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Found 136 results
  1. News Article
    An interim national director of patient safety has been appointed, after the permanent postholder was seconded to the Care Quality Commission. Professor Ramani Moonesinghe will replace Aidan Fowler, who is to be the CQC’s interim chief inspector of healthcare. His secondment is expected to last six months and will be full time. Professor Moonesinghe has been NHSE’s clinical director for critical and perioperative care since 2020. She played a key part in the pandemic, leading on the NHS’s critical care response. She works as a consultant in anaesthetics, perioperative and critical care medicine at University College Hospitals London Foundation Trust and is a professor of perioperative medicine at University College London, where she leads on a patient safety research collaborative. She is also head of the Centre for Perioperative Medicine and the Research Department for Targeted Interventions at UCL. Read full story (paywalled) Source: HSJ, 6 March 2025
  2. Content Article
    Technology plays an increasingly important role in our health and care system. It allows us to consult specialists and receive care from home, order medications using our phones, and receive new digital treatments. This shift towards technology can, and should, be positive; technology can drive change, facilitating better patient outcomes and experiences. However, NHS patients struggle with aspects of digital health care, such as having multiple apps with siloed records, fragmented digitalisation, a lack of digital options, and insufficient accessibility features.  This study from the King's Fund aimed to understand the skills, knowledge and capabilities needed for health and care systems to do this well. 
  3. Content Article
    Leeds Teaching Hospitals NHS Trust discovered a significant budget shortfall and had to act fast. The financial picture would only get worse unless they reduced spending. The Trust mounted an unprecedented response in record time, rallying 800 staff to come up with solutions in a massive, coordinated improvement workshop. The results were phenomenal — saving millions of pounds with a variety of updates to staffing and scheduling practices. And the Trust proved it was up to any challenge, no matter how large. “Our people, our culture and our methods came through for us in the most impressive and inspiring ways. When you invest in those components completely, it pays off a thousandfold,” — Professor Phil Wood, Chief Executive at the Trust.
  4. Content Article
    A new government has come into office facing public services in dire straits and a tough financial climate. Inevitably, finding ways to boost public sector productivity has come to the fore. This paper, authored by Alex Fox and Chris Fox, argues that traditional approaches to improving public sector productivity, such as adopting private sector practices, technology-driven reforms, and tighter management, have failed to address the complex and evolving needs of public service users. It proposes a shift towards a strengths-based, person-led model, where public services are co-produced with individuals, families, and communities.
  5. Content Article
    Identifying high and poorly performing organisations is common practice in healthcare. Often this is done within a frequentist inferential framework where statistical techniques are used that acknowledge that observed performance is an imperfect measure of underlying quality. Various methods are employed for this purpose, but the influence of chance on the degree of misclassification is often underappreciated. Using simulations, this study shows that the distribution of underlying performance of organisations flagged as the worst performers, using current best practices, was highly dependent on the reliability of the performance measure. When reliability was low, flagged organisations were likely to have an underlying performance that was near the population average. Reliability needs to reach at least 0.7 for 50% of flagged organisations to be correctly flagged and 0.9 to nearly eliminate incorrectly flagging organisations close to the overall mean. The authors conclude that despite their widespread use, techniques for identifying the best and worst performing organisations do not necessarily identify truly good and bad performers and even with the best techniques, reliable data are required.
  6. News Article
    Changing chairs, CEOs and finance chiefs has helped turn around several poorly performing trusts and systems, NHS England has said, but it plans to do more to “strengthen” leadership at troubled organisations. Dame Emily Lawson made the comments in an update to NHSE’s board on its “recovery support programme”, which is the current name of its intervention regime for the most poorly performing trusts and systems. The NHSE chief operating officer said: “We know we have got more to do… to strengthen leaders at the most challenged places. We are developing a more systematic way of identifying and developing talented leaders and matching them to roles where they can make the biggest impact when in post. “That means we need to give leaders the right flexibilities, incentives and support to turn things around.” Read full story (paywalled) Source: HSJ, 6 December 2024
  7. Content Article
     The NHS Oversight Framework (NOF) outlines NHS England’s national approach to oversight of integrated care board (ICBs) and trusts, and how it monitors performance against key NHS commitments. The Recovery Support Programme (RSP), working with regional and national NHS England teams, provides focused intensive support and oversight to ICBs and NHS trusts/foundation trusts that are in segment 4 of the NHS Oversight Framework. The RSP has been in place since July 2021 and replaced the previous special measures’ programmes. There are currently 20 NHS providers and 3 ICBs enrolled in the RSP and the list of organisations is published on the NHS England website. Organisations in the RSP receive support (for example, financially and through the provision of additional resource) for a time-limited period with exit criteria agreed that will demonstrate sustainable improvement and recovery. The RSP approach can be applied to an individual NHS organisation, or across a whole system, comprising the ICB and constituent NHS providers. This paper outlines the current RSP approach and describes the work underway to update NHS England’s approach to improve performance in the most challenged organisations.
  8. News Article
    ECRI, a global nonprofit organisation improving the quality and safety of healthcare in the USA has announced that it has acquired The Just Culture Company, which specialises in transforming workforce culture in high-risk industries. The Just Culture Company assists organisations in deploying a balanced system of accountability between the organization and employee that fosters a fair, learning culture – referred to as a “just culture” – by implementing its proprietary algorithm through advisory services, educational programmes and coaching. Through the acquisition of The Just Culture Company, ECRI now operates a leading cultural transformation organisation. “Alarming rates of preventable harm are inflicted on patients every day. By offering Just Culture programs throughout ECRI’s global network, we can prevent harm before it happens,” said Marcus Schabacker, PhD, president and CEO of ECRI. “To create lasting change and improve patient and workforce safety, we must shift from evaluating accidents and errors after they’ve taken place, to designing systems and cultures that prevent harm from happening in the first place.” The Just Culture Company has partnered with healthcare providers, health departments and insurers to assess and improve workforce culture, from C-Suite to frontline staff, through a holistic systems-based approach. “Our just culture model is founded on the principle that workforce learning, holistic system design, mentoring, and coaching are stronger interventions than the ‘shame and blame’ culture that’s so prolific in healthcare,” said David Marx, CEO of The Just Culture Company. “Errors must be recognized and addressed in a way that become learning opportunities for all the people in the system.” Read full story Source: ECRI, 2 December 2024
  9. Content Article
    The Patient Safety Authority (PSA) has published its ambitious new strategic plan, Reimagine Patient Safety 2029, with PSA’s vision of “safe healthcare for all patients” central to the plan’s three core goals summarised below: Push the boundaries of information science: Harness existing and cutting-edge information science to identify and understand patient safety issues. Leverage relationships: Collaborate with key stakeholders to implement impactful changes that improve patient safety. Maintain a strong organisational culture: Prioritize people and continuous organisational improvement.
  10. Community Post
    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?
  11. Content Article
    As the NHS is approaching its 75th birthday, this report from the Tony Blair Institute for Global Change proposes how the NHS needs to transform if it is to survive. The paper propose six areas for reform where radical-but-practical policy action will begin to transform the future of the NHS and deliver better patient care: 1. Put patients in control of their own health: First, the government must provide every person with a digital Personal Health Account (PHA) that offers a simple, single digital front door to the NHS and wider health-care services. It will become the portal through which people interact with the NHS, allowing patients to have direct access to services, including general practitioner (GP) appointments, at-home diagnostic services and even opportunities to participate in clinical trials. Most importantly, it will give people direct access to and ownership of their health data, including information provided by third-party providers or wearable technologies. 2. Create new access routes for services and providers: The range and availability of health-care services must increase to reflect citizens’ demands and their increasingly complex needs. Pharmacies, gyms, supermarkets, workplaces and other spaces should all be able to provide or facilitate the provision of health care, bringing services closer to patients and reducing demands on general practice. Most importantly, the PHA will create a new marketplace for services. This should focus on high-volume, low-complexity services – for instance dermatology – to make them directly available to patients. Introducing multiple providers, including third parties, will offer patients greater choice through the ability to balance outcomes, waiting times and costs. 3. Harness the power of genomics and other “omics” platforms to personalise care: The NHS Genomic Medicine Service should be made accessible to more patients for a greater range of conditions to improve early diagnosis, prevention and treatment. Specifically, universal clinical whole-genome sequencing should be offered to all patients upon disease diagnosis, all newborns and all healthy populations with known risk factors, including a family history of disease. As science progresses, other omics disciplines such as proteomics and metabolomics, should be integrated into routine clinical care, to improve the prevention, management and treatment of disease. 4. Create a locally led and self-improving system: There must be a new deal for accountability and autonomy between Whitehall and the Integrated Care Systems (ICSs). This must allow local leaders to operate with much greater freedom and hold them to account for delivering a set of clear and transparent outcomes focused on creating and improving health, rather than simply treating sickness and delivering against activity targets. ICSs should also be given multi-year budgets that are adjusted for the needs of their local population. And they should be allowed to keep and redeploy savings from innovating and improving care. Finally, quality and care outcomes should be made transparent and available to patients to empower them to make an informed choice between GPs and secondary care providers within an ICS. 5. Invest in new and more efficient infrastructure to deliver better care: NHS productivity and efficiency must be transformed through investment in basic technology as well as increasingly powerful AI, and by enhancing existing infrastructure. This will require upfront investment but will be offset, at least in part, through increased automation of processes and by finally tackling wastage across the system. The future operating model we are setting out in this paper will be much more capital intense, much more efficient and much less reliant on labour. 6. Energise and modernise the NHS workforce: The new NHS Long Term Workforce Plan is welcome and will provide much-needed investment to help create a pipeline of future talent, increase long-term capacity and provide new training routes to increase workforce diversity across the NHS. However, the NHS is facing an immediate workforce crisis with concerns over staffing pressures and pay that must be resolved. In addition, putting more staff into an outdated and unproductive delivery model is not sustainable and much greater focus is needed on harnessing the potential for technology to improve the efficiency of services, help to reduce the demands on frontline services and improve outcomes for patients. In addition, a comparable commitment and long-term plan is needed for social care and public health to create fully supported health and care services.
  12. Content Article
    The government has published its mandate to NHS England. This mandate is intended to apply from 15 June 2023 until a new mandate is published. NHS England has a duty to seek to achieve the objectives in the mandate. The Secretary of State keeps progress against the mandate under review, setting out his views in an annual assessment which is laid in Parliament and published. The government will agree with NHS England how it should report on overall progress against the mandate to support the Secretary of State in keeping this under review. This will include reporting at agreed intervals on other delivery expectations listed beneath the objectives. Mandate objectives Priority 1: cut NHS waiting lists and recover performance. Priority 2: support the workforce through training, retention and modernising the way staff work. Priority 3: deliver recovery through the use of data and technology. Continue work to deliver the NHS Long Term Plan to transform services and improve outcomes.
  13. News Article
    A teaching trust has had its maternity services downgraded to ‘inadequate’ after inspectors found stillbirths and massive haemorrhages were not being treated as ‘serious incidents’. Maternity services at St George’s University Hospitals Foundation Trust in south London were previously inspected in 2016, when they were assessed as “good”. The Care Quality Commission (CQC) said serious incident declaration meetings at St George’s were regularly classing serious incidents as “adverse incidents”, meaning executives were not informed and there were missed opportunities for learning and development. Inspectors also found incidents such as severe perineal tears, emergency hysterectomy, and birth injuries were rated as causing low or no harm when a higher level would have been appropriate, or and sometimes downgraded from a higher rating. Carolyn Jenkinson, CQC’s deputy director of secondary and specialist healthcare, said: “We saw areas where significant and urgent improvements are needed to ensure safe care is provided to women, people using this service, and their babies. “Both staff and people using the service were being let down by leaders who failed to respond quickly, resulting in care that was unsafe, and in the delivery suite, also chaotic.” Read full story (paywalled) Source: HSJ, 17 August 2023
  14. Content Article
    The publication of a new single, shared improvement approach, ‘NHS Impact’, is an exciting milestone. It reflects recognition, at the highest level in the English NHS, that improvement principles need to be part of the mainstream approach to the challenges facing the sector. Penny Pereira, Q’s Managing Director, considers the new approach, its potential impact and what it means for members and others working to improve health and care in England and beyond.
  15. Content Article
    Does your manufacturing facility experience an undesirable frequency of costly product losses? Are recurring operational issues impacting productivity and morale? Do people believe the causes of these production issues are ‘human error’? Do Quality Differently will show you: How to take a systems-based risk management approach to create more operational success. Practical examples to guide improvement in your operations. Ways to apply comprehensive approaches that reveal and address the combination of factors that influence performance outcomes. The lessons in this book were gathered while integrating human and organisational performance principles and practices at multiple biopharmaceutical companies and manufacturing sites—real-time experiences with frontline workers, support staff, and leaders. Do Quality Differently offers practical guidance for biopharmaceutical manufacturing plants and beyond—anywhere managing risk is paramount. Clifford Berry and Amy Wilson share a recent presentation that summarise key points from the book: HOP Integration - Berry Wilson.pdf
  16. Content Article
    Hospitals can significantly elevate patient satisfaction and enhance the delivery of healthcare services by incorporating best practices from adjacent and non-adjacent sectors. Chetan Trivedi explores several solutions, from multiple sectors, that can serve as a blueprint for hospitals across every key step of the patient journey, spanning from admission to discharge.
  17. Content Article
    The NHS is at a critical juncture in its 75-year history. With finances as tight as they have ever been, and a workforce stretched to breaking point due in part to spiralling demand from an older and sicker population and a shrinking labour pool, it is clear that things cannot carry on as they are. The time has come to think and act differently – at every level of the health and social care system – and to do so at pace. This long read describes five guiding principles that should inform implementing the NHS Impact approach to improvement at provider, ICS and national level to maximise the chances of success in the current climate. We also present recommendations for provider organisation, system and national leaders on the steps needed to translate these principles into sustained improvements across ICSs.
  18. Content Article
    This factsheet explains more about how the new independent Health Service Safety Investigations Body (HSSIB) will function
  19. Content Article
    MIT Sloan experts offer a systematic approach to organisational resilience that can help leaders manage risk and rebound rapidly when catastrophic events strike. In their executive education course, “Building Organizational Resilience: A System Approach to Mitigating Risk and Uncertainty,” Carrier and Levi lay out a playbook for improving organisational resilience. They advocate for an approach that leans on systems thinking and continuous improvement to help organisations identify problems before they occur. They also detail how to identify the right intervention points in operations and the supply chain to help an organisation stop or recover from an evolving critical situation before its impact turns catastrophic. In this article they summarise the key advice from their resilience framework. "It starts at the top with C-suite executives who are fully committed to understanding what’s happening on the front lines so they can ask the right questions and be open to the right recommendations and actions."
  20. Event
    until
    Following on from an initial webinar held in September 2021, this is the first in a new series of four webinars designed to support Q members to develop a deeper understanding of Quality Management Systems. Through an interactive session, with guest speakers Dr Amar Shah (East London Foundation Trust) and Dr Nicola Burgess (Warwick Business school), participants will: Gain understanding of the principles and mechanisms that organisations apply to deliver whole organisational quality management. Recognise different levels of organisational maturity and to be able to assess their own organisation against these levels. Consider “where to start?” through discussing and learning from others are different stages of organisational maturity. Whole organisational quality management relies on the support of colleagues at all levels across an organisation. So for this webinar we encourage you to bring a colleague. Pass on the invitation and make sure they know that you don’t need to be a Q member to join.
  21. News Article
    The offices of the World Health Organisation (WHO) for the Quality of Health Care and Patient Safety will be located in Athens, Health Minister Vassilis Kikilias and the WHO Regional Director for Europe, Hans Kluge, announced on Friday after their meeting in Copenhagen. "The choice of Greece is a recognition of the work by Prime Minister Kyriakos Mitsotakis, the Greek Ministry of Health and the Greek government in managing the pandemic and implementing public health policies, such as the successful implementation of the anti-smoking law, and promoting important reforms, such as passing the law for the establishment of the National Organisation for Quality Assurance in Health," the health ministry said in a statement. "Greece has recently led important developments in the field of health, such as legislation banning smoking in public places, the launch of the National Anti-Smoking Action Plan and reforms in the field of primary health care." "All the above, in combination with the excellence of the Greek health institutions and the leading researchers in the field of health and wellness, indicate a strong leadership within the European Region and beyond. In addition, they create an ideal framework for the creation of a much-needed centre of excellence in the field of quality healthcare and patient safety." Read full story Source: The National Herald, 16 October 2020
  22. Content Article
    Human Factors and ergonomics (HFE) expertise continues to have difficulty integrating its experts into healthcare. This persistent disconnect is compounded by unique aspects of healthcare as an institution, industry and work system. Clinically embedded HFE practitioners, a new HFE sub-specialty, are a conduit for addressing substantive mismatches between the two domains. Greater HFE penetration will require a fundamental change in stance for both domains, however, the burden will lie with HFE to be the more adaptive of the two. Learning more about the in situ work of this sub-specialty will provide insights for more nuanced approaches to bridging domain specific mismatches and obstacles.
  23. Content Article
    Workforce burnout and resilience in the NHS and social care report describes the causes and effects of burnout among staff working within the National Health Service as well as the impact of Covid-19 on burnout. 
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