Clinical and patient leadership
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Essential ingredients for improving and sustaining quality Prof Frank Joseph, Royal College of Physicians Day One, Pop-up University 6, 11.00
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Clinical and patient leadership
- 1. Clinical and patient leadership: essential ingredients for improving and sustaining quality Professor Frank Joseph Future Hospital Officer, Royal College of Physicians @FrankJoseph_FH
- 2. • Clinical and patient leadership in the Future Hospital Programme • Reflections from a Future Hospital clinical lead • Reflections from a Future Hospital patient representative • Exercise – how are you supporting clinicians and patients to lead improvement?
- 3. March 2012 Sept 2012 Sept 2013 June 2014 Sept 2014 ‘Most important statement about the future of British medicine for a generation’ Launch of Future Hospital Commission
- 4. Clinical leadership in the Future Hospital: • “Doctors assume clinical leadership (at individual patient and system level) for the care patients receive across specialties, across settings and across all domains of quality” • “This includes responsibility to…communicate effectively with patients, their families and carers, and empower them through effective collaboration; and collaborate with other teams and professions…”
- 5. Patient leadership in the Future Hospital: • Promotes partnerships: services working together with patients, carers, families and service users to co-design care and support • Recognises expertise, insights and skills of people who use services • Provides new perspectives that may not have been considered and offers ‘reality checks’ for clinical colleagues • Ultimately seeks to move from patient involvement to patient leadership: from “users and choosers” to “makers and shapers” of health services.
- 6. Why? • Engaging staff and patients is not an optional extra, but essential in making change and improvement happen • Organisations with engaged staff deliver a better patient experience and have fewer errors and lower infection and mortality rates, financial management is stronger, staff morale and motivation are higher and there is less absenteeism and stress • Patient engagement brings benefits in delivering more appropriate care and improving outcomes. No More Heroes, King’s Fund (2011)
- 8. Future Hospital development sites – selection criteria • Named clinical lead (application/interview) • Named local lay representative(s) (application/interview) • Demonstration of how the project will meet each of the 11 principles of patient care described by the Future Hospital Commission • Evidence of thorough consideration of approach to patient involvement • Assigned RCP Patient and Carer Network representatives.
- 9. Manchester Respiratory Future Hospital Pilot: leading change from the bottom Dr Binita Kane, Consultant Respiratory Physician University Hospital of South Manchester @binitakane
- 11. “Customer innovation” - Starbucks Why clinicians and patients as leaders?
- 12. vs (Jeremy Heimans TED Talk 2014) The world is changing …..
- 13. South Manchester CCG Central Manchester CCG University Hospital of South Manchester Central Manchester Foundation Trust South Manchester GP Federation Central Manchester GP Federation PATIENTS The Manchester Respiratory Future Hospital
- 17. The learning
- 18. Patient leadership and the Future Hospital Programme Alice Joy Royal College of Physicians Patient and Carer Network member RCP representative for West Birmingham & Sandwell Future Hospital development site
- 19. Quality improvement essentials: • Vision – clinical, patient and management • Solid foundation – where are we now and where do we want to be? • Full support, commitment and participation for the long haul • Flexibility to deal with the unexpected • Equal partnership and respect for all
- 20. Patient involvement: • Provides a rounded approach from the outset • Enables you to tailor the service to actual, not assumed, needs • Empowers patients, carers and staff alike Challenges: • Synchronising time and resources • Sustaining the impetus • Communication
- 21. Success depends on: • Recognising and tackling problems as they arise • Communicating and celebrating achievements Seems obvious, but you have to do it!
- 22. Exercise • How empowered are your clinical staff? How empowered are your patients? • What are you doing to support this? • What more can you do?
- 23. To keep up to date with the Future Hospital Programme, join the Future Hospital Partners Network www.rcplondon.ac.uk/projects/future-hospital-programme futurehospital@rcplondon.ac.uk | #FutureHospital
Editor's Notes
- The agenda for the session
- Recap on timeline of events that resulted in Future Hospital Programme March 2012 - the Royal College of Physicians established the Future Hospital Commission, chaired by Professor Sir Michael Rawlins. The Commission aimed to address growing concerns about the standards of care currently seen in hospitals and to make recommendations to provide patients with the safe, high-quality, sustainable care that they deserve. The Commission focused on five key areas: patients and compassion: leadership, responsibility and compassion on the wards and the operation on multidisciplinary teams place and process: patient pathway and the balance between generalist and specialist care people: composition and development of the medical workforce, and interaction between medical and other teams data for improvement: use of patient records, medical information and audit planning infrastructure: organisation of diagnostic, support and community services. The Commission involved professionals from across health and social care and Patients were involved throughout the work of the Commission. September 2012 – RCP publishes Hospitals on the edge. A report that set out the magnitude of the challenges facing acute care services. It was a call to action for all involved in the design and delivery of health services. The report detailed a looming crisis: rising clinical demands (37% rise in emergency admissions, fewer beds) changing needs (more older people, with multiple, complex conditions) fragmented care (patients being moved around the system with little continuity) out-of-hours care breakdown (higher mortality at weekends and fewer senior staff) medical workforce crisis (increased workload, recruitment problems in emergency and general medicine) September 2013 – Future Hospital Commission publishes its report, Future hospital: Caring for medical patients, and laid out a vision of how hospital services should adapt to meet the needs of patients now and in the future. The RCP establishes the Future Hospital Programme to implement the recommendations of the commission. These recommendations are based on the very best of our hospital services, taking examples of existing innovative and patient-centred services to develop a comprehensive model of care. June 2014 – The Future Hospital Journal is launched. A peer reviewed journal, it builds on the work of the Future Hospital Commission and aims to publish a broad range of content covering innovation in systems of clinical practice, administration and management, and the organisation and delivery of health care. Sept 2014 – The Future Hospital Programme announces the first four development sites – clinical teams leading projects to put the Future Hospital vision into practice in their local areas. A second wave of sites was announced in January 2016. The RCP is supporting these 8 sites by helping them implement new ways of working, providing access to quality improvement expertise, and assistance in evaluating their individual programmes of work. The lessons learned by the FH Programme team and each development site will be collated and shared with other partners and beyond to spread good practice and foster system-wide improvement in the care of medical patients.
- Carol Caporn (PCN representative at Betsi Cadwaladr development site) has said that ensuring patients are fully involved in projects ensures project decisions made by clinicians during ‘corridor conversations’ – which may not benefit the people who use services – are ‘reality checked’ and properly considered. From ‘users and choosers’ to ‘makers and shapers’ is a quote by Cornwall and Gaventa (2000), from ‘Patient and public involvement in health care quality improvement: how organisations can help patients’ Public Management Review. (2015)