Amanda Hedley, Sharon Fennell, Debbie Wall and Ron Cullen
The NHS Clinical Governance Support Team (CGST) has completed a pilot “protected‐time programme”, supported by a small team of national facilitators and delivered locally in 19…
Abstract
The NHS Clinical Governance Support Team (CGST) has completed a pilot “protected‐time programme”, supported by a small team of national facilitators and delivered locally in 19 NHS pilot sites across England. The programme worked on the premise that health professionals can successfully lead service developments when given time and space to do so. The paper describes the methodology behind this initiative, how local events were organised to “get the whole system into the room” and what was learned by applying tried and tested methodologies such as accelerated service improvement. Some of the changes being implemented in participating NHS Trusts are presented in brief, along with a more detailed case study of work undertaken at Royal Cornwall Hospitals Trust. Having completed the pilot programme, the team is supporting other CGST activities and applying the learning from working with large groups to improve locally delivered care in NHS organisations.
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Debbie Wall and Suzanne Window
A core objective of the NHS Clinical Governance Support Team (CGST) is to enable the NHS to improve the experience of patients and staff. In its programmes the CGST encourages…
Abstract
A core objective of the NHS Clinical Governance Support Team (CGST) is to enable the NHS to improve the experience of patients and staff. In its programmes the CGST encourages delegates to work with patients and carers to improve local health services, but does the CGST practice what it preaches in its own activities? This paper examines how patients and carers are involved in the work of the CGST, specifically as patient consultants in the CGST’s Performance Development Team (PDT). In their role as PDT members, patient consultants provide guidance to the PDT and the trusts with which they engage, focussing their activity and their thinking around improvements in the patient’s experience. They are also working with the wider CGST and are involved in mentoring the acting head of the team.
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Debbie Wall, Clare Gerada, Maurice Conlon, Sharon Ombler‐Spain and Lucy Warner
To report on the clinical governance work of the NHS Clinical Governance Support Team's, Primary Care Team.
Abstract
Purpose
To report on the clinical governance work of the NHS Clinical Governance Support Team's, Primary Care Team.
Design/methodology/approach
The review describes the formation of the NHS Clinical Governance Support Team's Primary Care Team and the development of a range of national clinical governance activities, drawing on a case study example.
Findings
The Team have been developing appraisal, and revalidation for general practitioners across the UK, supporting front‐line staff in primary care to improve patient experience by embedding principles of clinical governance into day‐to‐day practice, and are providing an online education and training programme to develop primary care managers. It has established links, and worked collaboratively with a range of partners in its activities.
Originality/value
The article provides a summary of the activities of the Primary Care Team and its activities to date. An example of supporting clinical governance in primary care is given in a case study of facilitating an influenza vaccination campaign.
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Marilyn Boggust, Michael Deighan, Ron Cullen and Aidan Halligan
National Health Service trust boards are constantly challenged to achieve a balance between their resources and meeting the needs of the communities they serve. In addition, the…
Abstract
National Health Service trust boards are constantly challenged to achieve a balance between their resources and meeting the needs of the communities they serve. In addition, the scientific, technological, political and economic factors, which influence health and social care, are driving change more rapidly than ever before in the Health Service. As part of its function to support NHS organisations with the implementation of clinical governance, the NHS Clinical Governance Support Team (CGST) has developed a strategic development programme for trust boards. The aim of the programme is to develop the board’s capability to meet its responsibilities for governance and the delivery of safe, high quality patient care.
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To report progress made by the National Clinical Governance Support Team's (CGST) Programme for Stroke between 2001 and 2004 and its effects on service provision.
Abstract
Purpose
To report progress made by the National Clinical Governance Support Team's (CGST) Programme for Stroke between 2001 and 2004 and its effects on service provision.
Design/methodology/approach
The effectiveness of the Stroke Programme on services was assessed by comparing changes in services in Trusts which had undergone the process with those in a control group.
Findings
Using the Review, Agree, Implement, Demonstrate (RAID) model, the Stroke Programme led to benefits which include greater participation by patients and carers in treatment programmes and in development of services. Quantitative assessment of the extent of change in stroke services showed a significantly greater change in stroke unit provision, staffing levels and new funding in those sites which had attended the Stroke Programme.
Originality/value
The review provides an overview of recent developments in stroke services in the UK and describes the benefits of intervention by the Clinical Governance Programme.
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Sarah Squire, Michael Greco, Bridget O'Hagan, Kathy Dickinson and Debbie Wall
To provide an overview of the learning from four practical programmes that explore different aspects of patient participation in healthcare provision.
Abstract
Purpose
To provide an overview of the learning from four practical programmes that explore different aspects of patient participation in healthcare provision.
Design/methodology/approach
To describe the origin and rationale for each project or programme, and to summarise the learning from it.
Findings
At a variety of levels, involving patients in the design of care services can provide new insights, and leads to more patient‐focused and locally appropriate solutions. Engaging patients appropriately is not a trivial exercise, and those that are engaged need appropriate support, but the resulting solution is often more widely applicable than is first anticipated and can be cost‐neutral.
Originality/value
The active participation of patients in the design and provision of care is a widely voiced public and professional aspiration, but is genuinely realised only rarely. The paper describes the principles, benefits and learning common to four practical expressions of that aspiration.
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Debbie Wall, Kathy Dickinson, Jackie Kilbane and Dave Cummings
Purpose – To report on how service changes can be accelerated by working with large groups that represent all parts of a complete healthcare service or care pathway, during…
Abstract
Purpose – To report on how service changes can be accelerated by working with large groups that represent all parts of a complete healthcare service or care pathway, during specific events, and using well‐defined facilitation techniques. Design/methodology/approach – Case examples are cited from the Clinical Governance Support Team's “protected time” programme and subsequent work, and specific quotes and examples from large group events are used to describe the potential impact of the approach. Findings – Established group facilitation techniques can be adapted for use in the context of a large group representative of a whole clinical system or pathway, to accelerate service improvement. Originality/value – The paper reports on the practical findings from Clinical Governance Support Team group facilitators working on large group events from a number of UK NHS Trusts.
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Debbie Wall, Maurice Conlon, Ron Cullen and Aidan Halligan
Effective appraisal is one of the key underpinning systems to allow the practical implementation of clinical governance. Between March and July 2002, over 800 GPs have attended…
Abstract
Effective appraisal is one of the key underpinning systems to allow the practical implementation of clinical governance. Between March and July 2002, over 800 GPs have attended the national GP “Training the Appraisers” Programme, funded by the Department of Health, and run by the NHS Clinical Governance Support Team (CGST) in partnership with Edgecumbe Consulting Ltd. The one day programme, which includes practical “real life” appraisal sessions for GPs, is well on the way to meeting its remit of training 900 GP appraisers (an average of three appraisers per PCT) in 2002. Once they have completed the course, trained appraisers can begin the process of conducting the first round of appraisals in their local primary care organisations. The GP Appraisal Programme recognises the potential of an effective system of appraisal to develop over time, so that patients can be confident that their family doctor is supported in taking regular, structured steps to ensure they are identifying and fulfilling their professional development needs and thereby enhancing the delivery of high quality care.
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John Badham, Debbie Wall, Maria Sinfield and John Lancaster
To review progress of the Essence of Care Programme of Clinical Governance. To describe its development and highlight its achievements.
Abstract
Purpose
To review progress of the Essence of Care Programme of Clinical Governance. To describe its development and highlight its achievements.
Design/methodology/approach
The background to the programme is outlined and the methods adopted by the Clinical Governance Support Team (CGST) and NHS personnel involved are described.
Findings
At the heart of commitment to improve quality of health care lies Essence of Care to which the fundamental needs and comfort of patients are paramount. This provides a benchmarking tool for national standards of practice across health and social care which is applicable across medical specialties and relevant to all health professionals involved in caring for patients. Fundamental aspects of care were identified based on concerns of patients and professionals; these include communication, personal hygiene, food and nutrition. Standards are agreed between patients, carers, user groups, health care professionals, professional bodies and NHS departments. Systems for feedback and monitoring ensure continual improvement. Wide dissemination has ensured that Essence of Care is embedded in the NHS.
Originality/value
This review summarises the aims, objectives and progress of the work of the Essence of Care Programme of Clinical Governance since its initiation.
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To hammer home that clinical governance is the defining heart and inspiration of quality in the NHS and to expand on its implementation by all concerned.
Abstract
Purpose
To hammer home that clinical governance is the defining heart and inspiration of quality in the NHS and to expand on its implementation by all concerned.
Design/methodology/approach
Lists the ideal aspects and attributes of clinical governance.
Findings
Finds that clinical governance is a sine qua non and mandatory lever for achieving quality in the NHS and that whatever changes are necessary must be fully carried out.
Originality/value
Arguably, coming as it does from the top of the hierarchy, this posits the most soul‐searching advocacy of clinical governance's importance for the NHS so far presented.