Blog - Patient: Engaging, sharing, supporting – Part 1

Kayleigh Price is AQuA’s Improvement Lead for Safety & Mortality. In part one of her blog, she shares some of her reflections on patient experience from the recent International forum on Quality and Safety.

Kayleigh Price

Last week I was lucky enough to attend the BMJ/IHI international forum on Quality and Safety in London, with a number of colleagues from AQuA. I had the opportunity to present a poster on the Measurement and Monitoring of Safety Programme, but that is not what I wanted to write about in these blogs…

Brains at the door and bodies in the room?

The messages coming out of the forum were loud and clear. Service users want to be involved in decisions about their care. They do not want to be an afterthought. They want to be engaged at every level of their care.

In the opening keynote session, Lord Darzi and Don Berwick were lightly grilled by two patient advocates; Margaret Murphy and Anya de Longh. The pair were firmly in the driving seat, as Margaret reminded us that our service users hold down jobs, look after their families and generally make decisions all day every day.

She then asked why it is that healthcare thinks people leave their brains at the door when they come in to have their bodies treated. And this is a very good point. If we want to move towards a shared decision making approach, we need to remember that our service users have brains, opinions and feelings and that they shouldn’t be  afraid to express them.

Service users say what we are too afraid to

I then attended a session focusing on how patients were engaged with the Q programme and the importance of engaging for a reason was emphasised. To cut a long story short, they were saying that engagement cannot be a tickbox exercise and advised a 4PI model for service user involvement, which encourages us (those in health and social care in general) to think about:

• Principles
• Purpose
• Presence
• Impact

They highlighted the fact that service users can often say the things that our clinicians and other healthcare staff can’t. They don’t have the fear of repercussions that we may have, or the need to navigate the political climate of the NHS. Where we might be thinking it but too afraid to say it, our service users will likely not feel the same restraints we do. After all, they are the ones who will be affected by the decisions we make, so why should they feel they cannot speak up?

Break the focus on transition

Next was a session on the ‘Patient Centred Health Care Home’ which extolled the benefits of involving patients in planning for transitions. The speakers in this session posited that we should consider movement between services less as a transition, more as an expansion or retraction of the current health delivery team.

Basically, the idea is that the service should expand and contract around the needs of our service users. The patient, their family and the GP are the core team (or health care home) and they draft in extra support from other services as and when the patient requires it.

This represented a different way of thinking about how patients move through the system, and for me highlighted the need to ensure primary care, and our patients are fully in the loop about the services they access. Which brings me rather neatly on to session four…

Patients records - partnerships of trust

This session was called ’Twelve Years of Empowering Patients, Improving Lives and Feeling Fabulous’ with the #Empowerlution. This session was presented by one Ingrid Brindle, chair of the award winning Haughton Thornley Patient Participation Group, and her general practitioner Amir Hannan.

They spoke about the fact that healthcare likes to hold on to the information we have about patients. We don’t like to give our patients access to their medical records. Ingrid and Amir posed to us that actually the very person who should have the access to the whole medical record is the patient. They are the ones making decisions about their health and healthcare on a day by day basis. The takeaway message was that ‘health is a lifetime project for us all, and we need all of the tools to manage it’.

To be continued?

In the next part of my blog, I will talk about patient innovators, technology and then hope you’ll join the conversation as I pose some questions on my final thoughts.

Read part two of Kayleigh’s blog here.

You can also share your thoughts with Kayleigh via Twitter @kayleighprice14, or email Kayleigh.price@srft.nhs.uk.

Blog - The Promise of Manager-Clinician Partnerships in the NHS

Andrew Wilson is a Senior Business Intelligence Analyst at AQuA. Following his visit to April’s International Forum on Quality and Safety in Healthcare in London, he shares his thoughts on how the NHS needs to bridge the gap between clinicians and managers…

Andy Wilson

There were many fault lines that scarred society in 2016. Deep divisions between young and old, town and country, were evident across the social fabric of these shores throughout the last year. When we think back to the world of 2015, it feels more distant rather than a mere eighteen months ago.

Whilst there is no doubt that, like any other area of government, the process of leaving the European Union will have a significant impact on healthcare, the opening paragraph was not written with Brexit in mind.

Whilst Brexit will undoubtedly have an impact on the NHS, the focus of this blog is on junior doctors. In early 2016, the junior doctors’ strikes were leading news stories for several weeks. Strong opinions were held on both sides of the argument about the morality of the strikes, their impact on patients, the main protestations of junior doctors and who is responsible for this disagreement reaching this point.

Whichever side or viewpoint you took on the junior doctors’ strikes, I’m sure that you would agree that these are the clinicians who in five, ten or twenty years from now will be clinical leaders across the NHS.

Throw into the mix the pressure the NHS will be suffering over the next decade, a larger population with greater healthcare needs, you could be forgiven for thinking that the chasm between junior doctor and management of the NHS is not traversable.

Learning from Guy’s and St Thomas’ example

At the Quality Forum conference I was fortunate enough to attend a presentation by Joanne Ward (a deputy general manager) and Chris Meadows (a Critical Care Consultant) at Guy’s and St Thomas’ NHS Foundation Trust.

Joanne spoke of how she felt it was critical that she spent more time in the clinical setting she was managing, to better understand the work the clinical team undertook, and their perspective of how the NHS functioned.

Chris told delegates of his experience as a new consultant, attempting to encourage his juniors to develop a better understanding of the work NHS managers do, and how the NHS functions. He also spoke about how their roles cross paths, and how the Trust had developed a programme to pair similar junior doctors and NHS managers, with the idea of letting them lead on a quality improvement project.

The programme consisted of a series of workshops and shadowing of roles to match managers and clinicians. The result of this was to have a formidable partnership that could engage with fellow clinicians to establish the underlying problem affecting patient care and work with managers to explore all options to achieve an improvement. Joanne and Chris also went on to talk about the various achievements of these partnerships had had at the Trust.

Hope for positive partnerships

So despite the picture of doom I painted earlier in this, I want to stress that here is just one (and I’m sure there are many more) tangible example of quality improvement working alongside the clinical leaders of tomorrow.

The gains in fostering more of these Manager-Clinician relationships are potentially massive in patient and experience terms, and there is a simplicity to their work financially too.

Link junior doctors with people who have the capability to change patient pathways, and you can achieve improved patient outcomes and a more engaged staff.

Blog - Thinking Safety at the Quality Forum

Andrea McGuinness is AQuA’s Programme Lead for Safety & Mortality. Here she shares her some of her early points from April’s International Forum on Quality & Safety in Healthcare Conference.

Andrea McGuinness

Even as I write this just half a day through the conference, I am already overwhelmed with the sheer volume and brilliance of health and care staff from across the globe.

The passion and ingenuity of people and most importantly, the pride with which they continue driving safety and quality, humbles me.

Here I just wanted to share with you a few key themes picked up from the conference so far…

Doing care with, not to

We need to make it the norm to have patients and families leading safety improvement. After all, who has most to lose when care goes wrong?  We have endless possibilities available to us once we get over doing to, and move to doing with patients and families.

Quality improvement and safety culture

The second theme making a massive impact on me is the power of quality improvement to provide safer cultures within all teams and across all aspects of health and social care. 

Speakers here are sharing how QI with leadership support releases staff to make services safer. It creates purpose and meaning for staff who are often frustrated and caught in a spiral of dissatisfaction about the services in which they work.

We have to choose to make a positive experience

My final theme is around the value and passion, commitment and concern that our staff have for the services they work in. What role do we have in creating positive environments for all those who experience health and care? Those who use and those who work within them?

Leadership, influence, permission and values are something every single one of us can affect. We all have the choice to do this. We can choose to make a positive difference   No one chooses to make a negative impact but do we sometimes choose not to bother?

What we see and hear from AQuA members, and from the international safety community, is that when we learn and share together we make it easier to make a positive difference, and we’ll be sharing more of our learning from the conference in the coming weeks.

You can find more about our work to improve safety on our website. Please do drop us a line if you’d like to discuss this, or anything in this blog further, at either @1McGuinness on Twitter, or via andrea.mcguinness@srft.nhs.uk.

AQuA Members – Join Our Engagement Sessions and Help Improve Our Programmes

We’d like to invite members to join us at our upcoming engagement sessions in May, to share their ideas and help shape our future improvement capability programmes.

Sessions will give members the opportunity to have a say in the content of our Building Capability for Improvement offers, which aim to develop the necessary improvement skills, capabilities and behaviours to support members in their individual role and level within the health and care system.

Liz Twelves, Academy Programme Lead, said:

“These sessions are a great chance for members to come along, get involved and explore ideas around what they find useful or want to see more of from our core quality improvement training and opportunities.

"Since AQuA started in 2010, we've trained over 9000 members in quality improvement, and want to make sure that support continues to be genuinely relevant across the whole range of roles environments they work across within health and care.

"As an organisation we really stress the importance of co-production, and we hope these sessions will help us to capture the valuable experience and insights from our members."

Currently our programmes are structured into four tiers, spanning frontline services right up to Board level. This spring our Academy team are reviewing how these opportunities work for members, including by considering who accesses these programmes and training at different tiers, and the various content and theories behind our teaching.

Sessions will take place at our offices in Sale on the following dates:

• CANCELLED - Friday 5 May, 10am – 12:30pm
• Thursday 11 May, 10am – 12:30pm

We are particularly interested in involvement from members who have attended any of the below programmes, though please feel free to come along if you have attended others.

• Introduction to Improvement / Quality Improvement (QI) Basics
• Introduction to Lean
• Improvement Practitioner
• Advanced Improvement Practitioner
• Board Development / Improvement Fellowships

If you would like to attend one of these sessions, please contact Jonathan Bevan, Academy Project Manager via Jonathan.Bevan3@srft.nhs.uk.

If you can't attend either of the sessions but would like to share your thoughts on our programmes, we would welcome your views via email, or can even arrange a telephone discussion. Please get in touch with Jonathan via the email above.

Please note, onsite parking is limited and will be allocated on a first-come first-serve basis. For details on alternative nearby parking, please visit our website.

Take our Survey - Share your Thought on Developing an AQuA App

AQuA is exploring the types of benefits an app could bring to its members, with the aim of adding value to the range of services, products and advice offered to health care organisations.

We would welcome your thoughts and views by completing the following short survey (approximately 5 minutes to complete).

An application or “app” is a type of software which runs on mobile devices such as handheld smartphones and tablet computers. Mobile apps are an increasingly popular digital trend with innovative, user friendly features which aim to;

• Support consumers’ lifestyle activities and interests: through online shopping apps, games and fitness/running trackers etc.
• Improve workplace productivity and efficiency: through notification reminders of important events/meetings, appointment scheduling, video and telephone conferencing
• Give direct convenient access to a range of information: including; emails, calendars, videos, news and weather reports

And much more….

Click here to take the survey

Please note this survey will close on 21 April 2017.

The REsTRAIN YOURSELF programme has been shortlisted for a prestigious national Patient Safety award

The University of Central Lancashire (UCLan) in partnership with the Advancing Quality Alliance (AQuA), have been shortlisted for a prestigious national Patient Safety award following their programme to reduce restraint in acute mental health, known as ReSTRAIN YOURSELF.

Paul Greenwood, AQuA Improvement Advisor

The Patient Safety Awards, which are now in their 9^th year, continue to recognise and reward outstanding practice within the NHS and independent healthcare organisations. UCLan and AQuA have been nominated in the Mental Health category. The REsTRAIN YOURSELF programme, which was funded by a grant from the Health Foundation, enabled UCLan as the lead partner and AQuA to work closely with mental health wards across the region to test and adapt an evidence based model called the 6 core strategies in the UK with a strong focus on trauma informed care. The evaluation work of this programme was undertaken by UCLan and together they have recently published a toolkit to support other organisations to reduce the use of restraint.

Paul Greenwood, Improvement Advisor at AQuA and lead for the REsTRAIN YOURSELF programmes said:

“I’m delighted that this work has been recognised by the Patient Safety awards. The partnership between AQuA and UCLan has started to build a really strong evidence base through the hard work of staff across the Trust’s in the region in reducing restraint in challenging environments. We hope that the toolkit we have recently developed will enable the learning to be spread across the UK and beyond.

“It’s an honour to be recognised alongside some other fantastic work in Mental Health and I’m looking forward to finding out the winner!”

Following their shortlist, the team will be travelling to London to present to the judges with the winners announced as part of the annual Patient Safety Congress which is being held in Manchester on the 4^th and 5^th July. 

We'd also like to congratulate the following members who also reached the awards shortlist:

• Blackpool Teaching Hospitals NHS Foundation Trust 
• Cheshire and Wirral Partnership NHS Foundation Trust 
• East Lancashire Hospitals NHS Trust 
• Lancashire Care NHS Foundation Trust 
• Lancashire Teaching Hospitals NHS Foundation Trust 
• Liverpool Community Health NHS Trust 
• Liverpool Heart and Chest NHS Foundation Trust 
• Mersey Care NHS Foundation Trust 
• NHS East Lancashire CCG 
• Salford Royal NHS Foundation Trust 
• St Helens and Knowsley Teaching Hospitals NHS Trust 
• Stockport NHS Foundation Trust 
• The Christie Hospital NHS Foundation Trust 
• University Hospitals of Morecambe Bay NHS Foundation Trust 
• Warrington and Halton NHS Foundation Trust 
• Wrightington, Wigan and Leigh NHS Foundation Trust

Useful Links:

Blog by Paul Greenwood on the work of the programme

RestraintReduction Toolkit

Blog - Joining the Improvement Mission - Jonathan Bevan

Jonathan Bevan, Project Manager

Jonathan Bevan joined AQuA at the start of 2017 as Project Manager for the Academy team. Here he reflects on his first few weeks in the role, and what he’s learned about the NHS and quality improvement so far…

Having previously worked alongside health service professionals and researchers in an academic environment, and with daily exposure to news stories about crises in the health and care sector, I have a good understanding of the pressures faced by my new colleagues in the NHS and beyond.

It may be a bit clichéd to talk of austerity limiting budgets and the ongoing need to ‘do more with less’, but this is the reality for health and care professionals. AQuA was established to help its members improve quality and increase efficiency in the delivery of health and care services.

The role AQuA has in helping improve outcomes for service users, as well as identifying and implementing cost saving opportunities, is invaluable, and I’m proud to have had the chance to join an organisation dedicated to addressing this need.

It took a while for me to gain an appreciation of the broad range of activities across the organisation, and its constituent programmes. AQuA’s structure and strategy is designed to adapt to reflect the changing landscape of health and care services, and AQuA’s ‘offer’ adapts to address national, regional and institutional priorities.

The mission of the AQuA Academy is to help build the capability and equip our members’ workforce with the skills and knowledge to identify and implement improvement work, by providing a programme of courses, coaching and mentoring opportunities.

Like in previous years, the programme is designed to cater for staff at all levels of an organisation, by offering four ‘levels’ of support from junior staff to board level. This reflects our belief that improvement is everyone’s business.

We’re currently designing our AQuA Academy 2017/2018 programme of courses, coaching and mentoring opportunities. It’s been a useful time for me to be getting started, as I’m able to be involved in the planning and to provide input from the start of a new ‘business cycle’.

In the new programme, the Academy will continue to offer innovative and inspiring core and bespoke courses on quality improvement, delivered by experts with experience of the sector.

Uniquely, I think Academy events usually involve two facilitators, which means that delegates can benefit from the advice and attention of two experts during group work. It’s also worth noting here that the involvement of our Lived Experience Panel also provides delegates with invaluable perspectives from service users, patients, carers and families.

It’s clear to me that these events provide fantastic development opportunities, represent excellent value for members, and the AQuA offering compares favourably with other management consultancies.

Finally, I’d like to thank my new colleagues for the welcome I’ve had to AQuA. I’m impressed by their expertise, their attitude and their commitment to providing training and consultancy to members and partners.

I’m excited by the prospect of working in this team, and the opportunity to bring my experience, skills and ideas to help continue AQuA’s mission.