Guidance for NHS trusts and foundation trusts: assessing the well-led key question

May 13, 2024 Comments Off on Guidance for NHS trusts and foundation trusts: assessing the well-led key question

What does this mean for libraries?

The key section for libraries is the section on ‘learning, improvement and innovation’ where it states under the ‘research’ sub-heading:

‘Having proactive healthcare knowledge and library services is vital to improve education, lifelong learning, research, the spread and adoption of innovation and evidence-based practice. These resources supply the evidence base to the NHS workforce to make decisions on treatment options, patient care and safety, service delivery and policy.’

When it comes to what good looks like for learning, improvement and innovation the guidance says, among other criteria, that staff work together to improve services by ‘using research evidence’.

The guidance also suggested that there should be plans to ‘build capacity and capability for developing the behaviours and skills needed to facilitate and nurture research, innovation and improvement.’ This is another area that library and knowledge services can support through, for example, providing training in information skills, support for writing for publication, and the provision and promotion of knowledge resources on how to carry out research and improvement work.

Source: Care Quality Commission (CQC) and NHS England

Link to main document

Date of publication: April 2024

Summary of driver: This new guidance is applicable to all Trusts from 2024 and brings together the approaches of the CQC and NHS England into one well-led framework and helps NHS trusts and foundation trusts understand what good leadership looks like. The well-led question is one of five that form part of the CQC single-assessment framework.

There are eight parts to the well-led guidance, namely: ‘shared direction and culture’, ‘capable, compassionate, and inclusive leaders’, ‘freedom to speak up’, ‘workforce equality, diversity and inclusion’, ‘governance, management and sustainability’, ‘partnerships and communities’, ‘learning, improvement and innovation’, and ‘environmental sustainability’.

Delivery plan for tackling the COVID-19 backlog of elective care

February 25, 2022 Comments Off on Delivery plan for tackling the COVID-19 backlog of elective care

What does this mean for libraries? 

Libraries are ideally placed to support the education and continuing professional development of the existing workforce, and particularly of new recruits in new roles. The report makes it clear that ‘further work is needed to more systematically train, recruit and retain staff’ is required, along with ‘more opportunities for current staff and those returning to practice to work flexibly and remotely, and to develop new skills to progress in their careers’ (p.14).

Library and knowledge specialists can help with ‘empowering staff to innovate and improve services for patients’ (p.15) by providing the evidence needed to support innovations through mediated evidence searches, training on how to search the evidence base, or supplying copies of necessary documents. Helping staff feel empowered to make changes will assist with staff retention.

Throughout the NHS, library and knowledge specialists can help mobilise the knowledge gained from new ways of working, and can do this by supporting staff to manage knowledge and ‘know-how’ through a range of techniques such as peer-assists and knowledge cafés. Library and knowledge specialists have also been involved in helping staff publish the results of research and innovation, both in peer-reviewed publications, and through more informal routes, and many library and knowledge services are working on institutional repositories to make local staff research and other publications more widely disseminated and discoverable.

Library and knowledge specialists support health literacy, and some already work with patient information groups to improve the quality of information provided to patients, ensuring it is both evidence-based and understandable. This is going to become even more important in the future to support the co-development of personalised care plans with patients (p.41).

Finally, library and knowledge specialists can help support the wellbeing of staff and students, and examples include collections of books for leisure reading, Books on Prescription, providing wellbeing areas, organising wellbeing events, or simply just being a place where staff can escape the pressures of a clinical environment and get some work or study done.

Source: NHS England and NHS Improvement

Link to main document

Date of publication: February 2022

Summary of driver:

Elective care covers a broad range of non-urgent services, usually delivered in a hospital setting, from diagnostic tests and scans, to outpatient care, surgery and cancer treatment. The report does not cover primary care, community care, urgent and emergency care and mental health services.

The aim is to deliver around 30% more elective activity by 2024/25 than before the pandemic, with waits of more than a year eliminated by March 2025.

There are four main areas of focus:

Increasing health service capacity

  • Expansion and separation of elective and diagnostic service capacity, including the physical separation of elective from urgent and emergency services
  • Growing and supporting the workforce
  • Using digital technology and advanced data systems to free up capacity
  • Working with UKHSA to safely adapt the UK’s infection prevention and control (IPC) measures
  • Making effective use of independent sector capacity

Prioritising diagnosis and treatment

  • A return towards delivery of the six-week diagnostic standard and reducing the maximum length of time that patients wait for elective care and treatment.
  • Clinical prioritisation: ensure the order in which patients are seen reflects clinical judgement on need.
  • Managing long waits: targeting support to reduce the number of people waiting a long time.
  • Increasing the number of cancer referrals, to ensure we also prioritise those patients who have not yet presented to services.

Transforming the way we provide elective care

  • Expanding community diagnostic centres (more than 100 are planned) with a focus on ease of access and convenience for patients.
  • Increasing surgical capacity through surgical hubs – separating out many of the low complexity surgical pathways through additional surgical hubs, improving outcomes for patients and reducing pressure on hospitals.
  • Improving patient pathways to reduce avoidable delays by ensuring we are making the best use of the latest technology, clinical time and expertise.
  • Improving access to specialist advice – providing greater flexibility in how advice from clinicians is accessed by patients, enabling more timely, convenient and appropriate care and avoiding the need for unnecessary appointments.
  • Making outpatient care more personalised – giving patients more choice around outpatient care, with options to book their follow-ups and attend video or phone consultations if preferred, simultaneously freeing up capacity for the most clinically urgent. This will include digital innovation through the NHS App.

Providing better information and support to patients

  • Targeted support information for patients, including through My Planned Care – initially delivering a new platform to increase transparency on wait times and provide a hub of support information for patients covering the entire pathway, before further development to integrate this with the NHS App.
  • Supporting patients to prepare for surgery – by co-developing personalised plans that provide them with the necessary information and guidance to prepare for the best possible outcomes.
  • Emphasising the expertise of NHS staff in providing high quality personalised and tailored support to patients, supported by the latest innovations in technology and improved data sharing

Enabling innovation and adoption in health and social care: developing a shared view

March 26, 2021 Comments Off on Enabling innovation and adoption in health and social care: developing a shared view

What does this mean for libraries?

The fourth principle suggested in this report, namely ‘adopt the best ideas and share your learning’ (p.11), is probably the area that library and knowledge services (LKS) have a big part to play.  The report suggests learning about what other organisations are doing, and LKS can support this by enabling access to the evidence base, by providing mediated searching, or by providing synthesising or summarising services that could include case studies of service innovations as well as other forms of evidence.

In addition, LKS promote and support the use of knowledge management techniques to help share learning. This could include techniques such as after action reviews or retrospects, the results of which could be made available in a repository. LKS staff can also support health and social care staff in writing up and publishing their innovation – this could be in a peer-reviewed journal, but it could also be shared via a repository, or more informally via a site such as Fab NHS Stuff. Initiatives such as the LKS North West Awards Project Group’s ‘Get Recognised for Excellence’ can help to raise awareness of recognition and award schemes for NHS staff and help to encourage staff to share innovations more widely.

Whilst innovation is not just about digital initiatives, these may be an important part of many innovations and bodies such as NHSX are supporting this strategy (p.17). LKS have a role to play in supporting the development of digital literacy so that digital initiatives can be rolled out with greater engagement and confidence from staff.

Many libraries are already working on staff publication databases, and some of these may include the outputs from knowledge management activities. There is a pilot project underway involving HEE, The British Library and a number of NHS LKS to create a repository of staff publications and other outputs, and as this is potentially rolled out more widely it should help to make it easier to find and share information about innovations.

Source: Care Quality Commission (CQC)

Link to main document

Date of publication: February 2021

Summary of driver:

The pandemic has required people to find innovative ways of providing services and collaborating across local systems. There have been many planned innovations brought forward, and greater sharing of information across the health and social care sector.

Services face continued pressure (for example, by 2043, almost a quarter of the UK population is expected to be aged 65 or older, up from about a fifth today ) but also opportunities to use new ideas and technologies.

There is a lack of clarity about innovation means, and how to do it. This report offers some evidence-based principles to underpin innovation, agreed with the national organisations involved in the report.

The agreed principles are:

  • Develop and deploy innovations with the people that will use them

This could include staff and service users. Co-production and user testing are recommended.

  • Develop a culture where innovation can happen

Give people permission to innovate. Leaders should seek ideas for improvement and listen to staff feedback. Success is celebrated but it is recognised that success is often partial, and that there is a lot to learn from what doesn’t work.

  • Support your people

An innovative organisation gives its people time to develop and deliver ideas. It is important to provide the training people need to use the innovation effectively.

  • Adopt the best ideas and share your learning

It is likely that someone else has faced a similar problem before. Support people to develop networks and learn about what other organisations are doing. Share learning with others.

  • Focus on outcomes and impact

Articulate realistic objectives and success measures that are clearly linked to the outcomes for people who use services. Impact should be measured carefully.

  • Be flexible when managing change

In the report, the term innovation covers both invention (creating new ideas, products, services or models of care) and adoption (implementing what has worked elsewhere). It is also important to adapt innovations to the local context.

There are some common misconceptions that the report highlights (p.12-14):

  • ‘Only brand-new ideas count as innovation’
  • ‘Innovation is all about cutting edge technology’
  • ‘A proven innovation can just be rolled out in a new setting and achieve the same outcomes’
  • ‘Innovation is just for the biggest and best organisations’

All organisations, big and small, need to be innovative but at a national level there are a number of projects taking place.

The Accelerated Access Collaborative (AAC) at NHS England and NHS Improvement will build on this publication and develop a strategy to increase capacity to adopt innovation.

Health Education England (HEE) will help staff to develop their capability to innovate and implement digital technologies.

The National Association of Primary Care (NAPC) will use the findings in this paper to continue to develop innovative solutions across health and social care and encourage colleagues to come together to think differently.

The National Care Forum (NCF) is part of the Care Provider Alliance, which is working in partnership with NHS Digital and Skills for Care on the Digital Social Care project. It will continue to champion the voice of care providers in creating and shaping innovation in care delivery to improve the quality of care.

The National Institute for Health and Care Excellence (NICE) will continue to work with system partners to encourage and support a quality and safety-focused approach, in which commissioners and providers use NICE guidance and other NICE-accredited sources to improve outcomes.

NHSX will work with regions, providers and commissioners to help scale digital innovation. The Social Care Institute for Excellence (SCIE) will use the innovation principles to support innovation in the sector via the Social Care Innovation Network (SCIN).

The report concludes with a number of case studies across health and social care, and shows how some or all of the six principles applied to them (p.20-36)

We are the NHS: People Plan for 2020/21 – action for us all

August 17, 2020 Comments Off on We are the NHS: People Plan for 2020/21 – action for us all

What does this mean for libraries? 

Where we can help: Section 4: New ways of working and delivering care (page 32) is all about upskilling and supporting staff via TEL which includes e-Learning for Healthcare (e-LfH) programme  and the new Learning Hub launched during COVID-19. HEE are committed to developing its e-learning materials.

Two of the ideas behind this include training and education and working with different technologies and this is  where LKS can support staff with training on Teams/zoom/WebEx as well as  hints and tips and flexible working. A lot of us moved our training online immediately so we know how things work and we have already ironed out the kinks and can help people set up.

As a sector, LKS staff are well placed to help with these transitions to different ways of working and learning. During COVID-19 it was apparent from sources such as the library list emails/Twitter/online meetings that LKS services and staff have made changes and innovations in how we delivered our services and utilised our space and the library staff and I think we have a lot of knowledge to share about this.

Both nationally and regionally, LKS staff have been offered a wide range of webinars and training during COVID-19. Topics have ranged from BAME, well-being, leading remote teams, flexible working and more. I think this gives us a head start in those conversations that are beginning to happen now in the NHS and this is the ideal opportunity for us to showcase how transferable our skill set is and how we can support staff through these changes.

The case studies (people stories) are about sharing knowledge and provide an ideal opportunity to link in with our knowledge management skills… just in time for Knowvember.

Source: NHS England

Link to main document

Date of publication: August 2020

Summary of driver:

“We are 1.3 million strong. We are all walks of life, all kinds of experiences. We are the NHS.”

The NHS People Plan follows on from the Interim People Plan (June 2019) which had already started implementing actions to support the workforce. The plan continues supporting transformation across the NHS but now includes COVID-19 support for where these actions were implemented at pace. The four main themes are listed below:

  • Looking after our people– with quality health and wellbeing support for everyone
  • Belonging in the NHS– with a particular focus on tackling the discrimination that some staff face
  • New ways of working and delivering care –making effective use of the full range of our people’s skills and experience
  • Growing for the future– how we recruit and keep our people, and welcome back colleagues who want to return

The Plan recognises “the NHS needs more people, working differently, in a compassionate and inclusive culture” and essentially, it is about making real and lasting change for NHS people, by all of us for all of us.

On Wednesday 5th August I took part in a Twitter chat on the NHS People Plan which was facilitated by NHS Horizons. Check the # to find out more #OurNHSPeople  #WeAreTheNHS  NHS Horizons

Do Randomised Coffee Trials work? Yes!

February 28, 2020 Comments Off on Do Randomised Coffee Trials work? Yes!

In the summer of 2019, we decided to run a knowledge management activity to mark KNOWvember, and chose to attempt a randomised coffee trial (RCT) across our two acute hospital sites. It was our first time running one, and for those that haven’t come across the concept before it involves matching people up across an organisation who then arrange to meet for half an hour over a coffee (or other hot drink) and talk about anything they wish to.

The name is a play on the term ‘randomised controlled trial’, but the matching doesn’t have to be entirely random, and it wasn’t in our case.

I must confess to being slightly sceptical before running it, and was concerned that people may feel it wasn’t a good use of staff time. My view has now changed, and the response has been very encouraging.

Promotion

We began promoting it in September, through blog posts, Tweets, adverts in the staff newsletter, and most successfully by global email.

We had a very good response and interestingly some people signing up had taken part in an RCT previously.

“I have been part of randomised coffee trials when I was working for HEE and it was really helpful!’ [theatres manager]

 “I would be happy to sign up to your coffee trial and meet others within the trust. Will give me an excuse to take a breather from the ward and have 5 minutes to myself’ [ward manager] 

In all 52 people signed up, including the Medical Director and the Director of Clinical Effectiveness. A couple of people even wanted to arrange two meet-ups, one at each site. 

Matching people

The matching of people was not entirely random (which we did make clear in our publicity) as we matched people that worked at the same hospital site, and who were unlikely to know each other. I also took a decision to match clinical staff with non-clinical staff where possible, to give participants a different perspective. Other than that, I picked the next name that matched the criteria from a spreadsheet and then contacted both participants to let them know who they were matched with, and that they now needed to contact each other to organise their meet-up.

It was inevitable that some people would know each other even after careful matching, and that some participants were unable to arrange a meet-up during November. However, this was only a small proportion and in most cases we were able to provide an alternative match.

The Trial

We wanted to encourage use of the library spaces, so we attached a hot drink voucher to the match email, and this could be redeemed by participants if they held their RCT in the libraries. Several people made use of this, and it helped us get some very good verbal feedback.

No agenda for set for the conversations, and we didn’t provide any suggested topics or questions. We made it clear in the publicity that discussions didn’t even need to be work related, and people were free to talk about any topic.

A couple of participants provided us with information on what they wanted to talk about:

“Part of my job description is promotion of our service- so any opportunity I can get to chat about it to an ‘unsuspecting victim’ is fab.’ [programme co-ordinator]

“I could use this as a plug for my fav charities! Could you sign me up please?’ [library assistant]

Feedback and impact

During December we contacted all the participants and asked for some written feedback, including what impact the RCT had had. Nine people responded, all with positive feedback, and these are some of the comments:

“I know this is ridiculously poetic; but it was like taking a hot air balloon ride after sitting in traffic on the daily route in. I guess what I mean is…every other meeting at work requires something of me; I need to get from one place to another, change “this” to “that” and being in those circumstances am often frustrated, anxious and feeling eager to achieve what I set out to.  A meeting where there is no expectation, no requirement to do anything and can just be simply about having a coffee and a chat with no agenda almost seemed more productive, it also gave me some perspective and encouragement.’ [programme co-ordinator]

“I have been involved in the randomised coffee trial and found it immensely helpful. Was really nice to meet someone from another area. Gained loads of insight into plans for the new year and as it was one of the library ladies she was able to complete a literature search for us to help with service improvement.’ [ward manager]

“Learned something about a service I knew nothing about. Identified cultural issues. Identified safety issues. Got to know a new colleague.’ [medical director]

Will we do anything different next time?

As a result of talking about the RCT at a Research and Innovation Committee meeting, it was suggested we run the next one in May 2020 to coincide with International Clinical Trials Day, and to jointly promote both.

We’ll also use as much of the feedback as possible from this RCT to promote the next one.

Other than that, I don’t think we would change anything and I would, where possible, match clinical with non-clinical staff again. RCTs are a tried and tested knowledge management technique and worked well in a hospital setting where we could match participants so that there was no need to travel to another site.

Further Reading

How to set up a Randomised Coffee Trial. NHS Horizons (2016) [SlideShare presentation]
https://www.slideshare.net/HorizonsCIC/how-to-set-up-a-randomised-coffee-trial

Randomised Coffee Trials. David Gurteen (2013)
http://www.gurteen.com/gurteen/gurteen.nsf/id/randomised-coffee-trials

 

Jason Curtis
Site Librarian
Shrewsbury and Telford Hospital NHS Trust

Digital champions for health: a blueprint for success

February 21, 2020 Comments Off on Digital champions for health: a blueprint for success

What does this mean for libraries? 

If a Digital Health Champions Network is created as recommended, this could be a way for library staff to gain recognition as providers of digital literacy support. The availability of good practice examples and suggested teaching plans could help library staff provide better support both to colleagues and to patients.

The existing Digital Champions Network already provides e-learning on how to provide digital literacy support – the report makes the point that digitally-skilled people may not always connect instinctively with someone who is new or lacking in confidence, and so having e-learning and guidance on how to provide support in a way that builds confidence is important. Unfortunately, the existing Digital Champions Network is currently open to sponsoring organisations only.

NHS LKS staff are already supporting the digital health literacy agenda in a number of ways, for example by demonstrating health apps, or signposting to good-quality health information resources. Some of this is during events such as Health Information Week and may involve partnering with public libraries, and some will be to staff within their organisations as LKS staff meet the recommendations of the Topol Review.

Source: Digital Unite and NHS Digital

Link to main document

Date of publication: February 2020

Summary of driver:

This report was produced by Digital Unite and commissioned by NHS Digital as part of a project exploring a national model for digital champions in health. It is estimated that 8% of  people in the UK could remain digitally disadvantaged in 2030 unless there is a big increase in the provision of digital support, and many of these people will be heavy users of health and social care.

Digital Unite provides vocational training and support for digital champions, and has worked with over 200 organisations (in areas such as social housing, charity and social care) to train over 6,000 digital champions.

A Digital Champion is someone who helps others to understand the benefits of being online and can spend some time showing them how. They may be staff or volunteers and they may also be friends and family members.

Digital Champions can provide ongoing digital skills support that could include signposting, hands-on help, or tuition in certain tasks such as sending an email. Health is a common topic of support for digital champions, even for those that work outside of health. There were specific issues raised around providing digital health support, such as confidentiality, dealing with people that are anxious about their health, and safeguarding issues.

The project found that though there are digital health champions projects already underway, these were ad hoc with no shared learning between them, and there is no specific training or repository of good practice available for digital health champions. A key recommendation is to start a specific Digital Health Champions Network (building on the existing Digital Champions Networks) to give local projects access to guides, learning, online forums and other resources. This online platform would also allow for recording details of digital health champions, numbers of interventions, and impact data.

MAP Annual Report 2019

February 11, 2020 Comments Off on MAP Annual Report 2019

Find out more about what the MAP Community of Practice achieved in 2019 and see our priorities for 2020 in our snazzy Annual Report! MAP Community Annual Report 2019

Infographic

MAP highlights of 2019

If you’d like to get involved with the community, or want to find out more contact Tracey.Pratchett@lthtr.nhs.uk

 

Quality and Improvement Outcomes Framework

January 21, 2020 Comments Off on Quality and Improvement Outcomes Framework

What does this mean for libraries? 

All NHS LKS that are delivering services to organisations which have a Learning Development Agreement with Health Education England will be expected to submit an evaluation against the Framework for each organization that they serve. The deadline for the first submission is 26th June 2020. It is not yet known how often libraries will be asked to submit an evaluation.

This Framework demonstrates a move from measuring quality in terms of process, shifting the focus to outcomes. Assessments will demonstrate how effectively organisations are using library services to deliver critical business functions and will highlight improvement areas through the validation process.

Each LKS will be expected to submit a self evaluation and provide evidence against the 6 key outcome measures. The submission will then be validated by  members of HEE Library and Knowledge Services Leads.

Source: Health Education England

Link to main document 

Date of publication: July 2019

Summary of driver:

NHS LKS will be assessed against the following 6 outcome measures:

  1. All NHS organisations enable their workforce to freely access proactive library and knowledge services that meet organisational priorities within the framework of Knowledge for Healthcare.
  2. All NHS decision making is underpinned by high quality evidence and knowledge mobilised by skilled library and knowledge specialists.
  3. Library and knowledge specialists identify the knowledge and evidence needs of the workforce in order to deliver effective and proactive services.
  4. All NHS organisations receive library and knowledge services provided by teams with the right skill mix to deliver on organisational and Knowledge for Healthcare priorities.
  5. Library and knowledge specialists improve the quality of library and knowledge services using evidence from research, innovation and good practice.
  6. Library and knowledge specialists demonstrate that their services make a positive impact on healthcare.

Further information and supporting documentation is available at https://kfh.libraryservices.nhs.uk/quality-and-improvement-outcomes/quality-and-improvement-outcomes-documentation/

Webinars are available at https://kfh.libraryservices.nhs.uk/quality-and-improvement-outcomes/quality-and-improvement-outcomes-documentation/quality-and-improvement-outcomes-framework-video-podcasts/

Protected: Meeting 19th December 2019 10-11am

December 18, 2019 Comments Off on Protected: Meeting 19th December 2019 10-11am

This content is password protected. To view it please enter your password below:

Benefiting from the ‘research effect’: The case for trusts supporting clinicians to become more research active and innovative

December 6, 2019 Comments Off on Benefiting from the ‘research effect’: The case for trusts supporting clinicians to become more research active and innovative

What does this mean for libraries? 

The report suggests that it is it is ‘increasingly important to ensure that the clinical workforce is equipped to appraise and generate evidence’ (p. 11). Libraries can support the appraisal of evidence with the provision of critical appraisal training, either provided in-house or through organising external trainers. On a day to day basis, libraries can signpost to resources such as the CASP critical appraisal checklists, or to PRISMA guidelines for systematic reviews, for example.

LKS staff can also get involved in creating systematic reviews, perhaps by designing and carrying out search strategies, providing advice on databases, or advising on where to publish. Where a librarian has made a significant contribution, this should be acknowledged through being listed a co-author.

LKS staff can get involved with local Research and Development or Innovation committees, to advocate for library services and also gain a better understanding of the local issues.

Many LKS services are already managing staff publications repositories, to track and promote local research publications, and these could include conference abstracts, poster presentations and innovations such as those published on Fab NHS Stuff.

Source: Royal College of Physicians

Link to main document

Date of publication: November 2019

Summary of driver:

This reports suggests how NHS Trusts can support staff to become more research active, and how this will benefit both patients and staff.

Involvement by staff in research can improve their morale, and is shown to help recruitment and retention of staff. One finding is that staff lack protected time to do research, and this reports suggests that this should be a key priority. Two-thirds of RCP members surveyed said they want to do more research.

Patient outcomes in Trusts that are more research-active are better, and CQC inspections include research activity in their remit.

Patients feel more valued by being involved in research, learn more about their treatment, and gain a sense of pride in helping others.

Research tends to be concentrated in certain areas such as the South East of England, or large urban areas. Smaller and rural hospitals must also be encouraged to become more research active and benefit from the research effect.

The report makes clear that research is more than clinical trials, and can include anything that provides new evidence, including robust service evaluation.

« Previous Entries