Patient Safety Spotlight interview with Magda Wroblewska-Trojanowicz, Family Liaison Officer Team Lead at Southern Health NHS Foundation Trust

Summary

This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Magda talks to us about her role as Family Liaison Officer Team Lead, how PSIRF has changed the way her Trust involves patients and families after patient safety incidents and the importance of placing patient and family perspectives at the heart of learning responses.

About the Author

Magda is a Family Liaison Officer and Team Lead at Southern Health NHS Foundation Trust in Hampshire. Originally from Poland, Magda moved to Southampton from the lovely port city of Gdansk. She studied Law and Criminology in England, qualified as a barrister in 2010 and worked in civil litigation prior to joining Hampshire Constabulary as a Police Officer. Magda was also elected as a Police Federation Representative where her area of focus was ill health retirement. 

Questions & Answers

Hi Magda! Please tell us who you are and what you do.

My name is Magda and I lead the team of Family Liaison Officers (FLOs) at Southern Health NHS Foundation Trust. We assist and support patients and families during NHS reviews or investigations and make sure they are meaningfully engaged and involved in the process if they want to be. Sadly, the majority of cases an FLO deals with are suicide-related and we extend our support to families affected by suicide and assist them during the inquest process, even after the NHS review or investigation is complete. This is important because we know that families who have lost loved ones to suspected suicide are at a higher risk of taking their own life. I am also a member of Hampshire Suicide Prevention Forum which allows me and my colleagues to be involved in wider suicide prevention.

How did you first become interested in patient safety? 

I joined the NHS five years ago as the single FLO in the Trust, and this was really the first time I was made aware of patient safety. I am a qualified lawyer and my previous roles were in law enforcement and civil litigation, so nothing to do with patient safety. But of course, I am a patient myself and have received care from the NHS. I have to say that I have always felt safe and cared for when receiving treatment, and this is what I want for everyone. However, I am very aware of the struggles the NHS workforce faces these days and that this has a big impact on patient safety. 

Which part of your role do you find the most fulfilling?

Our team is deployed when a patient’s care or treatment was not as good as it should have been, which means we step in when patients or family members are disappointed and often angry at the Trust. As we often support families when they lose loved ones to suspected suicide, there are a lot of emotions involved, and of course grief. What I find fulfilling is the fact that we are able to provide help and assistance at one of the most difficult times in people’s lives. We make sure patients and families are informed about the progress of any review or investigation, involved and included throughout and guided through complicated processes. 

It makes me really emotional when we receive feedback about the difference we have made for families. Recently, one family shared this feedback with us: “It was the most horrific time in our lives and the team made it so much better. They spent ages talking through everything, nothing was too much trouble. They are an amazing team and I can’t thank them enough. I never wish anyone to have contact with the team, however, if you have to, this team really does care and it's not a tick box exercise.”

How has the introduction of PSIRF changed your organisation's approach to family engagement? 

My Trust had FLOs in post prior to the introduction of the Patient Safety Incident Response Framework (PSIRF) and we already placed a high importance on patient and family engagement. However, PSIRF has definitely amplified this importance. It has given my team the opportunity to design and deliver training to staff across the Trust about compassionate engagement and involvement. It’s a bit of a lightbulb moment when I deliver the training and people realise the importance of preparing to contact the patient or family. Before, there was often an attitude of ‘we just need to get on with it’.

Under the new framework, learning responses happen within the team delivering care and each team has a Learning Response Lead (LRL) who is responsible for making initial contact with the family or patient following a patient safety incident. My team engages with the LRL at an earlier stage than we would have done previously, which allows us to talk about the potentially difficult conversations they might have with the patient or their family. These conversations are the bread and butter of our role as FLOs, and we now have more opportunity to equip frontline staff with the skills they need to engage patients and families well when things have gone wrong. 

That initial stage of engagement—when families are going through a very difficult time—is so important to get right. Our priority is always to avoid compounding harm. We help LRLs consider the most sensitive way to make contact—for example, there may be significant dates that they should avoid when making the initial call. The real difficulty is that frontline staff are under a lot of pressure, and finding the time and the right environment to make the call is hard. We tell people not just to fit it in when they have a five minute break—it needs time and attention. If that first conversation doesn't go well, it’s very difficult to repair the relationship with the patient or family. Our team is able to step in and support if staff need us to, and we are seeing an increase in staff contacting us.

This new way of working means that when we get involved as FLOs, we are already aware of a family’s situation. We can build on the contact they have already had with the LRL and investigation officer, which improves the relationship and gives better opportunity for patients and families to be meaningfully involved in the learning process if they want to be. The majority of our cases are suicide-related, which as I have mentioned, means that as FLOs we will be working with each family for a long period of time. My experience is that when that initial contact has been established really well, it’s much easier to offer the family effective support throughout the process that meets their needs and it is tailored to them and not prescribed by us.

Another positive thing about PSIRF is the flexibility it gives us with time frames. We can be led more easily by the family’s wishes—if they aren’t ready to engage but want to be involved in the learning response, we will wait for them. While we want learning to take place as soon after the event as possible, we also have to be mindful of the needs of the patient or family, and ensure that they are at the centre of the process.

How would you like to see the way healthcare organisations engage with patients and families develop further?

Engaging and involving patients and families is an integral part of a learning culture and I would like to see it as standard practice in the future, carried out in a meaningful and compassionate way. It would be great to see every organisation employing an engagement lead or FLO. I have no doubt that this would reduce the number of future incidents and develop and improve the relationship between patients and their families and healthcare professionals. It is a journey for us all, but it is a positive one where patients and families' voices are being heard and placed at the heart of any review, investigation or improvement work.

Why is it important that patients and family are involved in learning responses?

It is vital to have the involvement of patients and families in any organisational learning, as their perspectives will be different to those working within the Trust. An example would be assessing how well carers are educated about the medication their loved ones are taking—who is better placed to answer that question than a carer? They might tell us whether they are able to access the information they need from our website and about information they are getting from other sources. Without this input, any improvement work would be more clinically-focused and miss out on this real-world view.

However, getting these perspectives is dependent on the willingness of patients and families to be involved. It is absolutely understandable that many want to focus on moving on and getting back some semblance of normality. However, there are some patients and families who are very keen to help us learn from their experience. Working with families over time gives us the relationship to know when it’s appropriate to ask them whether they want to be involved in learning. In some cases, we are aware of their views through our long term contact and can feed these into improvement work.

If you could change just one thing in the healthcare system right now to improve patient safety, what would it be? 

I would increase the number of qualified staff to provide continuity of care and treatment, especially in mental health. We need the resources within teams to build resilience and in turn create safety for all patients. I think it is fair to say that it is a national issue and I would personally welcome greater funding and financial support for those who decide to study nursing or medicine. We need to attract more people into these incredibly rewarding and important careers.

Are there things that you do outside of work that have made you think differently about patient safety? 

Some years ago, before I joined the police, I decided to work in my local care home, a private setup with outstanding care. I wanted to know how to support people with dementia when I was serving on the front line—it was a great experience which helped me as a police officer. What I saw and experienced in this care home was amazing, compassionate care being delivered in a safe environment which helped all the residents to stay well. It showed me what it was possible to achieve with the right resources. I would love to see this gold standard care made available everywhere and for all patients, but I know it is very hard for the public sector due to demand and funding restrictions.

Tell us one thing about yourself that might surprise us!

I am a keen motorcyclist and ride a sport motorbike—it is a great way of relaxing and focusing on the present, which helps my mental wellbeing.

Related reading

• A simple guide to the Patient Safety Incident Response Framework (PSIRF)
• Patient Safety Spotlight interview with Louise Pye, Head of Family Engagement at HSIB