Wednesday, June 22, 2016

Blog: Magic in the Mundane - The Chemical Solution

Emma Walker - Portfolio Lead, - Academy, Safety
& Mortality and Shared Decision Making
Writing in 1988, Avedis Donabedian suggested that the key markers of high-quality care are outcomes. The likelihood of achieving these outcomes is increased if organisations have the necessary structures and processes of care in place to meet quality standards.

In other words, to deliver a high quality outwards-facing ‘product’ requires continually improving internal structures and processes.

This was reinforced for me when a team from AQuA made the short trip to Ellesmere Port in Cheshire to visit Innospec, a specialist chemicals company, traditionally specialising in octane additives used in making motor fuel. With demand for lead in petrol decreasing, in 2006 the entire existence of the business was under threat. They were faced with two choices: innovate or disband.

Ten years on, not only have Innospec survived, but are thriving, adding whole new lines of business such as 'performance chemicals' (that’s ingredients for shampoo to you and me). What’s been behind their success? Five factors became apparent.

  1. Focusing on leadership
    Innospec have demonstrated strong, stable and decisive senior leadership from the very outset of their improvement journey. They have clearly set the strategic vision, established acceptable standards, and followed through on promises to drive the business forward. This ability to look ahead and make long term plans about how to transform a business to meet the changing demand of customers is something that has perennially challenged NHS organisations all too often caught in management flux.

  2. Pre-empting failure
    All members of Innospec staff to speak up and articulate "What might go wrong here?" By identifying which mistakes could lead to a major incident, they are confidently able to predict the consequences of each error (e.g. would it lead to major harm?). By developing systems to mitigate human error they have made it easy to do the right thing and hard to do the wrong thing. This proactive approach to anticipate and be prepared for problems chimes with the Health Foundation and Professor Charles Vincent’s framework for measuring and monitoring safety.

  3. Learning from errors
    Innospec were keen to demonstrate how they learn from incidents, errors and near-misses, with a culture focused on learning not blame. They design processes with the customer at the centre, proactively ensuring there are sufficient measures in place to catch errors before they lead to harm. Initiatives such as ‘Near Miss of the Month’ awards help make safety everyone’s responsibility.

  4. Behavioural safety
    Innospec have developed a specific ‘behavioural safety’ training programme in order to embed a strong safety culture in all their staff. They utilise the risk elements of processes to drive safety improvements rather than as a ‘box ticking’ exercise. Impressively, all members of staff we spoke to felt able to detail potential hazards without hesitation or fear of reprisal – a real testament to their open and transparent culture. This approach links with AQuA’s approach to psychological safety, with programmes including resilience, appreciative inquiry and human factors.

  5. Culture
    The culture of Innospec is supported by leadership, but encourages a “bottom-up” approach to improvements. Their focus was on utilising the appropriate tool or technique in the right situation, rather than being hung-up on a specific methodology. The primary focus is on making incremental changes and process improvements using whichever technique fits the need of the business within a particular situation. This approach has the benefit of having the flexibility to vary depending on what they are trying to improve.
At this point you may well be thinking that this is nothing new, that there’s nothing here you haven’t heard before.

If so, you’re absolutely right.

Innospec didn’t go from the brink of failure to market-leading because of a magic bullet – the creation of an 'accountable fuel additive care organisation' if you will – but rather because they focused on the basics, and didn’t let their attention waiver for year after year. Mundane? Maybe. Effective? Certainly.

In our work at AQuA we have seen many times that such a focus on the basic components of improvement delivers results in healthcare (a point also made by Nigel Edwards in his recent blog on the Vanguards). Our work programme has been designed to help our members innovate, improve and develop – all while building a culture now which will sustain improvements into the future. To find out more, visit the AQuA website.

You can follow Emma on Twitter at @EmmaCherub or follow AQuA @AQuA_NHS.

This blog was originally published by the UK Improvement Alliance (UKIA). To find out more about their work please visit their website, or follow them on Twitter @theUKIA.

Tuesday, June 14, 2016

Exploring Whole System Flow event - 5 July


As part of an exciting new programme with The Health Foundation, we'll be hosting our very first event exploring Whole System Flow, 9:00am - 3:30pm on  5 July at the Samlesbury Hotel, near Preston.

Whole System Flow describes the coordination of all resources across a locality to deliver effective, efficient, person-centred care, in the right setting, at the right time.

Also referred to as Patient Flow, solving complex issues behind bottlenecks and delays in services is seen as a national priority for the NHS, if we are are to make efficient use of staff, services, equipment and information.

At the event, we'll be sharing our latest learning and developments on our work so far, and exploring some of the benefits of improved system thinking on safety, outcomes, productivity and experience as part of a whole system community.

We'll also be working with members to better understand the complexities behind their different systems of care, as well as looking at some of the key issues affecting flow and how we might work together on innovative solutions to these.

This event ideal for system leaders, senior decision makers, finance directors and informatics leads.

Please download the event flyer for further information, or book your place here.

If you have any queries about the event or would like to find out more, please email AQuA@srft.nhs.uk, or call 0161 206 8938.

Monday, June 13, 2016

Join us at NHS Confederation 2016

This week we'll be attending the annual NHS Confederation 2016 conference and exhibition in Manchester.


As the voice of NHS leadership and employers across the country, Confed brings together and speaks on behalf of the whole health and care system.

With a range of leading figures from healthcare, NHS staff and partners in attendance, the conference is always an exciting chance to explore latest developments and share learning alongside colleagues from across the country.

This year's conference will be focusing heavily on efforts to transform health and care for patients, and looking at new and emerging models of care, redesigning health and care systems, and better integration and efficiency of services.

We're delighted to be attending this year's conference, and look forward to meeting AQuA members and colleagues from across the NHS to share our work, and learn how other organisations are improving care for patients.

Come and visit our team at Stand 129 inside the exhibition hall, which you can find on the exhibition floor plan. We'll also be tweeting updates throughout the day from @AQuA_NHS with the hashtag #Confed2016.

You can also find a full programme of events and activities, as well as a list of speakers on the conference website, or follow @NHSconfed on Twitter for updates.

Wednesday, June 1, 2016

Success for AQuA Members at HSJ Value Awards 2016

AQuA members were among the finalists at this year's HSJ Value in Healthcare awards, which celebrate improving the value and efficiency of health and care services.

We were pleased to see a total of 11 of our member organisations represented at the ceremony in Manchester, and would like to congratulate them on their hard work in reaching the finals.

Staff from Wrightington, Wigan & Leigh NHS Foundation Trust collecting their award.

Wigan, Wrightington & Leigh NHS Foundation Trust celebrated success after collecting the award for estate management, whilst Wirral University Hospitals NHS Foundation Trust were also highly commended in the non-clinical support services categories.

Other AQuA members nominated for awards were:
  • East Lancashire Hospitals NHS Trust
  • Lancashire Teaching Hospitals NHS Trust
  • Mid Cheshire Hospitals NHS Foundation Trust
  • Pennine Acute Hospitals Trust
  • Pennine Care NHS Foundation Trust
  • Salford Royal NHS Foundation Trust
  • University Hospital of South Manchester NHS Foundation Trust
  • University Hospitals of Morecambe Bay NHS Foundation Trust
  • Warrington & Halton NHS Foundation Trust
Full nominations can be found on the awards website, and we look forward to seeing more success for our members at next year's awards.