Building skills for safety at board level

About the Safety Measurement and Monitoring programme

Our Safety Measurement and Monitoring programme began in December 2014. The aim is to test and develop the measurement and monitoring framework developed for health care by Professor Charles Vincent and colleagues.

We selected regional improvement bodies to deliver the programme through seven separate projects based in northern England and in Scotland. Each body is working with frontline NHS organisations over 18 months to test and develop the framework’s approach. The projects cover a diverse range of care, including:

• Developing measures to improve ambulance service safety  (North West Ambulance Service NHS Trust)
• A whole system approach to using data to improve safety in acute mental health services (NHS Tayside)
• Sharing learning and data to improve safety during transitions and handovers of care (Bradford District Care Trust)

Making Safety Visible

The Making Safety Visible programme was funded as part of this work. It aims to help boards and governing bodies improve how they measure the safety of care provided by their organisations. The programme is doing this by building the capability of senior leaders across over 20 health care organisations, and enabling them to apply the latest thinking to the measurement and monitoring of safety across their health and social care economies

The work is led by Haelo, Salford’s innovation and improvement science centre, working with the University of Manchester and the University of Oxford, who will be completing a full ethnographic evaluation of the impact of the work.

An important part of the programme is that it doesn’t just work with individuals from one organisation – such as a senior management team, or board. Instead, it brings together senior teams from across the whole health economy of an area, including clinical commissioning groups, senior leaders in social care, trust boards and local authorities.

The health service often has a focus on past harms. Abigail Harrison, Associate Director of Measurement and Innovation at Haelo, explains that this project is about getting people who work at a senior level to think in a radically different way about safety.

‘We wanted people to have the capacity to ask different questions of the data they’re being presented with. What is this telling us about safety today? Where are our gaps? How do we understand safety in real-time? And how do we use our measurement and monitoring data to predict and prevent safety issues from occurring?’

Participants are also encouraged to take practical steps to improve the way safety is measured and monitored, testing different approaches across their health economy using PDSA methodology.

‘What I really liked is [Haelo] has brought us all together. It is the whole health economy. It is not about primary care, it is not about secondary care, it is about putting the patient at the heart of everything we do.’ Dr Umesh Prabhu, Medical Director, Wrightington Wigan and Leigh NHS Foundation Trust

How does the programme work?

The learning programme uses the Breakthrough Series Collaborative model. Running the programme for the first time, Haelo brought together over 150 senior leaders from Greater Manchester and the surrounding area for three fast paced, engaging and interactive learning sessions, held over five days. Each learning session had a theme: Past, Present and Future – encouraging participants to break out of the mindset of focusing solely on past harm, and to think about reliability, real-time data, anticipation and preparedness and how to integrate all of their new thinking and learning in to their daily work.

Participants learned about theory through rapid fire presentations from experts in the field. They also explored new and innovative concepts and set themselves an overarching safety goal from which to develop a ‘safety measurement and monitoring’ plan.

Abigail says, ‘We found all the teams would have a clear articulation of their goal for the individual organisation, but not across the health economy. The space we were giving them and the questions we were helping them think through were really valuable. They could really think about what the challenges were and what they wanted to achieve, together.’

Evaluating success

The primary goal of the learning programme is to help people to think differently – and that can be hard to measure. An independent evaluation is being undertaken by the University of Manchester for which researchers are conducting interviews and observing board meetings, to get a sense of how conversations are starting to change across the health and social care economies involved.

Secondly, the programme aims to improve the way that safety is measured and monitored, and in the long-term, to have an impact on patient outcomes, not just in an acute setting but across the wider health and social care economy. Haelo is working on case studies which showcase work the participants have begun and will revisit these in 6-9 months’ time to encompass the longer term outcomes of the work.

‘It's about understanding how we use the data that we've got more effectively, so that we can be proactive in managing safety, rather than reactive.’ Karen Sharrocks, Head of Strategy and Corporate Services, Chorley and South Ribble CCG/Greater Preson CCG

For more information

For more information on the Making Safety Visible programme, visit the Haelo website. There are short films from the learning sessions and reviews, live blogs and resources from the learning programme and the Making Safety Visible summit. You can also search #makingsafetyvisible on twitter.

Making Safety Visible will be running again in 2016/17. To find out more about the next series of learning events, and enquire about joining the second cohort please contact katharine.goldthorpe@nhs.net