The NHS in England is a unified system with the ability to make systematic change on a national scale. However, it is also made up of a number of autonomous bodies in relation to patient safety, including national ones, with various responsibilities for provision, commissioning, assurance, leadership, regulation and supervision. Following on from the outstanding Berwick Report into patient safety a number of patient safety initiatives have sprouted to support the commitment to making our care the safest in the world. This includes:
- A national Patient Safety Collaboratives Programme
- A national Safety Fellowship
- Safety Action for England (SAFE)
- A national patient safety campaign, Sign up to Safety
These initiatives are at various stages of development and delivery, will all have a variety of timescales and involve a range of partner organisations that vary between them in number and scope. There is clearly a need to align activity, coordinate outputs and ensure the many components are pulling in the same direction and deliver more than the sum of their parts. The key unifying factor for the English Patient Safety Programme is the goal of reducing avoidable harm and saving. This should be the common and shared goal of the entire NHS in England; providers, commissioners, regulators, oversight bodies and the millions of people who work in it every day. There are a few things that can be done to support this shared goal and create a unified programme:
- Everyone play their part to create the conditions that support the reduction in avoidable harm and save lives
- Everyone across the system works together towards this shared cause and sets out how they will support the shared goal to create the heart of the movement
- We all aggrees to work in synergy with each other, interact, interconnect and produce a result that is larger than each part simply added together
- Each new initiative should use and builds on each other’s strengths in a way that produces a greater gain
- We should all agree to share success and failure to create a learning culture for patient safety
- Leadership and coordination at all levels of the NHS should pull together to support implementation
So what are the different initiatives?
The national Patient Safety Collaboratives Programme: The Patient Safety Collaboratives Programme is a new national network of 15 Patient Safety Collaboratives intended to be in place for at least five years. The Secretary of State described this as the engine room of the patient safety improvement throughout England. Each of the 15 Patient Safety Collaboratives will be led by an Academic Health Science Network to improve healthcare through better understanding of why certain healthcare interventions work in certain settings to deliver safe and reliable care. From hospital care to care in custody, and from local GP practices to mental health trusts, the collaboratives will address safety issues in every healthcare setting in a way we have never attempted before. Healthcare providers and their partners across each healthcare economy will be supported to come together, identify their priorities for improvement, and devise and implement solutions in a collaborative approach that delivers real change. The Patient Safety Collaboratives Programme will be inclusive, bringing people from all settings together, working with patients and carers, along with front line staff and management, and patient safety academics. Put simply, participation in the Patient Safety Collaborative programme is a clear way for organisations to Sign up to Safety and support the aims of the campaign.
The National Safety Fellowship: The Safety Fellows initiative aims to recruit over the next five years, 5,000 individuals with safety expertise to create enduring ‘local change agents and experts; safety ambassadors, safety agitators, safety evangelists – a grassroots safety insurgency across England which will seek out harm, confront it and help to fix it’. This initiative is being designed by and established with The Health Foundation.
Safety Action For England (SAFE): This is an initiative that will be piloted in the NHS so support NHS providers with a small team consisting of patient safety experts with a proven track record in tackling unsafe care; people frontline staff will respect, listen to and work with. This team will provide fast, flexible and intensive support when significant safety problems are recognised by an organisation and they need assistance to get things right. They will support the aims of the English Patient Safety Programme by helping equip organisations with improvement and safety capability and the support needed to fully participate in the campaign and the collaboratives.
A national patient safety campaign – Sign up to Safety: Sign up to Safety is a three year national patient safety campaign that aims to become the golden thread, the unifying force, that runs through the safety improvement activity of every provider of healthcare in England and which aligns the various initiatives underway. The vision for the campaign, and indeed the wider programme of work, is that the whole NHS will rise to the challenge and join. It is about more than the numbers of NHS organisations joining; the campaign will motivate participants to act. The campaign will support the movement to achieve demonstrable change no matter where the starting point is; shifting organisations from good to great. The central campaign organisers will reinforce local messages and energise individuals and teams, going beyond institutions to seek to sign as many individual staff in the NHS as possible to add to add to the movement. This will support and build with initiatives such as NHS Change Day and the Care Makers. Everyone that chooses to join will commit to the same shared goal: to reduce avoidable harm by a half and saving 6,000 lives nationally over the next three years.