#CWPZeroHarm

NHS Quality: Improving Patient Care conference26 November 2014

David WoodAssociate Director of Safe Services

CWP – provider contextand challenges

Provider of mental health and physical health services Established in 2002 as a result of five local NHS bodies merging Became a Foundation Trust in 2007 (first mental health trust in the

North of England) Operates across 3 local authority areas Works with 5 CCGs and 4 acute hospital trusts 3,500 staff Membership base of 15,000 people Serves a population of 1 million people CHALLENGES:

Geography Culture Complexity of services and pathways Lower profile

Quality drivers Hard Truths – Francis, Berwick CQC: state of care Local recurrent themes from serious incidentsand complaints correlating to national recurrentthemes from the same sources NHS Outcomes Framework 2014/15 The measurement and monitoring of safety Open and honest care

Tactical approaches Major cultural change focusing on continuous improvement Appointment of a Clinical Expert Champion for Zero Harm Board investment in staff to support them in delivering the best care

possible, as safely as possible, and in doing so reducing unnecessary avoidable harms

Quality strategic goals reflecting an aspiration of zero harm Unchanged for at least the next three years

To achieve a continuous reduction in avoidable harm and make measurable progress to embed a culture of patient safety in CWP, including through improved reporting of incidents

To achieve a continuous improvement in health outcomes for people using the Trust’s services by engaging staff to improve and innovate

To achieve a continuous improvement in people’s experience of healthcare by promoting the highest standards of caring through implementation of the Trust’s values

Strategic plan 2014/19

CWP strategic directionPopulation Needs

Approach to Integration

Strategic Enablers (internal and external)

CWP Approach to Quality:Zero Harm Strategy

Service Transformation

IT Enabling

Val

ues

High Quality Data

Continuous Improvement

Culture

Models of Delivery

Workforce Transformation

Values – the 6Cs

Department of Health – Compassion in Practice Adopted by CWP in 2013 – embedding the 6Cs into CWP culture

care... compassion... courage...communication... competence... commitment

Staff have signed up to be Care Makers to act as ambassadors for the 6Cs

Incorporated into supervision, appraisal and recruitment and selection processes

TeamCWP 6Cs

CWP approach to quality –‘Zero Harm’ strategy

Proactive response to tackle the patient safety challenge described in Hard Truths

Aspire to drive cultural change further and faster through our ‘Stop, Think, Listen’ campaign

Underpins 5-year strategic vision and aims to deliver improvements in safe care and provide better outcomes by encouraging staff to:

Stop: don’t rush in

Think: weigh up the risk, benefits and

options

Listen: hear the views of other staff, people

who use our services and partners

Support for effective care planning

Appointed a care planning lead Support delivery of more proactive, co-produced care and support

for people with long-term conditions Aim to ensure individual, person-centred care and treatment is

offered and delivered to all people accessing the Trust’s services Facilitate the delivery of effective care planning techniques to deliver

the best, sustainable outcomes

Intelligent analysis

Appointed quality surveillance analysts Help and support staff to understand variance in care delivery and

outcomes Promote positive variance and reduce negative variance Use triangulation Reduce risk through application of modern improvement methods:

PDSA cycles, statistical process control, human factors Reduce inefficient service delivery Surveillance of what works well and leads to good outcomes, not

just identification of ‘failings’…

Quality assurance v.continuous quality improvement

Developing and supporting staff

Organisational development and training to deliver safe and effective care to build a culture of zero harm

Human Factors awareness training

Human factors example

“Culture carriers” make three pledges to support delivery of safer practices through behavioural and cultural change in their clinical areas

Celebrating success and promoting best practice Annual Big Book of Best Practice and Best Practice event

Patient experience – continuous improvement

Higher Organisation Rank OPES Change

Cheshire and Wirral 1 81.5 3North Essex 2 80.1 9Humber 3 79.7 24Tees, Esk and Wear Valleys 4 79.5 14Cumbria Partnership 5 79.5 16Rotherham, Doncaster and South Humber 6 79.4 62gether 7 79.3 27Mersey Care 8 79.3 0Plymouth Community Healthcare CIC 9 79.1 -6Lancashire Care 10 78.9 -8Bradford District Care 11 78.9 8Dudley and Walsall 11 78.9 8Northumberland, Tyne and Wear 12 78.6 1Camden and Islington 13 78.1 40Dorset 14 78.1 0Somerset 15 77.9 33Manchester 16 77.9 -10Pennine Care 17 77.6 5Oxleas 18 77.4 -1Oxford Health 19 77.4 31Black Country 20 77.0 20

Cultural change

Ideal…

Interventions that lead to the maximum number of people achieving good

outcomes and positive recovery and the smallest number of people experiencing

adverse outcomes

The provider challenge Delivery of quality orientated services, ethically and economically Improve the health and well-being of local communities Competitive – winning commissioned services Keeping up with rapidly changing evidence bases Meeting local demand in line with funding and commissioning

models – best value money provider available

Understand varianceAspire to be a positive outlier

I m p r o v e m e n t/ P o s i t i v e o u t l i e r

Factors for success Board support Medical and Nursing

Director leadership Clinical engagement Stakeholder support Strategy – join up the

dots Behaviour, culture and

human factors Be in it for the long haul Continuous quality

improvement/ aim for positive variance not just consistency

Thank youdavid.wood@cwp.nhs.uk

@DavidWood_CWP#CWPZeroHarm

@cwpnhs