CQC’s rating
Infection Prevention & Control
INFECTION PREVENTION T &CONTROL 22-23 NOVEMBER 2016
EXCEL
2016 Floorplan
Emergency Mental Health
LONDON
www.infectionpc.co.uk
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www.patientfirstuk.com
ISSUE 1 • FEBRUARY 2016
SAFETY AND FINANCE: GETTING THE BALANCE RIGHT It would take a remarkable feat of absentmindedness for anyone involved in healthcare to forget Mid Staffordshire, Francis and the removal of the ultimate excuse for patient safety failings – money. It would take a truly remarkable leap of faith to believe any healthcare organisation has actually prioritised patient safety ahead of finances since that time. So, against a background of near universal deficit of NHS provider trusts (the 2015/16 provider deficit is likely to be £1.8bn) and the need for the system to plug a £30bn funding gap by 2020/21, it was thought provoking to read a letter reminding of the need to “focus more on financial rigour as one of the routes to excellent quality” from Professor Sir Mike Richards and Jim Mackey.
Director of Patient Experience and Infection Control at Guy’s and St Thomas’ NHS Foundation Trust) to the leaked publication of the National Institute for Health & Care Excellence’s long withheld recommendations on safe nurse staffing levels for A&E departments (surprise, surprise, we need more nurses), to staff shortages that sit behind a big increase in agency staff costs. For some, the mood music is less a reminder that finances and quality should be on equal footing and more a concern that it’s all about the money, leaving patient safety at best to languish “within the resources available”.
In January, the pair – Chief Inspector of Hospitals at the CQC and Chief Executive of NHS Improvement respectively – sent a joint missive to the Big Four (chief executive, finance director, medical director and director of nursing) in all NHS trusts and foundation trusts in England sharing the early outcomes of work focused on how CQC and NHS Improvement help and support “the right finance/quality balance that we all need”.
But there’s been consistency from Jeremy Hunt that quality and safety go hand in hand with efficiency – just last summer the Health Secretary and NHS Improvement forerunner the NHS Trust Development Authority announced that beacon US hospital Virginia Mason would mentor five NHS hospital trusts. The mantra of Virginia Mason CEO Gary Kaplan is: the path to better care is the path to lower cost.
“We know that, in the past, there was a perception that delivering financial targets was more important than delivering the right quality outcomes; and that, more recently, improving quality was more important than staying in financial surplus,” they wrote.
And there are chief executives of provider trusts who have delivered cultures of safety at the same time as financial stability and been rewarded with leading national patient safety campaigns, from Stephen Ramsden at Luton and Dunstable to David Dalton at Salford.
“We want to clearly and unequivocally state, with the full support of our other arm’s length body colleagues, that your task as provider leaders is to deliver the right quality outcomes within the resources available.”
Still, however, there remains unwanted variation in performance and outcomes across UK healthcare and tails of underperformance. Yes, increasing demands on healthcare providers from an ageing population, challenging consumer expectations and pressured finances are proving a toxic combination.
This will be reflected in the single new NHS Improvement regulatory framework for all providers and the CQC inspection regime going forward. Both organisations will be aligned to give a “single clear, consistent message”. They will jointly design the approach the CQC will use to assess trusts’ use of resources – including looking at how the CQC can use the financial data held by NHS Improvement and tap into the expertise if its staff. They will also be sharing revised National Quality Board staffing guidance and a new metric looking at care hours per patient day to gauge how trusts manage staffing resource. Staffing is most certainly a contentious area, from the news that new national whistleblowing guardian Dame Eileen Sills will be carrying out the role part time (2 days a week, with the remainder of her time focused on her existing role as Chief Nurse and
Human Error, Safety Incidents, Near Misses? Human Factors Solutions for all healthcare settings; acute, community, mental, primary & secondary.
Fundamentally, however, if the argument is that safe care equates to efficient care, the entire system – whether staff, providers, commissioners, inspectors, regulators or government – needs to ensure that the right organisational strategies, culture and performance are supported by the right framework and a financial view that enables medium and long term success.
Announcing new infection prevention and control event Advances in understanding of infection prevention and control transformed surgical and medical practices and healthcare environments in the 19th and 20th centuries but the massive challenge of antimicrobial resistance is placing renewed focus on this crucial area. The new Infection Prevention & Control conference @ Patient First is recognition of the critical role of infection prevention and control within patient safety, linking the clinical and managerial communities across the commissioner and provider landscape with industry expertise. Taking place as part of Patient First at London’s ExCeL on 22-23 November 2016, Infection Prevention & Control @ Patient First will deliver over 25 sessions covering a broad range of topics for an audience of directors, heads & leads of infection prevention and control, clinicians, microbiologists and pharmacists. For more information see page 3.
Some will argue current hard talk and short term focus on financial balance – moving from an underlying provider deficit that could be £2.5bn in 2015/16 to system break even in 2016/17 – do not support this objective. For example, in what
SAVE THE
DATE! 22-23 NOVEMBER 2016
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