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Trusts urged to use tech...
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Modern Matron
Medical Director
Head of Infection Prevention Control
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Quality Improvement Facilitator
Programme Lead – Patient Safety
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www.patientfirstuk.com • @Patient_First • #PtFirst17
ISSUE 4
HEALTH MINISTER OPENS PATIENT FIRST 2016 WITH A WORKFORCE QUALITY CHALLENGE It takes quality people to deliver a quality health service Philip Dunne, Health Minister said in the opening address to the 2016 Patient First conference In a specially filmed presentation, Mr Dunne said that “empowering the NHS workforce” was a key priority for the Department of Health. He told a packed conference theatre that the NHS had to start investing in tomorrow’s leaders. By encouraging quality people into Board positions outcomes will improve. “Trusts have got into difficulties because of the way the organisation is structured. The best-led Trusts will deliver the best care,” he said. During his presentation, Mr Dunne highlighted workforce innovations including the appointment of Trust ‘Freedom to Speak’ guardians, to hear staff’s concerns about services or attitudes within an organisation that get in the way of patient care.
Association of Primary Care, urged the Department of Health to focus on functional rather than positional leadership. He said: “We are not looking for a hero but for quality leadership embedded in daily practice”. He also said that service providers need accurate and meaningful data. Delegates also challenged the minister about the implementation of blanket bans on agency staff, saying that this had caused services to be withdrawn until full time appointments were made. The minister was also urged to improve staff morale, to put money
Infection Prevention & Control, into taking at Patient staffing,place and to move away from a box-ticking compliance culture that stopped organisations from affecting change. First, is a two day conference and exhibition supporting He also pointed out the benefits of employing full time rather than looking for solutions to prevent harm and improve agency staff, those for patient service and financial outcomes. A common response is to spend more to solve problems but that “does not care around necessarily solve problems affecting IPC. quality”, he said. You don’t need to tell us how important Infection Prevention & Control is. No matter what your role Fifty vanguards proposals and Sustainability and Transformation within the healthcare profession… we have it covered! Plans (STPs) would support “sustainable solutions”, he added, The minister reiterated the Department of Health’s determination to deliver seven day working and he said transparency would drive up outcomes. “No-one wants to be at the bottom.”
noting that all STPs will be published by the end of the year. “These are the right way to go – organisations will be less stove-piped and more able to think about outcomes and opportunities for the NHS to keep up with rising demand.”
CQC pledges a more targeted visit in next inspection phase The next phase of inspection activity will take a more targeted and tailored approach, inspecting a limited number of core services as the norm Professor Sir Mike Richards, chief inspector of hospitals at the Care Quality Commission.
He said the approach aimed to detect risk as early as possible, and to acknowledge improvement while making effective use of resources. But, he conceded that this approach could miss problems that a more comprehensive inspection would pick up. He told Patient First delegates: “The riskiest situations are those Continued on page 5
Join us in 2017! 21st – 22nd November
ExCel London For the full conference programme & to register for your place visit: www.patientfi rstuk.com
Following the presentation, and to facilitate feedback to the minister, session chairman Dr James Kingsland, president of the National
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Trusts urged to use technology to make savings Biomedical technology is a missed opportunity to make savings Dr Helen Meese, head of healthcare at the Institution of Mechanical Engineers, told the new dedicated patient safety technology theatre audience at Patient First 2016 Speaking to the audience in this conference education innovation for 2016, Dr Meese told the audience that biomedical technology could potentially save the NHS £700 million. But, achieving these savings does require a “culture change”, she said, citing problems such as slow adoption of technology, gaps between the supply of medtechnical expertise and clinical demand, unrealistic clinical expectations, financial barriers and little in the way of sharing or collaboration between trusts.
workforce. The AAR aims to fund and stimulate access to new ‘disruptive’ technologies in the NHS and eliminate the severe harm and death that can result from medical equipment failures. She advised delegates to engage with biomedical engineering associations and staff, and local Academic Health Science Networks (AHSNs) to find cost effective solutions for patient safety.
During her presentation, Dr Meese showcased technology in use in Trusts, including lung cancer indication detection equipment that has raised diagnosis rates across the Trust from 14.5 to 25 per cent, blood flow monitors that have reduced bed stays by two days per patient and yielded £1,000 savings per patient, and bed sore sensing technology that saves approximately £50,000 per month.
TECHNOLOGY @ PATIENT FIRST:
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I’m interested in digital technology and I’ve got lots of information about new innovation. I’ve picked up some practical knowledge to take back to work too. It’s been a very useful event. Cath Love, Senior Quality Manager, Isle of Wight CCG Our clients expect us to be at this show. We’ve just launched a new suite of products and delegates have been very interested to learn more about them. We’ve had some very beneficial conversations with new and existing clients. Laura Beyers, Account Manager, Datix Networking, raising awareness and meeting new and existing clients is why we attend this show. We also get valuable ideas and suggestions from delegates that we can implement.
She urged NHS organisations to use the NHS Accelerated Access Review as an opportunity to explore ways to make better use of medtech, and the existing NHS biomedical engineering
David Proctor, Implementation Consultant, Patientrack
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Whole system data collection TOP TWEETS is the “one to crack” FROM PATIENT FIRST 2016:
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Delegates in Patient First’s new Quality Improvement theatre in association with HQIP and NQICAN were told to focus their effort on whole system data collection. In his presentation on effectively combining primary and secondary care data for quality improvement, Charlie Davie, managing director of UCL Partners, Academic Health Science Network, said: “If we can crack this one area, how much more can we do?” Looking at the results of a root cause analysis of disease prevention and stroke risk factor management in London, Mr Davie demonstrated the need for whole system systematic screening and optimised treatment of risk factors (including care settings outside hospital). He also called for the whole system to become involved in routine and systematic monitoring, and follow up, and in providing targeted support for patients. Mr Davie warned that this would demand that data collection was embedded in everyday activities, and that attention should be focused on producing outcome rather than output data to understand what is important to patients. Also important are consistent measures and an attitude of “if it adds value, do more of it,” he said.
• Include comparative feedback and incentives as motivators. He reminded that audience that IT developments such as wearable health technology and home based diagnostic equipment create data at patient level but that too much data was as difficult to manage as too little. “The easier data is to collect, the more sustainable the project will be,” Mr Davie said.
To help engage secondary and primary care colleagues in the data collection agenda, Mr Davie offered the following practical tips: • Produce guidance and education to create belief • Use review and recall initiatives, near patient tests and IT decision prompts to facilitate action
If we can crack this one area, how much more can we do?
NHS Clinical Evaluation team sees stars by year end Star-ratings for products used in the NHS will be published by the end of the year, Jill Best, NHS Clinical Evaluation Team member, told Patient First’s infection control theatre. Based on literature review and clinician input, the star system would inform purchasing and consistency within the NHS, she said. The ratings aim to support the work of the NHS Clinical Evaluation Team, which was established in April 2016,with a remit to identify products which provide a high standard of patient care and deliver the best outcomes for the NHS. This remit will be
combined with a secondary consideration as to whether individual products can be procured effectively through combined NHS buying power to deliver greater value for money.
21st - 22nd NOVEMBER 2017 DELEGATES
Further information on the team can be found on the NHS Business Services Authority website. http://www.nhsbsa.nhs. uk/CommercialServices/5650.aspx
Register your interest at www.patientfirstuk.com
EXHIBITORS Call Rizwan Khan on 0207 348 5264
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@Patient_First #PtFirst17
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How effective is your organisation at infection prevention and control?
INFECTION PREVENTION & CONTROL @ PATIENT FIRST:
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In a presentation calling for a whole healthcare economy approach to infection prevention and control, Practice First delegates heard that over 38,000 E. Coli cases were reported by NHS Trusts in 2015-16. The Health Foundation, in its 2015 learning report, ‘Infection prevention and control: lessons from acute care in England’, has published 10 components for effective infection prevention and control. These include:
nurse consultant in infection prevention and control, and Susie Singleton, nurse consultant at Public Health England, delegates received some practical solutions to the problem of infection prevention and control. These include:
• Effective bed occupancy, appropriate staffing and workload, minimal use of agency/pool nurses
• See case follow up as an opportunity to share knowledge and concerns and review practice
• Sufficient and accessible materials and equipment, and optimised ergonomics
• Involve patients and the public in action plans
• Multimodal and multidisciplinary infection prevention and control strategies
• Develop local knowledge: Document antibiotic stop/ review date, indication (medicine and surgery) and adherence to local policy or microbiology and patient information including: age, gender, antibiotic treatment to date, antibiotic susceptibility information, practice/ area
• Standardised and systematic review of practice with timely feedback.
• Use Public Health England resources to support front line clinicians in antibiotic stewardship.
• Guidelines used in combination with practical education and training
As an infection control nurse, the infection control programme at the show has been great for me. I’ve picked up data and research that I can use in my own training back at work. Suzanne Carmody, Infection Control Nurse, The Lister Hospital We came here to talk about our new products, find new products and speak to senior people in infection prevention and control. We’ve ticked every one of those boxes. We’ve met key decision makers and introduced them to our products. This show has opened doors for us.
But, how many of these are embedded into your organisation’s practice, asked Dr Raheelah Ahmad, health management programme lead from Imperial College London. Fewer than 7 per cent of organisations are implementing all 10 components, she said.
Alan Wright, Managing director, Bio-Rite We’ve had six members of staff on the stand and they’ve been busy all day. We’ve been able to engage with some senior people and get some good quality leads. This is a new technology and the industry wants us to be here.
In the presentation, which was made jointly with Carole Clive, Worcestershire Health and Care NHS Trust
Angela Vessey, Director, Antimicrobial Copper
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CQC pledges a more targeted visit in next inspection phase
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Continued from page 1
within an individual service (ie, the wards).
where the leadership is weak. That is why we will focus efforts on the leadership domain.”
“Problems tend to be found in wards that are understaffed, especially those for the frail elderly.”
He also said that subject to consultation, the new inspection process would take account of new models of care, for example, multispeciality community providers.
The audience heard that organisational culture was a predictor of a CQC rating, and Professor Richards said: “Culture may be difficult to define, but it’s easy to recognize. Good indicators of an organisation’s cultural health include:
In a review of the previous hospitals’ inspection round (2013-16), he said that 70 per cent of NHS Trusts were rated as requiring improvement or inadequate, and 30 per cent were rated as outstanding or good. Among those rated as outstanding are Frimley Health, Salford Royal, Northumbria, Western Sussex and Newcastle NHS Foundation Trusts. He told the audience that safety causes acute Trusts the biggest inspection problems, and 82 per cent of inspected Trusts ad received an inadequate or requires improvement rating for safety. However, he noted that this did not detract from compassionate care, which was universally in evidence. He told the audience: “The degree of variation between the best and the worst is large and unacceptable, and there is variation between services within a hospital and
• Staff survey • Staff sickness levels • Whether there is an open and learning culture • Whether there is a ‘them and us’ attitude. He added that in addition to the culture, influences on a rating include: • Public • Staff who are capable, confident and supported • Commissioners’ and funders’ quality expectations. He told the audience that the CQC would publish a compendium of reports, to help promote best practice.
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Improved respiratory monitoring MEDICAL DEVICES @ saves money and improves patient PATIENT FIRST: care, safety technology theatre hears I’m here for two days to learn about
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Relative changes in respiratory rate are the most sensitive and specific predictors of deterioration in patients. If these can be effectively measured, this can save lives and improve care cost effectiveness, said Myles Murray, managing director and chief officer of PMD Solutions. In a presentation showcasing PMD’s RespiraSense breathing frequency monitor, Mr Murray said the device could help healthcare professionals to more accurately identify which patients need escalated care. Current treatment pathways are “not affordable or practical,” he said.
According to Mr Murray, increased respiratory rate is an early but reliable predictor of deterioration in health, with greater sensitivity to predicting outcomes than heart or blood pressure. The audience was told that one in five patients with a respiratory rate/minute of 25-29 will usually go on to die. “Continuous respiratory rate monitoring gives an advanced warning to medical staff at the very earliest stages of patient deterioration,” he said. Product benefits of RespiraSense include automatic threshold setting, and more sensitive monitoring that avoided respiratory rate ‘noise’ that is typically associated with other than breathing artefact such as walking or changing body position, said Mr Murray.
To find out more about PMD’s solutions and how they can assist you, please visit: www.pmd-solutions.com
new technology. I’m looking for new ideas and it’s been really good. The sessions are informative, the stands have been useful and I’ve signed up to see some reps after the show. A really good event.
Alex White, Medical Device Lead, Yeovil District Hospital It has been a successful event for us. We’ve had a lot of interest from delegates, seen existing users and picked up some good leads. Simon Nicholls, Sales Manager, Omnicell
I’ve been coming to this show for three years. It’s not easy to find the time to attend, but I make sure I do because I get so much out of it. The information available here is directly relevant to what I do day to day and really enhances my knowledge. Bertha Assanta, Senior Theatre Nurse, UCLH Foundation Trust
Supported by the Horizon 2020 Research and innovation Programme of the European Union
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Antimicrobial resistance is everyone’s responsibility, Patient First hears
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Very few people think that they, personally, are responsible for antimicrobial resistance Aliya Rajah, professional training and public engagement coordinator for Public Health England’s antimicrobial resistance programme, in Patient First’s infection prevention and control (IPC) theatre. Calling for every single person to respond to the call for IPC and antimicrobial stewardship, she said: “We need to move from awareness to engagement. Every prevented infection means one less antibiotic will be used.”
“We need to work with different healthcare professionals: no one intervention will achieve the desired outcomes.” He also noted that Sustainability and Transformation Plans will have a role to play locally in engaging people in AMR.
Providing the context for the call for action is the 2016 English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) report from Public Health England, which was published just days before Patient First. This reveals that the number of people affected by antibioticresistant Gram-negative infections continues to increase. It also concludes that while antimicrobial stewardship is improving in both general practice and hospitals, further work is needed in community health trusts.
In the presentation, delegates received information on resources to support IPC and antimicrobial stewardship, including HEE resources and the Antibiotic Guardian campaign website, http://antibioticguardian.com/ To date, this has received over 41,000 pledges of action from prescribers, educators and members of the public.
Adding his voice to the call for action, Mohammed Sadak, clinical lead and programme manager for antimicrobial resistance and sepsis at Health Education England, said that action to reduce antimicrobial resistance (AMR) had to be far-ranging and multidisciplinary. He said:
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= Booked
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FLOORPLAN
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Some of our Key Features for 2017: Plenary Theatre
ary atre
Medical Device & Medicines Safety Theatre
The Home for our strategic content, the plenary theatre will deliver sessions covering the big topics affecting patient safety.
Infection Prevention & Control Theatres 1 & 2 Our two Infection Prevention & Control theatres will run two separate streams covering key areas from antimicrobial resistance, CPE and drug resistant gram negative bacteria to commissioning toolkits and CQUINS, from whole healthcare approaches to IPC and integration of IPC with other quality and safely initives to other acute healthcare environment, theatre ventilation and water safety.
Patient Safety through Technology Theatre Dedicated to technology content, this theatre will provide our existing clinical and management delegates and our new CCIO audience with sessions designed to support the uptake of technology to improve safety.
= Available
New for 2017, working in association with National Association of Medical Device Trainers and Educators (NAMDET) this show floor feature will cover best practice, safety and procurement providing invaluable content and networking for medical device safety officers, medicines safety officers and representatives from the medical equipment groups within hospitals.
Quality Improvement Theatre Working in association with the Healthcare Quality Improvement Partnership (HQIP) and the National Quality Improvement & Clinical Audit Network (NQICAN), this theatre offers a wide range of quality improvement learning. Topics covered include: Strategy and leadership, Patient safety, clinical effectiveness and Quality Improvement culture.
Best Practice Theatre Programmed by The AHSN Network, this dedicated theatre offers a two day programme with examples of excellence in patient safety, practical advice and solutions and grass roots issues across the healthcare system.
To secure a stand at the largest patient safety event in the UK or find to out more about exhibiting, please call Rizwan Khan on 0207 348 5264 or email riz.khan@closerstillmedia.com
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national coverage, naturally.
With over 100 years collective experience in advising providers of health and social care all over the country, Ridouts is uniquely placed to work with you to achieve the best possible outcome, wherever you are in the UK. • Challenging CQC / CSSIW reports • Challenging CQC / CSSIW enforcement action • Safeguarding investigations • Inquests • Funding & fees • Regulatory due diligence +44 (0) 207 317 0340 www.ridout-law.com Ridouts Professional Services Plc is a public limited company registered in England and Wales. Authorised and regulated by the Solicitors Regulation Authority. SRA Firm Number: 622241. Registered no. 09482868
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Patient safety comes from organisations doing it for themselves, says NHS Improvement
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Healthier Recruitment is a recruitment business that specialise in permanent and fixed term introductions for the NHS and private healthcare organisations. We are proud to be working with Judgement Index; the values based assessment that has developed care companies into award winning organisations and is proven to reduce staff turnover and increase care quality.
NHS Improvement will help with priority areas, but patient safety “can’t come from London”. “We want to support localities to do it themselves,” Jim Mackey, chief executive of NHS Improvement, told the plenary theatre conference. He said that he publication of Sustainability and Transformation Plans should be a good way to share best practice across a geography, and that NHSI would create governance and engagement models to support localities in driving innovation, for example, in delivering holistic care across health and social care systems.
Our Culture
“Remember when the NHS said it could never be MRSA-free,” said Mr Mackey. Our Business
He also urged delegates to move away from the “false binary choice” of financial stability or quality/safety. “We can and must do both. It is possible to make progress if your staff are properly engaged,” he said.
“But nobody from the centre can fix patient safety for you. Improvement must take place at individual, team and institutional levels. The best improvement will come from talking to colleagues and patients to see what things you can change together,” delegates were told.
Your Patients
Your Organisation
Your Team
Our objective is to offer long term sustainable value to the organisations we support. In collaboration with Judgement Index we deliver a measured in-depth understanding of the candidate. We believe that ‘caring value based behaviour’ and capacity for ‘good judgement’ are critical factors to consider when hiring.
Sharing insight gained over a long career in senior NHS management, Mr Mackey urged organisations to measure and evaluate. “There is a direct relationship between impact and an organisation’s measurement capability,” he said.
Healthier Recruitment 020 7205 2202 www.healthierrecruitment.co.uk Judgement Index UK 0800 8101025 www.judgementindex.co.uk
Organisations were also advised to try new things, measure success, and keep learning from success or failure.
PROMATICA
www.Promatica.co.uk
DIGITAL SOLUTIONS
GP Realtime management of GP alerts through distributed Dashboards
Mental Health Safeguarding or general Alerts managed through single Platform fully connected
OOH Raise alerts anytime day or night from any location for optimal Patient Safety
Acute Connected Dashboards for realtime proactive response
QAMS
CONNECTED COMMUNITY WIDE
Evidence
MDT
All MDT teams can participate and respond to Alerts and Issues with Instant feedback
Robust Evidence of change and better Outcomes for quality of care
0330 111 2842 0796 775 6921 info@promatica.co.uk www.promatica.co.uk
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Exploring the future of community health services In a presentation in the new Patient First patient safety technology, Dr Ramin Nilforooshan, consultant psychiatrist and R&D medical lead at the Surrey and Borders Partnership NHS Foundation Trust, detailed progress on an NHS Five Year Forward View test bed project. This pilots the cost effectiveness of using home-based technology in the care of patients with mild to moderate dementia. In the project, patients with mild to moderate dementia record daily data such as blood pressure, hydration status, and general activity monitoring. The data is analysed by a monitoring team, which has the ability to alert a health or social care professional or community service to deliver customised patient care, as required. Data can also be used to support additional use of the NHS. In total 1,400 people can be recruited to the project, comprising 700 people with dementia and 700 carers. A report of the project will be complete by March 2018.
time, three quarters of the NHS budget will be spent on dementia,” he said. He told the audience that these figures demonstrate the importance of properly looking after people with dementia to prevent hospital admissions. But, he said: “The current system is not patient-led: appointments are not made according to patient need and they can be too far apart. How can you summarise six months’ of life in 10 minutes? Will people remember what is important?”
According to Dr Nilforooshan, 850,000 people in the UK have dementia at a cost of £26 billion per annum. This is expected to jump to one million by 2025. “One in five of these patients are frequent users of acute health services and in 30 years’
2 1 ST - 2 2 ND N O V E M B E R 2 0 1 7 E X C E L L O N D O N
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The current system is not patient-led: appointments are not made according to patient need and they can be too far apart. How can you summarise six months’ of life in 10 minutes? Will people remember what is important?
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