Live Blog: Experience Day – Northern Care Alliance

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Today (Wednesday 26 February) we are hosting the final of our Experience Days for 2019/20. We were delighted that the Northern Care Alliance stepped forward to host the day and talk to the network about their Insights from Spreading Best Practice Across their Provider Group Model.

You can read about the previous two experience days here:

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Throughout the day we’ll be hearing from the team who work at the NCA and they’ll be sharing their insights and examples of the work that they’ve been doing. You’ll be able to folllow the day on Twitter too using #QuestExperienceDay.

We start with a warm welcome by Karen Partington who is the Chair of NHS Quest. Karen starts with a reminder about the Quest Networks shared ambitions

Next up is Raj Jain, Chief Executive of the Northern Care Alliance who starts with outlining a bit more about the Alliance. The Northern Care Alliance (NCA) was formally established in April 2017 and currently covers The Royal Oldham Hospital, Fairfield General Hospital in Bury, Rochdale Infirmary, North Manchester General Hospital and Salford Royal NHS Foundation Trust. The Alliance brings together over 19,000 staff, 2000 beds and serves a population of over 1 million.

As well as acute hospital services the NCA also works in the community and Raj highlights the work of Neighbourhood Multidisciplinary Teams who serve the populations across the NCA footprint.

Raj explains that the NCA is not a ‘Super Trust’ but each of the four Care Organisations within the NCA have their own management teams who have responsibility for that geography, ensuring operational excellence and the relationships in that area and develop their own priorities. Raj and his team play a supportive role to the teams in each of the localities and develop that capability and capacity to enable the care organisations to deliver on their priorities.

Next up is Dan Grimes who is the Director of Operations at the Oldham Care Organisation. He is sharing the organisations work on the Kindness Collaborative and their commitment to #BeKindToEachOther. He started with sharing the stat that around 80% of staff will be a recipient of unkindness and around 38% of these people would subsequently  see a deterioration in their work and performance.

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The team identified four key ‘Kindness’ metrics which they plotted on a driver diagram and identified the primary and secondary drivers. Rather than defining traditional SMART objectives to sit alongside the driver diagram they reviewed some research by Massachusetts Institute of Technology (MIT) and instead decided to describe ‘FAST’ objectives.

  • Frequently Discussed
  • Ambitions
  • Specific
  • Transparent

Dan also discussed the differences between real teams and pseudo teams and the differences in outcomes between the two. In many cases, the absence of the typical traits of real teams can result in poorer performance and less innovation.

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Following the work done by the collaborative which included techniques such as breakthrough collaboratives the team have developing a change package to support roll out across the rest of the Alliance.

  • Change 1 – Collective Restoration
  • Change 2 – Create Group Norms
  • Change 3 – Recruitment and Retention
  • Change 4 – Take Time to Get to Know Each Other
  • Change 5 – Developing Real Teams
  • Change 6 – Developing an Outward Mindset

The team have also developed and conducted a baseline assessment which will be used throughout the year and consists of four questions:

  1. Did you receive the respect you deserve from colleagues at work?
  2. Are relationships at work strained?
  3. Have you experienced bullying and harassment in the last 12 months from your manager?
  4. Have you experienced bullying and harassment in the last 12 months from other colleagues?

The next steps for the collaborative is to move to ‘kindness at all times’ rather than it just being an initiative.

We’re now joined by John Bellerby who is a Quality Improvement Fellow and he is taking delegates through the Quality and Productivity Improvement strategy which is across the whole alliance. The strategy has been influenced by a number of information sources such as patient feedback, the 10 year plan, staff feedback and incidents and complaints.

We’re now hearing from Liam Doyle and Rui Maricato who are bringing the strategy to life by talking through their work on the Deteriorating Patient Collaborative which was identified following the CQC inspection of the North East Sector of the group. To support this, the Quality Improvement team worked with staff to develop solutions that fit the geography they were working in. The aim was to reduce the cardiac arrest rate (per 1000 admissions) for Collaborative Wards by 50% by 30th November 2017.

The team used Breakthrough Series Collaboratives (BTS) and subsequent learning sets and had a number of successes including a 42.34% decrease of cardiac arrest rates. The team have also developed a change package that can be used across the Alliance.

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After a quick bite to eat we’re back for the afternoon session. Following the morning strategy session, Rob Stoker and Karen Southern from the Quality, Productivity and Improvement Directorate (QPID) are giving attendees insights into their work on the productivity transformation programmes.

The team use the principles of Managing Sucessful Programmes (MSP) to ensure use of standardisation and approach.

Rob talks us through how the team are supporting the Elective Access Programme and, following a large diagnostic piece of work  the programme has developed a 5 year vision for elective access which looks at the operating model itself and booking to also factors such as experience, reducing unnecessary contacts and switching contacts to digital.

Rob also outlines a piece of work the team did within a single service. The Dermatology team in Salford wanted to develop a One-Stop clinic at Salford for two week wait patients where patients could have excisions and biopsies taken as part of the same appointment (if appropriate). The main aims for the work were to:

  • Reduce RTT times for TWW Dermatology One-Stop patients
  • Increase TWW throughput in the One-Stop Clinics

Following the pilot piece of work the service showed significant increase in the number patients that consultants were able to see as well as a reduction in wait times for patients.

Tammy Pike, the NCAs Assistant Director for Service User Experience is outlining their work on ‘Ask, Listen & Act which puts service user experience at the heart of everything they do.

Rather than developing a strategy they designed a plan on a page which included a number of ‘I’ statements and ‘we’ statements and made sure that this was accessible, readable and a usable living document. Plan to deliver person centred care, support & treatment

After a quick brew and a cake, Helen Carter, the groups Associate Director of Assurance and Quality is sharing her learning from the Nursing Assessment and Accreditation System (NAAS) which supports teams to reach and sustain high quality of care for patients across the Alliance. Through a consistent approach, staff engagement, adaptability the team delivered an increase in the NAAS results and currently 70% of wards have achieved green status and red rated wards have reduced from 35% to 4%.

The final presentation of the day is from Alice Davies, Associate Director of Nursing for Palliative and End of Life Care who is describing the SWAN model which they use as their approach to end of live care.

  • Sign – Is the patient believed to be entering the dying phase of life
  • Words – Sensitively communicate with the the patient, those important to the patient and those coming alongside them
  • Actions – Step outside the box and facilitate what is important to the patient and those coming alongside them
  • Needs – Are the needs of the patient being met, documented and reviewed regularly

Alice also shares some of the improvements they have made which has improved the experience for both the patients and their families.

Some absolutely fantastic and inspiring presentations today and delegates are taking lots away with them. We’re so grateful to colleagues from the Northern Care Alliance for sharing their work with the network. Thank you also to everyone who joined us today, we’re already looking forward to the next one!

You can access the slides from the experience day below: