Health Worker Safety: A Priority for Patient Safety – NHS Wales Delivery Unit

This year’s theme for World Patient Safety Day is the welfare and safety of healthcare workers. It recognises that working in stressful environments can make health workers more prone to errors, which can lead to patient harm. Quality and Safety is a theme running through all the DU’s work; this blog shares examples of how we contribute to patient safety and reducing harm in different services in NHS Wales.

This is a recent initiative from our dedicated Quality and Safety team:

The DU has established a national communication system, Covid-19 Rapid Sharing of Early Learning (CoRSEL), to help Health Boards and Trusts in Wales rapidly share early learning in relation to in-hospital transmission of Covid-19. Some of the most important learning can occur within hours or days of a transmission event and it’s important that NHS organisations can easily share that learning with each other, so that other organisations can take steps to make local improvements where necessary.

Sometimes learning isn’t related to incidents, but can be good ideas/practices that staff want to share, but there aren’t always national mechanisms for sharing this kind of learning. We have heard from staff that while early learning was shared through personal and professional networks, sometimes the messages took too long to get to the right part of the organisation to make effective changes. We wanted to set up a one-stop system that NHS organisations could rely on to share their early learning, using existing national communication mechanisms where possible.

Through CoRSEL, NHS staff, can log their early learning points directly into the DU’s CoRSEL database and we use the existing communications network for Patient Safety Alerts & Notices to share learning back out to HBs and Trusts. Individual organisations can then review the learning and decide if they need to make any local changes as a result.   

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Safe health workers, Safe patients

There is a growing body of evidence to support transformational change in how we assess the ongoing needs of people on discharge and prevent avoidable harm due to prolonged hospital admission.

The Discharge to Recover then Assess (D2RA) model for Wales is designed to support people to recover at home before being assessed for any ongoing need, in order to:

  • Avoid deconditioning and loss of confidence in hospital;
  • Minimise exposure to in-patient infection risk;
  • Maximise recovery and independence;
  • Reduce over-prescription of statutory services ‘to be on the safe side’;
  • Provide a seamless transfer to longer-term support in the community, if required.

The NHS Wales Delivery Unit (DU) has worked with Welsh Government and Improvement Cymru to describe what good looks like for Pathways 2, 3 & 4.

On 22 September 2020 we will be holding a virtual workshop to complete the same for D2RA Pathway 1 (Front Door Turnaround).

The model can only be safely delivered if the right community services are in place and we share our learning. The DU facilitates a Community of Practice for ‘Right-sizing Community Services for Discharge’, linked to the national modelling collaborative. It also jointly facilitates the Hospital2Home Community of Practice with the Welsh Government Transformation Programme.

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COVID-19 has led to longer waiting times for patients. The DU is working with Welsh Government and Health Boards to help clinicians identify patients at risk of harm on waiting lists and prioritise them for treatment.  The DU and Welsh Government are hosting a virtual workshop for clinicians and managers across Wales to share learning from work already undertaken and agree principles to develop a clinically-led, risk-based system further.  

This is part of a wider programme of work intended to lead to less waiting time and more targeted treatment options for patients, including optimising patient fitness prior to surgery and providing support and potentially alternative treatments to patients.

The DU hosts the Mental Health and Learning Disabilities Learning form Serious and Untoward Incident Group, which is a collaborative and rotationally chaired by the All Wales Senior Mental Health Nurses Advisory Group. Membership includes senior mental health staff from the NHS across a range of disciplines, Improvement Cymru and Welsh Government.

The aim of this group is to improve our systems’ ability to collate, share and deliver improved understanding of untoward incidents for more effective utility, particularly the prevention of incidents where this is possible and thus, to improve patient safety. The group provides a quarterly safe forum for members to share learning from local SI’s.

This forum has successfully continued as a virtual meeting during the COVID-19  pandemic. The group also sets the agenda and facilitates annual national learning events, drawing on wider learning from academic and local studies, and improvement opportunities relating to the management of SUIs in mental health.