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News Article
Service rated ‘good’ despite ‘weaknesses in culture’
Patient Safety Learning posted a news article in News
A trust’s maternity services were rated ‘good’ despite an independent report finding ‘weaknesses in the culture’ and ‘defensive and fractious’ behaviours, HSJ has learned. As previously reported, former staff at Sandwell and West Birmingham Hospital Trust had raised concerns with the Care Quality Commission (CQC) over what they described as a “toxic management culture” and “unsafe” staffing levels in the trusts maternity service. Particular concerns were raised around community midwifery services. This prompted an unannounced inspection by the CQC in May, which found “low morale and negative culture” in the services. However, the CQC ultimately concluded the trust was taking positive steps to address the problems and rated its maternity services “good” overall, as well as for leadership and safety. Some frontline staff in the service have questioned those findings, however, and pointed to an independent review which was conducted in the early months of 2021. This review, carried out by independent consultant Debbie Graham and seen by HSJ, concluded there was “evidence of weaknesses in the culture; evidenced in the behaviours of some staff which appears to go unaddressed; a lack of strong, visible leadership; a lack of a shared vision; the finding that some staff have a fear of ‘speaking up’; and poor communication systems.” Read full story (paywalled) Source: HSJ, 20 September 2021 -
News ArticleA retiring chief executive was “astonished” how many junior doctors had never met the senior directors of their hospitals — and stressed how being visible on the wards is “critical” to good leadership. Karen Partington, who has this month stepped down after 10 years leading Lancashire Teaching Hospitals Foundation Trust, said she had made it her mission to understand the feelings and motivations of frontline staff. In an interview with HSJ, she was asked if being visible and spending significant time talking to frontline staff is the most important bit of advice she would give a first-time chief executive. She said: “In my personal opinion, it’s critical. How can CEOs be compassionate leaders without understanding the daily pressures faced by the whole team?" “My executive team and I [would] meet regularly with our junior doctors and do a ‘you said, we did’ session, which really helped us to change their experiences for the better. But it was also an opportunity to ensure our frontline colleagues understood the environment they were working in as well. I have always found that when people understand ‘why’, [then] they will come up with the solutions." Read full story (paywalled) Source: HSJ, 14 September 2021
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EventThe Deteriorating Patient Summit focuses on recognising and responding to the deteriorating patient through improving the reliability of patient observations and ensuring quality of care. The conference will include National Developments including the recent recommendations on NEWS2 and Covid-19, and implementing the recommendations from the Healthcare Safety Investigation Branch Report Investigation into recognising and responding to critically unwell patients. The conference will include practical case study based sessions on identifying patients at risk of deterioration, improving practice in patient observations, responding to the deteriorating patient, improving escalation and understanding success factors in escalation, sepsis & Covid-19, involving patients and families in recognising deterioration, and improving the communication and use of NEWS2 in the community, including care homes, and at the interface of care. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/conferences-masterclasses/deteriorating-patient-summit or email kate@hc-uk.org.uk hub members receive a 20% discount. Email info@pslhub.org for the discount code Follow the conference on Twitter @HCUK_Clare #DeterioratingPatient
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EventuntilThis Masterclass is aimed at consultants and will be led by Dr Marcy Rosenbaum, Professor of Family Medicine and Faculty Development Consultant, Office of Consultation and Research in Medical Education, University of Iowa. Marcy is an expert in the skills that make difficult healthcare conversations easier, has published widely on the topic and is world renowned in training clinicians to use these skills effectively. The Masterclass will involve skills rehearsal with simulated patients and families. It provides consultants with an opportunity to refresh their expertise an to learn about the specific skills being taught to their trainees and NCHSs in the Human Factors in Patient Safety programmes. Register for the Masterclass
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EventuntilOn 23 June 2022, National Voices is holding an all-day conference, as we explore the topic of Integrated Care Systems (ICSs), on the eve of ICSs becoming statutory bodies that cover the entirety of England. Now is the right moment to identify the changes we want to see as a result of this fundamental shift in the way the health and care system is organised. We want to see better, more equal outcomes for people, especially those not currently well supported by existing models. We also want to see more coordinated and effective care that enables people to live well, with fewer barriers between communities and formal services. The day will consist of high profile, topical panel discussions and engaging workshops. During the conference we will have a number of expert speakers joining us, including the keynote speaker, Matthew Taylor, Chief Executive of NHS Confederation, and of course National Voices Chief Executive, Charlotte Augst. A series of workshops will cover crucial topics, including health inequalities, social prescribing and others to be confirmed. We look forward to welcoming a range of individuals and organisations to this event, which will offer an opportunity for the Voluntary, Community and Social Enterprise sector to have constructive conversations with system leaders; ensuring that people and communities are involved appropriately and that the result of the new ICSs is a positive impact on the way people experience healthcare. Register for the conference
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EventuntilThe NHS Communicate conference is back for a second year, offering an unparalleled opportunity for senior communicators across the health service to explore the reputational challenges facing the NHS and to share expertise and learning from healthcare and beyond. It seems like a long time since members of the public were clapping for NHS staff at the height of the pandemic. Today, the NHS finds itself under increasing operational pressure, with lengthening waiting times and an exhausted workforce with low morale. With public satisfaction at a 25-year low, and following recent tax increases to fund extra investment, public scrutiny of the NHS has rarely been greater. Building on the great success of last year’s inaugural event, NHS Communicate 2022 is a chance to explore the impacts of the pandemic on the reputation of the NHS and the role of communications in supporting and helping to build and sustain its profile and reputation. Whether it is demonstrating the value the NHS delivers to patients, or positioning the NHS as an employer of choice, NHS communications plays a vital role. Read more information and book a place
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EventuntilAre you interested in storytelling health? Do you want to use narrative as the basis for improvement? Do you want to work with people and hear about their experiences of care? Are you curious about storytelling? If so, come along to the NHS/Hope storytelling festival which is taking place between 9 and 23 March. You will find out about filmmaking, arts therapy, live performance, storytelling for quality improvement, staff stories, digital stories, how volunteers can capture stories, and hear from the author of a book about storytelling in health and how patient leaders are shaping our programme of digital storytelling. You will also hear how stories are being used across systems as a learning tool. There will also be the opportunity to take part in online training where you can gain a contribution to your CPD and gain some essential knowledge about a broad range of storytelling methods. Each session takes place between 6pm and 7.30pm and details can be found here.
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EventuntilFrom the perspective of a service user, interactions with health and social care are often exceedingly difficult to navigate. The NHS’s traditional to approach to managing patient pathways has involved letters, appointments at set times, and stress for an individual needing to communicate that a planned consultation is no longer needed – or is needed more urgently. Knowing which service to access, and how to do so swiftly, can be particularly challenging. All this is inefficient and can lead to poor patient experience. As the service seeks to manage the backlog of care, and to meet the continuing demands of an unpredictable pandemic, that becomes particularly problematic. So how might healthcare organisations help move from patients who are passive participants in pathways to active partners, able to regularly communicate as their needs change? How might self-referrals and patient initiated follow up processes be more widely rolled out? What unpinning technology would be needed to make such a shift? This HSJ webinar, run in association with Salesforce, will bring together a small panel to discuss these issues. Register
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EventuntilIn this webinar from Learning Disability Today, Alexis Quinn, autistic woman and author; Dr Jeremy Tudway, Clinical Director for Dimensions, and Max Green, Ambassador for the National Autistic Society, talk about how communication is key to providing good care to people with a learning disability and/or autism. It looks at how professionals communicate with the people they are supporting, what they do and don’t say, and how they say it. This webinar is for: GPs Psychiatrists Practice managers Professionals working with people with a learning disability and/or autism People with a learning disability and/or autism The panellists will discuss how communication is essential to improve the care and quality of life of people with a learning disability and/or autism. In the first part of this talk, Alexis Quinn talks about her experience in an Assessment and Treatment Unit (ATU) where she was over-medicated and subjected to restraint and seclusion. She will also discuss how support in the community could have prevented her hospital stay. In the second part of the talk, Dr Jeremy Tudway, Clinical Director for Dimensions, and Max Green, Ambassador for the National Autistic Society, will talk about how communication is key, looking at how professionals communicate with the people they are supporting, what they do and don’t say, and how they say it. Register
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EventuntilJoin the #SolvingTogether Connect Sessions, virtual sessions that anyone can attend where people share their ideas for addressing the challenges. They are informal opportunities to put forward ideas, and have discussion. Patients and health and care staff are all invited to attend. The MSTeams link to the session will be added to the event page at 9am on Thursday 2nd February.
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EventuntilVoices for Improvement: Facilitating the co-existence of Lived and Learned Experience Rachel Matthews, Head of Experience at National Voices and Associate Lived Experience Leader Keymn Whervin have co-designed and developed a prototype programme of coaching and mentoring, which will bring mutual benefit to those with Lived and Learned Experience and improve health and social care. We know that people with Lived Experience bring important insight to the design and delivery of care, and understand how resources can be directed for better value. However, they do not often get the opportunity to work alongside system leaders to support improvement. Voices for Improvement, a National Voices project in partnership with Q Community, offers Lived Experience Partners the opportunity to provide coaching and mentoring to those in senior positions in health and care. Through 1 to 1 coaching in action learning groups, Lived Experience Partner participants are trained to bring their perspective and insights to support leaders to develop their personal and organisational practice. We really believe that this has the potential to help to enact meaningful change through strategic co-production. The event This event will share our learning from this project as we prepare to launch. We want to bring you along for the journey, and allow you the chance to meet those who have contributed along the way. We are excited to share our methodology and invite participants to ask questions to see what getting involved in this work could look like for them, their organisations and their networks. Who is this event for? We are excited to welcome a wide range of people to this event: If you are a person with Lived Experience who is interested in becoming a Lived Experience Partner through the programme, or someone who knows people who may find this experience to be beneficial do come along and learn about what is involved. If you are a system leader or hold a position of influence within healthcare and you’d like to learn more about how to embed Lived Experience in your work through the expertise of a Lived Experience coach, we will explain more about the programme and open the floor to additional questions. If you are part of a larger charity with your own Lived Experience networks and want to learn about what makes our approach different, and how this could potentially help you do come along. Register for this event. If you have any questions, please email info@nationalvoices.org.uk Agenda to follow soon. Voices for Improvement builds on the exploration conducted in 2020 with the Voices for Improvement Advisory group including two representatives from the Rosamund Snow Community and with support from the Health Foundation.
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Event
Communications on the maternity frontline
Patient Safety Learning posted an event in Community Calendar
untilIn this webinar from BAME Birthing With Colour, the panel shares their experiences of what communication on the maternity frontline means in practice. They'll discuss what it takes to deliver critical information clearly and sensitively across a range of scenarios - what works and hasn't worked - as well as the tools available to support the clearest of communication and highest quality of care for women, babies and their families. Join the webinar to discuss: The realities of communication on the maternity frontline. Lessons learned and what to watch out for. Cultural sensitivity. Language barriers. Different levels of understanding. How can staff know they have communicated clearly? The tools available and being developed. Register -
EventuntilThe COVID-19 pandemic has exposed huge problems with the way Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions are made, understood and communicated with people with learning disabilities and their families and carers. There have been reports of unlawful blanket decision-making and of DNACPR orders noted without discussion with the people involved. This webinar will focus on some of the questions that have been raised over the past year. What exactly is DNACPR? Why are the terms DNR or DNAR unhelpful, confusing and potentially dangerous? In what circumstances is CPR not a good option, and DNACPR therefore appropriate? How should those decisions be made? Who should be involved? What if the person lacks capacity for a DNACPR decision – how can we make decisions based on best interest? Register
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EventuntilUncover the impact and value of media stories exposing patient safety incidents. Shaun Lintern, Health Correspondent at The Independent, will join Jonathan Hazan, Chair of Patient Safety Learning and Moira Durbridge, President of the Patient Safety Section of the Royal Society of Medicine, for this interactive webinar which will explain how the media work to promote patient safety stories, illustrate how media stories can be a spur to local patient safety improvements and show how the media can be a powerful medium for communicating patient safety. Register
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Content ArticleMost doctors enter their training with a desire to help people. When a patient asks us for assistance, and what is requested is within our power, we generally say yes. If what they want is not safe or evidence based—another home detox from alcohol, or a drug that is blacklisted in our formulary—we have good reasons for declining. When the main reason for saying no is that we are just too busy, however, it is far harder. Our ability to say no raises questions of equity and patient safety; as there are not enough GPs to cope with patients’ demands, we need to be careful how we spend our time. If we want to continue to look after our patients safely, we must also start learning to say no in other spheres, politely pushing back against the transfer of work from hospitals to general practice.
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Content ArticleRates of blood testing in primary care are rising. Communicating blood test results generates significant workload for patients, GPs, and practice staff. This study from Watson et al. explored GPs’ and patients’ experience of systems of blood test communication. The study found that methods of test result communication varied between doctors and were based on habits, unwritten heuristics, and personal preferences rather than protocols. Doctors expected patients to know how to access their test results. In contrast, patients were often uncertain and used guesswork to decide when and how to access their tests. Patients and doctors generally assumed that the other party would make contact, with potential implications for patient safety. Text messaging and online methods of communication have benefits, but were perceived by some patients as ‘flippant’ or ‘confusing’. Delays and difficulties obtaining and interpreting test results can lead to anxiety and frustration for patients and has important implications for patient-centred care and patient safety.
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Content ArticleHealthcare is traditionally a hierarchical industry. This structure can foster a culture of division amongst staff that is sometimes made worse by significant differences in background and training. However, in order to make sure care is safe and of a high quality, healthcare teams must develop good teamwork and communication. This is only possible if every member of the team feels respected and is free to speak up when they think something is wrong. In this podcast, host David Feldman speaks to Michael Brodman, Professor and Chair Emeritus in the Department of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai in the US. They discuss how mutual respect is essential for any institution developing a culture of safety and how the problems presented by medical hierarchy can be overcome.
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Content Article
Two years after Baroness Cumberlege shared her damning report, 'First Do No Harm', which highlighted serious failures in response to reports about harmful side effects from medicines and medical devices, too many mesh injured women still continue to be let down by the healthcare system. Women who have been harmed by pelvic mesh surgery have shared a series of appalling accounts of how they have been treated by their doctors while desperately seeking help for their injuries and complications. In this blog, we examine how these comments reveal an underlying misogyny held by many doctors, and a failure to take women’s concerns seriously. -
Content ArticleThis blog by doctors Clare Rayner and Amali Lokugamage argues that Long Covid rehabilitation needs a wider focus that goes beyond a purely biomedical paradigm to include complementary therapies and methods. The authors—who have both lived with Long Covid for more than two years—argue that although patients were the first to raise concerns about Long Covid, describe its symptoms and patterns and even research the condition, their narratives and voices are not being included in approaches to treatment. While the biomedical evidence surrounding Long Covid is currently limited, they highlight that there is much valuable lived-experience to be found in patient support and campaign groups, and that patients' knowledge should be drawn on to shape policy and guidance about the condition.
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Content ArticleThis white paper from the Institute for Healthcare Improvement (IHI) describes a framework to guide health care organisations in their efforts to provide safe, equitable, person-centred telemedicine. The framework includes six elements to consider: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design.
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Content ArticleThis improvement tool is designed to help NHS organisations identify strengths their leadership team and organisation, and any gaps that need work, in seeking to create an environment where people feel safe to speak up with confidence. It should be used alongside Freedom to speak up: A guide for leaders in the NHS and organisations delivering NHS services, which provides full information about the areas addressed in the statements, as well as recommendations for further reading.
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Content ArticleThis guide provides ideas for how an organisation can adhere to the NHS principles for leaders and managers in seeking to create an environment where people feel safe to speak up with confidence. This guide is designed to be used by any senior team, owner or board in any organisation that delivers NHS commissioned services. This includes all aspects of primary care; secondary care; and independent providers.
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Content ArticleMuch progress in the world depends on the spread of ideas, says Steven Shorrock in his new blog. There is no shortage of good ideas, and no shortage of bad ones, but ‘good’ and ‘bad’ are relative to our positions, and success and failure are not dependent on either. The success of an idea depends on a multitude of factors, such as the the multiverse of contexts in which it is introduced, the dominant paradigm, the nature of the related problem situation or opportunity, the quality of the idea itself, the communication of the idea, possible unwanted consequences, and the characteristics of the proponents and detractors.
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Content ArticleBullying, discrimination and harassment between healthcare workers can have an impact on how well individuals do their job, and may therefore lead to an increase in medical errors, adverse events and medical complications. This systematic review in BMJ Quality & Safety aimed to summarise current evidence about the impact on clinical performance and patient outcomes of unacceptable behaviour between healthcare workers.
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Content ArticleThis Healthcare Safety Investigation Branch (HSIB) investigation explores medicines omission among patients with learning disabilities who are cared for in medium and low secure wards in mental health hospitals. A medicine omission is when a patient doesn't receive medicines that have been prescribed to them, and the investigation focused on a number of factors that could contribute to omission: the environment in which medicines administration takes place the availability and use of learning disability nurses in these environments the skills required for nurses to help patients with learning disabilities be involved in choices about their medicines. For it's reference event, the investigation looked at the case of Luke, who was detained in a medium secure ward of a mental health hospital. He spent 21 months on the ward before moving into a low secure ward at the same hospital, where he stayed for a further 11 months. Both wards were specifically designated for patients with learning disabilities. While at the hospital, there were a number of periods when Luke was not given the physical health medication he had been prescribed for his diabetes and high cholesterol. Although Luke’s medication record regularly noted that Luke refused the medication, Luke and his Mother disagreed with this version of events, stating that other factors led to Luke’s medicine omissions.
