Risk, quality and trust: lessons from Francis

Jeremy Taylor, CEO, National VoicesAt CfPS Annual Conference

10 June 2014

Themes from the Francis inquiry...

• culture and behaviour• openness• transparency• honesty• standards• the patient and public voice• and it’s not just about mid-Staffs

The Government response

• Chief inspectors – “an Ofsted for health”• Duty of candour - when things go wrong• Berwick - on “zero harm”• Cavendish – on nursing• Hart/Clwyd – on complaints• Keogh – on 14 other worrying hospitals• “Hard Truths”• But it’s not about the Government

What matters to patients? – the evidence• Treat me as a person• I need access • I need information• Talk to me• Involve me• Involve my family and friends• Respect my privacy, confidentiality and dignity• Help me stay well and independent• Join things up, don’t pass me from pillar to post • I need practical support• I need emotional support

It’s not just about the ward

Living with .....

Out-of-Hours Doctors

GPDistrict Nurses

Social Worker

Malcolm &Barbara

Consultant Continence Adviser

Speech & Language Adviser

Dietician

CommunityDentist

OccupationalTherapist

Equipment Service

PhysiotherapistAlternating

Mattress technician

Wheelchair Service

Oxygen serviceDirect

PaymentsTeam; Rowan

Org.

Alzheimer’sSoc outreach

worker

Care team2 live-in carers (alternating weekly)Replacement carer[Some night nursing – Health]Emergency carers & Barbara

The Web of Care

(Last 7 yrs)

DementiaAdvisoryNurse?

Person centred coordinated care

“I can plan my care with people who work together to understand me and my

carer(s), allow me control, and bring together services

to achieve the outcomes important to me.”

Information

My goals/outcomes

Communication Decision making

Care planning

Transitions

Engaged,

informed patients

HC

Ps com

mitted to

partnership working

Organisationalprocesses

Responsive commissioning

Personalised care

planning

Coulter, Roberts, Dixon: Delivering better services for people with long-term conditions – building the House of Care, King’s Fund, October 2013

Being person-centred

• People - treat me as a person • Partners in decisions – involve me as much as I want to be,

don’t just “consent” me• Self-managers - help build my knowledge, skills, confidence, I

want to get on with my life• Citizens - understand my needs; respect my rights whoever

I am• People helping people - connect me with those who can help

me• Communities and leaders - we want to put something back:

benefit from our collective goodwill , experience and leadership

Being person-centred

• Risk - I want you to be safe and I want you to trust me

• Quality – “safety, effectiveness, experience” - but also what matters to me

• Trust – You need to earn my trust by being open, honest, and transparent. And you need to trust me

Kate Granger’s values

• Communication• The little things matter• Person –centred care• See me – not my disease• http://play.buto.tv/HMzZc

Some questions for scrutineers

• Can we find out what is going on?• What do patients and families think?• What do staff think?• What does the board worry about?• Do they learn? Do things change?• Are patients involved? How and where?• Are staff involved? How and where?• Where is the community?

• Thanks for listening!• www.nationalvoices.org.uk• Follow us on Twitter• @NVTweeting• @JeremyTaylorNV