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Found 127 results
  1. Content Article
    This chapter from Lucian Leape's book Making Healthcare Safe: The Story of the Patient Safety Movement examines the history of the patient safety movement in the UK. It looks at Chief Medical Officer Liam Donaldson's publication of An organisation with a memory, the establishment and subsequent reorganisation of the National Patient Safety Agency (NPSA) and other patient safety efforts by the Government across the UK.
  2. 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
  3. News Article
    The NHS must undergo radical change or it will continue to decline and lose public support, Tony Blair has argued on the service’s 75th anniversary. It must embrace a revolution in technology to reshape its relationship with patients and make much more use of private healthcare providers to cut waiting times, the former Labour prime minister says. The prevalence of chronic health conditions, long waiting times, the NHS’s stretched workforce and tight public finances in the years ahead mean the service must transform how it operates, he said. “The NHS now requires fundamental reform or, eventually, support for it will diminish. As in the 1990s, the NHS must either change or decline,” he writes in the foreword to a new report from his Tony Blair Institute thinktank, which sets out ideas for safeguarding the NHS’s future. He adds: “Change is never easy and requires brave political leadership. If we do not act, the NHS will continue down a path of decline, to the detriment of our people and our economy.” Read full story Source: The Guardian, 5 July 2023
  4. News Article
    NHS England has launched a “very aggressive campaign” to ensure all acute trusts give patients the ability to make appointments and receive messages online. Details of the new “national requirement” which must be met by the end of 2023-24 were sent by NHS England to acute trust chief information officers on Friday. NHSE wants all trust portals to integrate with the NHS App to enable patients to manage outpatient appointments and respond to messages through a single channel. Under NHSE’s requirements, the portals must: Enable patients to view their outpatient appointments; Enable the trust to send a waiting list validation questionnaire to patients; Provide patients with a single point of access to contact the provider, for example to cancel appointments; and Enable patients to access their correspondence from the trust. Read full story (paywalled) Source: HSJ, 31 March 2023
  5. Content Article
    NHS Providers offers a board development programme that aims to improve the effectiveness of NHS boards and organisations through practical, interactive training and development delivered by expert trainers with extensive senior-level sector experience. This webpage contains information about the board development programme including: core training modules. in-house training. induction programmes. bespoke development programmes.
  6. Content Article
    Behaviour Change Techniques are the ‘active ingredients’ of activities that lead to behaviour change. These cards were developed by Lucie Byrne-Davis, Eleanor Bull and Jo Hart to help those who work with people to try to change their behaviour, and particularly for educators, trainers, leaders and those involved in organisational development, quality improvement or implementation. This was was funded by Health Education England
  7. Content Article
    Delivering the future hospital is an account of the successes, challenges and learning from the Future Hospital Programme. The Future Hospital Programme (FHP) was established to implement the recommendations of the Future Hospital Commission. These recommendations were based on the very best of our hospital services, taking examples of existing innovative and patient-centred services to develop a comprehensive model of care. The FHP worked with eight Future Hospital development sites, comprising multidisciplinary teams of physicians, nurses, managers, allied health professionals, social workers and patients on discrete projects aligned to the vision of the FHC. Delivering the future hospital contains an overview of the improvement journey, outcomes and learning from each development site. In addition, to mark the end of their collaboration with the FHP, development site teams prepared a more detailed account of their experiences and learning. Both the summary and long-form reports are available from the link below.
  8. Content Article
    Is it realistic to think of separating NHS hospital sites more effectively for “cold” (elective) and “hot” (acute and urgent) care, so that outbreaks or seasonal surges don’t lead to elective care being cancelled or delayed? David Oliver, consultant in geriatrics and acute general medicine, explores this idea in a BMJ article.  
  9. Content Article
    We know that NHS organisations may sometimes need to reorganise their services to consider how they can best deliver care to patients. This can mean there is a need to repurpose existing environments, for example hospital wards or clinical areas. Staff may also be redeployed to deal with surges in demand when the pressure on the system is at its greatest. We commonly see this during winter, with ‘winter pressures’ wards, but we have also seen this become more common during other times of the year as the NHS deals with the lasting impact of coronavirus (COVID-19) and staff shortages in some key areas. It’s important that the NHS has this ability to adapt to try and make sure it can deliver the best and safest care to as many patients as possible. The ability to flex in this way helps to keep the NHS operating when it is at its busiest and makes sure that patients can still access appropriate care. Scott Hislop, the Healthcare Safety Investigation Branch (HSIB) Principal National Investigator, looks at the challenges faced by the NHS when flexing to meet demands and how to mitigate potential risks to patient safety.
  10. 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.
  11. News Article
    Dr Ted Baker has been formally appointed as the new chair of the Health Services Safety Investigations Body (HSSIB). The Secretary of State for Health and Social Care, Rt Hon Steve Barclay MP, made the announcement today (1 December 2022). Dr Baker is a retired consultant paediatric cardiologist, and most recently was Chief Inspector of Hospitals at the Care Quality Commission (CQC) between 2017 and 2022. Dr Baker says: “I am delighted to be joining such a ground-breaking organisation. I have been impressed by the quality of the work coming from the HSIB and I am excited to be joining the organisation at such an important time in its history." Source: HSIB, 1 December 2022
  12. News Article
    The ghosts of medical errors haunt Dr. Peter Pronovost. Two deaths, both caused by mistakes. First, his father’s, who died as the result of a cancer misdiagnosis. Then a little girl, a burn victim who succumbed to infection and diagnostic missteps at the hospital where Pronovost worked early in his career. Those deaths led Pronovost to pursue a medical career dedicated to patient safety, and to create the medical checklist he has become known for worldwide. Now, he’s implementing his second act, at University Hospitals in the USA, as its Chief Transformation Officer, a job he has held since late 2018. His goal: To transform a $4 billion health care system by reducing shortcomings in medical care and increasing the quality of treatment. The challenge fits Pronovost, says one of his former Johns Hopkins University professors, Dr. Albert Wu. “He’s one of the few people for whom the title might be appropriate, because his work has led to significant changes and innovations in how we deliver health care in the United States. “He’s a once-in-a-generation guy.” Read full story Source: Cleveland.com, 9 February 2020
  13. Content Article
    This 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.
  14. Content Article
    The focus on error detection and its management has not produced the expected gains in patient safety, primarily because these methods are not well suited to a complex adaptive system such as healthcare. Behaviours that produce errors are variations on the same processes that produce success, so focusing on successful practices may be a more effective tactic. One approach to focusing on success is positive deviance. While positive deviance can be used to describe the behaviour of an exemplary individual, the term can also be extended to describe the behaviours of successful teams and organisations.  Originating in international public health projects, positive deviance has recently been embraced to improve quality and safety of healthcare delivered in organisations. The premise is that solutions to common problems mostly exist within clinical communities rather than externally with policy makers or managers, and that identifiable members of a community have tacit knowledge and wisdom that can be generalised. Lawton et al. explain more in this BMJ article.
  15. Content Article
    The 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.
  16. Content Article
    If the NHS is to meet the challenges ahead, the people profession, which comprises human resources and organisational development practitioners, has a key role to play in shaping the future. This includes steering organisations towards the vision set out within the People Plan: more people, working differently, in a compassionate and inclusive culture. The Government recently announced that additional funding will be invested in the NHS over the next three years, funded by a new Health and Social Care Levy and a rise in dividend tax. The people profession – working alongside other decision-makers in the NHS – will have a key role in optimising available resources and maximising the value of taxpayer investment, to support recovery of routine services, to tackle waiting lists, and to deliver the care that NHS patients need. This report sets out a vision for how the people profession will develop and work differently over the coming decade. It draws on the diversity of voices from across the profession and beyond. It also sets out a roadmap for action.
  17. Content Article
    This document provides guidance for maternity services and Local Maternity Systems on how to develop a local plan for achieving Midwifery Continuity of Carer as the default model of care offered to all women. The guidance sets out recommended practice, how delivery against these plans will be assured nationally, and how provision will be measured at provider and Local Maternity System level. Midwifery Workforce Tools designed to help midwifery leaders safely plan, simulate and design maternity services can be used alongside this guidance.
  18. Content Article
    Appreciative inquiry is a collaborative, strengths-based approach to change in organisations and other human systems. It identifies the positive strengths of an organisation or system and builds on these, rather than focusing on problems that need to be fixed. This article for PositivePsychology.com outlines the history, theory and framework of appreciative inquiry, as well as looking at real-life examples.
  19. Content Article
    People in Place highlights the fundamental skills and people issues which will determine the future of health and care in the UK. The Covid-19 pandemic has made these issues clearer and more pressing, but it has also revealed an appetite for change and resulted in innovative ways of working. This report argues that building effective collective leadership into systems and places is vital to overcome staffing and governance issues in the NHS. Focusing on building long-term frameworks for change rather than responding to immediate pressures, it suggests practical tools and resources that could be used to bring about transformation within the system.
  20. Content Article
    The biopsychosocial model is both a philosophy of clinical care and a practical clinical guide. Borrell-Carrió et al. discuss the principles behind the biopsychosocial model and its application.
  21. Content Article
    The biopsychosocial model outlined in Engel’s classic Science paper four decades ago emerged from dissatisfaction with the biomedical model of illness, which remains the dominant healthcare model. Engel’s call to arms for a biopsychosocial model has been taken up in several healthcare fields, but it has not been accepted in the more economically dominant and politically powerful acute medical and surgical domains.  This editorial from Wade and Haligan reviews the historical context, achievements and recent developments of the biopsychosocial model, with a view to explaining how the model could be better employed to help (re-)organise and improve both the efficiency and the effectiveness of healthcare systems. This could improve patient outcome while also controlling costs.
  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
    Quality improvement and patient safety have been important topics on the agenda in the Danish health care system for >20 years. Over the years, Denmark has developed an array of national quality and patient safety initiatives.  This paper aims to describe how quality improvement and patient safety initiatives have been organised in the Danish health care system and highlight how accountability has been achieved.
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