Transcript Training for POhWER ICAS staff

PATIENTS FOR PATIENT SAFETY
in England and Wales
Anna Allford, Project Manager, AvMA
International Congress
Turkey
19-21 March 2009
Patients for Patient Safety
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WHO World Alliance for ‘Patients for Patient
Safety’ initiative
In England & Wales, a unique partnership
between:
Action against Medical Accidents
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Action against Medical Accidents (AvMA) is the independent
charity which promotes better patient safety and justice for people
who have been affected by a medical accident. A 'medical
accident' is where avoidable harm has been caused as a result of
treatment or failure to treat appropriately. AvMA believes that
whatever the cause of a medical accident, the people affected
deserve explanations, support, and where appropriate,
compensation. Furthermore, we all deserve to know that the
necessary steps will be taken to prevent similar accidents being
repeated.
We provide free and confidential advice and support to people
affected by medical accidents, via our helpline and casework
service and can refer to our panel of specialist clinical negligence
solicitors or other sources of support where appropriate.
NHS National Patient Safety
Agency (NPSA)
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NPSA is part of the NHS, established in 2001 with the
mandate to identify patient safety issues and find
appropriate solutions. NPSA is also responsible for the
National Clinical Assessment Service; National
Research Ethics Service; and National Confidential
Inquiry into Suicide and Homicide (NCISH);
Confidential Enquiry into Maternal and Child Health
(CEMACH); and the National Confidential Enquiry into
Patient Outcome and Death (NCEPOD).
NHS Patient Safety Journey
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An organisation with a memory
(DH 2000)
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Building a safer NHS for
patients (DH 2001)
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Safety First: A report for
patients, clinicians and
healthcare managers (DH
2006)
“Safety First”
Department of Health, 2006
Recommendation 13:
The active involvement of patients and their families
should be promoted by establishing a national network
of patient champions who will work in partnership with
NHS organisations and other key players to improve
patient safety: the network should have strong links
with WHO World Alliance for Patient Safety’s ‘Patients
for Patient Safety’ initiative
Rationale
Consumers in healthcare are at the heart of
patient safety. When things go wrong they and
their families suffer from the harm caused.
Such harm is made worse by the defensive
and secretive way that many healthcare
organisations respond in the aftermath of an
event
Rationale 2
Around the world, healthcare organisations that
are most successful in improving safety are
those that encourage cooperation with patients
and their families. Patients and their families
have a unique perspective on their experience
of healthcare and may provide information and
insights that healthcare workers may not
otherwise have known
Partnership
Partnership must be a key theme: patients,
health professionals, policy makers and
healthcare leaders should be working together
to prevent avoidable harm in healthcare. A
particular focus is to challenge the current
culture of denial
Patient Safety Champions
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May 2008 – 2 day Induction Workshop for 22
Patient Safety Champions
Additionally, 10 Patient Safety Action Team
(PSAT) members from Strategic Health
Authorities (SHAs) in England and 1 member
of the Patient Safety Team in Wales joined the
Workshop on day two.
Champions and NHS Partners
Induction Workshop Report
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The report of the Workshop is available on the
AvMA website together with the six month
report: www.avma.org.uk/champions
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A further follow-up event took place 28/29th
November 2008 to share experiences and
disseminate information and learning.
Role of Champions
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The role of the ‘champions’ is to champion the
cause of patient safety and the role that patients
can play in patient safety work. They provide a
patient perspective in the planning of patient
safety work in their region and get involved in
specific projects where they can make a useful
contribution.
Role of Champions continued
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In addition to being involved in regional and
national events and planning, champions have
worked with the NHS to organise particular
patient user groups; given talks / contributed to
training and resources such as videos / DVDs;
and taken part in reviews of Serious Untoward
Incident procedures and of how the NHS
implements guidance on Being Open when
things go wrong.
Role of Champions continued
Many Champions are also engaged in work to
improve patient safety locally with individual
NHS Trusts and Primary Care Trusts (PCTs) in
England (Local Health Boards in Wales).
 Crucially, rather than duplicate or replace
existing ways in which the NHS engages with
patients on patient safety, the champions are
there to act as a focal point and a resource and
facilitator for wider patient and public
involvement in patient safety in particular.
Partnership working
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Patient Safety Champions will be supported to
provide the patients’ perspective in improving
patient safety at all levels; locally, regionally
and nationally, throughout England and Wales.
Their role is to ‘add value’ to both existing and
planned work.
The current focus is on the policy Being Open
- communicating patient safety incidents
with patients and their carers (NPSA, 2005)
Being Open
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The NPSA has advised NHS organisations to put in place local
policies to improve communication with patients who are
unintentionally harmed by their treatment.
The NPSA's safer practice notice advises healthcare staff to
apologise to patients, their families or carers if a mistake or error is
made that leads to moderate or severe harm or death, explain
clearly what went wrong and what will be done to stop the problem
happening again.
Further information can be found on the website of the NPSA
http://npsa.nhs.uk/nrls/alerts-and-directives/notices/disclosure/
Partnership Working (continued)
Other national initiatives are being discussed
including:
The Patient Safety
Campaign in England
The 1000 Lives
Campaign in Wales
Partnership Working (continued)
The NHS Partners involved in this project
are being encouraged to invite the
Champions to help them include the
patient perspective in their work streams
for improving patient safety.
Wider Network
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The project is developing and supporting a community
of interest in England and Wales. This social
movement aims to ensure that the patients’ perspective
and voice is included in the NHS improvements in
patient safety.
Approximately 270 individuals and representatives of
organisations have registered on our database.
The network has been invited to various Workshops
and events and been invited to comment on national
Consultations
Wider Network (continued)
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The PfPS Project newsletter and email
bulletins are circulated to this group and the
AvMA website/forums provide a way to share
information and views
We also want to provide the opportunity for
people to become more involved in the project
by becoming ‘associate’ Patients for Patient
Safety ‘Champions’, working with and
supporting the activities of the existing
‘champions’.
Project Accountability
Strategy Advisory
Group
Accountability
Group
Project Team
Patient Champions
Members
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Accountability Group members Martin Fletcher, Sarndrah Horsfall, & Dr Kevin
Cleary, from the NPSA, and Peter Walsh and
Anna Allford from AvMA
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Project Team –
Peter Walsh, Anna Allford and Dr Kevin Cleary
Project Manager
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To facilitate and support Champions
To understand the skill set and provide a
developmental programme for Champions
To support their relationship with stakeholders
e.g. SHA PSATs and others
To promote the role of the Champions and
wider network by developing links and seeking
opportunities for them to represent the patients’
voice in improving patient safety.
Summary
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This project has developed ‘in-country’ Patients For
Patient Safety Champions in England and Wales
We are helping to establish and grow a community of
interest with people who want to help the NHS improve
patient safety and learn from the mistakes or accidents
Champions are already working in partnership with
NHS healthcare professionals and policy makers and
we want to share and disseminate the good practice
that exists.
For further information:
Anna Allford
www.avma.org.uk
[email protected]
Tel: +44 (0)20 8688 9555