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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

Vocational Learning Technology Fund

Business Engagement, Funding opportunities

online training

The aim of this Ufi Charitable Trust investment programme is to offer early-stage funding of up to £50k to organisations that are looking to develop new services or improve access to and delivery of adult learning through the imaginative use of digital technology. This programme will provide funding and support to help ventures in developing their ideas into a more robust digital product or service. Click here for more information, including  funding criteria and deadlines.

 

 

New £10 million community business fund

Business Engagement, Funding opportunities

coins money

Power to Change, a community enterprise support organisation, has launched a new £10 million Community Business Fund, which will provide grants of between £50,000 and £300,000 to community enterprises in England.

The funding is intended to increase the social impact of community enterprises and support them to increase trading income, secure assets or reduce costs.

Find out more here.

How to make the blog look colourful

Guidance

question-markQuick tip if you’re adding posts to the research blog: when adding an image within your post, remember to also click on ‘set featured image’ (bottom right-hand menu below ‘tags’) and select the image again.  This will show the image on the home page of the blog for your post summary (which may entice more people in to read it).

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.

RKEO Drop-in sessions – cancelled due to unpopular demand

Guidance

flyingIn response to positive feedback from academics about how much they benefit from face-to-face meetings with staff from RKEO, we set up monthly drop-in sessions for 2016.  Unfortunately, these were not as valued as we thought they would be, i.e. no academics chose to drop-in to the three held to date.  Therefore, all future sessions are now cancelled.

If there is a specific member of RKEO that you would like to meet with then please contact them directly to arrange a meeting.

Perspectives from an Early Career Researcher (ECR): Tips for Conference Engagement

PG research

Last week I attended the 20th European Congress of Physical and Rehabilitation Medicine (ESPRM) in Estoril, which covered topics from functional gait analysis-to-household ergonomics. By the morning coffee break of day one, it came back to me that engaging in a conference is an art-form. In this brief report I hope to share some tips, based on my own experiences in academia.

Beforehand, workload-dependent, leave all mobile technologies and laptops in your room. Emails can wait until the day’s end and social media will only serve to distract (Quentin Tarantino bans mobile phones from his film sets, so there).

Firstly, register early and familiarize yourself with the layout of the conference centre. Stop for a coffee; premium-grade typically dispensed by the sponsor’s kiosk.

Secondly, take the time to read the programme, and map your ‘conference schedule’ (i.e., what sessions you intend to attend). Breakfast presents a fine opportunity for planning, on a day-by-day basis. Schedule planning is important for larger meetings, which can deliver many parallel sessions. Attend a conference with an aim(s). Be strategic; balance topics specific to, and outside your research area. For example, I attended i) functional mobility in older adults (subject-specific), ii) Cochrane Review/PGR development (non-specific, CPD), iii) cognitive dual-tasking (semi-specific, interest), and iv) Nordic walking (personal interest) sessions. Specialist workshops, such as ECR sessions, are gold-dust as you gain insight from international perspectives and practices. I also recommend not studiously attending every single session; I did this in my first conference and burnt out post-coffee break on day two. Don’t feel guilty missing a session if you feel it holds no relevance to you (or your personal development), otherwise you risk losing concentration on the sessions you are interested in. Stop for a coffee.

Thirdly, relax, enjoy yourself and don’t be afraid to talk. You can often learn more (and establish links) during coffee breaks, than in the sessions. Yes, you are at work, and yes, you may be abroad, but don’t fall into wi-fi hunting. Ultimately, you will check, and respond to, emails. You can do this back home. Engage with the academic and local cultures. Remember wi-fi may be omnipresent, but it wasn’t until about 6 years ago.

Finally, ask constructive questions. If presenting, welcome questions as they reflect an interested audience, and may highlight areas that you haven’t yet considered. Do not view negative/antagonistic questions as a challenge, they may not agree with your perspective and/or may have misinterpreted you. Data rigour and quality control are imperative, but findings may be serendipitous.

If you can master these, please tell me how, as I’m still learning.

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Dr James Gavin

Lecturer (Exercise Physiology)

Department of Sport & Physical Activity

jgavin@bournemouth.ac.uk

Research Professional – all you need to know

Funding opportunities

Research-Professional-logoEvery BU academic has a Research Professional account which delivers weekly emails detailing funding opportunities in their broad subject area. To really make the most of your Research Professional account, you should tailor it further by establishing additional alerts based on your specific area of expertise. The Funding Development Team Officers can assist you with this, if required.

Research Professional have created several guides to help introduce users to ResearchProfessional. These can be downloaded here.

Quick Start Guide: Explains to users their first steps with the website, from creating an account to searching for content and setting up email alerts, all in the space of a single page.

User Guide: More detailed information covering all the key aspects of using ResearchProfessional.

Administrator Guide: A detailed description of the administrator functionality.

In addition to the above, there are a set of 2-3 minute videos online, designed to take a user through all the key features of ResearchProfessional. To access the videos, please use the following link: http://www.youtube.com/researchprofessional

Research Professional are running a series of online training broadcasts aimed at introducing users to the basics of creating and configuring their accounts on ResearchProfessional. They are holding monthly sessions, covering everything you need to get started with ResearchProfessional. The broadcast sessions will run for no more than 60 minutes, with the opportunity to ask questions via text chat. Each session will cover:

  • Self registration and logging in
  • Building searches
  • Setting personalised alerts
  • Saving and bookmarking items
  • Subscribing to news alerts
  • Configuring your personal profile

Each session will run between 10.00am and 11.00am (UK) on the fuorth Tuesday of each month. You can register here for your preferred date:

24th May 2016

28th June 2016

These are free and comprehensive training sessions and so this is a good opportunity to get to grips with how Research Professional can work for you.

Committee inquiries: open calls for evidence

Below is a list of committee inquiries with current open calls for evidence. Please contact Emma Bambury-Whitton if you would like to discuss submitting evidence.

Commons Select Committee inquiries

Joint Committee inquiries

Public Bill Committees