Sign up to Safety aims to deliver harm free care for every patient, every time, everywhere. It champions openness and honesty and supports everyone to improve safety for patients.
Grove House Surgery through the Commissioning for Quality and Innovation (CQUIN) framework wishes to engage with the Somerset CCG Sign up to Safety programme and its ethos. The following action plan has been drawn up to support the CCG objectives of:
1) Increasing incident reporting and learning from incident in primary care both clinical, including medication incidents and non-clinical; and
2) Support learning from service user feedback including Friends and Family Test
The Five Sign Up to Safety Pledges
1) Put safety first. Commit to reduce avoidable harm in the NHS by half and make public the goals and plans developed locally.
We will record all significant events including medication issues, and keep records of the meetings and discussions.
In discussions, agree and progress issues which need to be escalated ie to CCG, NHS England etc. We use the CCG feedback reporting scheme and encourage staff to use when appropriate.
We will record all complaints, and keep records of the meetings and discussions.
Regularly review any events, complaints etc in our team and whole practice meetings and training sessions. Consider setting up shorter, more frequent sessions if required.
Identify causes and address them wherever possible.
Continue our work to review our protocols and processes and amend as necessary.
Ensure we continue to focus on the health needs of our patients, both physical and mental health, and particularly for the most vulnerable (Test and Learn pilot, Health Connections etc).
Prepare care plans for patients where appropriate.
Listen to patient suggestions, complaints and comments, and feedback via our website and our newsletters.
Significant Event meetings continue to be held regularly, where events are discussed in detail with the whole practice. Meetings are noted/minuted. At the meetings agreement is reached on escalation and/or sharing of learning and outcomes.
We also now hold monthly monitoring meetings where any new complaints, significant events and comments from our Friends and Family Test are discussed in brief. Safety issues are also discussed at these meetings including infection control and prescribing. These meetings began in September and are attended by all GPs, Lead Practice Nurse, Practice Manager, Assistant Practice Manager and Lead Receptionist.
Where appropriate complaints are also discussed at whole practice meetings and reviewed annually in April.
Meetings are minuted/noted.
We are continually monitoring, updating and adding to our protocols and processes, for example if there are changes to national guidance or if prompted by the outcome of a significant event in addition to the routine reviews.
We continue to support and work with others on the Test and Learn (Mendip Symphony) project, we attend the Your Health and Wellbeing Mendip meetings, and we communicate regularly with the Health Connectors who visit the surgery weekly. In addition we also hold proactive care home reviews and have improved our care plans for those patients at increased risk of hospital admission by making them clearer to complete, read and update. We have agreed a process for our carers and vulnerable patients to ensure they can access our services as conveniently as possible.
We report patient suggestions and comments from the Friends & Family test to our Patient Participation Group and publish results on our website and in our newsletter. They are also shared with staff.
We will explore offers of support from the CCG such as safety audit visit, tools and training, and also liaise with other organisations such as AgeUK (falls etc). We plan to use national and local campaigns to promote safety issues.
We ensure our equipment is calibrated and PAT tested as required.
We meet with one local pharmacy regularly, have held exchange visits and have good communication with others nearby also.
2) Continually learn. Make their organisations more resilient to risks, by acting on the feedback from patients and by constantly measuring and monitoring how safe their services are.
Review staff training and learning – ensure mandatory updates etc are undertaken.
Arrange to review and monitor safety alerts in wider team.
Undertake risk assessments (and analysis).
Ensure infection control audit carried out annually, and action plan monitored and reviewed regularly.
Consider methods of engagement with our patients particularly making use of technology.
Consider specifically targeted surveys based on patient feedback through FFT, complaints, suggestions etc.
Feedback via our website and newsletters.
We have purchased on line training to ensure all staff have access to mandatory updates. We review these at annual appraisals at interim one to one staff supervision meetings.
Safety alerts are raised at our monthly monitoring meetings.
A risk assessment has been carried out and actions planned.
Annual infection control audit has been undertaken, actions carried out and monitored at our monthly monitoring meetings.
We encourage patients to use on line services including feedback.
We are monitoring complaints, suggestions and comments and plan to carry out targeted surveys in the New Year.
We give feedback through our website and newsletters, and to our Patient Participation Group. We also encourage feedback from patients, by providing suggestion boxes, as well as contact forms on our website and by promoting our PPG. Our PPG members were involved in arranging a stall at a local fete with other practices locally to promote the services of local GPs and improve communication with the community.
3) Honesty. Be transparent with people about our progress to tackle patient safety issues and support staff to be candid with patients and their families if something goes wrong.
Support and encourage staff to abide by the principles of duty of candour.
Listen to patient and staff opinions and suggestions.
Review these in our whole team meetings and training sessions.
Feedback via our website and newsletters.
We encourage staff to feedback at significant event meetings, whole practice and team meetings and have explained and observed the duty of candour. We encourage them to give us views and suggestions. We conduct significant event analyses in an open, supportive, blame free way encouraging commentary from all involved.
We discuss patient and staff views and suggestions at both staff and PPG meetings. Our PPG meetings are bi monthly. Team meetings and training are monthly.
We regularly review any complaints and significant events. We also review comments made in F & F Test.
We have a blame free culture policy.
We continue to use our training sessions and staff meetings to support staff, as well as annual appraisal and one to ones during the year. We remind staff of personal responsibility to be aware of risks, hazards etc and to report incidents and errors.
We encourage feedback to CCG and other organisations as appropriate.
4) Collaboration. Take a leading role in supporting local collaborative learning, so that improvements are made across all of the local services that patients use.
Continue to participate in peer group meetings and seminars (federation meetings, Mendip Group, CCG meetings, Practice Manager meetings, LMC events, study groups and training etc).
Develop and continue our role as a training practice, for clinical and non-clinical staff.
Work closely with other local organisations – CAB, Social Services, Health Connections, Community nurses.
Progress our involvement in the planned Health Campus to liaise and engage more with secondary care.
Strengthen and develop our links to local voluntary organisations.
Develop our Test and Learn pilot working with secondary care, Social Services and Community nurses.
We continue to actively participate and in some cases organise and host peer group meetings, seminars, ie those listed above plus local hospital meetings, and GP trainer meetings and updates. We also work closely with local pharmacies, care homes and all our suppliers. We have recently written to all care homes to explain how to access our services in the most effective way. Practice Manager attends some local government meetings (health and wellbeing board and migrant workers forum).
We continue as a training practice, training GP registrars, nurses, and admin staff including a business apprentice. We also share our training programme with local practices and they are invited to attend if they wish. This includes clinical discussions with consultants, Information technology training etc.
We continue to work closely with other local organisations and include them in meetings and reviews if possible and when appropriate.
Our involvement in the Project Board for the local planned health campus continues both to enable the move to new premises for our surgery, and to improve services for the local community by engaging more with secondary care, ultimately improving patient care through more streamlined care pathways, equitable access to community and secondary care, and improved preventative health strategies for patients across the locality.
We have good relations with local organisations who offer support to our patients such as Salvation Army, AgeUK, Mendip Care and Repair, Citizens Advice Bureau etc.
We continue to work with and support the Mendip Symphony Test and Learn pilot, as well as our internal palliative care and unplanned admission meetings.
We plan to meet with the discharge liaison nurses in the New Year to improve communication and understanding of how patient discharges can be planned so they are seamless and reduce the risk of readmission, medication errors and patient dissatisfaction.
5) Support. Help people understand why things go wrong and how to put them right. Give staff the time and support to improve and celebrate the progress.
Review and encourage improved communication methods generally.
Share learning from significant events, complaints, suggestions etc.
Ensure there is focus on positive events and progress made.
Our communication methods are discussed at team/practice meetings and in appraisals and one to ones. We have recently reduced the use of emails and use a staff weekly circular and increased the frequency of face to face meetings as a result of staff suggestions.
We meet and train regularly when significant events, complaints and suggestions are discussed including those from staff.
We support and encourage our staff to celebrate successes, and appreciate and acknowledge their achievements.
We involve staff in discussing errors etc and in resolving them.
We have a regular morning “break” when clinicians can briefly meet and discuss any issues with each other as well as the non-clinical staff.