Presentation slides from a Whole Systems Integration workshop hosted by

1. Whole System Integrated Care
NWL Whole Systems Integrated Care
Patient Safety Workshop Write Up
Thursday 20th November 2014

2. Aims for the day
• Introduce the Whole Systems Integrated Care (WSIC) programme and its
importance for improving patient safety in North West London
• Give an overview of Imperial College Health Partners (ICHP) and its work on patient
safety in North West London – including the new Patient Safety Champion Network
• Gather feedback and ideas on how patients can get more involved with helping to
improve patient safety in North West London – both through the WSIC programme
and ICHP’s Patient Safety Programme

3. different
organisations
will come
together as
one to
provide
seamless
care
Care will
be
organised
around
people’s
needs
The way services are paid
for will be joined up
Receiving care
• Care is organised around groups of
people with similar needs
• Delivery is organised around the
individual
• People are involved in developing
their own care plan
• Care plans include the opportunity
for self-care
• Care plans use the services provided
in the community and by the
voluntary sector
• People can choose the services they
want
• Different health and social care staff
work together as one team to deliver
the care people need
• The team communicate frequently
• The GP remains the first point of
contact
Paying for care
• Budgets from social care, mental health, hospitals, community, GPs etc are pooled
• Those in charge of budgets make sure that care is still delivered by the
organisations that already exist in a local area
• Contracts are put in place to provide clear rules around this arrangement
• The contracts set out targets that care providers need to deliver against
Providing care
• Health and social care professionals
come together to form an
Accountable Care Partnership (ACP)
• The ACP
 Works in a coordinated and
collaborative way
 listens to the views of all of its
members
 Always include GPs
 Decisions are made together
 can invite other providers to
help deliver specialised care
 Identifies as a single
organisation
 When money is over or
underspent, the ACP agrees
together what to do
What will it be like when
care is integrated?

4. The vision of care for North West London
In North West London we have a vision of consistent and joined up care with General
Practice at the centre, supporting people to lead independent and healthy lives

5. Josephine Ocloo is a member and
project lead for Imperial College
Health Partners, Patient Safety
Champion Network. She is deeply
involved in patient safety, and is
currently the Patient and Public
Voice representative and co-chair
of the National Patient Safety
Steering Committee, NHS England.
“Driven by a personal tragedy,
Josephine campaigns to give a
voice to those who feel they have
been wronged by the medical
profession and to make healthcare
in Britain safer” (Guardian Story
2008).
Patient safety – Josephine shares her personal story:
Josephine Ocloo: "I have lost my child in
horrendous circumstances under an
organisation that was supposed to be caring
for her." Photograph: Teri Pengilley

6. Patient safety video – group reflections
The implication
of workforce
cuts on patient
safety have been
ignored
Clinicians should feel
sufficiently supported
by their professional
network to enable
acknowledgement of
‘mistakes’
Clear channels
need to exists
for complaints to
be made by
patients and
their families
A ‘witch-hunt’
of clinicians is
not an effective
means to
improving care
Honesty and
transparency between
clinicians and patients
is essential to build
trust
Josephine shared her story and a World Health Organisation video on patient safety.
After the video had finished, a brief discussion was held on each table and the following
reflections were shared:

7. Imperial College Health Partners: Who we are
Ronke Akerele is the ICHP Director of
Programmes, Change and Performance
Management. She spoke about who Imperial
College Health Partners are:
• A Partnership organisation bringing
together 21 NHS, health science and
academic across North West London.
• A designated Academic Health Science
Network (AHSN) for the same area.
ICHP are focused on:
• Enabling discovery of new ideas and innovations, and facilitating the adoption and
diffusion of these across the NHS
• Reducing variation and spreading best practice across healthcare
• Strengthening synergy between the NHS and industry for the benefit of patients
and to create wealth for the local population, the NHS and the UK.

8. Patient Safety Champion Network
What is the challenge?
Patient engagement varies across NWL –
not always opportunities to become
involved with improving patient safety
locally.
NHS professionals sometimes need support
to engage patients and the public in
improving patient safety, particularly those
involved with patient safety incidents.
“The most important single change in the
NHS in response to this report would be for
it to become, more than ever before, a
system devoted to continual learning and
improvement of patient care”
Berwick Review, August 2013 (in response
to the Francis enquiry)
How are ICHP going to achieve this?
By developing a Patient Safety
Champion Network to:
• Support and promote patient and
public improvement in ICHP work
programmes
• Act as a catalyst for broader patient
and public engagement across NWL
• Provide a learning and resource hub
for patients and public, to support
them to become more involved in
patient safety

9. Group exercise – towards a safer system in NWL
The first group exercise focused on making the system safer. On each table was an Early
Adopter Model of Care, which was talked through on the day, and the discussions that
followed were based on this model.
Working together, you
examined and discussed the
following:
• How can we work towards a
safer system across NW
London?
• What are the possible risks?
What could go wrong?
• What could we put in place
to mitigate any risks?

10. Group exercise – Hillingdon Model of Care diagram
This diagram was shared as part of the group exercise.

11. Feedback– towards a safer system in NWL (1/2)
Risks Mitigation
Lack of incident reporting A forum for reporting, recording and evidence of lessons learnt
Lack of governance to
ensure quality assurance
Monitor patient experiences, staff satisfaction and safety incidents
Monitor Third Sector to ensure delivery against agreed contract, address
complaints adequately
The point of access must be
efficient and timely
Be realistic about the capacity of clinicians
National targets to reduce delays
The system must have a function to identify isolated individuals unknown
to services
Care plans are not reviewed
regularly
GPs to have capacity to review care plans fortnightly
Patients to be provided with a copy of their care plan which they can edit
Access to prescriptive drugs
is complex
Use of medicines to be reviewed
Patients to have a better understanding of their medication intake
(medication passport) and be assessed for capacity to manage this
independently
Implement a reminder service (texts)
Simplify instructions provided with the medication
A ‘virtual ward’ results in
social isolation
Governance&
ReportingFunctionalFeatures
The outputs from these discussions fell under four main categories: governance & reporting,
functional features, workforce & training, and information sharing & accountability

12. Feedback– towards a safer system in NWL (2/2)Workforce&Training
InformationSharing&
Accountability
The outputs from these discussions fell under four main categories: governance & reporting,
functional features, workforce & training, and information sharing & accountability
Risks Mitigation
Ensure recruitment of quality workforce The receptionist is a key role that requires further training
Integrating a Mental Health specialist within the MDT
Community healthcare services need to recruit senior nurses
to ensure clinical leadership
GP practices must undergo a cultural shift in
order to work towards the model
Ensuring GPs are adequately resourced to make the
transition
Social services lack capacity to provide a
comprehensive Out of Hours service
Social Services training to better understand health needs
Ensuring confidentiality whilst improving
information sharing between providers
Independent quality assessor
Third sector access to information being recorded
Quality measures to check information is stored safely,
shared safely and content is accurate
Lessons to be learnt from the Mental Health Care Programme
Approach
Inability of community providers to liaise
with acute services
Shared IT systems
Shared care plan with access for patients and carers
Clear accountability is required throughout
the model to enable decision making
A consistent liaison point for each patient throughout their
journey of care

13. Group exercise – Working together on patient safety
The second group exercise focused on the practical steps towards improving patient
safety, involving a discussion of the following questions:
• When and where are the opportunities where patients and professionals can work
together to ensure the patient stays safe?
• What are the three things that patients could do to help professionals keep them safe?
• How can the Patient Safety Champion Network support patient engagement in patient
safety within this work going forward?

14. Feedback – Working together on patient safety (1/3)
Discussions focused on the proposed purpose of the Patient Safety Champion network,
and the following outcomes were suggested:
1 The network must have the power to help drive change
2 A forum for patients and professionals to put forward their ideas
3 Empower patients to lead change themselves
4 Avoid potential duplication with PPGs and Healthwatch
5 Be clear on objectives and vision
6 Enable patients to represent the most vulnerable patients

15. Feedback – Working together on patient safety (2/3)
Further key outputs from this discussion included:
Mapping of existing patient safety activity
• Establish a map of existing patient involvement in patient safety activity and how
the network adds value.
• Establish across NWL the clear channels where the network can be heard – Board
governance, incident reporting etc.
• Good local links for the network
Complaints
• Members to act as advocates for those patients who have made complaints –
“complaints buddies”
• A role in reviewing patient safety complaints coming into the Trusts and how they
were dealt with.
• Support patients who have had a bad experience.

16. Feedback – Working together on patient safety (3/3)
Further key outputs from this discussion included:
Patient Safety reporting
• Work with CCGs and provider organisations to look at existing risk management
and safety reporting.
• The network must sit within the system.
• Perform a regular checking function for patient safety reporting.
Workforce, training and development
• Network should offer training and development for members.
• Participants to be paid for their time.
• Ensure diversity of representation within the network membership
Holding the Whole Systems Integrated Care programme (WSIC) to account
• How does it ensure patient safety?
• Can we develop WSIC champions from the group?

17. Feedback on the day!
At the end of the session, feedback forms were handed out and completed. Some of
the key responses from the feedback are as follows:
 97% said you enjoyed the day
 88% said you learned something new and useful
 97% found the talks by guest speakers valuable
 97% would like to be involved in more discussions about patient safety
 94% found the working towards a safer system in NWL exercise useful
 91% said you found the themes discussed useful and interesting