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Sam

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  1. News Article
    Treatment with isotretinoin for UK patients under 18 years of age must be approved by two prescribers in a series of regulatory changes announced by the Medicines and Healthcare products Regulatory Agency (MHRA) to strengthen the safe use of this drug. Isotretinoin, also known by the brand names Roaccutane and Reticutan, is an effective treatment for severe acne or when there is a risk of permanent scarring. While the drug has helped many patients with severe acne, concerns have arisen among patients and members of the public regarding suspected mental health side effects, including depression, anxiety, psychotic symptoms, and suicide, as well as sexual side effects. Following an expert safety review, the Commission on Human Medicines (CHM) agreed in April of this year to a number of recommendations to strengthen the safe use of the treatment. The safety review concluded that because of gaps in the available evidence, it was not possible to say that isotretinoin definitely caused many of the short-term or long-term mental health and sexual side effects. However, since the individual experiences of patients and families continued to cause concern, the experts recommended that action be taken to ensure patients were made aware of these potential risks and that they were carefully monitored during treatment. "The overall balance of risks and benefits for isotretinoin remains favourable," the authors of the report concluded, but further action should be taken to ensure patients were fully informed about isotretinoin and were effectively monitored during and after treatment, they recommended. Anna Rossiter, programme manager for Medicines for Children at the Royal College of Paediatrics and Child Health, said the information for young people and their families "needs to be written in a format that is easy to understand and must set out the possible side effects that might be experienced". Read full story Source: Medscape, 1 November 2023
  2. News Article
    A public inquiry into the deaths of at least 2,000 mental health inpatients has been relaunched with new powers. The Essex Mental Health Independent Inquiry was established in 2021 to investigate the deaths of people on mental health wards in the county. The number of initial responses to the inquiry from current and former staff was described as "disappointing". The inquiry has converted to a statutory inquiry meaning witnesses can be forced to give evidence. It is understood the new chairwoman is considering extending the inquiry's timeframe to include deaths from the start of 2000 until the end of 2023. Baroness Kate Lampard, leading the inquiry, said: "I am determined to conduct this inquiry in a fair, thorough and balanced manner. "I am also concerned to ensure that I do not take any longer than necessary - the recommendations from this inquiry are urgent and cannot be delayed." She added: "To be clear from the outset, I will not be compelling families to give evidence. "Evidence from staff, management and organisations will be gathered in a proportionate, fair and appropriate manner." Read full story Source: BBC News, 1 November 2023
  3. News Article
    The safety of people with learning disabilities in England is being compromised when they are admitted to hospital, a watchdog says. The Health Services Safety Investigations Body (HSSIB) reviewed the care people receive and said there were "persistent and widespread" risks. It warned staff are not equipped with the skills or support to meet the needs of patients with learning disabilities. The watchdog launched its review after receiving a report about a 79-year-old who died following a cardiac arrest two weeks after being admitted to hospital. As part of its investigation, HSSIB also looked at the care provided in other places to people with learning disabilities. It warned systems in place to share information about them were unreliable, and that there was an inconsistency in the availability of specialist teams - known as learning disability liaison services - that were in place in hospitals to support general staff. It also said general staff had insufficient training - although it did note a national mandatory training programme is currently being rolled out. Senior investigator Clare Crowley said: "If needs are not met, it can cause distress and confusion for the patient and their families and carers, and raises the risk of poor health outcomes and, in the worst cases, harm." Read full story Source: BBC News, 2 November 2023
  4. News Article
    Former BBC Technology correspondent Rory Cellan-Jones, now a writer and podcaster, has Parkinson's disease. Two weeks ago, after fracturing his elbow in a nasty fall, he found out just how difficult it can be to get answers from the NHS. "Getting information about one's treatment seems like an obstacle race where the system is always one step ahead. But communication between medical staff within and between hospitals also appears hopelessly inadequate, with the gulf between doctors and nurses particularly acute. "I also sense that, in some cases, new computer systems are slowing not speeding information through the system. On Saturday morning, as we waited in the surgical assessment unit, four nurses gathered around a computer screen while a fifth explained to them all the steps needed to check-in a patient and get them into a bed. It took about 20 minutes and appeared to be akin to mastering some complex video game beset with bear traps." Rory's latest experience as a customer of the health service has left him convinced that more money and more staff won't solve its problems without some fundamental changes in the way it communicates. Read full story Source: BBC News, 29 October 2023
  5. News Article
    NHS bosses are using misleading figures to hide dangerously poor performance by A&E units in England against the four-hour treatment target, emergency department doctors claim. Some A&Es treat and admit, transfer or discharge as few as one in three patients within four hours, although the NHS constitution says they should deal with 95% of arrivals within that timeframe. How well or poorly A&Es are doing in meeting the 95% target is not in the public domain because the data that NHS England publishes is for NHS trusts overall, not individual hospitals. That means official figures are an aggregate of performance at sometimes two A&Es run by the same trust or include data for any walk-in centres, minor injuries units or urgent treatment centres that a trust also operates. Forty-eight trusts have two A&Es and many also run at least one of the latter. The Royal College of Emergency Medicine (RCEM), which represents A&E doctors, wants that system scrapped. It is urging NHS England to start publishing data that shows the true performance of every individual emergency department against the 95% standard. “The current data is misleading,” Dr Adrian Boyle, the college’s president, told the Guardian. “It’s a good example of a lack of transparency and also of performance incentives. Being open about the long delays in some A&Es would shine a light in some dark places.” Read full story Source: The Guardian. 28 October 2023
  6. News Article
    The parents of a baby boy who died at seven weeks old after a hospital did not give him a routine injection have described the failure as “beyond cruel”. William Moris-Patto was born in July 2020 at Addenbrooke’s hospital in Cambridge, where it was recorded in error that he had received a vitamin K injection – which is needed for blood clotting. The shot is routinely given to newborns to prevent a deficiency that can lead to bleeding. His parents, Naomi and Alexander Moris-Patto, 33-year-old scientists from Chatteris, Cambridgeshire, want to raise awareness about the importance of the vitamin after a coroner concluded William would not have died had the hospital administered the injection. On Friday, the coroner Lorna Skinner KC described the omission as “a gross failure in medical care amounting to neglect”. Alexander Moris-Patto, a researcher at the University of Cambridge who recently co-founded William Oak Diagnostics to test for deficiencies in babies, said: “What’s come out of the inquest for me is that the systems they [the trust] put in place to try to prevent this happening again are not satisfactory.” He stressed the importance of the vitamin K injection, adding that about 1% of the UK population opt out of it. “We want people to know more about it, to understand how critical it can be, and for hospitals to take seriously the responsibility they have in those first precious hours of a baby’s life,” he said. Read full story Source: The Guardian, 29 October 2023
  7. News Article
    Record numbers of patients are complaining to the NHS Ombudsman about poor care, exorbitant fees and difficulty getting treatment from NHS dental services in England. Mistakes by dentists mean some patients are being left in agony – in some cases unable to eat – while others are being landed with huge bills for work on their teeth. “Poor dental care leaves patients frustrated, in pain and out of pocket,” said Rob Behrens, the parliamentary and health service ombudsman. The number of complaints he receives every year about NHS dental services has jumped from 1,193 in 2017-18 to 1,982 in 2022-23 – a rise of 66%. Behrens also disclosed that the proportion of complaints he upholds about NHS dentistry after an investigation has increased from 42% to 78% over the same period. That 78% figure for upheld complaints about dental services is “significantly more” than for any other area of NHS care, such as GP, hospital or mental health care, where the overall average is 60%, he said. Dentistry has become one of the public’s main concerns about the NHS, especially the obstacles many people face when trying to access NHS care. A BBC survey last year found that 90% of surgeries across the UK were not accepting new adult patients and 80% were not taking on children as new patients. Read full story Source: The Guardian, 30 October 2023 Related reading on the hub: “I’ve been mocked, scolded and gaslighted”: a harmed patient’s experience of orthodontic treatment A patient harmed by orthodontic treatment shares their story We want to hear from patients with experience of NHS and/or private orthodontists and dentists in any healthcare setting, including community practices and hospitals. Did the orthodontist/dentist give you the treatment and support you needed? If you had ongoing problems, how did the orthodontist/dentist and other healthcare professionals respond? Have you tried to make a complaint? Share your experience of orthodontist and dentistry services
  8. News Article
    To new parents processing the shock of delivery and swimming in hormones, newborns can feel like a tiny, terrifying mystery; unexploded ordinance in a crib. “We were totally unprepared,” says Odilia. Neither she or her husband had ever changed a nappy and had no idea the baby needed feeding every three hours. “If you’re a new mum or dad, you have no idea,” recalls Anouk, a new mother. “I’m a doctor,” says Zarah, another new mother, incredulously. “So, you would expect that I’d know something, and I knew some things, but you really don’t have any clue.” The difference for these new parents, compared to the rest of us, is that they gave birth in the Netherlands. That meant help was instantly at hand in the form of the kraamzorg, or maternity carer. Everyone who gives birth in the Netherlands, regardless of their circumstances, has the legal right – covered by social insurance – to support from a maternity carer for the following week. These trained professionals come into your home daily, usually for eight days, providing advice, reassurance and practical help. It’s a different role to midwives, who continue to monitor women and babies after the birth in the Netherlands; the maternity carer updates the midwife on the mother and baby’s health and progress as well as supporting the parents as they come to terms with their new child. A maternity carer in the Netherlands, explains Betty de Vries of Kenniscentrum Kraamzorg, the organisation that registers maternity carers, “takes care of the woman the first week, advises her on breastfeeding and bottle feeding, hygiene, gives advice … everything to do with safe motherhood and a safe baby. She is there for the whole day most of the time so she can see how they are doing.” Her colleague, director Esther van der Zwan, adds: “It’s a lot of responsibility.” To prepare, maternity carers train for three years – a combination of academic and on-the-job placements – and have regular refresher training in everything from CPR to breastfeeding support.
  9. News Article
    Some care home residents may have been "neglected and left to starve" during the pandemic, Scotland's Covid Inquiry is expected to hear. Lawyers representing bereaved relatives said they also anticipate the inquiry will hear some people were forced into agreeing to "do not resuscitate" plans. Shelagh McCall KC told the inquiry that evidence to be led would "point to a systemic failure of the model of care". The public inquiry is investigating Scotland's response to the pandemic. Ms McCall is representing Bereaved Relatives Group Skye, a group of bereaved relatives and care workers from Skye and five other health board areas of Scotland. In her opening statement, she told the public inquiry that families wanted to know why Covid was allowed to enter care homes and "spread like wildfire" during the pandemic. She added: "As well as revealing the suffering of individuals and their families, we anticipate the evidence in these hearings will point to a systemic failure of the model for the delivery of care in Scotland, for its regulation and inspection. "We anticipate the inquiry will hear that people were pressured to agree to do not resuscitate notices, that people were not resuscitated even though no such notice was in place, that residents may have been neglected and left to starve and that families are not sure they were told the truth about their relative's death." Read full story Source: BBC News, 25 October 2023
  10. News Article
    No senior NHS England director is prepared to take responsibility for ADHD services — which are facing waits of up to a decade and severe medication shortages — HSJ has discovered. Despite soaring demand for assessments and widespread drug shortages recently triggering a national patient safety alert, responsibility for attention-deficit/hyperactivity disorder services does not sit within any NHS England directorate. HSJ understands that none of NHSE’s mental health, learning disability, or autism programmes have been given any resources for ADHD. It is also claimed that the medical and long-term conditions teams “are not very interested” in taking responsibility, and “assumed someone else was doing it”. A senior source, very close to the issue, told HSJ that no NHS senior director had taken “ownership” of the issue, and there was a widespread misapprehension that responsibility for ADHD services was part of the autism remit given to the mental health directorate. “We haven’t got the attention we need around ADHD,” said the source, “we need a [dedicated] neurodiversity programme.” Read full story (paywalled) Source: HSJ, 26 October 2023
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    With a strong national drive to standardise on a handful of EPR systems what are the risks of creating monopolies? What are the risks of vendor-lock in for future innovation, costs, choice and interoperability. Join our panellists as they debate this key industry topic. Find out more
  12. Event
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    This lecture will briefly outline challenges in quality and safety in healthcare, will identify the patchy history of attempts to make improvements, will emphasise the need to build and evidence base for improvement, and will outline some of the challenges and opportunities in evidence generation. Mary Dixon-Woods is Director of THIS Institute and The Health Foundation Professor of Healthcare Improvement Studies in the Department of Public Health and Primary Care at the University of Cambridge. Register
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    This conference focuses on priorities for improving urgent and emergency care services in England. It will be an opportunity to examine progress and next steps for: the Delivery plan for recovering urgent and emergency care services - published by NHS England in January 2023 the Re-envisioning urgent and emergency care report - published by the NHS Confederation in December 2022. Stakeholders and policymakers will assess key priorities, including implementation and investment of the delivery plan, and the way forward for reducing waiting times and improving patient outcomes. Further sessions look at issues surrounding the workforce and service capacity, speeding up patient discharge, next steps for the same day emergency care policy, and the future outlook for virtual wards. Includes keynote sessions with: Ashley McDougall, Director, Health Value for Money, National Audit Office; Dr Adrian Boyle, President, Royal College of Emergency Medicine; and a pre-recorded contribution from Miriam Deakin, Director of Policy, NHS Providers. Overall, areas for discussion include: the delivery plan: progress, trends and challenges in delivering sustainable recovery of urgent and emergency care in England - priorities for improving accessibility workforce: what will be needed to deliver aims of the NHS Long Term Workforce Plan for emergency care strategies for growing the emergency care workforce, as well as training, professional development and retention priorities for supporting staff and addressing challenges for the workforce that are specific to emergency care waiting times: enabling same day emergency care targets to be met - latest thinking and best practice in effective hospital design, and developing capacity and flow - priorities for funding hospital bed occupancy: addressing issues with speeding up patient discharge - the role of social care and options for expanding care in the community - progress in delivery of virtual wards capacity and accessibility: the role of Integrated Care Systems in developing effective pathways for improving capacity - involvement of the independent sector quality: next steps for driving up standards - enabling long-term sustainable system recovery - priorities for aligning needs in emergency care with wider policy developments and initiatives Register
  14. News Article
    Financial directors need to take responsibility for safety, which should be at the core of how the NHS runs services, the leadership of the Health Services Safety Investigations Body (HSSIB) said at its launch Wednesday. The Healthcare Safety Investigation Branch is now an independent body – and has been renamed HSSIB – although maternity investigations are hosted by the Care Quality Commission. Questioning how many finance directors across the NHS take responsibility for safety, HSSIB’s interim chief investigator Rosie Benneyworth said: “We need a position where finance directors in every organisation are as responsible for safety as the person leading the safety agenda and vice versa, the safety person works with the finance agenda to support them. “Often you see the finance director and safety lead don’t work effectively together and we need to change that.” Dr Benneyworth said progress will not be made unless operational delivery, financial delivery and safety are tackled “in the same breath”. HSSIB’s new chair Ted Baker also called for safety to become a core part of running services “in the way running the accounts is”, as it is currently still seen “as an add-on”. He stressed that safety “drives efficiencies, enables innovation and saves costs”. Read full story (paywalled) Source: HSJ, 19 October 2023
  15. Event
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    The Learn from Patient Safety Events (LFPSE) service is the NHS's new system for the recording and analysis of patient safety events. Very little research had been done before to understand the best ways to make sure patients, service users and their families can give their views on safety incidents, for the whole NHS to learn from. Learning from patients’ experiences and how they feel about the care they have received is known to be a very good way to make healthcare services better. However, getting the right information from people in the right way, and making sure the right NHS staff see it and can act on it, is difficult to do. This Show and Tell outlines the research completed to understand how we can do this better through the introduction of the LFPSE service. Audience: This is a publicly open event for anyone interested in understanding the work that NHS England has completed into understanding the best ways to make sure patients, service users and their families can give their views on safety incidents, for the whole NHS to learn from. Speakers: Lucie Mussett Patient Safety Lead & Senior Product Manager for the Learn from patient safety events (LFPSE) service Hope Bristow – Senior User Centred Designer (Informed Solutions) Natasha Hughes – User Researcher (Informed Solutions) Register
  16. Event
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    This two-day King's Fund conference aims to explore how the current strain on services makes listening to people more difficult but even more important, at a time when public satisfaction with the NHS is at an all-time low. Join us to hear about how you can make sure building in the user voice is routine and core to the business of the health and care system, not just ‘a nice to have’. Conference sessions will: discuss how the NHS and social care cannot deliver quality unless listening to patients and carers, and acting on their feedback, lies at the heart of its culture.   provide learning on how to listen well and what meaningful engagement with people and communities looks like. Gain insight into the findings from the Fund’s project on understanding integration with the HOPE (Heads of Patient Experience) network by working with six sites on an action learning piece. Learn about how health and social care decision-makers cannot overcome challenges and answer long-term questions alone - such as how the system will address the deep inequalities and how it can adapt to provide the joined-up, efficient care that people want and gives them more control – public input is crucial. Join peers to share learning on grasping this opportunity to finish building a culture where listening to patients, service-users, and communities is everyone's business.   Register
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    This free online event is an exciting opportunity to hear nursing workforce expert, Professor Alison Leary MBE, speak on the subjects of safe caseloads in community nursing. Professor Alison Leary PhD RN FRCN is Chair of Healthcare & Workforce Modelling at London South Bank University and Director of the QNI’s International Community Nursing Observatory. We will also hear from Cathy Woods and representatives of the software company Yarra, on the Use of E-CAT software for Monitoring Caseloads. The E-CAT product for district nursing is an electronic tool which supports caseload analysis and audit. Underpinned by a bespoke dependency tool and based on a methodology validated by the University of Ulster, the tool looks at caseload variables at all levels, from caseload holder to commissioner and facilitates caseload benchmarking and performance management. The tool has been implemented in all five health trusts in Northern Ireland providing a significant regional evidence base. We will be able to hear about the experience of using E-CAT in Northern Ireland from the NI Public Health Agency. Register
  18. News Article
    A trust saw nearly 1,000 safety reports filed after introducing a new electronic patient record (EPR) – including one where a patient died and 30 others where they suffered harm. The Royal Surrey Foundation Trust and Ashford and St Peter’s Hospital Foundation Trust installed a new joint EPR system in the middle of last year. But Royal Surrey’s board was told there had been 927 Datix reports — which are used to raise safety concerns — related to the introduction of the “Surrey Safe Care” system, running up until mid September this year. The catastrophic harm involved a patient death which the trust says was not “directly linked to technical problems” with the EPR, as “human factors” were involved, including inexperience or unfamiliarity with the electronic prescribing system. Louise Stead, chief executive of Royal Surrey, said: “Implementing an electronic patient record is a huge shift for any workforce and we experienced some issues with the functionality of the system and getting users sufficiently trained and confident in using it correctly. We have worked hard to address these issues as quickly and responsibly as possible. “Our fundamental aim is for ‘zero harm’ and any harm caused to a patient is taken extremely seriously and investigated. In the case of these Datix incidents the vast majority (over 99%) resulted in low or no harm to patients. “However, one case resulted in the tragic death of a patient and we have been working closely with their family to be transparent and learn every possible lesson. This case was not directly linked to technical problems with the electronic patient record system and human factors did contribute. We are sincerely sorry for the failure in their care and devastating impact upon this person’s family.” Read full story (paywalled) Source: HSJ, 11 October 2023
  19. News Article
    An NHS trust and ward manager have appeared in court charged with the manslaughter of a 22-year-old mental health patient who died in hospital in July 2015. Alice Figueiredo was found dead at Goodmayes Hospital in east London, and an investigation into her death was opened in April 2016. The Crown Prosecution Service (CPS) authorised the Met Police to charge North East London NHS Foundation Trust (NELFT) with corporate manslaughter last month following a five-year investigation. It is just the second NHS Trust to face manslaughter charges. The Trust is additionally charged with an offence under section three of the Health and Safety at Work Act in connection with mental health patient Ms Figueiredo's death. Ward manager Benjamin Aninakwa also faces a charge of gross negligence manslaughter and an offence under section seven of the Health and Safety at Work act. NELFT is just the second ever NHS Trust believed to have been charged with corporate manslaughter, after Maidstone and Tunbridge Wells Trust was charged over the death of a woman who underwent an emergency Caesarean in 2015. Read full story Source: Mail Online, 6 October 2023
  20. News Article
    ADHD patients around the UK are finding they can't get hold of medication since a national shortage was announced. Three different medicines are affected, and the government says some supply issues could last until December. The Department for Health and Social Care (DHSC) says "increased global demand and manufacturing issues" are behind the shortages. Medication helps to manage symptoms, which can include difficulty concentrating and focusing, hyperactivity and impulsiveness. Dr Saadia Arshad, a consultant psychiatrist, who specialises in diagnosing and treating people with ADHD. She says the shortage of medication is "not a new issue, but it's a recurring one". Dr Saadia says suddenly stopping meds can lead to patients "feeling jittery, finding it difficult to pay attention, staying focused and feeling restless". Even though she understands the shortage can be worrying, Dr Saadia says it's important that people don't take measures into their own hands. "These medicines can be quite potent and the response to medication for two individuals is not the same," she says. "So please do not take any action without discussing it with your clinician." Read full story Source: BBC News, 6 October 2023
  21. News Article
    Seven trusts have been added to NHS England’s list of providers with the worst elective and cancer problems, putting the number of organisations in the ‘tier 1’ group back into double figures – and five leaving it, HSJ has learned. Since last summer, NHS England has put trusts considered most “at risk” of missing recovery trajectories into “tiers” for either elective or cancer performance, or both. The list has changed significantly for quarter three of this year, despite only a few months passing since the last rankings were revealed in August. HSJ understands this is due to system-level agreements and some national factors, including the impact of ongoing industrial action on elective activity. The number of trusts in the most challenged “tier 1” group for both elective and cancer performance has increased from eight to 11, with seven new providers entering this tier and five leaving. Read full storySource: HSJ, 9 October 2023
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    Agenda and registration
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    Last year, our helpline advisers dealt with an average of two calls a day relating to complaints – could the caller complain about what had happened? How to complain? Who to complain to? This event is for patients and carers who would like answers to some basic questions about complaining about care. Solicitors Chris James and Josh Hughes from law firm Bolt Burdon Kemp will be joining our Chief Executive Rachel Power in this online event. Between them they’ll: Help people understand the NHS complaints process, including its limitations Describe how to get the most out of making a complaint Explain were the distinction can lie between poor service and a claim in negligence. Register
  24. News Article
    Police are investigating possible corporate manslaughter at the hospital where serial killer Lucy Letby worked. The former nurse, 33, was jailed in August for murdering seven babies and attempting to kill six others at the Countess of Chester Hospital. Cheshire Police said the latest investigation was in its early stages. Lawyers representing some of the victims' families said they were "reassured" steps were being taken to consider the actions of management. Organisations and companies can be found guilty of corporate manslaughter as a result of serious management failures resulting in a gross breach of a duty of care under The Corporate Manslaughter and Corporate Homicide Act 2007. Det Supt Simon Blackwell, of Cheshire Police, said the inquiry would focus on the indictment period of the charges for Letby from June 2015 to June 2016. He said the investigation would consider areas "including senior leadership and decision making to determine whether any criminality has taken place". "At this stage we are not investigating any individuals in relation to gross negligence manslaughter," he added. Read full story Source: BBC News, 4 October 2023
  25. News Article
    Trust leaders have been asked to “self-assess” the quality of their “improvement culture” as part of an initiative launched by NHS England chief executive Amanda Pritchard in the spring to lead the service's new improvement drive. The call came from NHS Impact, led by former Modernisation Agency chief David Fillingham, who along with NHS Impact’s deputy chair – University Hospitals Coventry and Warwickshire Foundation Trust CEO Andy Hardy – has written to service leaders, setting out the first stage in the improvement drive. They have asked the boards and CEOs of trusts and integerated care boards to “engage directly” with a new self-assessment tool and maturity matrix created by NHS Impact. This is designed to gauge their progress on adopting the five practices that NHS IMPACT claim “form the DNA of an improvement culture”. Those five practices are: A shared purpose and vision which are widely spread and guide all improvement effort. Investment in people and in building an improvement focused culture. Leaders at every level who understand improvement and practise it in their daily work. The consistent use of an appropriate suite of improvement methods. The embedding of improvement into management processes so that it becomes the way in which we lead and run our organisations and systems. Read full story (paywalled) Source: HSJ, 29 September 2023 .
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