This week, the 1,000 Lives Campaign which was designed to improve patient saftey in the NHS in Wales comes to an end. Here is an article which I wrote for the Western Mail about the campaign.
Patient safety is the highest priority for anyone working on the frontline in NHS Wales and it’s making a real difference in primary care.
That’s why the British Medical Association strongly supports the 1000 Lives Campaign and works hard to highlight those areas of patient safety and care that are important to our members.
For doctors, safety and quality go hand in hand, and the Campaign has created a focus around which those can be considered every day, in every patient contact, by health professionals and managers alike.
As we come to the final months of this two year campaign, we are pleased to see how much progress has been made across Wales.
When the initiative was launched in April 2008, it was the first time that primary care had been included in a similar patient safety campaign anywhere in the world.
Wales has led the way and our members have contributed in many of the Campaign’s areas, including improving leadership, medicines management and general medical care.
We have seen the impact made by establishing patient safety WalkRounds and culture surveys which have empowered our members to talk about their concerns and hopes for improvement.
Again Wales has led the way in this area, becoming the first country to arrange a safety culture survey for its general medical primary care services at a national level.
And the response from our members have been extremely positive with over 60 per cent of GP practices taking part.
The results have been helpful in identifying aspects of care working well, but also raised areas where there is scope for improvement.
BMA Cymru supports a healthcare service that listens to the concerns of doctors, acts on those concerns to improve safety and quality of care, and in which health professionals are not afraid to speak out.
Last year we published the ‘Speaking up for Patients’ report based on survey responses from 565 doctors working in England and Wales.
Almost three quarters (74%) said they had concerns about issues relating to patient safety over the course of their career.
Within in this group, 73% said their concerns related to standards of care.
Seven in ten doctors said they had raised their concerns but were not always satisfied with the response.
Often they were not asked for further information or made aware if any action was taken to improve the issue.
WalkRounds and culture surveys have the potential to examine and improve patient safety issues across the whole patient pathway.
Other areas that have helped to improve patient care are in medicines management and work to improve the quality of life for chronic heart failure patients.
More than 80 GP practices are working with Health Boards to reduce, where possible, the number of unnecessary hospital admissions for patients with chronic heart failure.
The promotion of evidence-based procedures such as timely and accurate diagnosis, medication therapy, and lifestyle advice could make a significant impact on the disease process.
GPs are also currently carrying out detailed work to improve the reliability of instructions given to patients about their medication.
We have already seen the difference this has made for patients who take Warfarin and we are looking at other areas including diabetes.
The development of the primary care trigger tool to measure improvements is also being embraced by members.
We know that all our GP practices are continually making changes to ensure the care they deliver to their patients is the best possible.
But now, thanks to the trigger tool they will be able to actually measure those improvements, see how they are working and if they are making a difference.
One of the fundamental features of the new tool is looking at harm caused by failure to recognise or adequately manage a new presentation of an acute illness.
If a patient’s problem does not respond to treatment or they develop an adverse reaction, they are likely to make another appointment.
It is these unscheduled reattendances that can act as triggers of possible harm.
We are proud to see the progress made through the 1000 Lives Campaign, and that doctors across Wales are playing their full part in it.
BMA Cymru will continue to support the Campaign and to highlight those areas of healthcare over which our members have concerns – so that patients can look forward to even safer services in Wales.
What are your views on the 1,000 Lives Campaign?
Showing posts with label 1000 Lives Campaign. Show all posts
Showing posts with label 1000 Lives Campaign. Show all posts
Monday, 19 April 2010
Tuesday, 3 November 2009
HIV Related Discrimination by Healthcare Professionals
I’ve just got back from the Assembly, where Dr Tony Calland and I gave evidence to the Equality of Opportunity Committee on discrimination against people living with HIV by healthcare professionals.
This by its very nature is a difficult issue.
But it’s compounded by the fact that there is no real evidence base in Wales from which to work from – at the moment the evidence of discrimination (by doctors and other health care professionals) is anecdotal.
And therein lays the problem. This lack of comprehensive evidence base is what the committee is working from; and as Jonathan Morgan AM points out they well struggle with this particular inquiry.
Advances in medicine and the ‘normalisation’ of how the HIV virus is treated have challenged much of the stigma previously found in healthcare settings.
That is not to say that discrimination is not occurring. I accept that unfortunately it may well be.
As we said in our paper, discrimination of people diagnosed with HIV by any healthcare professional is unacceptable, and is a breach of fundamental human rights – rights that are central to the practice of medicine.
Discrimination - whether actual or perceived - has a negative impact on health outcomes, and contributes to both a reduced use of prevention services and perhaps a higher rate of onward transmission. I suspect, however, that this point is obvious to most people.
Surprisingly perhaps, what’s less obvious to many people is what actually constitutes stigma and discrimination – and the effect that it can have.
Any drive to combat this should be directed at the whole healthcare team (managers, doctors, nurses, receptionists, social workers, clerks).
Non-HIV specialists may feel a lack of confidence in treating HIV patients – even if they present with common complaints. I would argue that for these clinicians, a tendency to refer HIV patients to specialist clinics or consultants arises from a lack of specialist knowledge and a desire to do right by the patient, to ensure they get the right care, rather than a reluctance to treat HIV patients on the basis of prejudice or discrimination.
This applies to many other conditions, such as diabetes and cancer, not just HIV.
It’s also important to remember that clinicians employ universal cross contamination measures for all patients (e.g. see 1000 lives campaign), because every patient could potentially have, for example, a blood borne virus or transmissible infection and are so far undiagnosed.
Precautionary measures which may seem to be over-the-top are often standard clinical practice.
A lack of knowledge about HIV, and misconceptions about onward transmission, fuels stigma and discrimination. As Dr Calland told the Committee this morning – ignorance may be the problem not prejudice.
I will follow the Committees inquiry with interest, and in the meantime we are planning to meet with the various organisations and representatives in Wales to see how we can improve on this agenda, jointly.
This by its very nature is a difficult issue.
But it’s compounded by the fact that there is no real evidence base in Wales from which to work from – at the moment the evidence of discrimination (by doctors and other health care professionals) is anecdotal.
And therein lays the problem. This lack of comprehensive evidence base is what the committee is working from; and as Jonathan Morgan AM points out they well struggle with this particular inquiry.
Advances in medicine and the ‘normalisation’ of how the HIV virus is treated have challenged much of the stigma previously found in healthcare settings.
That is not to say that discrimination is not occurring. I accept that unfortunately it may well be.
As we said in our paper, discrimination of people diagnosed with HIV by any healthcare professional is unacceptable, and is a breach of fundamental human rights – rights that are central to the practice of medicine.
Discrimination - whether actual or perceived - has a negative impact on health outcomes, and contributes to both a reduced use of prevention services and perhaps a higher rate of onward transmission. I suspect, however, that this point is obvious to most people.
Surprisingly perhaps, what’s less obvious to many people is what actually constitutes stigma and discrimination – and the effect that it can have.
Any drive to combat this should be directed at the whole healthcare team (managers, doctors, nurses, receptionists, social workers, clerks).
Non-HIV specialists may feel a lack of confidence in treating HIV patients – even if they present with common complaints. I would argue that for these clinicians, a tendency to refer HIV patients to specialist clinics or consultants arises from a lack of specialist knowledge and a desire to do right by the patient, to ensure they get the right care, rather than a reluctance to treat HIV patients on the basis of prejudice or discrimination.
This applies to many other conditions, such as diabetes and cancer, not just HIV.
It’s also important to remember that clinicians employ universal cross contamination measures for all patients (e.g. see 1000 lives campaign), because every patient could potentially have, for example, a blood borne virus or transmissible infection and are so far undiagnosed.
Precautionary measures which may seem to be over-the-top are often standard clinical practice.
A lack of knowledge about HIV, and misconceptions about onward transmission, fuels stigma and discrimination. As Dr Calland told the Committee this morning – ignorance may be the problem not prejudice.
I will follow the Committees inquiry with interest, and in the meantime we are planning to meet with the various organisations and representatives in Wales to see how we can improve on this agenda, jointly.
Thursday, 8 October 2009
Reporting patient safety concerns will lead to better patient care
Today the NHS National Patient Safety Agency published the latest incident report for NHS organisations in Wales. The information is compiled from reports from frontline NHS staff and is published twice a year.
Today’s publication shows that 90% of all patient safety incidents result in no (67.9%) or low (22.1%) harm to the patient. That leaves 10% of reported incidents which are classed as moderate (8.2%), severe (1.4%), and contributing to death (0.4%).
The figures include incidents that did not result in any harm but had staff not identified it, could have done so. Overall the proportion of serious incidents has remained stable as reporting rates have increased. The most commonly reported incident type were patient accidents (36.4%).
Patient safety is a top priority for anyone working on the frontline in the NHS in Wales. That’s why the BMA is such a strong a supporter of the 1000 Lives Campaign and has worked so hard to continually improve patient safety, and therefore improve patient care. For us, the safety and quality agendas go hand in hand.
There is a lot of good work being undertaken in Wales to improve patient safety, and in representing the medical profession we are keen to see that develop and expand in the new NHS Wales. Earlier this year we published the Speaking up for Patients report - based on survey responses from 565 doctors working in hospitals in England and Wales.
Almost three quarters (74 %) said they had had concerns about issues relating to patient safety, malpractice or bullying, over the course of their NHS careers. Within this group, 73 % said their concerns had related to standards of patient care.
Seven in ten doctors (70 %) who had had a concern raised it with the relevant authority at their trust. However, many said that their experiences of reporting issues had been negative, for example because they were unaware that anything had happened as a result, they were not approached for further information, or the information they provided was shared more widely than they were comfortable with.
A significant proportion (15.5 %) of doctors who reported concerns said that their trusts had indicated that by speaking up, their employment could be negatively affected. Despite these experiences, around three quarters (74.5 %) said they would be prepared to report concerns again in future.
In the minority of cases where doctors had not raised their concerns, this was most commonly because they were not confident that it would make a difference (81%).
I think we can conclude from this that organisational support is absolutely paramount to improving patient safety across the NHS.
The information published today will be vital to the new LHBs in Wales when setting local priorities and identifying areas for action. LHBs and healthcare professionals will be able to compare patient safety performance (in like-for-like service areas) across Wales. To improve that performance, they must provide an open culture of organisational learning by ensuring that patient safety is a high priority, and by encouraging and facilitating incident reporting.
Today’s publication shows that 90% of all patient safety incidents result in no (67.9%) or low (22.1%) harm to the patient. That leaves 10% of reported incidents which are classed as moderate (8.2%), severe (1.4%), and contributing to death (0.4%).
The figures include incidents that did not result in any harm but had staff not identified it, could have done so. Overall the proportion of serious incidents has remained stable as reporting rates have increased. The most commonly reported incident type were patient accidents (36.4%).
Patient safety is a top priority for anyone working on the frontline in the NHS in Wales. That’s why the BMA is such a strong a supporter of the 1000 Lives Campaign and has worked so hard to continually improve patient safety, and therefore improve patient care. For us, the safety and quality agendas go hand in hand.
There is a lot of good work being undertaken in Wales to improve patient safety, and in representing the medical profession we are keen to see that develop and expand in the new NHS Wales. Earlier this year we published the Speaking up for Patients report - based on survey responses from 565 doctors working in hospitals in England and Wales.
Almost three quarters (74 %) said they had had concerns about issues relating to patient safety, malpractice or bullying, over the course of their NHS careers. Within this group, 73 % said their concerns had related to standards of patient care.
Seven in ten doctors (70 %) who had had a concern raised it with the relevant authority at their trust. However, many said that their experiences of reporting issues had been negative, for example because they were unaware that anything had happened as a result, they were not approached for further information, or the information they provided was shared more widely than they were comfortable with.
A significant proportion (15.5 %) of doctors who reported concerns said that their trusts had indicated that by speaking up, their employment could be negatively affected. Despite these experiences, around three quarters (74.5 %) said they would be prepared to report concerns again in future.
In the minority of cases where doctors had not raised their concerns, this was most commonly because they were not confident that it would make a difference (81%).
I think we can conclude from this that organisational support is absolutely paramount to improving patient safety across the NHS.
The information published today will be vital to the new LHBs in Wales when setting local priorities and identifying areas for action. LHBs and healthcare professionals will be able to compare patient safety performance (in like-for-like service areas) across Wales. To improve that performance, they must provide an open culture of organisational learning by ensuring that patient safety is a high priority, and by encouraging and facilitating incident reporting.
Tuesday, 21 April 2009
1000 Lives Campaign, one year on
So, we’re a year on from the start of the 1000 Lives Campaign and it does seem that progress has been made in the first twelve months, with an estimated 410 lives being saved in that time.
A year ago, we welcomed the initiative and its drive to create safer environments and consistently high standards of care for our patients.
Now, as the Campaign enters its second year, the key is to maintain the momentum and spread the good practice that has been achieved across all organisations in Wales.
Our members will continue to contribute to the Campaign’s aims and highlight areas that require greater focus to make NHS Wales safer for all patients.
We will keep on highlighting areas of concern which doctors believe are having adverse consequences for patient care and clinical outcomes. And this Campaign provides the right background context in which to do so.
A year ago, we welcomed the initiative and its drive to create safer environments and consistently high standards of care for our patients.
Now, as the Campaign enters its second year, the key is to maintain the momentum and spread the good practice that has been achieved across all organisations in Wales.
Our members will continue to contribute to the Campaign’s aims and highlight areas that require greater focus to make NHS Wales safer for all patients.
We will keep on highlighting areas of concern which doctors believe are having adverse consequences for patient care and clinical outcomes. And this Campaign provides the right background context in which to do so.
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