Patient Safety

The Trust is committed to delivering high quality and safe care in a safe environment to all our service users.  Our staff take their responsibilities for your safety very seriously and the Trust is always seeking to improve your experience.

We are committed to making the safety of our patients and the quality of their care our highest priority.  To do this, we promote and support patient safety in many ways.  Click on the headings below to find out more about what initiatives have been put in place to ensure our patients receive the highest possible standards of quality and safe care and treatment.

Since 1 April 2016, the Trust has been working with the newly formed NHS Improvement.  NHS Improvement is responsible for overseeing foundation trusts and NHS trusts, as well as independent providers that provide NHS-funded care. They support the Trust to provide patients with consistently safe, high quality, compassionate care within local health systems that are financially sustainable.

From 1 April 2016, NHS Improvement is the operational name for an organisation that brings together various organisations, include Monitor and national Reporting and Learning System, both of which were concerned with patient safety.

For more information on NHS Improvement visit the Improvement Hub Website. 

• Quality Champions

  We are committed to delivering a safe, effective and caring service and all our staff have a role to play in making this their top priority.  

  During 2016, the number of Quality Champions increased to over 350.  Quality Champions are trained in both the techniques of quality improvement and the human dimensions of change. Quality Champions are currently undertaking and leading over 120 quality improvement projects.   Champions include clinical and non-clinical staff from a wide range of professional backgrounds and with varying levels of skills and experience in quality improvement.

  All Quality Champions who complete the training programme and commence an improvement project are awarded a bronze badge. Silver and gold badges are awarded to those Champions who sustain their improvements and disseminate them to other organisations.

  The Quality Champions’ programme has received national recognition and was successful in winning the Health Service Journal Award for Patient Safety in 2014. Plans are in place to continue to sustain and build the quality Faculty in 2016/17 by offering a broader range of training programmes with the aim of involving more junior staff.  Junior doctors undertake Quality Champions training as part of their protected study time to support them to see the opportunity to improve both clinical and non clinical care whilst they still have “fresh eyes” in an area.

  In December 2015 three of our Quality Champions were awarded Advancing Quality Awards, by AQuA (Advancing Quality Alliance). They were presented with their awards at a Quality Champions Committee meeting on Friday 26 February 2016.  Two of our consultants were also recipients of Clinical Excellence Awards in January 2016. Professor Nirmal Kumar received a Silver Award, whilst Mr Martyn Porter, attained a Gold Award. 

• Incident Reporting

  To improve patient safety, we must learn from any incident, regardless of its severity.  We encourage all our staff to report incidents, including near misses, onto our risk management system, Datix. 

  
  Strong reporting is a sign that a Trust takes patient safety and learning seriously. Our reporting system enables us to see if there are any recurring trends which we need to prioritise. Incident reporting enables us to manage performance and assure our staff, patients and the public that systems for managing risk are robust and effective. 

  We are seeing an increase in Near Miss reporting which is a clear indication of an organisation with a positive and improving safety, incident reporting and learning culture. Within the Trust, there has been a drive through various work streams and training programmes to raise awareness and understanding of Near Miss reporting and its value in learning and improving safety.

  Our Datix Daily Teleconference continues to promote timely escalation of incidents which results in early identification, escalation and investigation of potential and actual serious incidents and Never Events.  Our weekly Executive Scrutiny Committee oversees the management of incidents, formal complaints, claims and inquests. 

  The Trust promotes a just culture to support staff to speak up and ensure that they are supported when they do so:
  If you make an error you are cared for and supported;
  If you behave in a risky manner by not adhering to policies, you are asked why first before being judged;
  If you recklessly and intentionally put your patients or yourself at risk, you are accountable for your actions. 

• Reducing Harm

  Harm is measured by the NHS Safety Thermometer on a monthly basis.  The Safety Thermometer is a tool which has been developed nationally to measure the level of harm in care settings from pressure ulcers, falls, urinary tract infection in patients with an indwelling urethral catheter and venous thromboembolism. WWL’s results can be seen at
  http://www.safetythermometer.nhs.uk/

• Infection Control

  We take a zero tolerance approach to infections and do everything possible to prevent healthcare associated infections such as MRSA and clostridium difficile (C.diff).

• Safeguarding Adults and Children

  We take our safeguarding responsibilities very seriously and have dedicated leads to ensure that adults and children who use our services receive safe care and work closely with other agencies in order to provide appropriate support where this is required.

  View Safeguarding Vulnerable Adults and Children Web Pages

  Safeguarding Vulnerable Adults
  Safeguarding Children

• Safe Practice on the Wards

  The Trust utilises a number of mechanisms to maintain and monitor safe practice for our patients:

  Internal Inspections
  The Trust undertakes internal inspections every six months.  These inspections involve an extensive and enthusiastic team of voluntary inspectors, which continues to grow since the inspections began in December 2013. They represent a wide spectrum of groups within the organisations, and include patients, nurses, doctors, allied health professionals and managers/non-clinicians.  The CCG often join us and we have had colleagues from other Trusts who have also participated.   The internal inspections result in identification of “ten things to celebrate” and “ten things to improve”. 

  Leadership Quality and Safety ‘Walkabouts’
  Executive and Non-Executive members of the Trust Board and Trust Governors visit wards and departments and hold conversations with groups of staff about patient safety using an “appreciative inquiry” approach.  A training programme for Governors, Non-Executive Directors and Executive Directors has been developed and delivered.

  Corporate Nurse ‘Walkabouts’
  Our Corporate Nursing Team undertake monthly ‘walkabouts’ where they visit wards and talk to patients and employees - at all levels so they hear their views on patient safety and their ideas about what can be done to keep improving things. Strong communication between clinical staff is crucial to the safety of patients.

• Staffing Levels

  Having the correct staffing levels and skill mix is vital to ensuring we deliver quality patient care and patient safety.  We are committed to a quality workforce to deliver the care we want for our patients.  Every ward has an agreed skill mix / number of staff per shift that reflects the varying workload of the areas and will be agreed in conjunction with the Matron.  All wards and departments have white boards which are maintained and updated daily. Staffing levels are displayed.

• Hospital Escalation Line for Patients (HELPline) - 01942 822111

  We recognise that effective communication between patients, relatives and healthcare professionals is of the utmost importance during a hospital stay. When a patient becomes unwell it is vital that the concerns of the loved ones and carers are listened to and acted upon appropriately.

  The HELPline is available to all inpatients and their families (after discharge the Patient Relations Team would address any concerns in the usual way). Families are able to discuss concerns not resolved at a local level when those concerns arise. Families and carers can be assured that the Trust is committed to listening to the concerns of patients and their loved one.

  The HELPline provides relatives and carers with access to a Matron or Senior Nurse 24 hours a day. The Matron or Senior Nurse will be able to resolve issues or concerns that have not been addressed at ward level. It is hoped that this simple solution will help to deal with problems quickly, reducing any potential further distress for families and patients.

• Clinical Trials

  Research is a core activity of the NHS and is central to the promotion provision and continuous improvement to the quality and safety in all aspects of the service we offer. The Trust participates in high quality ethical research which aims to improve patient outcomes and is governed by the ‘Research Governance Framework’.
  View our Clinical Trials Web page

• Transparency

  During 2012/13, the Trust participated in a Transparency Pilot Project.  Monthly Reports were produced on the numbers of falls and pressure sores that occurred in our hospitals, as well as providing patient and staff feedback on the quality of care on our wards.

• Open and Honest Reports

  We know that there is a strong link between high quality and safe healthcare and a positive reporting culture. A positive reporting culture promotes learning through strong positive communication and identifying problems early. Open and Honest Care reports promote this culture by publishing a suite of safety and experience indicators including the number of pressure ulcers and falls that patients sustained in our care, the friends and family test results and patients and staff experience of the organisation.

  The aim of the report it to improve practice, staff and patient experience and to create a culture of safe, effective and compassionate care.

• AQuA (the Advancing Quality Alliance)

  We are members of AQuA – the North West’s Improvement Agency – which aims to promote best quality care across the region.  For more information go to the Advancing Quality Alliance (AQuA) website:  http://www.advancingqualityalliance.nhs.uk/

  WWL is also part of the NHS QUEST network, a member convened network with 11 other NHS trusts. The focus is on relentless improvement at pace through working together, sharing challenges and designing innovated solutions to continuously improve the care we give to patients.

  The work falls into four main streams:
  Leadership
  Improvement programmes
  Measurement
  Capability building

  Andrew Foster, WWL CEO is the current chair of NHS QUEST and is working closely with NHS Improvement to spread the methodology and success of QUEST to other NHS organisations.

  For more information go to the NHS Quest website: https://www.quest.nhs.uk/about-us/

  Leadership
  This is facilitated through a number of avenues including site lead WebEx’s, site leads meetings, and board meetings. QUEST will also be a facilitating Making Safety Visible programme during 2016. WWL will not be participating in this as we participated last year this was supported by the Greater Manchester Academic Health Science Network.

  Improvement Programmes
  QUEST is currently supporting a number of improvements through the use of clinical communities. Clinical communities are communities of practice made up of individuals from the member organisations with knowledge of the subject area. The communities look at methods to improve patient care and utilise PDSA (Plan, DO, Study, Act) cycles to try innovative approaches. The community is supported by QUEST who provide expert facilitation and data capture and measurement.

  WWL is participating in the following clinical communities:
  Medication safety
  Theatre safety

  Measurement
  QUEST support the measurement needs of the clinical communities as well as producing a dashboard to allow organisations to benchmark against each other.

  Capability Building
  QUEST is hosting an IS4leaders programme (Improvement Science for Leaders). This programme is aimed at teams who have an improvement objective in mind. The team are supported and given tools to implement the improvement projects.

• Patient Safety Game – Snakes Alive

  Keeping patients safe is the aim of everyone who works in our Hospitals. Chris Birchall, Head of Research and Development, Innovation and Clinical Trials along with IT have developed a fun way for patients finding out how best to stay safe whilst in Hospital.
  
  Play the Patient Safety Game and See How Well You Do!