Clinical and patient leadership: essential ingredients for improving and sustaining quality

Professor Frank Joseph Future Hospital Officer, Royal College of Physicians@FrankJoseph_FH

• Clinical and patient leadership in the Future Hospital Programme

• Reflections from a Future Hospital clinical lead

• Reflections from a Future Hospital patient representative

• Exercise – how are you supporting clinicians and patients to lead improvement?

March 2012 Sept 2012 Sept 2013 June 2014 Sept 2014

‘Most important statement about the future of British medicine for a generation’

Launch of Future Hospital Commission

Clinical leadership in the Future Hospital:• “Doctors assume clinical leadership (at individual patient and

system level) for the care patients receive across specialties, across settings and across all domains of quality”

• “This includes responsibility to…communicate effectively with patients, their families and carers, and empower them through effective collaboration; and collaborate with other teams and professions…”

Patient leadership in the Future Hospital:• Promotes partnerships: services working together with patients, carers,

families and service users to co-design care and support• Recognises expertise, insights and skills of people who use services • Provides new perspectives that may not have been considered and

offers ‘reality checks’ for clinical colleagues• Ultimately seeks to move from patient involvement to patient

leadership: from “users and choosers” to “makers and shapers” of health services.

Why?• Engaging staff and patients is not an optional extra, but essential in

making change and improvement happen• Organisations with engaged staff deliver a better patient experience

and have fewer errors and lower infection and mortality rates, financial management is stronger, staff morale and motivation are higher and there is less absenteeism and stress

• Patient engagement brings benefits in delivering more appropriate care and improving outcomes.

No More Heroes, King’s Fund (2011)

Future Hospital development sites – selection criteria• Named clinical lead (application/interview)• Named local lay representative(s) (application/interview)• Demonstration of how the project will meet each of the 11 principles

of patient care described by the Future Hospital Commission• Evidence of thorough consideration of approach to patient

involvement • Assigned RCP Patient and Carer Network representatives.

Manchester Respiratory Future Hospital Pilot: leading change from the bottom

Dr Binita Kane, Consultant Respiratory PhysicianUniversity Hospital of South Manchester@binitakane

NHS organisations

“Customer innovation” - Starbucks

Is this how we do things in the NHS?

Why clinicians and patients as leaders?

vs

(Jeremy Heimans TED Talk 2014)

OLD POWER

NEW POWER

The world is changing …..

South Manchester

CCG

Central Manchester

CCG

University Hospital of

South Manchester

Central Manchester Foundation

Trust

South Manchester

GP Federation

Central Manchester

GP Federation

PATIENTS

Joined up respiratory services

The Manchester Respiratory Future Hospital

HOW ??No formula

Relationships

The Future Hospital

Co-designing services

The learning

Patient leadership and the Future Hospital Programme

Alice JoyRoyal College of Physicians Patient and Carer Network memberRCP representative for West Birmingham & Sandwell Future Hospital development site

Quality improvement essentials:• Vision – clinical, patient and management

• Solid foundation – where are we now and where do we want to be?

• Full support, commitment and participation for the long haul

• Flexibility to deal with the unexpected

• Equal partnership and respect for all

Patient involvement:• Provides a rounded approach from the outset• Enables you to tailor the service to actual, not assumed,

needs• Empowers patients, carers and staff alike

Challenges:• Synchronising time and resources• Sustaining the impetus• Communication

Success depends on:

• Recognising and tackling problems as they arise

• Communicating and celebrating achievements

Seems obvious, but you have to do it!

Exercise

• How empowered are your clinical staff? How empowered are your patients?

• What are you doing to support this?

• What more can you do?

To keep up to date with the Future Hospital Programme, join the Future Hospital Partners Network

www.rcplondon.ac.uk/projects/future-hospital-programme

futurehospital@rcplondon.ac.uk | #FutureHospital