Category / REF Subjects

Lessons from Southern Health – leadership to support a culture of voice across complex integrated systems

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Dr Lee-Ann Fenge

Over the past few years there have been a number of reports which have highlighted concerns about failures of care and patient safety within a range of NHS settings raising serious concerns about the leadership of such organisations. Most recently The Care Quality Commission has identified “serious concerns” about the safety of mental health and learning disability patients at Southern Health NHS Trust. The concerns highlight the failures of leaders to deliver, monitor, assure, and safeguard a culture of safety, quality, and compassionate care and services.

This inspection took place following the publication of an independent review (the Mazars report  that described a number of concerns about the way the Trust reported and investigated deaths, particularly of people using its mental health and learning disabilities services, and a lack of leadership, concerning the reporting and investigation of unexpected deaths of mental health and learning disability service users.

So what leadership challenges are there in turning this situation around? Undoubtedly there have already been improvements in the care offered within the Trust, and the commitment of staff to provide high quality care is beyond doubt. However, the problems result from on-going senior leadership failures within the organisation. Leadership is the most influential factor in shaping organisational culture (Faculty for Medical Leadership and Management, 2015), and is essential to ensure high quality, safe and compassionate healthcare. A key failing identified in Southern Healthcare concerns a lack of robust governance arrangements to investigate incidents, resulting in a lost opportunity to learn from these incidents.

This highlights the importance of senior leadership in establishing and maintaining a culture which is open, responsive and able to learn. Such a culture includes a climate in which communication is valued as a two process which values critical upward communication. This requires a culture of ‘voice’ in which concerns raised by patients, carers and staff are listened to and responded to appropriately. This was sadly lacking at Southern Health and action was not taken to address known risks to the safety of patients, including a lack of response to previous concerns highlighted by the CQC in January 2014, October 2014 and August 2015.

The Trust also failed to respond appropriately to staff concerns about their abilities to discharge certain roles and duties. This perhaps illustrates the failure of senior managers to create a culture of ‘psychological safety’ for staff in which to identify, respond and learn from these problems. Psychological safety has been shown to be a crucial element in organizational efforts to detect and prevent problems (Edmondson et al. 2016). A culture which provides psychological safety for staff embraces ‘challenge’ as a pivotal learning mechanism, and this is supported by the work of McSherry and Pearce (2016) who suggest that safe, quality care requires leaders who can challenge and be challenged.

It is important to learn from the failings of Southern Health. Increasingly NHS leaders need to be able to respond to growing complexity across integrated systems of care. They need the ability to support a system of communication which values the ‘voice’ of all stakeholders to create innovative solutions to 21st century challenges. This requires system leadership that works in partnership across organisations ‘to construct the services that are needed’ (HSJ, 2015:4). It also requires a commitment to create a shared vision of care which values the voice and presence of patients, carers and staff as key stakeholders.

References

McSherry, R.and Pearce, P. (2016) ‘What are the effective ways to translate clinical leadership into healthcare quality improvement?’ Journal of Healthcare Leadership; 2016 (8): 11-17

Keynote Speaker at BAM Marketing and Retail SIG Event on Sustainability and Ethical Consumption

Research themes

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Professor Juliet Memery was a keynote speaker last week at a British Academy of Management Event held at the Surrey Business School, University of Surrey. The event on Sustainability and Ethical Consumption was hosted by the BAM Marketing and Retail Special Interest Group and brought together academics and practitioners to discuss research in the area. The event aimed to make an assessment of sustainability and ethical consumption research by looking back at its original purpose, how it has developed, where it is now, and what it could or should develop into, so providing food for thought for future research in the area. The day was well attended with over 30 presentations being made and a lot of insightful discussions were held.

The event is tied to a special issue of ‘Management Decision’, a peer reviewed journal published by Emerald, on Sustainability and Ethical Consumption which will be edited by the co-organisers and keynote speakers. Details of the special issue will be advertised in the near future, and submissions are invited from researchers in the area.

New comparative paper India-Nepal

international, Publishing

India-NepalThis week saw the publication of a new paper co-written by BU staff in the Sociological Bulletin.  This is the first paper comparing Indian and Nepali Maoist rebels providing health services and health promotion to the communities under their influence.  It presents the key provisions either made by rebel health workers themselves or by putting political pressure on government health workers to deliver better services in the areas controlled by rebels. Prof. Edwin van Teijlingen’s co-authors are based in India and Nepal.  Prof. Gaurang R. Sahay is based at the Centre for Study of Developing Societies, Tata Institute of Social Sciences, Mumbai, India, whilst Bhimsen Devkota is Professor in Health Education, Tribhuvan University, Nepal.

This sociological paper is based on a mixed-method approach comprising 15 interviews and a questionnaire survey with 197 Nepalese Maoist health workers and a secondary analysis of policy documents and other published materials on the Maoist health services of India. The paper suggests that rebel health services in India and Nepal followed a fairly similar approach to what and how they offered health care services to local populations. Maoists becoming a government party changed the political landscape for the rebel health workers in Nepal. However, not incorporating the Maoist rebel health workers into the government health system was a missed opportunity. There are lessons that India and Nepal can learn from each other. Should the Maoist rebels and the Government of India come to an agreement, potential for rebel health workers to be integrated in the official health care system should at least be considered.

The paper benefitted from an earlier review through eBU: Online Journal.  The feedback from the eBU: Online Journal’s reviewers helped shape and polish the paper before submission to the Sociological Bulletin.services-ebu-logo

 

Edwin van Teijlingen

CMMPH

 

 

References:

  1. Sahay, G., Devkota, B., van Teijlingen, E.R. (2016) Rebel Health Services in South Asia: Comparing Maoist-led Conflicts in India & Nepal, Sociological Bulletin 65(1):19-39.

‘Re-Imagining Conflict-Transformation: Making Memory Meaningful’ – A one-day Workshop on 6th May 2016

conferences, Fusion

This one-day workshop explores interdisciplinary and innovative approaches to dealing with a country’s troubled past through memorialisation as a key aspect of transitional justice. It is organised by the Conflict Transformation Studies team as part of the Centre for Conflict, Rule of Law and Society (Bournemouth University).
Location: Executive Business Centre (7th Floor, EB706), 89 Holdenhurst Road, Bournemouth, BH8 8EB

Programme:

9.00 Arrival and registration

9.30 Introduction and Welcome by Melanie Klinkner and Welcome by Sascha Bachmann (Director of the Centre for Conflict, Rule of Law and Society)

9.40 Key Note Address by Nora Ahmetaj, Co-founder of the Centre for Research, Documentation and Publication (Kosovo): ‘Critical approaches to ‘reconciliation’ and transitional justice in Kosovo’s post-war memory’

10.40 Coffee Break

11.00 Panel 1: Chair Avital Biran

Ellie Smith, Newcastle University Forum for Human Rights and Social Justice: ‘Commemoration and Memory: specific justice needs of victims in the aftermath of international crimes and gross violations’

Robyn Leslie, King’s College London: ‘Remember Marikana: apportioning blame or accepting complicity?’

Nina Fischer, University of Edinburgh: ‘National Memory of Trauma and the Perpetuation of Conflict: Israel/Palestine’

12.30 Lunch

13.15 Panel 2: Chair Melanie Klinkner

Denisa Kostovicova, London School of Economics: ‘War Crimes Talk: Transitional Justice and Communication’

Hanna Kienzler, School of Social Science and Public Policy, King’s College (London): ‘Embodied struggles for societal change’

Linda Gusia, University of Prishtina: ‘Breaking the Silence – Recognition of the survivors of wartime sexual violence in Kosovo’

Laura Grace and Stephanie Schwandner-Sievers, Bournemouth University: ‘Quests into post-war Kosovo’s memoryscapes: the interdisciplinary, anthropological and co-creative challenges of BU’s fusion project for a serious game’

15.15 Coffee Break

15.45 Roundtable discussion

What and/or who can make transitional justice initiatives work? How can contested memories be integrated to support conflict transformation? Reflections and insights from past, present and towards the future. Facilitated by Stephanie Schwandner-Sievers and Melanie Klinkner (Bournemouth University).

Confirmed panel Members include:

Nora Ahmetaj (Centre for Research, Documentation and Publication),

Nina Fischer (University of Edinburgh),

Eric Gordy (University College London),

Hanna Kienzler (King’s College London),

Denisa Kostovicova (London School of Economics), and

Christian Pfeifer (Forum Civil Peace Service).

17.00 Closing remarks

Tabled Paper(s): Vjollca Krasniqi, University of Prishtina: ‘War, Law, and Justice in Kosovo’.

Contact: For more information, please contact the organisers Melanie Klinkner (mklinkner@bournemouth.ac.uk) or Stephanie Schwandner-Sievers (sssievers@bournemouth.ac.uk). For urgent matters on the day, please contact Reception at the Executive Business Centre on 01202 968003

Registration: this event is free of charge. However, spaces are limited. For participation please register by 27 April 2016 with the organisers.

HRA Approval for NHS Research

Research Ethics

HRA Approval is the new process for the NHS in England that simplifies the approvals process for research, making it easier for research studies to be set up. It replaces the need for local checks of legal compliance and related matters by each participating organisation in England. This allows participating organisations to focus their resources on assessing, arranging and confirming their capacity and capability to deliver the study.

Laura Purandare, Research Monitor RBCH, has kindly agreed to run a seminar on 4th May at 2pm in BG14 to explain the changes.

The session will cover:

  • What HRA approval is
  • The implementation of changes
  • The difference it proposes to make to health research in England
  • What it means for our researchers
  • Key resources

The session will last approximately an hour, and Laura will be available for questions following the session. We hope to see you there.

Team-work on Team-based Learning Project : My experience as a URA

Centre for Excellence in Learning, conferences

Blog post by Jade Offer, Undergraduate Research Assistant (Innovative Pedagogy)

I applied to become an Undergraduate Research Assistant (URA) as I believed it would help me develop and learn new skills, and it did! As an accounting student, I enjoy working with numbers and that is why I initially applied. The field I choose was unrelated to my degree course and was something I knew little about: the teaching of pathophysiology to student nurses. Despite this I was fully immersed within the research and have really enjoyed my experience.

Fortunately enough I was chosen alongside a fellow student to work on a research project entitled: An Evaluation of Team-based Learning (TBL) in teaching Applied Pathophysiology to Student Nurses. Working with a fellow research assistant made the job even more fun, and was extremely helpful as we could talk and meet with each other to analyse the data, and to aid each other in inputting the data efficiently. We were welcomed into a team with the research leads; Dr Jonathan Branney and Dr Jacqueline Priego, both of whom provided amazing support for us both as we analysed and organised the research they had previously conducted. They both took time out of their schedules to teach us how to use the new research software we needed to use and made regular contact to assist us, which was greatly appreciated.

My involvement in the project

  • Attend regular meeting with the team to discuss next steps
  • Reading previous literature on TBL (relevant articles to our research)
  • Developing spread sheets to organise relevant exam results data
  • Using transcript software to analyse qualitative data
  • Using SPSS to carry out statistical analysis on the quantitative data collected
  • Communication Skills- Composing and delivering presentations

I also had the opportunity to be involved in SUREBU 2016, which is a showcase of research carried out by Bournemouth University students. We were both given the opportunity to present at national conferences, which we hope to attend, as it is an amazing opportunity and privilege. We have also been given the amazing opportunity to be involved in writing a professional research paper that our team hopes to get published, which is very exciting!

What I have gained

  • Presentation skills- delivering a verbal presentation of our findings and how the research was conducted
  • The importance of participant anonymity and the rules of handling important data
  • The important of research in making future changes and trialling new ideas
  • The development of a research project- from raw values to understandable statistics
  • A keen interest and knowledge of Team-based Learning
  • Knowledge in a new field which I would not have otherwise been exposed to

 I would highly recommend applying for a URA job, it has been such a beneficial experience for me; acquiring new skills, developing existing ones and meeting and working along side motivated and friendly individuals. Immerse yourself in the research job and you will find it an invaluable experience alongside your studies.

Jade Offer, BA (Hons) Accounting and Business student, year one

Dr. Jenny Hall on spirituality in midwifery: new publication

Publishing

Dr. Jenny Hall in CMMPH published her latest article ‘Facilitating learning of spirituality in midwifery’ in the academic journal Spiritual Care [1].   She highlights that there has been considerable discussion in the literature around spirituality at the end of life but little relating to childbirth. Perhaps because of this facilitation of learning around the subject is limited. The aim of this article is to raise awareness of these issues and promote future discussion and research.

Congratulations

 

Prof. Edwin van Teijlingen

CMMPH

 

Reference:

Hall, J. (2016) Facilitating learning of spirituality in midwifery, Spiritual Care 5(2): 81–88.  DOI: 10.1515/spircare-2016-0021,

Seminar, Prof Edwin van Teijlingen, ‘Maternal Mortality in Nepal’, Wed 20th April, Royal London House, R303, 13:00-13:50.

BU Challenges, Centre for Excellence in Learning, conferences, Fusion, Fusion Investment Fund, international, Knowledge Exchange, Knowledge Transfer, REF Subjects, Research assessment, Research Ethics, Research Integritiy, Research themes

Maternal Mortality in Nepal
Abstract: The session links various social and political factors that affect maternal mortality. Women dying in pregnancy and childbirth is very much a problem of and in low-income countries. This talk focuses on Nepal, one of the poorer countries of the world, to highlight a range of maternal health issues and wider influencing factors including globalisation and the influence of global organisations such as the World Health Organisation.

For further information regarding the Social Science seminar series, get in touch with Dr Mastoureh Fathi (mfathi@boutnemouth.ac.uk).