AQuA Welcomes Delegates to First Event on Whole System Flow

Last week we welcomed over 80 delegates for an exciting first look into Whole System Flow, as part a new programme of work between AQuA and The Health Foundation.

Delegates join us at the Samlesbury Hotel, Preston for our first event on Whole System Flow.

Colleagues from both AQuA member organisations and wider afield joined us at the Samlesbury Hotel, Preston to learn about our latest developments around this work.

At the event, our Chief Executive David Fillingham discussed the need and context behind developing this new offer, and how we hope to take it forward over the coming year.

Speaking after the event, he said “As this new piece of work begins to gather pace, it was fantastic to see so many of our members and colleagues from across health and social care join us to hear how we hope to take this forward.

We know that solving the complex issues behind Whole System Flow will require a joined-up approach across different organisations, services and staff, and we’re really grateful such a positive input from delegates to help shape our next phase of work over the coming months.”

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, it is considered a priority for the NHS if we are to understand and solve the complex issues behind delays in services, and make efficient use of staff, services, equipment and information.

Throughout the day Wendy Lewis, our Programme Lead for Whole System Flow, also led a number of workshops and activities with delegates; reflecting on the benefits behind system thinking and exploring how organisations might better work together to understand systems of care and design innovative solutions.

We were also joined by Christine Owen from the Improvement Hub at Healthcare Improvement Scotland, who gave an overview of their work on Flow in Scotland, as well as Bryan Jones of The Health Foundation.

In September, The Health Foundation will be publishing a paper on David’s initial findings on Whole System Flow. We will also be discussing this further at a second event to be held in October, with further details to follow in the comings weeks.

Below you can find a collection of tweets throughout the day:

UKIA members visit the North East Transformation System

UKIA members visit the North East for the
latest on Lean methodologies.

A team of staff from the Advancing Quality Alliance (AQuA) as well as other members of the UK Improvement Alliance (UKIA) recently travelled to Gateshead for an exciting visit hosted by the North East Transformation System (NETS), to share work on their latest improvement projects.

The UKIA, of which AQuA is a founding member, aims to bring together organisations from across the UK's four countries, to share best practice on quality improvement and learn from each other.

Over the two days the group explored Lean tools and methodologies for improvement in healthcare, alongside colleagues from Haelo, Healthcare Improvement Scotland, 1000 Lives Improvement NHS Wales and Yorkshire & Humber AHSN.

In his first network meeting as UKIA Director, Richard Taunt explored the following questions with members:

• How members continue to foster successful improvement relationships
• How members facilitate new and joint improvement projects
• How UKIA can work as the 'front door' to improvement work across UK healthcare

Members also welcomed Jim Mackey, Chief Executive of recently established NHS Improvement, who discussed the latest developments to drive improvement across the whole of the NHS, and how to balance competing demands between quality, finance, innovation and performance.

Lesley Massey, Director at AQuA, said: "As the work of the UKIA gathers pace, this was a great opportunity to come together with members to look at the latest thinking and shining examples behind Lean methodologies.

"Everyone really enjoyed the opportunity to see Lean in action, with visits to the Surgical Care Centre, Pathology hub, and Urgent Care Centre at Queen Elizabeth Hospital in Gateshead.

"We were also very grateful to Jim Mackey for joining us from NHS Improvement, and hope we can continue to support the drive for quality improvement at a national level."

Richard Taunt, UKIA Director added, "The visit to Gateshead was super for a number of reasons: the honesty of Jim Mackey, the expertise of the Trust, but above all the commitment of UKIA members to working together to improve health and care really shone through.

“As we move into our next phase of development as an Alliance, we're starting from great foundations."

For more information on the UKIA, please visit their website or follow them on Twitter @TheUKIA. You can also follow Richard via @RichardTaunt.

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.

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.

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.

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.

AQuA Staff become Dementia Friends

AQuA Staff with Dementia Friends pledge cards.

The Advancing Quality Alliance (AQuA) was delighted to welcome volunteers from the Alzheimer’s Society, to deliver a series of Dementia Friends Information Sessions to increase staff awareness of the disease.

Taking place ahead of Dementia Awareness Week 2016, these sessions form part of the Alzheimer’s Society national campaign to create dementia-friendly communities and confront misconceptions. Leading the training was Sheelagh Machin, one of AQuA’s Lived Experience Affiliates and volunteer for the Alzheimer’s Society.

During the sessions, staff took part in talks and discussions about the disease to help understand the condition better, and dispel some of the stigma and myths associated with dementia. Staff were also encouraged to become Dementia Friends by pledging to raise awareness amongst friends, family and other colleagues.

Sheelagh also spoke about her own personal experience of caring for both of her parents who were diagnosed with dementia.

AQuA Director Elizabeth Bradbury said: “Our session was an hour well spent. We really connected with the topic of dementia, and what this means for each one of us personally, particularly with many staff touching on their own experiences of the condition.”

“It also gave us the chance to think about our professional roles supporting dementia, and reflect on the implications for some of our work with AQuA members.”

With 35 staff now trained as Dementia Friends, all staff thoroughly enjoyed taking part in the training and learning more about dementia.  AQuA also welcomed the chance to take our first step towards becoming a dementia friendly organisation.