To mark World Patient Safety day Clare Wade, the RCP’s Head of Patient Safety, reflects on the college’s work on patient safety.
The RCP advocates for safety to be approached as a core domain of healthcare quality. We work to influence and inform the core components of culture, staffing and processes of care and learning. To highlight just a few examples of the work our members and fellows have been involved in:
- Safe medical staffing guidance which for the first time considered the levels of experience and staff numbers, alongside the minimum time needed for key patient related activities that improve care
- our report Advancing medical professionalism that affirms the key day-to-day practice to ensure safe care
- guidance on Supporting junior doctors in safe prescribing, sharing best practice in reducing potential harm
- reports such as Improving teams in healthcare and Never too busy to learn which help set the agenda for current and future healthcare teams to deliver safe care and to learn.
The RCPs work on patient safety is guided by our membership, and external stakeholders. The patient safety committee is the coordinating point for all our work related to patient safety. It brings together key colleagues at the RCP, medical specialist societies and other national clinical and arms-length bodies with a remit in patient safety, ensuring that learning and opportunities focused in one clinical area are shared and disseminated more widely for greater patient benefit. In addition this forum allows the sharing of good patient safety practice between specialty societies.
We also have a group who look specifically at medicine safety. The group was developed as a result of concerns and interests across organisations including the Royal College of General Practitioners, the British Pharmacological Society and the Royal Pharmaceutical Society. The group aims to produce guidance, influence policy, and explore joint professional training. The group are currently working on implementing a recent Healthcare Safety Investigation Branch (HSIB) recommendation to work with other royal colleges and bodies to standardise professional development and postgraduate learning in medicine safety. The group is also collaborating with NHS Improvement to deliver medicine safety improvement as described in their recently published Patient Safety Strategy.
You may also have heard of our flagship patient safety initiatives, the first of which is NEWS2, the National Early Warning Score which was developed by the RCP and supports clinical teams across the UK and internationally to identify the sickest patients and those at risk of deterioration, ensuring earlier intervention to save lives and reduce the need for intensive care. We continue to work closely with leaders in the field of patient deterioration through our NEWS Advisory Group to learn from good practice and challenges with implementation, identify areas for future research, and guide clinical teams. The widespread implementation of NEWS2 is fundamental to the principle that a single early warning score embedded within a healthcare system has the potential to transform patient care and outcomes. NEWS2 also provides the basis for standardising the training of all staff engaged in the care of patients and is supported by an online training module and certification.
Following the success of the NMCRR programme that saw structured judgement review (SJR) implemented in the majority of acute NHS trusts across England and NHS staff trained in the methodology, The RCP is proud to continue leading work in the important area of learning lessons and sharing good practice. Phase 2 is now underway and will offer trusts a health check of their clinical governance and wider support systems alongside bespoke improvement packages.
Collaboration with other mortality programmes ensures joint learning and implementation of opportunities to make care safer, and enquiries received from international healthcare systems interested in SJR training ensures that we continue to facilitate the spread of this transformational work. We are looking forward to our second mortality conference on 17 October in London. This year the theme is ‘Collaboration and globalisation’.
Our work also stretches beyond the NHS; in December 2018 three RCP patient safety experts travelled to The Gambia to facilitate workshops with multidisciplinary staff from the Medical Research Council Unit. A meeting with senior leaders also took place where mutual feedback was provided and an action plan was developed for implementation, with the aim of improving the patient safety culture. Follow-up initiatives included supporting the implementation of SJR for mortality review.
We are continuing to develop our offer to support hospitals internationally to understand their culture in relation to patient safety, and to explore developing improvement strategies.
If you want to know more or are interested in supporting our patient safety work please get in touch at firstname.lastname@example.org.