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Patient & Public Involvement blog

Patient & Public Involvement blog: a monthly update on HQIP's PPI work, including all the latest news and views from HQIP's Patient Network

1 May 2013: Healthwatch update

By: Kim Rezel, PPI lead, HQIP

null Just a quick note to flag up that Healthwatch has produced a promotional film, see here. I think it looks great and I hope it is able to reach out to a lot of people.

Members of HQIP's Patient Network have varied reports on the progress of their local healthwatch, but everyone is still hopeful and positive about what it will be able to achieve. This video shows what it's view is for the future and I hope it will achieve a wide and diverse membership in all areas.

Keep up to date with Healthwatch news by signing up for their newsletter through their website here www.healthwatch.co.uk

29 April 2013: NICE needs trauma patients!

By: Margaret Hughes, HQIP Patient Network

null I attended a scoping workshop with NICE last week. It was my first one and I found it very interesting. Everyone made me feel very welcome and my thoughts and ideas were listened to. Indeed, a couple of points were incorporated into the draft guidelines document for further discussions.

NICE is developing guidance related to trauma, with the expected publication date of 2015. There are five different aspects of trauma care under development: complex fractures, fractures, major trauma, spinal injury assessment and trauma services delivery.

They are desperate for patient/carer involvement and all that is needed is some knowledge of the subject being developed. It is important you can give the patient or carer perspective. They have enough professionals involved, but us on the patient side see things differently of course and it is crucial our view is incorporated into these very important guidelines.

The guidelines, when published, will be used to provide the standards by which care is delivered and frequently used in clinical audit and by commissioners. They are very important and we must be involved the opportunity...so don't let it slip by!

All the details are on the NICE website. Please click here for general guidance on how to get involved, click here for spinal injury details and click here for major trauma the deadline is 14 May - not long!

20 March 2013: Francis Report shows PPI is essential

By: Margaret Hughes, HQIP Patient Network

null In the light of the Francis Report, which identified that clinical audit was not robust at Mid Staffs, the opportunity has never been greater than now to introduce patient involvement in clinical audit.

I believe that if patients had been properly involved there, as part of the clinical audit ‘every step of the way' approach, the right questions would likely have been asked at the right time.

To any other trust reading this I'd simply remind them that all the information required to get started is on the HQIP website - don't get left behind.

Kim Rezel and I presented recently in Leicester where they had some really interesting examples of patient involvement from the mental health sector. That sector, nationally, are ahead of the game in Patient and Public Involvement anyway, but it was exciting to see that they are moving into Clinical Audit. Hurrah for Leicestershire Partnership NHS Trust.

What is happening where you are?

1 March 2013: A view from the front row at Healthwatch England's second committee meeting

By: Kim Rezel, PPI lead, HQIP

null I was really pleased when I found out that I had a place at the second Healthwatch England (HWE) committee meeting, held in London. I had watched the first meeting live on webcam (http://www.healthwatch.co.uk/news/healthwatch-england-committee-meeting-0) but it was easy to get distracted and lose the thread of the discussion. Saying that, I think the future meetings will now be easier to follow now that I have experienced the context first hand. I recommend you keep an eye on the HWE news bulletin to find out when the next committee meeting is coming to a town near you: http://www.healthwatch.co.uk/get-our-newsletter.

Dr Katherine Rake has been in post as CEO of Healthwatch England for all of six weeks, so I was very impressed with the work that she has already achieved in that time. A business plan has been drafted and presented at the meeting and included the 8 principles of consumer rights. Based on this plan for 2013/14, HWE are initially prioritising four items including:

the right to be heard
the right to redress (making complaints, raising concerns and those comments being responded too)
supporting local Healthwatch (LHW) branches at this key stage of development before 1 April and
establishing HWE as an effective organisation

All the HWE committee members have been involved in regional events and have been learning about the needs of LHW. There have been five regional events so far with over 300 organisation represented. All the papers discussed at the HWE meeting can be found here: http://healthwatch.co.uk/content/committee-meetings-0.

The committee also discussed the Francis report, specifically looking at the recommendations related to Healthwatch including:

providing basic standards so that LHW are consistent
ensuring that local authorities pass over all relevant funds for LHW
creating guidance to help the working relationship between the Health and Well-being Board and LHW and
distributing training and expert advice to LHW etc

To me it seems that a lot of work is being done to try and meet the 1 April launch of LHW and so far this is being done openly and with wide consultation. The HWE committee put across clearly that their priority for LHW is that they must have "excellent engagement in the community" with specific focus on hard to reach groups.

Fingers crossed to a good start continuing into the new financial year! Before I go, HWE have announced a conference in Birmingham on Wednesday 13 March for chair's and chief executives of LHW. Are you going to attend? If so, please let us have your views and feedback: http://healthwatch.co.uk/news/healthwatch-england-national-conference.

22 February 2013: A report from CAI conference 2013

By: Margaret Hughes, HQIP Patient Network

Margaret Hughes I recently had the pleasure of attending the joint HQIP & Healthcare Conferences 'Clinical Audit for Improvement' 2013 conference in London.

We had the opportunity to hear some of the great movers and shakers in health including Professor Sir Bruce Keogh NHS Medical Director DoH, Niall Dickson CEO General Medical Council and Dr David Scott Chairman, Medical Managers Sub Committee BMA and Clinical Lead for Paediatrics East Sussex Healthcare Trust. All held together by our own CEO Robin Burgess who spoke eloquently on the National Clinical Audit and Patient Outcomes Programme. That was only the first morning! The subjects were all relevant to the rapid changes in the NHS bringing us up to date with happenings across the health economy and particularly what is happening nationally and locally in clinical audit.

Of great interest to me were the two presentations looking at revalidation and clinical audit. I have been involved in the development of revalidation for a number of years with the Royal College of Physicians and now all the work is coming to fruition. This is a good hook for patient and public involvement in clinical audit in trusts as all doctors have to show their involvement in service improvement and show patient feedback. Patient Involvement could tick both boxes. Bingo. HQIP guidelines can show you the way.

The first morning set the tone for the rest of the two day conference. On that first day I was unable to attend a workshop as I was helping Kim deliver a masterclass to a full house on patient and public involvement in clinical audit. I will write about that later.

On day two, I was able to attended a workshop facilitated by Kate Hill, a solicitor, who delivered a legal master class. This was excellent and I would recommend both the facilitator and the content. It was really enlightening to hear how the language used in patient documentation can sometimes be so ill conceived as to be very useful to the prosecuting council in a court room.

One last interesting point, I stayed overnight in London in a great hotel except I had to share my room with the tube line going into Great Portland Street. The price I have to pay for having fun.

8 February 2013: Get involved with Healthwatch: Department of Health response to Francis

By: Kim Rezel, PPI lead, HQIP

null The Department of Health has responded to the Francis report, published this week, saying that it is committed to connecting with patients.

One of its next major moves to drive this is the Department's facilitatation of a series of patient-focused workshops to facilitate greater involvement in 'consumer champion' Healthwatch.

These are being led by the new independent body, in partnership with charities such as National Voices. Find out more here, including how to get involved with the sessions.

http://healthandcare.dh.gov.uk/charities-people-power-local-health-care/

Back to top >>

7 February 2013: Francis report, patient-friendly clinical audit reports and the Patient Network meeting

By: Kim Rezel, PPI lead, HQIP

null A glance at the now published Francis report, shows the importance of patient groups , highlighting the failings of LINks and the need for patients, families and carers to raise serious issues and fatal problems with the Mid Staffs Trust. We hope this report and Healthwatch will enable good processes in place for future patients and public to voice their concerns. Last week saw the first Patient Network meeting of 2013, it was a packed agenda, where we welcomed four new members, discussed new HQIP work and speculated about the Francis report.

The Department of Health have also published a response to the inquiry committing to reconnecting with patients.

Department of Health response to Francis inquiry

The Diabetes UK blog has come to an end now that they have completed their patient-friendly clinical audit report found here: Diabetes UK Patient summary. Read their blog to follow the process they undertook: Diabetes UK blog.

The NJR have also published 2012’s patient-friendly report – found here.

Please make sure you have a look, especially at the new interactive version, I find this a really easy way of reading a document on a monitor and much more environmentally friendly! I’d really like to hear your feedback about this, so please email me your views.

Both reports were achieved with high-level patient involvement, it will be interesting to hear your comments about their accessibility and readability. Some of the Patient Network members, with their other hats on, were involved in their development and welcomed the approach and said that they felt very involved in the whole process. It is key that all clinical audit reports are also published in a “patient-friendly” way, and in order to achieve that it seems obvious to me, you must involve the patients! Please have a look at our guide on some suggestions on how to develop a patient-friendly clinical audit report.

How to develop a patient-friendly clinical audit report, HQIP

Next week HQIP are holding their annual conference at the Hallam Centre in London. Members of the Patient Network and myself will be presenting and facilitating a masterclass in involving patients in clinical audit.

I'll let you know how it goes!

18 January 2013: Patient and consumer involvement in audit

By: Robin Burgess, CEO, HQIP

Robin Burgess

This week has seen a range of patient related issues come into the spotlight. We are preparing for our annual review of our accreditation for the Information Standard, which reviews the information we publish for and about patients. We have a lot of great work this year to talk about which we think have improved the level of reporting of audit findings to patients and consumers. Notable within this is the guidance on developing a patient audit report at the national level. Whilst some audits have done this for years, including the National Joint Registry in the last couple, it is pleasing to see other national audits also producing similar reports - and writing in to thank us for the guidance and how much it helped them produce their own. We want to see, over time, one produced for every audit.

On a related theme, just to remind everyone of our continuing work to ensure all audit reports are published on data.gov at the lowest level of granularity as soon as can be organised. This project, part of the Transparency and Open Government work, continues apace.

Don't forget as well that the announcement in the Commissioning Board Planning Guidance (pdf), to publish surgeon level data by this summer, has speeded this work up in the case of certain audits. This piece of work is also moving on rapidly, getting surgical community buy-in to make this happen. A joint meeting, co-hosted with the Royal College of Surgeons, with the affected societies and Sir Bruce Keogh attending, is booked for the 4th February. When these data are published it will be a big boost to the volume of data available to patients. As well as involving patients, we have to provide them with access to audit findings in an easy to access and understandable fashion: it's a priority for us.

Patient consent issues are also crucial. I attended a useful review meeting hosted by the Health Research Authority this week looking for ideas on how the Section 251 exemption from patient consent that applies to national audits and research could be developed - they now have responsibility. Of course Section 251 should only be applied where patients cannot consent - where they can they should. The Caldicott commission will have something to say about this too, when it reports later this year. The key issue that emerged is that researchers and research departments at the local and academic level, need more education about why patient consent rules exist, their value, and why exemption should be avoided. However, if required, the processes needed to obtain it need to be rigorous and robust. Still, it seems to be the case that some in the research community see such necessary controls and constraints on use of unconsented patient data as just a chore. This has to change, so whilst the procedures to obtain exemption need to be efficient, researchers accept why they are in place and how important they are.

HQIP has patient and consumer interests in its DNA, and we will continue to stress the importance of patient and user involvement in health, and to come, social care audit processes. Notwithstanding the range of work to engage patients in governance and practice, and to direct data and evidence from audit to patient audiences, there is still a long way to go. CASC's annual survey of some of those primarily active in clinical audit in local trusts has recently highlighted the need to improve local participation of patients in audit; in their new 2012 report ‘59% rated patient involvement in clinical audit as ‘poor', 35% ‘average' and 6% as ‘good' (http://www.clinicalauditsupport.com/download/DraftCASCsurvey2012.pdf). This is a highly critical self-assessment of practice at the local level.

The examples and guidance on our website are here to help people address this - locally and nationally. We all know how challenging PPI is; but it has to happen.

19 November 2012: Patient success in the North West

By: Margaret Hughes, HQIP Patient Network

Margaret Hughes Wrightington, Wigan and Leigh NHS Foundation Trust Hospital, Clinical Audit Lay Team (a patient panel) are busy designing the questionnaire for our first solo effort at clinical audit. We have been working very closely with the clinical audit manager and the newly appointed clinical audit chair. We are also receiving many requests to help other professionals with their audit plans. It has been a long time coming but it would seem we have now arrived!

So much so that we are thinking about bringing forward the recruitment of more patient members which we had planned for the middle of next year. The work load would seem to indicate that we need to move faster and perhaps recruit for the next financial year.

Many people said it couldn't be done but we have proved otherwise. A PPI champion, a will to succeed, HQIP and perseverance won the day. Patients can work as partners in clinical audit to make a difference and improve quality of care.

Without the encouragement of Kim and Kate from HQIP none of this would have happened. The tools that are available from HQIP have been invaluable particularly the Patient and Public Engagement in Clinical Audit 2009 (pdf) which gave me the idea and became my bible when I was devising the training programme and compiling a training manual. If only I had waited as everything is now available on the HQIP website. I could have saved myself the effort.

Also, the e-learning tool is superb. I do recommend it.

17 October 2012: Three new PPI tools - and we need your help!

By: Kim Rezel, HQIP PPI Lead

A true spirit of partnership reigns over this blog entry: I have three new PPI-related resources to talk about, and in return we need your help finalising one of them and we need more case studies.

Firstly then to the launch of our three new products on 3 and 9 October at two ‘PPI in clinical audit' events in London and Manchester:

Online learning for patients (beta version)
How to develop a patient panel guide
A guide to writing a patient friendly report

Across the two we saw 50 delegates, of which over a quarter were patient representatives, either at local or national level. Well over half were local clinical audit staff with a small number of delegates from national audit and social care audit. Clinicians were thin on the ground and we intend to put this right for future products and events.

The events saw presentations from myself and QID lead Kate Godfrey, which can be found here. We are extremely grateful to our two patient presenters: South London and Maudesley Trust service user representative Bridget Jones (presentation here) and HQIP Patient Network member Margaret Hughes (presentation here) who presented at London and Manchester respectively.

In the afternoon we focused on the action plan which forms part of ‘developing a patient panel' guide, asking delegates to go through the objectives in their groups. Our guests definitely found talking to other attendees, who had experienced varying levels of PPI, very enlightening.

A few delegates already had access to trust-wide patient panels, while others were starting from scratch. I plan to follow up with delegates to find out how our guidance helps them develop PPI in quality improvement and what else we can do to support them.

We need your help!

We have a chance to update our e-learning tool at the end of November. We really need you to review the product, use it for what it's been developed for and either use it yourself as a training tool or encourage people who are new to clinical audit to learn about it with this product. Please let me know your comments by the 10 November. http://www.hqip.org.uk/guidance-support/understanding-clinical-audit-online-learning-for-patients.html
A few delegates talked about how helpful they find the case studies on our website -http://www.hqip.org.uk/patient-and-public-engagement-2/#case. WE NEED MORE! Please contact me with your stories of patient and public involvement in clinical audit. I am happy to write up the case study for you to check and correct, so please don't worry about the extra workload!

Finally we heard about an organisation called Patient Opinion which is a way for individuals to share their stories and for organisations to respond, please have a look here: https://www.patientopinion.org.uk/ - we'd be very interested to hear what you think.

9 October 2012: Data-sharing - patient involvement vs patient safety

By: James Thornton, communications manager, HQIP

At today's ‘Healthcare Efficiency Through Technology' (HETT) event in London, something of a sea-change in the information revolution was noticeable. The impetus toward greater information sharing continued, but several speakers took the opportunity to urge the need for a more qualified approach.

Speakers described a growing maturity to the transparency agenda - away from what some have criticised, albeit quietly, for its ‘publish and be damned' approach.

Doctor Shahid Ali, GP and clinical lead for the Patients and Intelligence Directorate, chaired one session, presenting a keynote entitled ‘the NHS Commissioning Landscape and Technology: Better Information, Better Choices, Better Outcomes'.

He focused on long-term conditions (LTCs), highlighting their responsibility for 70% of healthcare spending. And he began by advocating patient initiatives few would disagree with: ‘proactive' and ‘personalised' care to create ‘empowerment' via ‘patient access to patient data'.

And he practices what he preaches. At his surgery any LTC patient booking an appointment gets either a 30- or 60-minute session to not only deal with their immediate issue but assess their overall health based on sharing as much of a patient's data with them as possible in order to help create personalised understanding of individuals own health. Part of a proactive approach he claims has seen 40% financial savings and 70% less time spent dealing with patients than the approach was strictly reactive.

Contextualisation and linkage

All great stuff, undoubtedly. Doctor Ali however, urged caution, saying that "data must be contextualised" lest it do more harm than good.

And, when questioned by a clinician on how his approach would work with patients who may not - due to education or language barriers - have a lower level of understanding, and Doctor Ali admitted that he did not have answers and that ‘maybe carers could help'. On language barriers, he conceded that while translations could be created, some patients may well speak a language fluently but not be able to read it.

This is not to shoot down what seems a refreshingly strategic approach to healthcare, but caution clearly makes sense and a multi-disciplined approach would appear to too.

Ali was followed by NHS Information Centre executive director Doctor Mark Davies, who presented on providing improves access to data in health and social care. Interesting then, as a practicing GP and lead of an information organisation that he chose to begin his session with a quote from Google's Erich Schmidt on how we are all now faced with ‘a tsunami of data'.

While Davies was keen to remind the audience of how the government had enshrined ‘information as an integral part of the service to patients and service users' his key focus was that data must be meaningful and it must be linked. He finished by providing ‘a personal example' that he had ‘the misfortune to have had multi-generational first-hand experience of' - that of the Hebden Bridge asbestos factory which in the earlier 20th century had been the majority employer for a local community that had since suffered decades of healthcare issues. Those issues, Davies said, had been massively exacerbated by a lack of linkage.

Transparency and reassuring patients

When the National Information Governance Board's Dame Fiona Caldicott took the stage to update on the early findings from her team's enquiry into data sharing, the first factor she outlined was ‘confusion among the public about what is done with their data'. Fortuitously or otherwise, she was followed on stage by Jonathan Bamford, head of strategic liaison at the Information Commissioner's Office.

During an engaging presentation, in which he was clear on the tough sanctions in place for those breaching data-sharing regulations (either by lack of governance or deliberate criminality - his office seeks custodial sentences these days he told delegates), he implied that one of his organisation's proposed changes, providing a clear definition of explicit consent, had been achieved.

To be fair to Bamford, this was not the main focus of his presentation and he certainly was not trying to indicate that all the data battles had been won. But, the point did jar directly with Caldicott's first findings.

There can of course be no such thing as a perfect system. And few would say that the majority of work in improving previous systems has been put in place. Personally though, it was refreshing to see so many high profile information governors take what amounted to a collective pause for thought.

Any thoughts on this piece, or indeed any localised examples of good PPI and data sharing do please share them with us on email, facebook, Twitter or NCAF.

14 September 2012: PPI events, meetings and awards update

By: Kim Rezel, HQIP PPI Lead

Kim Rezel The sign up for the two PPI workshops in October has been brilliant and they are both now full! However, please let me know if you're interested in attending any future events on public and patient involvement in clinical audit, as if we have enough interest we will add another date. Click here to see the agenda for those forthcoming October events (pdf) >>

The summer has been a busy one, with a Patient Network meeting in mid-July in which the upcoming projects were discussed. We also welcomed another new member and received a training session from our Comms' manager on how to use the National Clinical Audit Forum (NCAF).

In August we held a judging panel where three members of the Patient Network reviewed the PPI submissions for HQIP's Clinical Audit Awards 2013. Unfortunately, entries were very limited compared to previous years and the applications did not meet the criteria. We were very disappointed as we were unable to find three nominees or a winner. We are hopeful that the new products, detailed below and available next month, will help facilitate more PPI in organisations and will result in improved initiatives and more best practice to share in 2013.

The e-learning tool, the 'Patient Panel' guide and a short guide in 'writing patient friendly reports' are all at their final stages of development and are currently being reviewed by the Patient Network. Hard copies will be available at the October events with all of the products available online from early October - to be announced in our eBulletin.

Please don't forget to contact me should you want to attend the PPI workshops in October, I am keeping a waiting list and we will add another date if we have enough interest.

11 July 2012: Patient focused events and PPI plans progress

By: Kim Rezel, HQIP PPI Lead

Kim Rezel You may have seen our recent news announcing two dates in October that will see the launch of the first new patient e-learning tool and a 'How to guide' for setting-up patient panels. See more detail on those plans here in May's blog entry here.

These two workshops will involve a detailed look at the new guide, with group work that will revolve around the action plan included within it. Although our main audiences are clinical audit staff and patients/volunteers with an interest in clinical audit, we are also really keen to meet volunteers who are already engaged in clinical audit and hear about good examples of patient involvement at all levels of quality improvement.

We hope to get a good response for these workshops and are open to holding more events should the interest be there, so please contact me if you are unable to attend the two dates.

WEDNESDAY 3 OCTOBER - London

TUESDAY 9 OCTOBER - Manchester

We have our next Patient Network meeting coming up next week, where we have a lot to discuss with the development of all the new products. Please let me know if you're interested in becoming a member, you can find our previous minutes and other information about the Patient Network here: http://www.hqip.org.uk/hqip-patient-network/

I hope many of you sign up to the autumn events and that I'll be seeing you then!

12 June 2012: Patient safety and building a safer NHS

By: Jenny Mooney, Clinical Outcome Review Business Manager, HQIP

Jenny Mooney I recently had the privilege of attending and presenting at Patient Safety Congress, the UK's largest patient safety event, to hear about national and international initiatives to reduce adverse events in healthcare and improve patient safety.

I was pleased to be given the opportunity to speak at the event about the work of the four Clinical Outcome Review Programmes, commissioned by HQIP and which I oversee management of.

Through analysis of organisational and patient data (including the review of anonymised patient case notes on a national scale) the reports are powerful in highlighting where the quality of care delivered falls short of expected standards and in producing recommendations where improvements to the quality and safety of patient care can be made.

The Congress was ably chaired by Dr Phil Hammond; GP, comedian, and vice chair of the Patients Association. Phil is passionate about ensuring that compassion and the patient voice remain the focus of the NHS.

His investigation ‘'Shoot the Messenger'' aimed to highlight the treatment of NHS staff who sought to expose failures in patient care within their organisation. He concluded that if we are to address issues of safety and quality improvement in the NHS, we need to ensure patient stories are heard and staff that have concerns about patient care are listened to without fear of recrimination.

The support in the NHS Constitution for staff who whistle-blow and the setting up of a dedicated whistle-blowing phone line are, in my opinion, to be welcomed, but their necessity serves to remind us of the journey yet to be travelled.

24 May 2012: Patient involvement plans for this year and next: Guides, online learning, live events

By: Kim Rezel, HQIP PPI Lead

Kim Rezel This month sees a lot of new work in development for HQIP and our Patient Network. A major part of this is that we want to ensure we are producing more practical help for organisations in involving patients in their clinical audits, taking the lead from some of the feedback we received in the HQIP survey. Below, I've written a list of some of our plans for this year and next:

A practical guide with a useful action plan template, "How to create a patient panel", for organisations who want to develop their lay involvement
Two patient-focused online learning tools. The first, "An introductory session in understanding clinical audit", is for patients with an interest in understanding what clinical audit is and understanding a basic clinical audit report
The second online learning tool will be called "A foundation session in understanding clinical audit". This will be in four-parts and will be for patient/volunteers who are interested in participating in clinical audit at a more in-depth level and joining a "patient panel". Clinical audit teams will be able to use this tool to help in their training programmes for volunteers
A patient consent information leaflet. This is being designed to help patients understand the national clinical audit programme, before consenting for their data to be used
We are creating a guide for clinical audit teams on how to write patient-friendly clinical audit reports
Live events this autumn to launch and try out the products highlighted above - for both patients, patient representatives and clinical audit staff. The likely dates are as follows: Wednesday 3rd October - London; Tuesday 9th October - Manchester. Please add those dates to your diary, I'd love to see as many patient representatives at the events as possible.

Finally, we also continue to expand our case study library, if you know of any good examples of patient involvement in clinical audit, I would love to hear from you: kim.rezel@hqip.org.uk. These examples are all being used in the writing of all the above products and is a great way of sharing best practice.

18 May 2012: Feedback on attending the Patient Information Forum 2012

By: Brian E Hodges, HQIP Patient Network member

This event took place on 1 May at the very accessible Think Tank Science Museum in Birmingham. The title this year was ‘Choice - valueless without meaningful information'. Essentially this means that while patients are entitled to choose where they go for their treatment; our choice is still limited without having accessible information.

The keynote session was by Earl Howe - Parliamentary Undersecretary of State for Quality. He spoke of the Department of Health's Consumer Health Information Strategy for England. This strategy promises that the patient will have access to information as it should not only be available, but also written "with the patient at it's heart". We await the results with interest.

The plenary and workshop sessions were all interesting in their own way; they were about sharing information, promoting clarity and cooperative decision making. One of the most exciting was by Doctor Mohammed Al-Ubaydli , CEO of the Patients Knows Best organisation, and his mantra is ‘the patient is king'.

As he pointed out, by giving information to the patient it overcomes the issues of different doctors and different systems. It seems so obvious, I wondered why I hadn't thought of that!

I look forward to the new Information Strategy to see how far this concept has been adopted.

9 May 2012: Quality of Health Principles - setting out a good patient experience

By: Sarah Markham, Patient Network member

I recently saw a link on the HQIP website to 'Quality of Health Principles'. Launched in November last year, Changing Our Lives worked closely with people with learning disabilities, physical disabilities, people with visual and hearing impairments and people with mental health issues and older people to develop the principles, setting out what a good patient experience should look like. The Department of Health and some of the people who developed the principles are now working together on the Audit programme which will see these principles used as a basis for audits of local health services.

I was very impressed with the document, it is attractive and straightforward, the photographs are a good idea too. I found the best part the glossary which is very informative.

The principles can be found here >>

30 April 2012: a patient's view of the European National Clinical Registries & Audit Summit

By: Margaret Hughes, Patient Network Delegate

Margaret Hughes I was privileged to attend the European National Clinical Registries & Audit Summit last Friday (27April 2012) at London's Victoria Park Plaza Hotel. The venue was ideal as it was located almost next door to Victoria mainline and tube stations.

The conference took place over two days allowing for many delegates to attend from as far afield as Australia, America and all over Europe. In total I think I counted 17 different countries including all four countries in the UK - a measure of the recognition and importance that registries and clinical audit are given across the world. The conference was chaired by HQIP Chief Executive Robin Burgess and Paul Bartels, President of the European Society for Quality Healthcare (ESQH).

It was interesting to hear a speaker from Sweden - Professor Göran Garellick - give recognition to John Charnley, who is widely acknowledge as being the first surgeon to successfully perform a hip replacement in the 1950's (at Wrightington Hospital where I am a patient ), having recommended in the 1960's that a national register should be set up to record joint replacements. It took 40 years to get around to it in the UK. Sweden are a world leader in clinical registries and have over 40 at present.

We heard from speakers from Denmark, France, Spain, America and Great Britain. Documenting the strengths and weaknesses of registries across Europe and the problems associated with working in a federal country like Spain where every area does something different and trying to bring the information together, is almost insurmountable.

The UK's Professor Michael Roberts spoke of the European COPD audit. This had been successfully carried out in spite of many challenges, and had proved to be a big learning curve for the future. The final speakers before lunch talked of pooling data across Europe for conditions in common, using as an example device registers for joint replacement.

After lunch the conference split into two streams and I attended the first one "Using release of results to improve quality of care: shared issues for national registry programmes". This was well facilitated by Helen Laing (NCAPOP lead) and Dr Yvonne Silove (NCA development manager) from HQIP. They were followed by the information manager from the UK Lung Cancer Audit, Julie Henderson and Dr James Kent, who had left Medicine to work in business management. They were both very interesting with lots of food for thought. This was followed by the plenary questions and answers session to a board of international experts.

It was a long day and many people (including me) were flagging by the end. The person sitting next to me faced a journey of six hours home to Norway although the actual flight was only two hours. I was pleased that I only had a two train journey!

Overall, it was an excellent day with lots to think about. It was particularly interesting to note that the challenges faced by trying to carry out the European COPD audit for the first time closely resembled the problems I faced trying to set up a lay team of auditors at my Trust for the first time...

12 April 2012: HQIP Advisory Group, PN events and e-learning tool update

By: HQIP PPI Lead Kim Rezel

Today sees two Patient Network (PN) representatives meet with HQIP's Chair and CEO Robin Burgess.

Among the things they are discussing will be fine-tuning how the HQIP Board and the PN will work together across the next 12 months. Not least here will be the role of the new advisory group for the Board. Plans for this group are still at an early stage of development, but it is hoped it will include representatives from both the PN and patient representative organisations, and help shape HQIP's work.

The next PN meeting is on the April 25and we have a busy agenda planned, including a presentation from South London and Maudsley Trust. We have invited them along as the Trust has achieved very successful patient involvement in clinical audit, as shown by their runner-up spot in last year's Clinical Audit Awards at the HQIP Annual Conference.

Coming up in the next few weeks, PN representative Brian Hodges and I will be attending the Patient Information Forum in Birmingham, where we look forward to hearing some innovative ideas around communication tools and presentation to the public.

As mentioned last month, we are in the process of creating an online learning tool aimed for patients and patient representatives, designed to firstly enable understanding of clinical audits reporting and secondly offer a foundation course for those wishing to get more involved with the audit process.

Work on this e-learning tool is coming along well - we now have designers on board, and so the next stage will be for the PN working group and me to meet to agree the educational objectives for the resource and the content for it...watch this space, and if you have any suggestions, do let me know: kim.rezel@hqip.org.uk

9 March 2012: Chair named, CAI feedback, e-learning tool imminent!

By: HQIP PPI Lead Kim Rezel

Since our last update the HQIP Patient Network have appointed a Chair - John Lynch spent a career in IT but as a long term patient from a heart condition John has been involved in the voluntary sector since his early retirement. He has been a chairman for the Enfield Christian Social Responsibility Association and the Enfield Community Health Council and has been involved in various working groups including in the strategy, development, research and ethics departments of both Enfield and Haringey Trusts.

Presently John is also the Chair of the Enfield LINks which has received Pathfinder status for Enfield HealthWatch. As the role of Patient Network chair John says "I hope to lead the team of Patient Network volunteers along a path that will ensure that patients' voices are heard and respected in both health and social care arenas - with a particular focus on clinical audit issues and related programmes that will result in improved outcomes for patients."

In the past few months the Patient Network (PN) have been very active with strong involvement at the HQIP Annual conference and attendance at the CAI conference. Members are also attending the upcoming European National Clinical Registries and Audit Summit as well as a Patient Focus conference for the NJR.

Margaret Hughes presented at the HQIP Annual conference to a great response, eloquently speaking about her involvement in clinical audit, how she started and where she is now; playing a pivotal role in her own trust at Wrightington, Wigan and Leigh, and as a valued member of the PN.

John Lynch and another member of the PN will be meeting with members of the HQIP Board in the second of what we hope will become a regular event. HQIP want to ensure that there is an opportunity for the PN to put their views to the board and also for the Board to have the chance to feedback to the PN.

CAI Conference feedback

One of the PN Jagadish Jha attended last months' CAI conference and had the following to report back:

"Simon Bennett, Head of Clinical Governance at Department of Health was unfortunately not able to attend the conference, so HQIP CEO Robin Burgess had to play the double role of chair and presenter for both of the morning slots. He did it remarkably well, and did not show any signs of fatigue!

I asked Robin about clinical audit for dental services and he told me there was none. There is a gap there which needs to be addressed, I feel. Dental charges are very high for patients often on low income but not receiving any benefits, and the same can be said for opticians' charges.

At the conference itself, I particularly liked Simon Bennett's paper "Giving patients the information they need to make choices and to take control" we were each given a copy and Robin presented the paper on Simon's behalf. I also attended two masterclasses; 'Clinical audit action planning' and 'Junior doctors and clinical audit'.

The former was in two parts. The first was facilitated by Nancy Dixon who talked about planning, action logs, resulting in improvement and the second part by Colin Bryant, who talked about his experience in military medicine, for example in the treatment of trauma . Nancy had a lot to say about the efficiency of the American system but admitted that poor people there have a raw deal. Colin made us laugh by saying how people shouted at each another in the military, but people outside the military treated each other with respect.

The latter masterclass involved a presentation by junior doctors and was very informative. It concluded that at least one round of repeating data collection is important to determine the effectiveness of any action taken to improve patient care. Unfortunately there was not much time left for Q&A.

Elsewhere, clinical champion (HQIP) and Doctor in Pathology from Maidstone and Tunbridge Wells NHS Trust, Graham Russell talked about closing the audit cycle: audit leading to action and improvement and re-audit being essential in an audit programme. He provided case studies of re-audit and change in practice.

Finally Lynne Hoffin and Lee McCleary, Team leader and Care assistant respectively, talked about a particular case of palliative approach to mouth care, involving the multi-disciplinary team and re-audit leading to improvement in the Ayrshire Hospice.

In conclusion a very worthwhile examination of all the major themes in clinical audit, using specific subjects."

Online learning tool set for launch

Over the coming months the PN and HQIP will be finalising an e-learning package for patients who would like to be involved in clinical audit. Please keep an eye on the PPI and news pages for more information, and if you haven't already, sign up for the HQIP eBulletin.

We are looking to expand the Network and welcome anyone to contact Kim Rezel at HQIP if you are interested in joining the group. We meet every three months, but if you prefer to only have "virtual involvement" we are still very interested in hearing from you. Expenses, based on the HQIP expenses policy, are covered in the document: http://hqip.org.uk/assets/PPE/Patient-Network/External-expense-claim-guidance-FINAL-2.pdf

If you have any views about national or local clinical audit and patient involvement, please get in touch with me: kim.rezel@hqip.org.uk

16 June 2011: Social care, HQIP conference and PPIweb pages

By: HQIP PPI Lead Kim Rezel

Welcome to the launch edition of HQIP's PPI blog - a monthly update on the latest developments in HQIP's ongoing Patient & Public Involvement work, including all the latest news and views from HQIP's Patient Network.

It's a fitting time to go live with the blog as Patient Network members have been very busy in recent times getting involved in various consultations, events and discussions.

The first point of note is that three members recently met with members of the HQIP Board to discuss their representation on it. Progress has been made to create clearer and more regular lines of communication, and one member will attend part of the next Board meeting. The discussion however is to be continued, and hopefully a permanent solution will be agreed at the next meeting.

Meanwhile, two members attended the first HQIP Social Care workshop which was attended by, among others, social care providers and was held in partnership with the Social Care Institute for Excellence (SCIE). The workshop is the first discussion in what HQIP hopes will be a big project, integrating successful quality improvement approaches in health and social care. The Patient Network input was invaluable and members will continue to be part of this ongoing consultation process.

Looking ahead, HQIP's annual conference in October will be more patient-focused than ever before. Patient Network representative Kate Wilkinson will give the opening keynote address on 10 October in Manchester, followed by NHS Medical Director Sir Bruce Keogh. The event will also have its usual Clinical Audit Awards ceremony, in which one of the categories is Patient Involvement. Members of the Patient Network will be on the Awards panel along with myself and HQIP Quality Improvement & Development Lead Kate Godfrey to judge the top three submissions and the overall winner

Elsewhere, look out for HQIP's PPI strategy which will formalise and frame our PPI aims, objectives and activities. This will be available soon on our PPI pages along with all the existing case studies, useful guides and tools and the Patient Network minutes.

A final update for now is a note that the next Patient Network meeting will be at HQIP's offices on 6July. We are always interested in recruiting new members, so if you are interested in getting involved as a carer, service user, member of the public, patient please contact me on 020 7469 2511 or via kim.rezel@hqip.org.uk.

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