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Content Article
Safe to speak up? NHS Staff Survey Results 2021
Patient Safety Learning posted an article in Culture
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In this blog, Patient Safety Learning analyses the results of the NHS Staff Survey 2021, specifically focusing on responses relating to reporting, speaking up and acting on safety concerns. It reflects on the importance of staff feeling able to speak up about patient safety incidents and the implications when this is not the case. It describes the NHS’s current approach to creating a patient safety culture and emphasises the need for NHS England and NHS Improvement, in partnership with the National Guardian and Care Quality Commission, to bring forward robust and specific commitments to drive this work forward. -
Content ArticleThis statement from Hugh Alderwick, Director of Policy, outlines the Health Foundation's response to the House of Commons votes on the Health and Care Bill on 30 March 2022. He highlights the potential for the policies voted through to increase health inequalities, and to stall attempts to improve health and care workforce planning.
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Content Article
In this blog Patient Safety Learning sets out its initial response to the report of the Independent review of maternity services at Shrewsbury and Telford Hospital NHS Trust (also known as the Ockenden Maternity Review).- Posted
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Content ArticleAlthough leaders might say they value inquisitive minds, in reality most stifle curiosity, fearing it will increase risk and inefficiency. Harvard Business School’s Francesca Gino elaborates on the benefits of and common barriers to curiosity in the workplace and offers five strategies for bolstering it.
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Content ArticleThe positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance. This study from Baxter et al. sought to explore how multidisciplinary teams deliver exceptionally safe care on medical wards for older people. Based on identifiable qualitative differences between the positively deviant and comparison wards, 14 characteristics were hypothesised to facilitate exceptionally safe care on medical wards for older people. This paper explores five positively deviant characteristics that healthcare professionals considered to be most salient. These included the relational aspects of teamworking, specifically regarding staff knowing one another and working together in truly integrated multidisciplinary teams. The cultural and social context of positively deviant wards was perceived to influence the way in which practical tools (eg, safety briefings and bedside boards) were implemented. This study exemplifies that there are no ‘silver bullets’ to achieving exceptionally safe patient care on medical wards for older people. Healthcare leaders should encourage truly integrated multidisciplinary ward teams where staff know each other well and work as a team. Focusing on these underpinning characteristics may facilitate exceptional performances across a broad range of safety outcomes.
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Content ArticleThe 'Policy Makers’ Forum: Patient Safety Implementation on 23–24 February 2022' was convened to sustain the global patient safety movement and initiate national action by policy makers and healthcare leaders for implementation of the Global Patient Safety Action Plan 2021–2030. The forum provided a global platform for engaging with senior policy makers and healthcare leaders in the discussion around implementation approaches for the Global Patient Safety Action Plan 2021-2030 within broader health agenda at country level; and also allowed sharing of best practices and lessons learned in addressing patient safety at policy and practice levels. WHO’s Director-General Dr Tedros Adhanom Ghebreyesus and Deputy Director-General Dr Zsuzsanna Jakab, and Global patient safety advocate Mr Jeremy Hunt, Chair of the UK Health and Social Care Select Committee delivered messages expressing their commitment to patient safety. The event also included keynote addresses, diverse country experiences with innovative implementation approaches, and a panel discussion on the role of policy makers and health care leaders in implementation of the global action plan. WHO introduced a draft consensus statement on the same topic for review and consensus of the event participants, which is currently being finalised based on the inputs received during the highly interactive breakout sessions.
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Content Article
Civility Saves Lives Infographics
Patient Safety Learning posted an article in Good practice
Civility Saves Lives have created a number of infographic each with a key message of civility. A selection are shown below and more can be found through the link at the bottom of the page. -
Content ArticleThis is draft material and is not live guidance. It is shared for information and will be tested with organisations who have agreed to pilot the new Complaint Standards. The model complaint handling procedure describes how your organisation will meet the expectations of the NHS Complaint Standards in practice. Download a Word version of the model complaints handling procedure from the link below to test within your NHS organisation.
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Content ArticleRoger Kline, Research Fellow at Middlesex University Business School, comments on the Government “Action Plan” on racism.
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Content ArticlePlans to establish integrated care systems (ICSs) as statutory bodies in the health and care bill foreshadow further changes to the organisation of the NHS. Unlike previous reorganisations, the changes expected to occur in 2022 have developed from within the NHS rather than being imposed by the government. Not only this, but leaders in the NHS have also played a major part in shaping the nature of these changes in partnership with the centre. This paper from the NHS Confederation focuses on the changes needed to create the conditions in which ICSs can improve outcomes for patients and the public and outlines a series of simple rules to guide those leading the reform programme. The ideas put forward are intended to provide a basis for debate with healthcare leaders and others in England about next steps. The paper starts from the premise that a key role of leaders is to harness the intrinsic motivation of health and care staff and public health teams to perform to the best of their abilities. The distinctive contribution of ICSs is to work with partners in making use of all available assets and leading improvements in patient care and outcomes that require actions across the organisations and services that make up the health and care system. Staff must be fully engaged in this work as it is through their actions that patients and the public will experience improvements
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Content ArticleIn October 2021 the UK Government launched a review of leadership in health and social care, led by former Vice Chief of the Defence Staff General Sir Gordon Messenger. In this article, the NHS Confederation - the membership organisation that brings together, supports and speaks for the whole healthcare system in England, Wales and Northern Ireland - looks at the key issues for NHS leadership that NHS Federation members would like to see addressed in Sir Gordon Messenger’s final report, expected to be published in April 2022.
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Content Article
Safety culture discussion cards (Eurocontrol)
Patient Safety Learning posted an article in Good practice
Safety culture has been shown to be a key predictor of safety performance in several industries. It is the difference between a safe organisation and an accident waiting to happen. Thinking and talking about our safety culture is essential for us to understand what we do well, and where we need to improve. These cards from Eurocontrol are designed to help us to do this. -
Content ArticleThis interactive timeline from The King's Fund sets out reviews and other significant developments concerning NHS and social care leadership in England between 2008 and 2022.
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Content Article
Five fundamentals of civility
Patient Safety Learning posted an article in Good practice
Graphic showing the five fundamentals of civility. -
Content ArticleIncivility in the healthcare system can have an enormous negative impact and consequences. In contrast, civil behaviour promotes positive social interactions and effective workplace functioning. This article focuses on the first two fundamentals of the five fundamentals of civility: respect and self-awareness.
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Content ArticleThrough her work on a range of different elements of the Midlands leadership learning offer, Emma Coller has had great success in facilitating the development of the leadership skills and behaviours needed for positive change. Here she shares her insights on the appreciative inquiry process and how it works.
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Content ArticleThe Additional Roles Reimbursement Scheme (ARRS) was introduced in England in 2019 as a key part of the government’s manifesto commitment to improve access to general practice. The aim of the scheme is to support the recruitment of 26,000 additional staff into general practice. This is a huge ambition and requires significant and complex change across general practice. While primary care networks (PCNs) have swiftly recruited to these roles, they are not being implemented and integrated into primary care teams in an effective way. This research by The King's Fund focused on four roles to examine the issues related to their implementation: social prescribing link workers first contact physiotherapists paramedics pharmacists. The research examined the experiences of people working in these roles, and of the people managing them. It found a lack of shared understanding about the purpose or potential contribution of the roles, combined with ambiguity about what multidisciplinary working would mean for GPs. If the scheme is to be successfully implemented, it will require extensive cultural, organisational and leadership development skills that are not easily accessible to PCNs.
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Content ArticleThe announcement of the Messenger Review triggered some immediate concerns. The service has been subjected to a string of leadership reviews over the last decade. The initial media briefing, attributed to ministers, came across as unfairly critical of current NHS leadership. And there were worries about the potential for unhelpful distraction at a time of huge operational pressure. But the review brings a vital opportunity we must not miss. In light of the proposed Messenger Review, Chris Hopson delineates four areas of improvement where the NHS can improve its leadership capability and capacity
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Content ArticleThe Covid-19 pandemic has rapidly accelerated a trend of decline in access to and outcomes in healthcare. This situation means that people who have the means to do so are opting for faster, private care, creating a two-tier healthcare system. However, IPPR polling shows that near-universal public support remains for retaining a universal, free, comprehensive and tax-funded NHS. The public highly values the principles of the NHS as a system that universalises the benefits of the best healthcare and shares the cost across the population. This report by The Institute for Public Policy Research (IPPR) think tank proposes policies based on three aims: recovery, building back better and increased sustainability facing an uncertain future.
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Content Article
Crossword counterpoint: glimpses of NHS whistleblowing terrain
Hugh Wilkins posted an article in Whistle blowing
This blog is prompted by a recent newspaper crossword in which one of the clues, quadruplicated, was 'Whistle-blower'. The four answers were, respectively, 'canary', 'snitch', 'telltale' and 'betrayer'. The blog draws attention to negative perceptions of whistleblowers in the eyes of some people. It emphasises how wrong these perceptions are and how damaging this can be, with serious patient safety implications. In this blog I provide a crossword counterpoint (attached below to solve), which seeks to support learning about the realities of hostility against some staff who speak up in the NHS. I will share a follow-up blog which contains the solution to this crossword and seeks to provide further education on this topic where there is so much confusion and misunderstanding. -
Content ArticleThe West Suffolk Review, commissioned by NHS England on behalf of the Department for Health and Social Care, was published last month. NHSE/I asked the West Suffolk Board to produce an action plan for the 28 January meeting of the Board of Directors. This paper summarises the current position in relation to the learning, reflection and response thus far, including the organisational development actions that have already been taken and require further embedding. It also highlights the engagement undertaken to date, and what more needs to happen, to ensure our plans are based on the priorities for staff, governors, patients and teams and can carry the confidence of stakeholders. The report, 'West Suffolk Review – organisational development plan (p. 217)', sets out nine broad themes of work, linked to the trust’s core functions, “that capture the priority areas for organisational and cultural development at WSFT in light of the learnings from the report”. The document sets out how the trust’s governance, freedom to speak up, HR, staff voice, patient safety and other parts of its corporate infrastructure failed and contributed to a scandal.
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Content ArticleHealthcare is recognised as a high-risk industry, involving complex systems, vulnerable individuals, and constantly evolving clinical treatments and healthcare products. This is the recording of a webinar hosted by NHS Supply Chain which looked at key patient safety issues in the NHS. It includes examples of learning related to patient safety and assurance priorities for safe healthcare products and services. Speaker panel: Helen Hughes, Chief Executive of Patient Safety Learning Tracey Cammish, NHS Supply Chain Heather Tierney-Moore OBE, NHS Supply Chain Dave Fassam, Healthcare Safety Investigation Branch (HSIB)
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Content ArticleA new report by the NHS Race and Health Observatory makes robust recommendations—we must act on them, write Mohammad S Razai and colleagues in this BMJ opinion piece. The magnitude of racial health inequalities reported in the NHS Race and Health Observatory’s recent review comes as no surprise. It highlighted the overwhelming, stark, widespread, and longstanding inequalities that people from ethnic minorities in the UK experience in access to healthcare and outcomes. The report found that this occurs “at every stage, throughout the life course, from birth to death” and is “rooted in experiences of structural, institutional, and interpersonal racism.” This evidence has been known for a long time, with the disproportionate impacts of Covid-19 on people from ethnic minorities drawing even greater attention to and wider recognition of these facts. Will evidence, however, be enough to compel those charged with the nation’s health to acknowledge and take urgent action to redress these egregious inequalities?
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Content ArticleFor about two decades, the U.S. healthcare system was making strides in improving patient safety, as demonstrated by the reduction of healthcare-associated infections and other complications of care. Though there was still room for improvement, the trends were certainly in the right direction. Since the Covid-19 pandemic began, however, many indicators make it clear that healthcare safety has declined. The public health emergency has put enormous stress on the health care system and disrupted many normal activities in hospitals and other facilities. Unfortunately, these stressors have caused safety problems for both patients and staff. The fact that the pandemic degraded patient safety so quickly and severely suggests that our healthcare system lacks a sufficiently resilient safety culture and infrastructure. The authors of this article in the New England Journal of Medicine believe the pandemic and the breakdown it has caused present an opportunity and an obligation to reevaluate healthcare safety with an eye toward building a more resilient health care delivery system, capable not only of achieving safer routine care but also of maintaining high safety levels in times of crisis.
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Content ArticleThis dissertation from Ivan Pupulidy, Tilburg University, introduces a network of practices that transformed the United States Department of Agriculture (USDA) Forest Service accident investigation. This dissertation uses case studies to show the interweaving of organisational and individual journeys, each of which began with the strength to inquire and to challenge assumptions. The case studies show how constructed realities, including my own, were challenged through inquiry and how four practices emerged that supported sense making at both the field and organisational leadership levels of the organisation.
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