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Avon & Wiltshire Mental Health Partnership was fined £80,000 in August by Taunton Magistrates’ Court after the trust admitted that it had failed to provide safe care and treatment to people in its care.
The Care Quality Commission brought the prosecution following an incident at Applewood Ward, an inpatient mental health ward unit in Swindon that cares for people who need to be admitted to hospital as a result of severe mental health problems.
In this series of case studies, we highlight what providers have done to take a flexible approach to staffing.
The case studies show different ways of organising services. They focus on the quality of care, patient safety, and efficiency, rather than just numbers and ratios of staff.
They illustrate how providers have redesigned services to make the best use of the available range of skills and disciplines. Or they found new ways to work with others in the local health and care system.
The RCN has published a report outlining the evidence behind its calls for specific legal responsibilities for workforce planning and supply across the health and care system.
The report, titled Standing Up for Patient and Public Safety, follows the release of recent NHS figures showing there are now a record 43,617 vacant nursing posts in the NHS in England.
Free access. Despite consensus that preventing patient safety events is important, measurement of safety events remains challenging. This is, in part, because they occur relatively infrequently and are not always preventable. There is also no consensus on the ‘best way‘ or the ‘best measure’ of patient safety. The purpose of all safety measures is to improve care and prevent safety events; this can be achieved by different means. If the overall goal of measuring patient safety is to capture the universe of safety events that occur, then broader measures encompassing large populations, such as those based on administrative data, may be preferable. Acknowledging the trade-off between comprehensiveness and accuracy, such measures may be better suited for surveillance and quality improvement (QI), rather than public reporting/reimbursement. Conversely, using measures for public reporting and pay-for-performance requires more narrowly focused measures that favour accuracy over comprehensiveness, such as those with restricted denominators or those based on medical record review.
After 9 months of the 18-month Reducing Restrictive Practice programme, staff on Nostell ward reduced their use of ‘restrictive practices’ by 56%. The reductions have been achieved using innovative methods of care, including changing access rules to areas that were previously restricted by time or location, such as the patient’s therapy area. The national programme, which launched in November 2018 and concludes in March 2020, aims to reduce the use of restrictive practices by one third in 41 wards across 25 mental health trusts.
The introduction of standardised patient information boards will improve safety and communication at The Shrewsbury and Telford Hospital NHS Trust (SaTH), which runs the Princess Royal Hospital in Telford and the Royal Shrewsbury Hospital, by providing clear and easy patient information a glance.
The symbols used on the patient information boards are consistent with those already used across the Trust to provide uniformity for staff who move between wards and departments.
Key information on the information boards includes clinical alerts for diabetes, dementia, allergies and if the patient is a risk of falling.
Clinical negligence claims are costly events, both in terms of the harm caused and the expense that results. Helen Vernon, Chief Executive of NHS Resolution, discusses the importance of generating and sharing insight from the harm that can result in clinical negligence claims.
Dr Nikita Kanani, NHS England and NHS Improvement’s Medical Director of Primary Care, describes the changes that will underpin safety improvement in primary care.
The key ingredients for healthcare organisations that want to be safe are: staff who feel psychologically safe; valuing and respecting diversity; a compelling vision; good leadership at all levels; a sense of teamwork; openness and support for learning.
Chief Executive of the West of England Academic Health Science Network and Patient Safety Collaboratives lead Natasha Swinscoe, and Head of Patient Safety Programmes Phil Duncan on how the National Patient Safety Improvement Programme will use continuous quality improvement to deliver safer care.
Giving everyone in the NHS a foundation level understanding of patient safety is critical, but we also need experts to lead on safety in their own organisations. Feedback from the consultation strongly supported the development of a network of patient safety specialists in local systems.
These specialists should be recognised as key leaders within the safety system, visible to their organisations and others, able to support their organisations’ safety work. In some ways the concept is similar to designating someone a Caldicott Guardian, Director of Infection Prevention and Control or Freedom to Speak Up Guardian. But in contrast to these designations we want the introduction of the patient safety specialist concept to develop existing people and roles rather than create new posts.
Prof Wendy Reid, Executive Director of Education and Quality and National Medical Director at Health Education England (HEE), describes the plans for a universal patient safety syllabus and training programme for the whole NHS.
Background: Safe patient handling practices reduce injury risk for healthcare workers (HCW) and patients, but may conflict with goals of rehabilitation and person-centred care by minimizing (a) active participation in transfers and (b) autonomy and dignity while using mechanical lifts. Active assist transfer devices (AATDs) have potential to address both safety and support needs for appropriate clients. You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
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Responding to the Independent Review of Gross Negligence Manslaughter and Culpable Homicide, Danny Mortimer, chief executive of NHS Employers, said: “Employers will welcome this report, which carefully balances an appreciation of the impact of clinical errors and mistakes on patients and their families, and our medical workforce.