Involving patients and
engaging with staff to
deliver quality care
Managers in Partnership annual conference
Julie Mellor
...
Involving patients and engaging
staff to deliver quality care
Two propositions:
1. Involving patients, families and carers...
Staff satisfaction and quality

3
Cases: lack of care
• Mr H– doctor ignored mother’s concerns and did not get
her agreement to change son’s medication
• Di...
Engagement among staff
Case of Mr R:
• Poor communication and multidisciplinary team working
• Not fed for 26 days
• Other...
3. Complaints: the toxic cocktail
• The problem: reluctance by
patients to complain combined
with defensiveness by hospita...
Reasons for reluctance to
raise concerns or complain
CQC research
54% of those
who want to
complain don’t
do so
26% do not...
Reasons for defensive
response by staff
1. Do not have the authority or resources to resolve
complaints
2. They are on the...
Three core reasons
why people come to us
1. I can’t get a decent explanation.
I don’t know what happened.
2. Something has...
A step change is required…
Shift the culture from defensive to
open, from a focus on blame to a
focus on putting things ri...
Critical success factors to
deliver step change
What users need
• Information accessible 24/7
• Advocacy support to use th...
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Involving patients and engaging staff to deliver quality care

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Presentation to the Managers in Partnership conference by the Health Ombudsman, Dame Julie Mellor on 27th November 2013.

Published in: Health & Medicine
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Involving patients and engaging staff to deliver quality care

  1. 1. Involving patients and engaging with staff to deliver quality care Managers in Partnership annual conference Julie Mellor Parliamentary and Health Service Ombudsman 27 November 2013 1
  2. 2. Involving patients and engaging staff to deliver quality care Two propositions: 1. Involving patients, families and carers in decisions about care 2. Improving complaint handling in hospitals 2
  3. 3. Staff satisfaction and quality 3
  4. 4. Cases: lack of care • Mr H– doctor ignored mother’s concerns and did not get her agreement to change son’s medication • Distress for complainant and son • B’s best interests under Mental Capacity Act 2005 not considered • Missed opportunities to save her • Mr A & his family expressed wish for him to die at home, not in a care home. • His ability to decide not respected 4
  5. 5. Engagement among staff Case of Mr R: • Poor communication and multidisciplinary team working • Not fed for 26 days • Other professionals raised concerns, but could not make themselves heard 5
  6. 6. 3. Complaints: the toxic cocktail • The problem: reluctance by patients to complain combined with defensiveness by hospitals and staff to hear/address concerns • This matters because: complaints are not addressed and opportunities to learn and improve services are lost 6
  7. 7. Reasons for reluctance to raise concerns or complain CQC research 54% of those who want to complain don’t do so 26% do not want to be seen as ‘troublemaker’ ‘Patients come first in everything we do. We fully involve patients, staff, families, carers, Dehydration personal communities, and professionals inside and outside the NHS’. The NHS Constitution 64% of those that do complain say it doesn’t make a difference 11% feared adverse effect on their care 7
  8. 8. Reasons for defensive response by staff 1. Do not have the authority or resources to resolve complaints 2. They are on their own when dealing with a complaint 3. Fear of disciplinary action, blame and consequences 4. Perception of disloyalty to team or the organisation by listening to/addressing a patient’s concerns 5. Frightened by patient/carer/family behaviour and/or accusations 8
  9. 9. Three core reasons why people come to us 1. I can’t get a decent explanation. I don’t know what happened. 2. Something has gone wrong, and there is a lack of acknowledgement of mistakes or an inadequate apology. 3. There is insufficient remedy. 9
  10. 10. A step change is required… Shift the culture from defensive to open, from a focus on blame to a focus on putting things right • So that people are listened to and concerns addressed • Hospitals use learning from complaints to drive service improvement • Restoration of public confidence in health and social care services 10
  11. 11. Critical success factors to deliver step change What users need • Information accessible 24/7 • Advocacy support to use the complaints system What service users need to focus on What the system as a whole needs to focus on • Vision, measurement & accountability • Developing and sharing good practice • Board leadership • Listening and addressing concerns on the front line • Capability & capacity of complaints function 11
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