Hospital Dr News

Engaging and empowering NHS staff is key to driving improvement in hospital care

A key hallmark of improving NHS trust performance is for the senior management to review the culture of the organisation

This is the conclusion of a CQC report which says trust management must resolve any disconnect between clinicians and managers, between medical and nursing teams or between different hospitals in the same trust.

Driving improvement: Case studies from eight NHS trusts, reveals the journey of improvement travelled by eight trusts from the perspective of staff, patients and organisations that represent them, and highlights how engaging and empowering staff has been critical in driving up quality.

The report says the priority for leaders was to bring all the elements of the trust together by engaging with staff and allowing open and honest conversations about what needed to happen to improve.

The report focused on trusts that have improved their CQC rating by one or two levels between inspections.

Trusts placed emphasis on the visibility of leaders: chief executives and senior staff spent time on the ‘shop floor’, meeting staff and setting up regular channels of communication.

They worked with staff to produce a set of shared values that would underpin positive cultural change and understood that staff needed to have ownership of those values if they were to be meaningful.

For some this involved recognising the need to tackle equality and diversity issues relating to staff and patients and in the wider community.

The trusts also took action to change their approach to quality improvement and the report highlights a number of different initiatives. For example, Leeds Teaching Hospitals NHS Trust and Barking Havering and Redbridge University Hospitals NHS Trust are two of five trusts chosen to work with the Virginia Mason Institute as part of a programme led by NHS Improvement to help improve patient pathways.

As well as corporate initiatives, trusts set up their own local initiatives. At University Hospitals of Morecambe Bay NHS Foundation Trust quality improvement is driven through Listening into Action projects where front line staff propose projects that will make a difference to patient care.

Strengthening processes for reporting and learning from incidents was also integral to improvement for most trusts with many evidencing how this has led to improved outcomes for patients.

Professor Sir Mike Richards, CQC’s Chief Inspector of Hospitals, said: “Each trust had its own approach to change, but there were themes common to all and numerous examples quality initiatives, collaborative working, and programmes of engagement that have helped to drive forward improvement.

“Real change does not happen overnight the improvements made by each trust are a testament to the time, effort and determination of staff and local partners. I hope their stories will encourage and inspire others in their own improvement journey.”

He also admitted that the NHS also needs more funding to promote improvement.

NHS pay was frozen in 2012 and 2013, and since 2014 rises have been limited to 1%.

In the trusts, the staff surveys reflected significant improvements in the number of staff that would recommend their hospital to family or friends and recommend their trust as a place to work.

Jeremy Hunt, Secretary of State for Health, said: “Our mission is to make the NHS the safest healthcare system in the world. A crucial part of this is the CQC inspection regime which has proved that when challenges are highlighted transparently, the NHS can make dramatic improvements in the quality of care it gives to patients.

“The NHS couldn’t do this without strong, visible leaders across the country who work with their excellent staff to improve care for patients.

“I want to congratulate all the trusts on a remarkable turnaround, and I hope others will be inspired to put these important lessons into practice at their own hospitals.”

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