A year in NHS Quest – 2018

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We are delighted to start this newsletter by confirming that the North West based improvement bodies the Advancing Quality Alliance (AQuA) and Haelo have joined together as one single entity, operated by AQuA, from April 2019. You can read more about the amalgamation here.

Building on the reputation of both organisations for being trusted and respected sources of quality improvement expertise, we believe the amalgamation will strengthen our offering to NHS Quest members and help to further expand the network. We would like to thank everyone for your commitment and on-going contributions to this thriving community.

There are some changes to the NHS Quest programme team and updated details of the team can be found at the end of this newsletter.

 

Leadership Networks | Improvement Programmes | Building Capability

 

Growing membership, immersive Experience Days and improvement programmes are just some of the highlights from 2018 that are included in your NHS Quest New Year update below.

Please click here to see the full programme of activities coming up in 2019.

Membership

NHS Quest welcomed three new members into the network during 2018.

Countess of Chester Hospital NHS Foundation Trust, Cardiff and Vale University Health Board and Frimley Health NHS Foundation Trust take our membership to 16 organisations across the majority of regions in the UK.

Leadership networks

NHS Quest Experience Days provide a platform for peers to engage with each other and facilitate knowledge sharing across the network. Each experience day of 2018 was designed around a specific theme, two of which were hosted by NHS Quest members.

 

The Winter Pressures Experience Day was an intensive leadership learning day for CEO and COO member colleagues to connect as a group of system leaders from across different systems of care.

NHS Quest hosted an Experience Day on the theme of “Winter Pressures” to build a shared understanding of leading beyond hierarchy, with a particular focus on urgent and unscheduled care and winter pressures.

Participants were asked to do some pre-thinking, which formed part of the learning resource on the day. Barriers to Trustworthy Leadership were explored, including hierarchies, harsh financial realities, differing agendas, professional identities, political backdrops and disempowering contexts.

The Winter Pressures Experience Day provided a rare opportunity for senior leaders in health and social care in the North West to work as a connected group and exchange ideas with trusted peers across the UK. This was reflected in the feedback; attendees felt that the event facilitated communication and provided a shared thinking space, enabling honest discussions about leadership.

 

The Technology Enabled Innovation in Healthcare Experience Day provided an opportunity for members to see leading technologies in healthcare implemented across the system and learn about the future of digital transformation in the NHS.

Representatives from 7 NHS Quest trusts were welcomed to Homerton University Hospital NHS Foundation Trust for the day.

Tracey Fletcher, Chief Executive of the trust, explained how Homerton are seeking to improve the services they provide using technology. East London, like many other regions, has experienced rapid population growth over the past few years. This growth has driven Homerton to consider how they utilise technology to support these changes.

Dr Deblina Dasgupta, Medical Director designate, shared the story of Homerton’s digital journey, highlighting the benefits for patients. Through the Hackney IT Enabler Board, the hospital has linked with partners in a local ‘Health Information Exchange’ (HIE), which provides a connection between different systems across Hackney and allows the sharing of data. Approximately 75% of over 75s in the Homerton area now have care plans in place, which is a great achievement.

Attendees visited different areas of the hospital to experience Homerton technology first-hand. This experience was the highlight of the day for many attendees.

Dr Simon Eccles, NHS National Chief Clinical Information Officer for Health & Care, discussed how technology can transform efficiency and patient experience. He explained that patients should be empowered to manage their own care and frontline staff must be supported for digital transformation to become a reality. Simon stressed that deep understanding of the benefits of digital health tools among CEOs, clinical and non-clinical leaders can no longer be negotiable. The talk resonated strongly with many attendees, who found Simon’s vision for the future of the NHS highly motivating.

Dr Jim Richie, Consultant, Digital Control Centre, NCA, spoke about Patient Pass, an online digital referral system, which has drastically freed up the time of Speciality Registrars. Although overall referral numbers have increased since the introduction of the system, the workload of staff has not.

 

East London NHS Foundation Trust showcased the work they have embedded to improve the mental health and well-being of staff from the perspectives of service users, site leads and frontline employees.

Over 30 members with representatives from across 12 NHS Quest organisations attended the Staff Mental Health & Wellbeing Experience Day, which coincided with World Mental Health Day 2018​. After introductions from each of the trusts, ELFT’s Chief Executive, Navina Evans, spoke about the importance of learning from patients and service users. Attendees then heard from a service user, Adrian, who stressed that “nothing can beat someone with lived experience” when it comes to making meaningful improvements to mental health services.

Next was a panel interview with NHS Quest’s Marie Gabriel and Navina Evans, who emphasised that the Quest family are committed to utilising improvement methodology to increase staff wellbeing. ELFT’s move into using improvement methodology has revealed what wasn’t working well for them and allowed them to look at viable change ideas, which demonstrates the value of the network to members and their staff.

During the “World Café,” 3 NHS Quest member trusts spoke about their staff wellbeing practices. Nicole Ferguson from Wrightington, Wigan and Leigh offered key learning on CPD for staff who have experienced trauma in the workplace. Jackie Stephen from Barnet, Enfield and Haringey spoke about using quality improvement methods to raise awareness and measure the impact of increasing staff morale and reducing violence and aggression. The third session was delivered by the Wellbeing in City and Hackney team, from Homerton University, who stressed the importance of ensuring that systemic operations are working properly before encouraging wellbeing initiatives.

The Experience Day ended with sessions from ELFT leaders Andy Cruickshank, Stephen Sandford, Deeksha Mehta and Duncan Gilbert, who presented on innovating to reduce violence, creativity and culture, and the Enjoying Work QI project. Feedback from attendees was extremely positive, who felt that the networking opportunities and creativity sessions were valuable aspects of the event, and that there was “a wide range of topics with good delivery.”

For full coverage of the day please take a look at our live blog of the event.

 

The board have agreed 3 Experience Days in 2019:

  1. Leading as peers – humility to lead and courage to follow with be hosted by Huddersfield Royal Infirmary on 3rd April 2019;
  2. Achieving reliable utilisation, implementation and spread of learning at organisation and network level will be held at Salford Royal Hospital on 4th July 2019;
  3. Developing models of community integration will present learning from Cardiff and Vale University Health Board and Canterbury, New Zealand. It will take place at Cardiff and Vale University Health Board (Date TBC).

 

This year members from 14 organisations, including CEOs, Site Leads and special guests, traveled from far and wide to join the second Quest Connect event in London which focused on the future of NHS Quest and how the network can help members achieve the triple aim.

 

 

During the day, attendees heard from Mike Farrar (Director, Spread Innovations) who outlined a number of the key strategies for addressing some of the current challenges in healthcare. Mike highlighted areas where the Quest network has particular expertise, including Lean Management techniques, new digital technologies and Whole System and Integrated Care approaches. Members were also given a detailed overview of the key learning points from the CEO global study tour which fed into a wider group discussion about the most effective ways that the network can demonstrate impact.

The afternoon was focused on the Quest Outstanding Employers strategy, with an engaging presentation delivered by colleagues at Wrightington, Wigan and Leigh NHS FT who have developed the sophisticated Xopa system, the IT platform behind Go Engage, which has been designed by the NHS for NHS.

Throughout the day, members also had the opportunity to view poster presentations from Improvement Science for Leaders Alumni and to meet some of the teams who graduated from Cohort 3. Deirdre Anderson, Transformation Manager, Pedro Cunha, Colorectal Surgeon and Chioma Obasi, Quality and Patient Safety Manager described how the programme had transformed their thinking and approach to improvement. This was a great opportunity to celebrate their achievements.

The next annual Quest Connect gathering of the network will be held on 12th November 2019.

 

The CEO Global Study Tour was an intensive week of learning and analysis to identify, analyse and consider adoption of leading edge practice in a number of areas deemed essential for the creation of a sustainable NHS.

Nine trusts and organisations participated in the tour which focused on: population health management, the application of Artificial Intelligence/Machine Learning, patient safety, stratification of populations and the development of personalised care,  excellence in HR and employment practice, leading edge health innovations and creating health and well-being orientated cities and towns. A total of twelve sessions were delivered over 4.5 days, with a number of presentations being delivered by organisations working at the cutting edge of healthcare innovation.

The next CEO away day will be held on the 7th June 2019.

Improvement programmes

NHS Quest trusts strive to have the safest operating theatres in the country and have formed a Clinical Community with a shared aim of developing exceptional safety awareness and healthy departmental cultures in this high-pressure environment.

Since the launch of Clinical Communities, the NHS Quest trusts have been working on a variety of key goals, including creating of a culture of high quality care and patient safety, standardising best practice, and having the right resources. NHS Quest is helping trusts to achieve these aims through the promotion of teamwork and a shared vision, continuous improvement and learning, and learning from excellence.

Improving Theatre Safety Clinical Community events and webexes with expert panels have been running throughout 2018 at a number of NHS Quest member trusts across the UK. The fourth event was hosted by the Royal United Bath NHS Foundation Trust. Attendees represented 7 NHS Quest member trusts.

The day began with a networking activity where attendees were asked how we can engage the community with events, webexes and resources. The first guest speaker, Dr Suzette Woodward, National Campaign Director at Sign Up to Safety, led a session on Rethinking Patient Safety. Following this, Dr Lesley Jordan, Obstetric Consultant Anesthetist, offered valuable insights on perceptions around debriefing after theatre and overrunning lists. Continuing on the theme of debriefing, Catalyst Sessions with Suzette Woodward were given to promote the value of storytelling.

The second guest speaker for the day, Dr Jane Carthey, Human Factors and Patient Safety Consultant, presented Human Factors insights on debriefing. She noted that clinical communities should “Empower people to innovate and remember the debrief is a conversation not a form and we have lost sight of that. Avoid the risk of turning the debrief into another checklist.” All of the Theatre Safety events have been extremely well received by attendees, and key behavioural insights were particularly valuable to our members.

For full coverage of the day please take a look at our live blog of the event.

The next ‘Improving Theatre Safety Clinical Community’ Event will be held on the 30th of April via WebEx.

 

The aim of NHS Quest Best Employer is for members to achieve staff engagement and wellbeing scores of 4 or more by 2025. Members have developed an evidence-based model and measurement framework to enable organisations to baseline, benchmark and improve.

In July 2018, an NHS Quest Best Employer Event was held at Haelo, with representatives from 8 member trusts. Much of the day was focused on the lessons learned during the testing phase of NHS Quest Best employer, the rationale and proposal for moving forward, eliciting what data is collected locally, and deciding how best to utilise NHS Quest events for learning and continuous improvement.

The next face-to-face ‘Best Employer’ Event will be held in Salford on the 15th of April 2019.

Building Capability

NHS Quest helps build Quality Improvement Science capability through the Improvement Science for leaders (IS4L) programme, study days and bespoke training. 6 NHS Quest trusts are participating in Cohort 4 of the team-based Improvement Science for Leaders (IS4L) programme.

Bradford Teaching Hospitals NHS Foundation Trust are working to improve Medicines Optimisation on their paediatric ward. A team of pharmacists, nurses and quality & safety staff are identifying patients being discharged and the medicines they need from the pharmacy, prioritising discharge prescriptions based on bed pressures and reducing wastage of medicines. Their aim is to have 95% of paediatric patients on Ward 30 discharged by 10am on the expected day of discharge by May 2019.

Calderdale & Huddersfield Foundation Trust are aiming to improve their identification and treatment of patients with sepsis in the Emergency Department. They want 90% of ED patients to be treated with fluids and antibiotics within 1 hour of triggering Red-Flag Sepsis observations by the end of March 2019. They’re also working to achieve better communication with other departments who are part of the patient pathway. IS4L will help them bring colleagues from the ED, nursing staff and data analysts together to enable them to achieve their aims and evaluate their progress.

East Lancashire Hospitals NHS Trust is working on a Model Ward Project. Their aim is to standardise quality care across all in-patient wards, which aligns with their key organisation objective to “encourage innovation and pathway reform and deliver best practice.” The trusts recognised a need to balance patient flow with the provision of optimum patient pathways. As part of their mission, they hope to optimise handovers by ensuring that 80% of all patients on the Acute Medical Unit, requiring an admission to a respiratory ward, will have only an electronic handover by March 2019.

Homerton University Hospital NHS Foundation Trust are aiming to decrease late diagnoses of speech, language and communication needs (SLCN) in children and young people living in Hackney, East London. They hope to increase the number of children aged 5 years and under attending initial SaLT assessment by 20% by March 2019. In working with partners from across the health and education economy, HUHFT aim to progress towards a strategic goal of integration of services, as well as improving patient experience and offering a high quality and effective service to all.

Salford Royal Hospitals NHS Foundation Trust are working to develop their Nutrition Support Team. The broad aims are to: reduce A&E admissions for enteral tube related issues by 30% by March 2019; reduce harm associated with nutrition support; and establish a multidisciplinary nutrition clinic. These goals align with the organisation objectives of eliminating preventable deaths, providing reliable care, and improving patient health, wellbeing and independent living.

Wrightington Wigan and Leigh Foundation Trust have a vision of improving whole system flow to ensure that their health economy partners are working seamlessly together.  They will use length of stay and readmission rates as indictors of effect service integration, with the ultimate goal of freeing up beds in a pressured acute hospital. Their aim is to reduce 30 day inpatient readmission rates for COPD patients at their Wigan site to 12.5% by July 2019. The IS4L programme will help the trust unify and develop their team of GPs, consultants and project leads from across the borough, as well as building on their quality improvement skills.

These teams will graduate from the programme in May 2019 with a celebratory event in recognition of their hard work and fantastic achievements which are having a direct impact on improving the quality and safety of patient care.

Applications have now closed for cohort 5 of Improvement Science for Leaders which will take place from June 2019 through to March 2020.

Coming up

There are a variety of exciting events coming up for the NHS Quest network this year. Take a look at all the dates coming up in 2019, for Leadership Networks, Improvement Programmes and Capability Building.

As a member of NHS Quest, you have access to the members’ area which hosts all our programme resources. If you require log-in details, please contact the team.

Celebrations

During 2018, NHS Quest members won a number of national and local awards including Top Hospital Awards, Queen’s Award for Voluntary Services, Nursing Times Award, Patient Safety Awards and the HSJ Awards. Congratulations from NHS Quest!

NHS Quest Team

Zoe Egerickx has stepped down from her role and we would like to thank Zoe for her amazing support and contribution to the NHS Quest network over the last few years.  Zoe has ensured a solid and credible legacy for the network.

Andrea McGuinness (Head of Improvement) at AQuA is now the Programme Lead for NHS Quest and has already started to meet with some of you in her new role. Andrea has worked within the NHS for over 30 years in clinical, managerial and quality improvement roles.  A Registered General Nurse, Andrea has significant clinical background in addition to an MSc in strategic leadership and change management.  At AQuA, Andrea has lead national quality and safety improvement programmes on behalf of The Health Foundation and NHS Improvement.  A founding member of the Q Community, Andrea has also undertaken the IHI Patient Safety Officers Programme.

Neil Wilkinson has stepped into the Project Manager role. Neil has worked within the NHS for 15 years and has experience of implementing change and delivering improvement projects. Neil will be your point of contact (nhs.quest@nhs.net) for all things relating to the programmes for NHS Quest members.