Patient Safety Specialists are on the march. David Hare explains what you need to know.
Patient safety is undoubtedly everyone’s business.
We know from a range of metrics – whether it is the Care Quality Commission’s (CQC’s) scores or national audits – that independent providers and practitioners take the issue of safety and quality very seriously and perform well when compared with the wider healthcare system.
But with so many initiatives currently in place to foster a safe culture – from Duty of Candour to Freedom to Speak up Guardians, as well as the new Patient Safety Incident Framework (PSIRF) and the change in reporting safety events to Learning from Patient Safety Events (LFPSE) – taking a more co-ordinated approach to safety and quality is essential.
As part of the National Patient Safety Strategy, which calls for a ‘whole systems’ approach to safety and quality where all parts of the healthcare ecosystem play their part, the NHS therefore introduced the requirement to establish Patient Safety Specialists (PSSs) in all providers delivering NHS-funded care, which will include most independent sector providers.
At its heart, the role is designed to be a focal point for patient safety activities and ‘provide dynamic senior patient safety leadership’. This includes helping to drive a culture of safety, learning from incidents and ensuring consistent improvements in care.
Share ideas
With the role still relatively new, this autumn the Independent Healthcare Providers Network (IHPN) was pleased to hold our first ever event to support patient safety specialists working in the sector.
It provided a great opportunity to hear from experts from academia and NHS England, patient safety partners, and for PSSs to network and share ideas on how to gain maximum benefit from the role.
The theme of the day was to ‘innovate, collaborate and elevate patient safety specialist leadership’. This was reflected in the agenda where we brought together a diverse range of speakers from both the NHS and independent sector to talk about PSSs.
We also looked at wider patient safety initiatives, including medical examiners and the implementation of PSIRF and LFPSE.
Looking at the practicalities of the role first, PSSs have a wide remit. It covers everything from embedding PSIRF, transitioning to LFPSE and supporting uptake of the patient safety syllabus.
And it has to lead on involving patients in the patient safety framework, ensuring a robust system for responding to National Patient Safety Alerts; as well as supporting relevant national patient safety improvement programmes – including Martha’s rule.
Key role
Given the importance of fostering a culture of safety and improvement, PSSs should have direct access to an organisation’s board, and will play a key role in interacting with the various legal frameworks, regulatory bodies like the CQC and external agencies such as the Health and Safety Executive.
This to-do list, which will be on top of the specialists’ day job, may well sound intimidating and so was great to hear from The Healthcare Improvement Studies (THIS) Institute at the event, who have been conducting an evaluation into the PSS role in both the NHS and independent sector.
Overall, it found that while there is real enthusiasm for the role, PSSs were undoubtedly concerned about the feasibility of delivering it and the managing the competing priorities of having both an operational and strategic role in a healthcare provider.
We were therefore delighted to be joined by Bill Savage, who is a patient safety partner (PSP) – one of the eight priorities of a PSS – and Julie Watkinson from Nuffield Health, who were able to talk about their journey in developing the patient safety partner and what they learnt on the way.
Engaging with patients
While the ‘innate ability to understand complex information and not be terrified’ is definitely top of the list for the partner role, as well as ‘embracing acceptance of the corporate independence’ that comes with being a PSP, what really came across from their presentations was the importance of engaging with patients and their families throughout the process.
In particular, calling out the ‘roulette of acronyms’ often used in healthcare was highlighted, with a timely reminder that many of our patients and families do not speak in our ‘code’.
The importance of culture in delivering safe care was a key theme throughout the day and was really brought to life by the NHS’s head of patient safety policy, Hester Wain, who provided invaluable insights into what we mean by safety culture and how we can continue to turn the dial.
For all the patient safety initiatives that currently exist in our health system, developing a culture of safety is not just about documents or procedures – as important as they are.
It is about creating an environment where everyone from staff, patients, and families can thrive to ensure safe, high-quality care.
Hester identified the three key elements you need to achieve this:
- Continuous learning
- Psychological safety
- Empowering everyone to speak up
While this may sound a touch ‘fluffy’ to those working in the sector who are highly skilled, highly trained technical clinicians, a safe and open culture can really make a substantive difference in reducing patient harm.
Study after study shows that a poor safety culture can lead to higher re-admission rates, increased patient safety incidents and complication rates.
Safe cultures
Fostering positive safe cultures is not easy, but ultimately it is about both practitioners and organisations challenging their own actions and really putting patients at the centre. Or as Hester sagely put it: ‘Anyone can do an investigation, but does it make a difference?’
Bringing the conversation back to the here and now, we were also pleased to be joined by a number of experts who were on hand to talk about some of the specific priorities for PSSs.
Dr Suzy Lishman, an independent mortality adviser for Spire Healthcare and a NHS medical examiner, spoke about the new National Medical Examiner system and death certification reforms.
Wendy Halliburton, a patient safety specialist at North Tees & Hartlepool NHS Foundation Trust, discussed her involvement in implementing the new Patient Safety Incident Response Framework (PSIRF) and Mandy Williams set out her experiences in improving the quality of patient safety incident reporting and supporting transition to the Learning from Patient Safety events (LFPSE) as a patient safety reporting lead and user researcher.
These sessions provided much food for thought for attendees with some fantastic discussion and Q&As afterwards.
With over 25 Patient Safety Specialists currently working in IHPN members alone, we were delighted to play our part in supporting the development of this important new role and work they do. We hope to build on this event and host further events in the coming years.
David Hare is chief executive of the IHPN.
