Sir Keith Pearson opened this session on the first day of conference, by suggesting there is an issue with alignment of what we provide and what we should be providing, in terms of patient dignity and achieving quality healthcare services for all.

Chair: Sir Keith Pearson

Speakers:

• Judy Gillow, director of nursing, University Hospital Southampton, NHS Foundation Trust
• Kate Bradley, director of workforce, University Hospitals Leicester 

Kate Bradley shared what has been done at Leicester on patient care and said that in her role as a board member she is constantly asking herself ‘how do we assure ourselves that patients are getting quality care?’

Key themes from Kate’s presentation:

Patient stories

University Hospitals Leicester invites complainants to board meetings to share their stories with the board and other attendees, including patient public advisors and the press. Inviting patients to share their positive and negative views in this way has led the board to think differently and helped to embed quality into their thinking.

Embedding values with quality at the heart

This is being done, for example, by embedding values in to the appraisal process and by ensuring that recruitment panels talk about the organisation’s values during the recruitment process.

10-point plan for improving patient experience

Leicester’s 10-point plan for improving the patient experience is about raising standards.Patient polling is also used as a technique to get patient feedback in real time – this information is used to create patient dashboards which visually highlight areas where quality may be an issue.

8-point plan for staff experience

As well as the patient experience, Leicester has also focused on the staff experience and introduced an 8-point plan for staff that is integrated with the staff survey.

Barriers to quality

Kate highlighted sickness absence and a lack of leadership as barriers to quality. Where there is an issue with sickness absence and leadership, quality is much more likely to be compromised.

Judy Gillow

Judy demonstrated how her trust is using safe staffing levels to ensure quality services for patients.

Gathering evidence

A compelling business case is needed to convince the board of the need to put resource and attention into this area. Evidence shows that hospitals with optimal staffed wards have a lower mortality rate and better patient outcomes. The Health Select Committee 2009 stated that inadequate staffing levels have been major factors in undermining patient safety in a number of notorious cases.

Tips

• Prior to implementation, it is essential to have good quality data, for example, on patient acuity/dependency and service demand.
• Leadership is key to success. Not just top down leadership but leadership at all levels.
• Dashboards should be looked at weekly – an increase in sickness absence can be an early alert.
• The board should do regular walkabouts and have discussions with staff to get an idea of what is happening and whether there are any issues to be addressed.
• Quality should be the top strategic priority.
• Just good enough is not good enough.

Discussion

The general consensus was that it is very difficult to measure how good staff are at ensuring patient dignity and that more leadership and role modelling is needed on what constitutes a good patient experience. Sir Keith said that we need to get better at rewarding and recognising ‘simple acts of human kindness’.