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Found 121 results
  1. Content Article
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    The Patient Safety Incident Response Framework (PSIRF) sets out a new approach to learning and improving following patient safety incidents across the NHS in England. Compassionate engagement and involvement of those affected by patient safety incidents is central to the PSIRF approach. Building on our workshop that explored different models for engaging with families, this workshop will highlight how different organisations are approaching engaging with staff affected by patient safety incidents. PSIRF webinars are open to everyone to attend, including both NHS and arm’s length bodies Presenters: Tracey Herlihey, Head of Patient Safety Incident Response, NHS England Lauren Mosley, Head of Patient Safety Implementation, NHS England, Mrs Christina Rennie, Consultant Ophthalmologist, Clinical Director of Patient Safety and Patient Safety Specialist, University Hospital Southampton NHS Foundation Trust Register for this event Registration closes at 12noon Wednesday 19 April 2023. A link to join the webinar will be sent to registered delegates shortly after registration closes.
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    Dr Kate Crossland, Guys & St Thomas' NHS Trust (2 March 2023) - as the founder of the national Palliative Care Sustainability Network, Kate talks about what motivated her to make sustainable changes in the workplace and influence changes across the wider Palliative Care field. Laura Jane Brown (14 January 2023) - talks about her recent work exploring NHS staff's attitudes to Net Zero. Dr Cliff Shelton, a leader, teacher and researcher in Healthcare Sustainability at Manchester Foundation Trust (1 December 2022) - discusses sustainable anaesthesia, peri-operative medicine and nitrous oxide manifolds. Professor Marion Lynch, Global Health Consultant and Research (24 November 2022) - talks about health and well-being to promote resilience, and empower nurses to create a modern and sustainable workforce. Rob Chuter, Christie Foundation Trust, Manchester, Radiotherapy Physicist (19 November 2022) - the Founder and Chair of the Institute of Physics and Engineering in Medicine (IPEM) Environmental Sustainability Group (ESG) chats about his passion for preserving our planet. Dr Fin Craig, Consultant in Paediatric Palliative Care, Great Ormond Street Hospital (1 November 2022) - shares his passion for all things green.
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    The Protection for Whistleblowing Bill takes this agenda forward in a meaningful and measurable way. An Office of the Whistleblower will help everyone who has an interest in removing barriers to safe care. An Office of The Whistleblower will help confirm, identify, promote and follow up on actions to resolve root causes of systemic patient safety failings. This includes building on what is already in place. Some of the benefits of the Protection for Whistleblowing Bill, from a healthcare perspective, include that the Office of the Whistleblower will be: Accessible to members of the public who blow the whistle. Providing support for genuine whistleblowers whoever they are e.g., clients, patients, carers, relatives, contractors. Providing mechanisms to ensure that the substance of whistleblowing reports is investigated. Ensuring the failings identified by the whistleblower are followed up with action. Provision so that the whistleblower knows the outcome. Scrutiny of the regulators’ approach to whistleblowing and related actions. Ensuring consistent use of accredited investigators and appropriately skilled expert witnesses. Enforcement powers.
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    The Queen Elizabeth Hospital (QEH) King’s Lynn NHS Foundation Trust is a rural district general hospital in West Norfolk. In 2019, QEH had the worst NHS Staff Survey results in the country. This case study explores what the organisation did and how it applied staff engagement methods to improve its NHS Staff Survey scores. Key benefits and outcomes QEH has been recognised as one of the most improved trusts in the country, recognising its exit from the recovery support system (previously called special measures). The trust has been recognised as a national leader for its work on menopause and supporting staff. Over 75% of QEH staff know how to access and feel comfortable and confident accessing wellbeing services.
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    University Hospitals Sussex NHS Foundation Trust identified two main solutions: Annualised self-rostering/self-preferencing rotas so staff had more control over their working hours. Introduction of a clinical fellow role with 25% non-clinical time to allow these staff to undertake other projects – for example, teaching medical students. These two solutions were initially started for the A&E departments and then medical juniors whilst implementing the same systems but also allowing for continuity of ward care. The Trust decided to use the HealthRota system, to implement an annualised system for consultants (using a period-of-activity contract), middle grades (using a combination of period-of-activity and hours contract) and junior rotas (using hourly contracts), alongside self-rostering or self-selecting preferences, with staff choosing the amount of clinical work they wish to do. The Trust now benefits from 24/7 A&E consultant cover at Brighton, and cover between 8am and 10.30pm every day of the week at the Princess Royal Hospital. In five years, the Trust went from seven consultants and seven registrars on A&E (for two sites) to 23.8 full-time equivalent consultants and 20 registrars. In addition, the costs of using locum doctors have been massively curtailed. For example, before the annualised rota system was introduced, in A&E alone £1.3M was spent on locums at RSCH and PRH. For 2022-23, the only locum need has been for sickness cover.
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    The Green Team Competition is a quality improvement initiative at the Christie NHS Foundation Trust run with support from The Centre for Sustainable Healthcare, which encourages more sustainable ways of delivering healthcare. Teams were asked for ideas to cut carbon, but also help patient care and save money. Competitors, from endocrinology, palliative/supportive care, outreach, surgical theatre, radiotherapy and anaesthesia did just this – in bucket loads! The projects were varied and ranged from streamlining resuscitation equipment and preventing theatres delays/cancellations, to removing, literally, tonnes of carbon through leaky nitrous oxide pipework. The judges were bowled over with all the results, but awarded the palliative/supportive care team as winners with their photobiomodulation therapy for treating/ preventing oral mucositis. Photobiomodulation therapy is the application of light (usually a low power laser or LED) to promote tissue repair, reduce inflammation or induce analgesia. The ‘highly commended’ award went to the Endocrine/Ward 11 team (who looked at introducing screening tools to prevent hip fractures. The results of the projects were wonderful, predicting savings of over £550,000 a year. The environmental benefits were really impressive – with carbon reductions equivalent to doing 734 return journeys from Manchester to Kings Cross! But the real overall winners are our patients. As an example, In the Palliative/Supportive Care project, Alex Langstaff (the Clinical Nurse Specialist who led the project) was able to show not only massive cost and environmental benefits of photobiomodulation, but the huge impact on patients – which the judging panel were particularly impressed with. She demonstrated significant reduction in hospital admissions and clear improvements to patient’s quality of life. Alex is now working to buy six machines to embed photobiomodulation into future treatment regimens. The Green Team Competition has inspired green thinking amongst the competitors, why not think about your own ideas?
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    Eight steps toward creating more psychological safety at work Make psychological safety an explicit priority. Facilitate everyone speaking up. Establish norms for how failure is handled. Create space for new ideas (even wild ones) Embrace productive conflict Pay close attention and look for patterns Make an intentional effort to promote dialogue Celebrate wins
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    Recommendations Disaster planning – No hospital had disaster plans for a prolonged, noninfluenza pandemic and all failed to imagine and plan for a second wave that might be worse than the first. The development of templates for local responses to major disasters, developed by experts, would relieve smaller organisations of tasks for which they do not have the appropriate staff, skills or experience. Estates – The problem of ageing and often inadequate infrastructure was a dominant theme. Problems with estates actually drove, and constrained, the pandemic response. A national stocktake of the shortcomings of hospital estates needs to be urgently undertaken, in preparation for any future pandemics. The Health Infrastructure Plan needs to be reviewed in light of the pandemic, with a view to ensuring robust supplies of oxygen and adequate ventilation and appropriate infection control measures in all hospitals, rather just in the planned new builds. Capacity – Concerns over capacity are tightly linked to the above issues with estates and buildings. Most organisations struggled with bed capacity in all clinical areas (ED, ICU and the downstream wards) even prior to the pandemic. Those that were able to readily expand capacity were those that, by chance, had unused spaces that could be rapidly repurposed. This points to the urgent need for the capacity of smaller hospitals to meet their current need, particularly with regard to intensive care provision, as well as giving consideration to how surge capacity can be embedded within organisations. Management – No organisation felt that all aspects of their management and communications were entirely right, and the interviews highlighted a number of problems with approaches taken by different organisations. The most pervasive issue was a failure to recognise that different stages of the pandemic would require different approaches. The transition out of the ‘emergency’ phase of the pandemic proved to be particularly problematic almost regardless of the approach taken. The other major issue was the extent to which organisations were able to put in place managerial structures which were robust and responsive, capable of both making short-term/tactical and long-term/strategic decisions. Few organisations actively built ‘learning loops’ into their pandemic response. These findings suggest that improving the ‘situational awareness’ of executive teams about what types of management ought to be used when, and how to switch modes, would be highly beneficial. The appreciation of streamlined processes and speedier decision-making suggests that thought ought to be given to how aspects of this can be retained, while still ensuring quality controls and good governance. Dealing with difficult behaviour – Even in organisations where operational issues could be considered to have been well managed, perverse behaviours were able to disrupt aspects of the pandemic response. Questions over who is responsible for the management of staff and to what extent staff can be compelled need to be explored at national and local levels, and the question of what the appropriate response is to such difficult behaviour needs to be answered. Mental health and wellbeing – All organisations took mental health and wellbeing seriously, putting in place programmes of support for staff. We had not expected the levels of distress that were shown from our cohort of interviewees, which strongly suggests the resources in place to support the emotional health and mental wellbeing of senior managers is s inadequate and this needs to be addressed urgently at local and national level.
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    Addressing these safety challenges must be a key priority for the new Prime Minister and Health Secretary. This report makes five recommendations, highlighting the vital role that the intelligent collection and monitoring of patient safety data, and the rapid response to any concerns they raise, can play in the continuous improvement of patient safety. Underpinning all of these recommendations is the principle that, first and foremost, patient safety needs to be seen and truly understood from the patient’s perspective. Recommendations: The breadth of patient safety data needs to increase. The accuracy of key patient safety measures needs to improve. A workforce plan for the NHS and social care system is urgently needed. Integrated Care Systems need to play a central role in monitoring patient safety. Progress in the safety of maternity services needs to accelerate.
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