A few weeks have now passed since A promise to learn – a commitment to act was published. As Director of Nursing for Salford Royal NHS Foundation Trust, I have been spending my time talking to staff and patients about the report and how we can use it to focus our efforts to improve patient safety here.
In my view, the report is a new hope for the NHS – for me it represents my promise and my commitment to the people who access services at Salford Royal and our wider population. It is also my promise and commitment to all those who work at Salford Royal and the wider NHS.
At the launch of the report, Jeremy Hunt said the Government would respond in due course to its recommendations, as they plan to respond to Robert Francis QC’s 290 recommendations in the autumn.
This, however, is no reason for others to wait. We don’t need permission from the centre to listen more carefully to what patients are telling us about our service, or to reinvigorate our own leadership with the approaches outlined in the report. So I (as I hope many others are also) am starting to work on my promise and I am paying particular attention to three areas:
- listening to staff
- listening to patients.
As the report made clear, good leadership is essential. All leaders need to clearly articulate and signal the behaviours they expect of themselves and staff within their organisation and be visible advocates for quality and safety. Staff will pay attention to what leaders pay attention to.
One way we have done this at Salford is that as well as being clear about ‘never events’, we also have a set of six ‘always events’ – the things which should always happen. They provide a clear and simple way for all of us to understand how behaviours translate into actions that improve patient care – for example they include that patients and carers will always know who is in charge of their care, and that patients and carers will always be listened to.
At Salford, we listen to staff and to patients in a range of ways. As well as the usual ways of listening – such as surveys, Patient Advice and Liason services and complaints – we use other opportunities such as our HELP (Helping to Empower Loved ones and Patients) telephone line for patients or family to alert an independent clinician of concerns regarding care whilst in hospital. We use walkrounds to not only listen to staff but to work alongside them to understand the context in which they deliver care.
I want to use the momentum of A promise to learn – a commitment to act to get deeper and really understand what patients and staff are telling us about our services and how we can improve safety. In doing so, I am preparing myself and others to welcome the warnings of problems and hear difficult messages about those intractable problems that exist but sometimes we don’t want to hear.
I am also paying particular attention to variation in care delivery – why is it that one part of the organisation seems to be able to get things right, while another doesn’t? Why do different professional groups have completely different experiences when working on the same ward? These differences will help me understand the bespoke support and interventions the different staff groups, wards and clinics need to improve quality.
I am prepared to continue to actively listen to patients and staff and I am prepared to accept the challenges that these conversations will pose to me as a leader. I promise to play my part in this generational opportunity to improve our NHS. I hope you do too.
Elaine is Director of Nursing at Salford Royal NHS Foundation Trust and was a member of the Berwick Review group, www.twitter.com/elaineinglesby