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News ArticleAn NHS trust has concluded that its former chief executive is not a “fit and proper person” to be on an NHS board, after investigating allegations of sexual harassment and inappropriate behaviour, HSJ has learned. HSJ understands The Robert Jones and Agnes Hunt (RJAH) Orthopaedic Hospital Foundation Trust commissioned a specialist external workplace investigation into Mark Brandreth, which considered serious allegations made about his behaviour during his time as trust chief executive between April 2016 and August 2021. Mr Brandreth is understood to dispute the allegations as well as the investigation’s findings, and is seeking to challenge RJAH’s handling of the complaints and its process for deciding he did not meet the Fit and Proper Person Test. Sources with knowledge of the situation said almost 30 female RJAH staff members came forward to give information to the investigation, but it focused on 12 employees who were willing to give evidence. HSJ has been told that as a result of the investigation, which concluded at the end of last year, the trust’s chair has informed NHSE in writing that it believes Mr Brandreth does not meet the “Fit and Proper Person Test”, implying he should be ruled out of board roles – or roles with equivalent responsibility – at English NHS organisations and adult social care providers. However, the trust, in Shropshire, is not planning to publish its ruling and – with no professional regulation in place for health and care managers and/or board members – it is unclear how effective the conclusion will be if it is not made public. A female staff member told HSJ of her concerns that “nothing is being done”. Read full story (paywalled) Source: HSJ, 21 February 2024
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Content ArticleExtracts of a letter from David Osborn to the UK Covid-19 Public Inquiry Legal Team regarding misleading evidence by Professor Yvonne Doyle, which: Highlights errors in Prof Yvonne Doyle’s evidence to the Inquiry relating to the declassification of Covid‑19 as a high consequence infectious disease. Calls into question Professor Sir Jonathan Van Tam’s evidence to the Inquiry in which he sought to attribute responsibility for the downgrade from FFP3 to FRSM to Public Health England. The letter sets out his involvement in the issue of the 4-Nations IPC guidance version 1.0 which implemented that downgrade. Further reading on the hub: Healthcare workers with Long Covid: Group litigation – a blog from David Osborn
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Content Article
In December 2022, a newly formed group called 'Long Covid Doctors for Action' (LCD4A) conducted a survey to establish the impact of Long Covid on doctors. When the British Medical Association published the results of the survey, the findings were both astonishing and saddening in equal measure.[1] The LCD4A have now decided that enough is enough and that it is now time to stand up and take positive action. They have initiated a group litigation against those who failed to exercise the ‘duty of care’ that they owed to healthcare workers across the UK during the pandemic. In this blog, I summarise how and why I feel our healthcare workers have been let down by our government and why, if you are one of these healthcare workers whose life has been effected by Long Covid, I urge you to join the group litigation initiative. -
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To coach or not to coach? Part 2 – by Dawn Stott
Patient Safety Learning posted an article in Good practice
In a new series of blogs, Dawn Stott, Business Consultant and former CEO of the Association for Perioperative Practice (AfPP), discusses how coaching and developing teams can support patient safety and its outcomes. In part one, Dawn looked at the strategies and coaching methodologies that can be used to develop individuals and to support patient safety. In part two, Dawn looks at how coaching can improve individuals, and discusses the indicators of improvement, prosocial behaviours and the importance of good communication to improve culture and, ultimately, patient safety. -
Content ArticleDr Phil Hammond dissects the medical lives of professionals at all levels of the health service in his podcast, Doctor, Doctor. In this episode, he speaks to Dr Rosie Benneyworth, interim Chief Executive Officer of the Health Services Safety Investigations Body (HSSIB).
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Content ArticleThere are many unheard and under-acknowledged voices and perspectives in the health and social care workforce, and they usually belong to those in the most junior, poorest-paid and precarious roles. All these voices deserve more attention than they get, but those of newly qualified and registered nurses and midwives are especially important given the current retention crisis in both professions. Since spring 2023, the King's Fund have been working with 22 newly qualified - newly registered if they trained internationally – nurses and midwives on a project called Follow Your Compassion. A documentary record of the everyday working lives of these nurses and midwives across a variety of settings across the UK health and care system, the project is a companion piece to The Courage of Compassion (2020), a report by The King’s Fund and RCN Foundation which described the core workplace needs of nurses and midwives, and what must be done to meet them.
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Patient Advocacy Leadership Collective
Patient Safety Learning posted an article in International patient safety
The Patient Advocacy Leadership Collective (PALC) is an innovative hub that provides connectivity, community resources, and tools focused on sustainable capacity building for patient advocates globally. The PALC is an excellent platform with a focus on supporting the growth, development, and leadership of patient advocacy organizations and offers a NextGen Leadership, Mentorship, and Global Health Fellows programme. -
News Article
‘Get on with it’: patient champion demands epilepsy drug redress
Patient Safety Learning posted a news article in News
Ministers must begin paying compensation to the families of children disabled by the epilepsy drug sodium valproate by next year, a report will say this week. The report’s author, Dr Henrietta Hughes, England’s patient safety commissioner, says valproate is “a bigger scandal than thalidomide, in terms of the numbers of people affected”. She will back calls for financial redress for the thousands of children left physically and mentally disabled. Every month, three babies are still being born who have been exposed to the drug. Speaking before the report’s launch, Hughes, 54, a GP, said the state had failed pregnant women by not telling them about key information regarding the drug’s risks. “These families have already been betrayed, because they weren’t given the right information to be able to make decisions to keep themselves and their family safe,” she said. “There are senior politicians of every stripe who have expressed their sincere sympathy and support for patients who have been harmed. I take the view that people who seek high office need to also accept the responsibility that comes with that high office. “The time for redress is now. The government is responsible. I’ve been asked to give them options for redress and I’ve done that. They have the recommendations, they have the advice, they have everything they need. Get on with it.” Read full story (paywalled) Source: The Times, February 2024 -
News Article
Rishi Sunak admits he has failed to cut NHS waiting lists
Patient Safety Learning posted a news article in News
Rishi Sunak has admitted the government has failed on a pledge to cut NHS waiting lists in England. The prime minister said the government had "not made enough progress" but that industrial action in the health service "has had an impact". Mr Sunak made the comments in an interview with TalkTV. Cutting NHS waiting lists is one of five priorities Mr Sunak set out in January 2023, along with measures on the economy and illegal immigration. At the time he said "NHS waiting lists will fall and people will get the care they need more quickly" but did not set a timeframe for achieving that. Asked if his government has failed to achieve that pledge, Mr Sunak said: "Yes, we have." The prime minister continued: "What I would say to people is that we've invested record amounts in the NHS - more doctors, more nurses, more scanners. "All these things mean the NHS is doing more than it ever has but industrial action has had an impact." Read full story Source: BBC News, 5 February 2024 -
Content ArticleIt’s long been recognised that cross-functional collaboration is essential. Still, stubborn silos that bog down execution, hamper innovation, and slow decision-making are still a common and persistent challenge. This article highlights three traits that high-performing leaders have in common and strategies for leaders to increase their own lateral agility.
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News Article
Next government should declare NHS a national emergency, experts warn
Patient-Safety-Learning posted a news article in News
The NHS is in such a dire state the next government should declare it a national emergency, experts are warning, as it emerged that record numbers of patients are being denied timely cancer treatment. It is facing an “existential threat” because of years of underinvestment, serious staff shortages and the demands of the ageing population, according to a group of leading doctors and NHS leaders. Whoever wins power after the general election will have to “relaunch” the health service and ask the public to do what they can to help save it and preserve its founding principles, they say. The call, by a commission of experts assembled by the BMJ medical journal, comes as new figures show that since 2020 more than 200,000 people in England have not received potentially life-saving surgery, chemotherapy or radiotherapy within the NHS’s supposed maximum 62-day wait. Professor Pat Price, a leading NHS oncologist who helped analyse NHS cancer care data, said that the UK was facing “the deepest cancer crisis” of her 30-year career treating cancer patients. The acute concern about the NHS’s ability to cope with the rising tide of illness deepened last night when A&E doctors claimed that a government plan launched a year ago to relieve the strain on overcrowded emergency departments had made no difference. A&E remains in “permacrisis” while care in units is “as unsafe, or more unsafe, than at this time last year”, despite Rishi Sunak hailing his “ambitious and credible plan to fix it”. Although 5,000 more hospital beds have been created, the “half-baked” plan has “made little real difference to the experience of patients and the working conditions of health care professionals”, said Dr Ian Higginson, the vice-president of the Royal College of Emergency Medicine. Read full story Source: Guardian, 31 January 2024 -
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To coach or not to coach? Part 1 – by Dawn Stott
Dawn Stott posted an article in Good practice
In a new series of blogs for the hub, Dawn Stott, Business Consultant and former CEO of the Association for Perioperative Practice (AfPP), discusses how coaching and developing teams can support patient safety and its outcomes. In part one, Dawn looks at strategies and coaching methodologies that can be used to develop individuals to be the best they can be. We all develop at different rates; having an external view point that supports your progress is something to grab with both hands. It is not about about how good you are right now; it is about how good you can be. -
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Top picks: Nurses championing patient safety
Patient_Safety_Learning posted an article in Nurses
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Nurses are at the forefront of health and social care delivery. Often they are also leading, championing and driving change for patient safety. In this edition of our ‘Top picks’ series we celebrate some of the amazing work nurses are doing to prevent avoidable harm and improve patient and staff experience. The examples below include blogs, interviews and practical improvement projects. They have been shared with us by members of the hub, a global community of people passionate about patient safety. You can sign up to the hub here, it’s free and easy to do. -
News ArticleSenior leaders are resorting to “ticking the duty of candour box” instead of developing a “just and learning” culture in their organisations because their bandwidth is full, the patient safety commissioner has said. Speaking with HSJ as she begins the second year of her first term in the newly-established role, Henrietta Hughes said the bandwidth of senior leaders is “too full for them to make and maintain the necessary culture change”. She warned the duty of candour — giving patients and families the right to receive open and transparent communication when care goes wrong — gets seen as a “bit of a tick box exercise, ‘doc tick’ as it’s described to me, which is a bit depressing really”. A GP herself, she said individual doctors typically respond to concerns or they are handled by someone who knows the patient. Elsewhere, complaints are often addressed through a chief executive’s office, once all staff have provided written statements, she said. She added: “[In general practice] it feels more compassionate and empathetic… I find it’s often quicker to have a conversation with the patient before it turns into a formal complaint and resolves it quickly.” “What needs to change is that [NHS] trusts are currently held accountable to a very narrow set of criteria — financial and operational performance,” she said. “This is how we will improve safety and experience, transparency, a just and learning culture, and improve morale.” Read full story (paywalled) Source: HSJ, 30 January 2024
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Content ArticleIn his IHI Forum 2023 address, IHI President Emeritus and Senior Fellow Don Berwick explained why competitiveness does not lead to the best possible care. He shared his view on the limitations of free-market healthcare and his personal experience of how kindness can support our efforts to improve care.
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Content Article"Our #health system in the UK is in a mess. It has failed to modernise (by this I mean to become fully accountable to #patients and the public, and truly patient-led). Instead, the system has become more and more hierarchical, bureaucratic and crony ridden, mostly as a result of constant meddling and pointless reorganisations instigated by politicians. All political parties in government for the past 30 years have had a hand in this decline." This is my view? What is yours? A new Inquiry gives us all an opportunity to have our say. I am proud to have worked in and for the NHS for most of my working life; proud to have been trained in the #NHS and proud of the work being carried out by clinical teams today. Great work which has benefited patients, often not because of the leadership but despite of the leadership. I'm retired so I can say what I like. If I were working and said anything even vaguely like criticism, however constructive it was, I would be out of a job and my career would be blighted for life. I'm speaking from experience here, unfortunately. I urge everyone to respond to the consultation (link below). In your response think forensically and write it as a statement of truth. Acknowledge the successes and areas that have delivered safe and effective services. If you are being critical give examples and say if it is an opinion or back up what you say with evidence. If we work together across boundaries we can develop a truly patient-led NHS.
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Content ArticleThe role of the board is critical in ensuring that high quality patient outcomes are first and foremost in an organisation’s culture. Health care organisations should capitalise on the expertise of their board, applying their knowledge to guide improvement in organisational performance. For board members to be effective, they need the knowledge, information and guidance on board processes that support quality and safety. By providing resources and education on best practice processes, boards can successfully impact efforts to improve quality and patient safety across the world.
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News Article
NHS trust ‘abandoned’ budding paramedic who took her own life
Patient Safety Learning posted a news article in News
Rebecca McLellan, a trainee paramedic, pursuing the job she had dreamed of as a child, took her own life at the age of 24. Amid the devastation felt by her loved ones, serious questions have now emerged about the standard of care she received at Norfolk and Suffolk NHS Foundation Trust (NSFT). In notes recorded before her death last November, McLellan said that Norfolk and Suffolk NHS Foundation Trust (NSFT) had “abandoned” her in a time of need. An internal investigation has now been launched by the mental health trust, which has been dogged by safety concerns for more than a decade. Relatives of McLellan, who lived in Ipswich, Suffolk, and was being treated for bipolar disorder, are among hundreds of bereaved families who believe their loved ones were failed under the care of the trust. Her mother, Natalie McLellan, 48, said it was clear that some of her daughter’s feelings of helplessness in her final months were “shaped by their inadequacy”. “She was somebody that had it all,” said Natalie. “She had a supportive family, she had a nice flat, she had a nice car, she was doing exactly what she wanted to do in life. She had a voice, she was able to speak and advocate for herself as a medical professional. If she can’t get help, what the hell hope is there for anybody else? Recent months have seen calls for a public inquiry and criminal investigation into NSFT after bosses last year admitted to losing count of the number of patients that had died on its books. Campaigners describe the mismanagement of mortality figures as “the biggest deaths crisis in the history of the NHS”. The Times has spoken to trust staff, bereaved relatives and MPs who say that despite repeated promises of improved care the trust’s overstretched services remain unsafe and require urgent reform. Read full story (paywalled) Source: The Times, 26 January 2024 -
Content ArticleJoint Commission Resources (JCR) has created the Board Education Resource Center: a collection of complimentary resources to give boards and executive teams the vital support and education they need to best serve their organisations and communities.
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News Article
New inquiry: NHS Leadership, performance and patient safety
Patient Safety Learning posted a news article in News
The Health and Social Care Committee has launched a new inquiry to examine leadership, performance and patient safety in the NHS. Inquiry: NHS leadership, performance and patient safety MPs will consider the work of the Messenger review (2022) which examined the state of leadership and management in the NHS and social care, and the Kark review (2019) which assessed how effectively the fit and proper persons test prevents unsuitable staff from being redeployed or re-employed in health and social care settings. The Committee’s inquiry will also consider how effectively leadership supports whistleblowers and what is learnt from patient safety issues. An ongoing evaluation by the Committee’s Expert Panel on progress by government in meeting recommendations on patient safety will provide further information to the inquiry. Health and Social Care Committee Chair Steve Brine MP said: “The role of leadership within the NHS is crucial whether that be a driver of productivity that delivers efficient services for patients and in particular when it comes to patient safety. Five years ago, Tom Kark QC led a review to ensure that directors in the NHS responsible for quality and safety of care are ‘fit and proper’ to be in their roles. We’ll be questioning what impact that has made. We’ll also look at recommendations from the Messenger review to strengthen leadership and management and we will ask whether NHS leadership structures provide enough support to whistleblowers. Our Expert Panel has already begun its work to evaluate government progress on accepted recommendations to improve patient safety so this will build on that. We owe it to those who rely on the NHS – and the tax-payers who pay for it – to know whether the service is well led and those who have been failed on patient safety need to find out whether real change has resulted from promises made.” Terms of Reference The Committee invites written submissions addressing any, or all, of the following points, but please note that the Committee does not investigate individual cases and will not be pursuing matters on behalf of individuals. Evidence should be submitted by Friday 8 March. Written evidence can be submitted here of no more than 3,000 words. How effectively does NHS leadership encourage a culture in which staff feel confident raising patient safety concerns, and what more could be done to support this? What has been the impact of the 2019 Kark Review on leadership in the NHS as it relates to patient safety? What progress has been made to date on recommendations from the 2022 Messenger Review? How effectively have leadership recommendations from previous reviews of patient safety crises been implemented? How could better regulation of health service managers and application of agreed professional standards support improvements in patient safety? How effectively do NHS leadership structures provide a supportive and fair approach to whistleblowers, and how could this be improved? How could investigations into whistleblowing complaints be improved? How effectively does the NHS complaints system prevent patient safety incidents from escalating and what would be the impact of proposed measures to improve patient safety, such as Martha’s Rule? What can the NHS learn from the leadership culture in other safety-critical sectors e.g. aviation, nuclear? Read full story Source: UK Parliament, 25 January 2024- Posted
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Content ArticleIn this BMJ Leader article, Roger Kline discusses the failings of the Countess of Chester NHS Boards in 2022 following the arrest of Lucy Letby. Roger highlights that this is not unique to the Counter of Chester: Reputation management that avoids timely decisive action is familiar to staff in many NHS organisations. Primacy of finance at a time of gross NHS under-resourcing has roots in Government policy and a national failure to challenge it. The failure of the Countess of Chester Board to be curious and create a culture where staff who raised concerns were seen as “gold dust” not troublemakers, is commonplace not unique. Roger acknowledges that there are no simple solutions but says that the regulation for managers is a performative gesture unless accompanied by other measures. He suggests that we "Make patient safety the prime litmus test for all initiatives and 'stop the line' (from Board to ward) when it is not. Do not allow organisational reputation to ever influence decision making in response to concerns. Be relentlessly 'problem sensing' not “comforting seeking'”.
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Content ArticleRecurring problems with patient safety have led to a growing interest in helping hospitals’ governing bodies provide more effective oversight of the quality and safety of their services. National directives and initiatives emphasize the importance of action by boards, but the empirical basis for informing effective hospital board oversight has yet to receive full and careful review. This article presents a narrative review of empirical research to inform the debate about hospital boards’ oversight of quality and patient safety.
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Content ArticleThe early recognition and treatment of deterioration in patients in clinical settings can help reduce avoidable deaths. NHS England commissioned Florence Nightingale Foundation (FNF) to examine the barriers which prevent worries and concerns being raised about a deteriorating patient. Evidence suggests that organisational culture, professional hierarchies, and the nature of leadership in healthcare environments are the three key factors behind this reluctance. The findings highlight the importance of psychological safety which is highly influenced by authentic leadership in overcoming these barriers.
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Content ArticleOn the 24 October 2023 the Health and Social Care Select Committee announced that its independent Expert Panel would be undertaking an evaluation of government progress on implementing accepted recommendations to improve patient safety. As part of this review, the Committee wrote to the Secretary of State for Health and Social Care requesting a list of key independent public inquiry and review recommendations pertaining to patient safety and whistleblowing in the NHS that that the Government has accepted since 2010. This letter sets out the response to this request from Maria Caulfield MP, Parliamentary Under Secretary of State.
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Content ArticleIn this interview for inews, Professor Ted Baker, Chair of the new Health Services Safety Investigations Body (HSSIB), talks about the role of HSSIB in identifying system-wide safety issues in the NHS. He discusses why we need new approaches to tackling patient safety problems and outlines the importance of considering how the wider system leads to human error. He also talks about the impact of bullying on NHS staff, describing his own experiences as a junior doctor, which nearly led him to give up his career. He also describes the vital role of whistleblowers in making changes that genuinely improve patient safety, highlighting the problems currently facing staff who speak up for patient safety.
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