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September 23rd 2016

Gavin Boyle
This week’s blog is brought to you by the letter P and the letter S and the number 7. I’ve obviously been watching too much Sesame Street – my wife says I look quite a lot like Bert but I can never work out which is which out of Bert and Ernie! My mind this week has been on two things, which are perhaps regular themes in the blog – one is Partnerships – ‘oh no, not that again’! And the other is Safety. 
So starting with the latter – it was really great this week that, despite all the busyness, we had the opportunity as a whole Board to spend day and a half thinking about patient safety and the things we could do to help keep our patients free from harm.
Now, you may think that there shouldn’t be any harm in hospitals and I would agree with you, but it’s a fact that delivering healthcare in a hospital environment is not without risk – indeed, international studies, drawing on experience from hospitals all over the developed world suggest that as many as one in ten patients experience some form of harm during their hospital stay.
Now, clearly, this won’t always be serious but sometimes it can be. The sort of harm that is common includes falls, developing infections, clots from being immobile, etc. One of the things we do as a Board when we meet is to review the numbers of these events that have occurred and the work that has taken place within our hospitals to reduce them. I’m pleased to say that thanks to the leadership of Cathy Winfield our Chief Nurse, Dr Nigel Sturrock, our Executive Medical Director and Sir Stephen Moss, one of our Non-Executive Directors who chairs our Quality Committee and the work of all our clinical teams, the rates of our harm in our hospitals are better than this international comparator. But there’s no room for complacency. 
Many errors in hospitals reflect the fact that care is delivered by human beings who can make mistakes – to err is, after all, human. But the sort of lessons we can learn from these ‘human factors’ is that it is possible to design our systems of care in ways that can hugely reduce the risks to patients. A lot of the thinking around this has been borrowed from the airline industry, which has taken huge strides to reduce their risks by strengthening their safety checks and processes.  And we’re doing the same, looking at all our processes to see how we can make them more standardised and reduce the potential for human errors.
One of the interesting lessons from the airline industry is the importance of people being able to speak up if they feel something is wrong. It may surprise you to know that there are many well documented cases where flight crew have been aware of problems but felt unable, for one reason or another, to say something, with catastrophic consequences. Hopefully, a thing of the past – but one of the things I’m really passionate about is the need to help create an environment where everyone feels able to speak out if they think something is not right. This can only be achieved through openness and giving our people the confidence, no matter what grade they are, to step forward and say how they feel. 
One of the things we committed to as a Board is to spend more of our time focusing on these issues of safety and openness – really because it’s at the heart of why we are here – to deliver great care – and a fundamental part of our ambitions to make our hospitals a great place to work, too. 
So now on to partnerships - and here it’s really a continuation of my theme of openness and transparency. As regular readers will know, we are working hard with our near neighbours in Burton to try to develop an integrated way of delivering better services for our patients. There have been lots of discussions over the summer, particularly between clinical teams from Burton and Derby seeking to work out just how to do that. We are now trying to crystallise all these ideas into something called a ‘Strategic Outline Case’ which we will take to both our Boards in the next couple of months to help us decide what to do next. 
I’ve spent a lot of time this week with my counterpart, Helen Scott-South, Chief Executive at Burton – Helen is an old hand from Derby so I am sure many of you will know her. We’ve been meeting up with lots of stakeholder organisations such as the local authorities’ Overview and Scrutiny Committees in Staffordshire and Derbyshire, Health and Wellbeing Boards and governing bodies of commissioning organisations, to tell them more about the work we’ve been doing. This is all part of our commitment to openness and to be accountable to our communities. We’ve also established a Patient Reference Group to help involve service users in the development of these plans too. I’ll keep you posted about how the work’s going but I think there’s some really exciting opportunities emerging, which could be good news for people in Derbyshire and Staffordshire alike.
Sadly this week, I’ve not been able to do one of my usual ‘out and abouts’ – but my diary just seems to have been taken over by all the above. I mentioned last week about my experience accompanying Dr Sturrock on his ward round, which has stayed with me. I’ve been thinking about some of the people we met that day and how their lives had been interrupted by ill health. I came across a marvellous quotation this week by a chap call Don Berwick - who’s a sort of international patient safety expert based in the US. The quote was:
The names of the patients whose lives we save can never be known. Our contribution will be what did not happen to them. And, though they are unknown, we will know that mothers and fathers are at graduations and weddings they would have missed, and that grandchildren will know grandparents they might never have known, and holidays will be taken, and work completed, and books read, and symphonies heard, and gardens tended that, without our work, would never have been.”
Have a great weekend

(Sorry – there wasn’t actually anything about the number 7!)


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