Transforming Healthcare: Journey to Outstanding Care
Embark on a transformative journey towards outstanding healthcare delivery led by a dedicated team. Through meticulous self-assessment, peer reviews, and continuous improvement, the focus remains on providing caring, safe, and excellent care. Explore the phases of this journey, including CQC self-assessments, triangulation & analysis, and peer reviews, all aimed at achieving excellence in patient care and staff performance.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Caring, safe and excellent Journey to Outstanding Board update Outstanding care delivered by an outstanding team Marie Crofts, Chief Nurse 11th May 2022
Our Journey So Far Caring, safe and excellent Triangulation & Analysis August 2021 July 2021 To avoid false assurance, CQC Self-Assessment ratings were compared with supplementary evidence e.g., Ulysses Risk Register, TOBI, Complaints etc and amended as required. One to one feedback was given to teams as to why their ratings were amended. CQC Self Assessments In July 2021, each team was invited to complete a CQC self- assessment. November 2021 Selection of Teams Clinical Directors, Heads of Nursing and Governance Managers selected clinical teams to be Peer Reviewed between Jan - March 2022 and nominated Peer Reviewers. Peer Review Workshops December 2021 Nominated Peer Reviewers with expertise and lived experience are being invited to workshops in preparation for Peer Review visits.
Phase 1 - CQC Self-Assessments Caring, safe and excellent Of the 183 eligible teams, 99% (181) have completed a CQC Self-Assessment and their self-ratings are as follows: 140 (76%) 0 35 (20%) 7 (4%) (0%) R E Q U I R E S I M P R O V E M E N T G O O D O U T S TA N D I N G I N A D E Q U AT E 10 teams were rerated from Good to Require Improvement following review of supplementary sources of evidence.
Phase 2 Triangulation & Analysis Caring, safe and excellent Please note that the above may change should teams update their CQC Self-Assessment ratings.
Caring, safe and excellent Phase 3 Phase 3 Peer Reviews Peer Reviews As of November 2021, each directorates Clinical Director, Head of Nursing and Governance Manager has had monthly meetings with the programme lead to select the teams to undergo peer reviews in quarter 4 From 21st December 2021, five Peer Review Workshops have been organised each month for nominated staff and Experts by Experience to attend in preparation for conducting the peer reviews. As of 18th March 2022, 95 staff and 10 service user and carer representatives have attended the peer review workshops and their details; including area of expertise; have been logged on a central register so that they can be called upon to join peer reviews in future. Participants who attend the workshops have been asked for feedback and rated the workshops as 4.6 (where 5 is excellent and 1 is poor).
Caring, safe and excellent Peer Review workshop evaluation
Caring, safe and excellent Peer Review Workshops
Caring, safe and excellent Peer Review Schedule Directorate Clinical Team Peer Review Team Lead Peer Review Team Peer Review Visit Pre-Meet Dates Buckinghamshire Mental Health Aylesbury CMHT* Nilam Patel 2nd February 2022 28th February Ruby Ward* Sarah Amani 7th February 2022 22nd February Aylesbury CRHT Gaurav Salhotra 21st March 2022 24th March Oxfordshire & South-West Mental Health South Oxfordshire CAMHS GMH* Lisa Miller 7th February 2022 9th March Banbury Adult AMHT Matt Kent 15th February 2022 24th February Morrell Crescent Anne Clarke 15th March 2022 25th March North Oxfordshire CAMHS GMH Andrea Davis TBC 22nd March Specialized Services Evenlode Ward Moira Gilroy 10th January 2022 28th January Kennet Ward Denise Inggall TBC 23rd March Forensic Community MH Team TBC TBC 25th April Community Services Wallingford Community Hospital TBC TBC TBC South District Nursing Team TBC TBC TBC Chiltern Health Visiting Team TBC TBC TBC
Caring, safe and excellent Observations from First Group of Peer Reviews Most of the peer review leads have shown exemplary leadership and been very well organised, with a few issues with a very small minority who have had to be given intensive support to fulfil their role Likewise, most clinical teams being peer reviewed have prepared well and ensured staff are aware of the peer review, its purpose and engaged well in focus groups or booked 1:1 time with the peer reviewers for interviews Where information has been requested e.g. patient and carer details for interviews, the clinical teams have been forthcoming and where there have been urgent concerns about care these have been escalated to Service Managers, Heads of Nursing and Clinical Directors
Caring, safe and excellent Observations from First Group of Observations from First Group of Peer Reviews Peer Reviews Directorates have engaged well in the process- Community directorate, owing to pressures, have not attended any workshops To keep community service staff engaged, CQC preparedness surveys to check their understanding and confidence with answering CQC Key Lines of Enquiry have been completed by 107 community services staff. Whilst the feedback on the Journey to Outstanding Peer Review Workshops has been very positive, it s important to note we need to adjust this training to ensure accessibility for all- including our users with learning disability Although 105 staff have attended the Journey to Outstanding Peer Review Workshops, only a small minority are middle - senior level managers who then take on the role of leading and coordinating the peer reviews.
Caring, safe and excellent Findings/ Recommendations- Oxon CAMHS Continue recruitment drive particularly for care coordinators, currently 11 vacancies between the Getting Help and Getting More Help teams Team would like more training on delivery of NICE guidelines e.g. Eye Movement Desensitization and Reprocessing (EMDR) Reintroduce mitigation calls to help those children and young whilst they wait for treatment More support from HR regards other creative ways to fill staffing gaps for Band 6 Care Coordinators, Band 7 Psychologists and permanent Psychiatrists It can feel like firefighting with little time to think strategically, the team may want to introduce Pause Weeks or team development half days Calling successful job applicants whilst they await clearance of checks may also reduce attrition from recruitment process Include clinical leads in senior management meeting
Caring, safe and excellent Findings / Recommendations Aylesbury CMHT Only 3 staff who attended the focus group a key recommendation is for the peer review team to join an existing meeting e.g. a business meeting, to hear views from more staff There is a need for the team managers to ensure that they share the key themes from incidents/complaints Waiting times have increased and it can be difficult to allocate care coordinators There is a long waiting list for psychology typically over 12 months wait Some delays are due to challenges faced by other teams e.g. social care More recommendations will be added once the peer review is concluded by end of March
Caring, safe and excellent Findings / Recommendations - Ruby Ward Senior staff to be more visible on the ward through shift work and lead on implementing an ongoing staff recruitment and retention scheme with support from HR Signage and boards on the ward should be laminated or covered and information e.g. smoking cessation support, daily activity programme should be clearly displayed Declutter clinical and medicines room so cleaning and medicines management can be conducted without obstructions Update staff board with up-to- date team members and add a You Said, We Did board Address the issues highlighted in the patient record review audit and ensure care plans are not generic and are tailored to individual risks Consider requesting an external facilitator to support the team develop a vision and reintroduce the reflective practice group Organize training to improve Where materials are needed for activities, the ward manager should apply for funding from charitable funds skills for working with individuals with personality disorders and complex needs skills for working with individuals with personality disorders and complex needs staff s understanding and skills for working with individuals with personality disorders and complex needs skills for working with individuals with personality disorders and complex needs charitable funds skills for working with individuals with personality disorders and complex needs Consider booking staff on to National Autistic Society 22nd March 2022 training due to take place on 22nd March 2022 or 7th June 2022 7th June 2022 7th June 2022
Phase Four Learning from Others Caring, safe and excellent NAME OF TRUST SERVICES PROVIDED CQC RATING 1 Berkshire Healthcare NHS Foundation Trust Mental Health; Community; Learning Disabilities Outstanding 1. Clinical Team Managers will be supported to contact and visit Trusts who are rated as high performing for similar service areas. 2. This approach allows the establishment and growth of professional relationships and networking across the wider NHS 2 Cambridgeshire Community Services NHS Trust Community Outstanding 3 Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust Mental Health; Learning Disabilities Outstanding 4 Derbyshire Community Health Services NHS Foundation Trust Community; Learning Disabilities Outstanding 5 Dorset Healthcare University NHS Trust Mental Health; Community; Learning Disabilities Outstanding 6 East London NHS Foundation Trust Mental Health; Learning Disabilities Outstanding 7 Hertfordshire Partnership University NHS Foundation Trust Mental Health; Learning Disabilities Outstanding 8 Lincolnshire Community Health Services NHS Trust Community Outstanding 9 Newcastle-upon-Tyne Hospitals NHS Foundation Trust Acute; Community Outstanding 10 Norfolk Community Health and Care NHS Trust Community Outstanding 11 Northamptonshire Healthcare NHS Foundation Trust Mental Health; Community; Learning Disabilities Outstanding 12 South Warwickshire NHS Foundation Trust Acute; Community Outstanding 13 The Royal Marsden NHS Foundation Trust Acute; Community Outstanding 14 South Central Ambulance Service NHS Foundation Trust Emergency/Urgent care Good 15 South London and Maudsley NHS Foundation Trust Mental Health; Learning Disabilities Good 16 Southern Health NHS Foundation Trust Mental Health; Community Good 17 Herefordshire and Worcestershire Health and Care NHS Trust Mental Health; Community; Learning Disabilities Good
Caring, safe and excellent Next Steps for the process Next Steps for the process Ensure colleagues from Community Directorate attend peer review workshops and schedule peer reviews Completion of the CQC packs for NED s Learning from Others Using this learning, work with teams to devise transformational programmes with a QI approach to improvement Level 3 QI training for leaders
Caring, safe and excellent Information sources Quality and Safety Dashboard Workforce indicators Staff survey External concerns/ reviews eg MHA inspections Quality Account Patient Experience and Involvement work Quality Improvement Key programmes of work including RJLC; EDI; IQRA Innovations and research
Caring, safe and excellent Key hotspots currently Ruby ward District Nursing City AMHT Childrens Integrated Therapy Service CAMHS NDC Podiatry
Caring, safe and excellent CQC new approach to inspection Evidence of risk of harm Focus on urgent and emergency care so they can understand pressures; lobby nationally and share good practice System inspections if they will be of benefit carry out activity to support the system over winter, including supporting the establishment of new designated settings to help ensure people can be safely discharged from hospital when they are medically fit to leave. Begin a programme of activity to inspect providers currently rated as requires improvement to identify where improvement has taken place and possibly re-rate, with a view to supporting the creation of additional capacity in the system NO return to routine frequency inspections
Caring, safe and excellent CQC new approach to inspection Continue ongoing monitoring of services, including a monthly review of the information we hold about a service to identify any risk to quality and safety. Use their independent voice to amplify the urgency for immediate support for services under pressure and for the development of new models of care. Making the case for services designed around local need so that people get the right service in the right place at the right time. Delivered by a workforce who are valued and supported. Prioritise registration activity where we can support the creation of extra capacity in the system. Use information to determine where registration activity needs to be focused. Deliver a more co-ordinated approach to inspecting urgent and emergency care pathways this winter. Where we identify risk we will look at how services across a system are working together. To identify improvements that could benefit people using services and staff delivering care. Monitor and assess where there is a risk of a closed culture developing. This includes monitoring and acting on information of concern about blanket bans on visiting. Our monitoring will also show us where we need to look at services we've had limited or no contact or information from over a period of time.
Caring, safe and excellent Key measures where we are- some examples? Culture open; transparent; compassionate; restorative; support to colleagues Learning from all incidents; PSI s/ complaints Clear understanding from ward to Board of implementation of QI to drive improvements in patient care High levels of co-production Improved staff survey results in engagement questions; implementing RJLC and 30 staff trained;; civility and respect campaign; well- being support offer; Schwartz rounds Revised approach to patient safety; audit team moved under QI team 80+ QI projects and establishment of QI hubs across Trust; over 350 people trained at different levels; BC development for additional investment Lived exp facilitators now recruited; co- produced strategy to be finalised; over 85 peer support workers; nationally acclaimed evidenced based IPS programme
Caring, safe and excellent What else do you need? Information packs- see contents list Site visits Peer reviews Bespoke sessions Practice interviews
