investigation and Learning. The event will look at the development and implementation of the New Patient Safety Incident Response Framework (previously known as the Serious Incident Framework) a version of which has now been published and which is being tested in early adopter sites. NHS Improvement is working with these early adopters to test implementation, and analysis of this will inform the final version. Local systems and organisations outside of the early adopter areas are free to use the already published version of the PSIRF to start to plan and prepare for PSIRF’s full introduction from Spring 2022. The conference will also update delegates on best current practice in serious incident investigation and learning, including mortality governance and learning from deaths. There will be an extended focus on ensuring serious investigation findings lead to change and improvement. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/serious-incident-investigation-patient-safety or email kate@hc-uk.org.uk Follow on Twitter @HCUK_Clare #NHSSeriousIncidents hub members can receive a 20% discount. Email info@pslhub.org discount code.
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Content Article
Draft Code of governance for NHS provider trusts (May 2022)
Patient Safety Learning posted an article in Boards
This code sets out a common overarching framework for the corporate governance of trusts, reflecting developments in UK corporate governance and the development of integrated care systems.- Posted
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- Code of conduct
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Content ArticleHertfordshire Partnership University NHS Foundation Trust's Quality Account has been designed to report on the quality of their services in line with regulations. The aim in this report is to describe in a balanced and accessible way of how the Trust provides high-quality clinical care to service users, the local population and commissioners.
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Content ArticleThe Quality Network for Inpatient Working Age Mental Health Services (QNWA) based within the Royal College of Psychiatrists' Centre for Quality Improvement are pleased to announce the publication of their 8th edition standards. Since the publication of the first edition standards in 2006, the Network has grown to include over 140 members from the NHS and private sector. This new edition of standards aims to reflect the changes in working practices and legislation over the last two years in addition to placing greater emphasis on equality, diversity and inclusion as well as sustainability in inpatient mental health services. The eighth edition standards have been drawn from key documents and expert consensus and have been subject to extensive consultation with professional groups involved in the provision of inpatient mental health services, and with people and carers who have used services in the past.
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- Mental health
- Mental health unit
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