17/07/2009 by Patrick Keady.

Listening to Evan Davis on BBC Radio 4, I was particularly interested in the language of his guests.

James Dyson introduced himself as the founder of vacuum cleaners that work better.

Marta Lane Fox, recently appointed Champion of Digital Inclusion, is working to make life better for the six million economically and socially disadvantaged people in the UK that have no access to technology.

And Adrian Ringrose  the chief executive of a company that enables public sector organisations do what they do, by doing all the bits that these organisations don’t want to think about.

When introducing ourselves in the NHS, we tend to use different language. And this episode of BBC Radio 4’s The Bottom Line promised a lot. It was a discussion about creativity and innovation.

To be good at innovation and creativity, Martha Lane Fox said that boldness and self-confidence works for her. James Dyson added that innovation for him is caring about solving problems and taking little incremental steps to get there.

And Adrian Ringrose gave his insight into the public sector. He suggested that it is more important to do what we do in the public sector - by the rules, rather than focusing on the end game.

A generalisation perhaps, he reminded us that it is the end point that matters and we are more likely to get there by building on our mistakes.

And my guess is that this point resonates with you and many leaders in NHS risk management, governance and safety. I enjoyed this edition of BBC Radio 4’s The Bottom Line and I know that you will too.

Posted in Risk Management, Innovation, Creativity, Patrick Keady, NHS, Personal Development, Governance, Strategy | Print | No Comments »

28/02/2009 by Patrick Keady.

This morning I received an INLPTA Certificate from David Smallwood, for completing the NLP Master Practitioner course.

David is a certified trainer of business-focused NLP, a certified NLP health practitioner and a certified INLPTA trainer. And he was my principal trainer throughout all of my NLP training at diploma, practitioner and master practitioner levels. David is a wonderful inspiration, an excellent trainer and unbeatable value for money too.

Having completed the NLP practitioner course last year, David commented that it was during the master practitioner training that I really demonstrated the integration of my Practitioner training.

A number of people have asked what the NLP master practitioner training is all about and how it differs from NLP practitioner training.

While I had the skills and understanding of an NLP practitioner, the master practitioner training leveraged my learning from there to go to levels of competency that to an untrained observer might appear amazing. See what Richard Bandler has to say about master practitioner training.

While the focus in practitioner training was on learning the fundamentals, the master practitioner training was about Mastery. This brought with it new levels of understanding and skills development so that I am now able to run the NLP patterns as well as able to tailor, re-organise, and even make new patterns on my own that are appropriate to the situation in hand.

I learned new distinctions and developed new skills and David trained us with his eye on precision and elegance. The epistemology of the master practitioner training was very different too from that of the practitioner - in terms of outcomes, behaviours, ways of being, and ways of relating to the world.

The master practitioner training was about me and the many routes open to me to achieve my outcomes, my better outcomes. It was about my ability to facilitate behavioural change and to do so elegantly, generatively, and with precision.

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12/02/2009 by Patrick Keady.

‘Without a national study, politicians and health professionals go into denial ….. we don’t have a problem’. This was one of the comments for Sir Liam Donaldson when he opened the Patient Safety Research Portfolio Conference this morning at the Royal College of Physicians

Speaking to a selection of the researchers that participated in the 36 patient safety research projects undertaken over seven years, at a cost of about 70p per NHS England employee per annum. He outlined his vision of the ten contributions that patient safety research offers to improving healthcare, as follows:

•    increasing awareness of patient safety - with clinicians, provider organisations and commissioners
•    understanding the causes of patient (un)safe-ty – and in relation to sleep deprivation, Sir Liam reminded us of the importance of the 48 hour week - clinicians are more likely to kill patients when they are tired.
•    more research in the young discipline of patient safety will enhance safety and improve productivity
•    establishing conceptual concepts - to enhance the ‘poverty of concepts in patient safety’
•    developing solutions – including improved design in healthcare, a recurring theme throughout the day
•    setting standards for information – before and after studies, randomised control trials etc
•    informing evidence based care
•    evaluating progress including checklists - twice as effective as education
•    nurturing researchers
•    and promoting leaders in patient safety

Professor Richard Lilford oversaw the Patient Safety Research Portfolio from its inception and this morning, he highlighted some of the successes of the programme. These included Professor Nick Barber’s discovery that nursing homes openly welcomed the prospect of his team observing medication errors and recommending improvements – their willingness could be related to the significant amount of time that care home staff spend in medication-related activities.

The day was chaired by Professor Paul Barach, one of the best Chairs that I’ve seen at a healthcare seminar/conference. He has has a very rare ability. He keeps the audience interested, even during the ‘graveyard shift’.  And he ensured that all 17 leaders in patient safety research, delivered their presentations in less than 4 hours. Now that is a rare achievement.

Citing an (unnamed) study elsewhere in the world, we heard that 9% of clinicians wash their hands before they touch a patient in the operating room and 17% do so after they touch the patient. Enter Professor Sheldon Stone summarising the successes of the Clean Your Hands campaign – and reminding us of the rationale for the campaign - 8% of patients acquire healthcare associated infections and their mortality is six times higher. Direct contact by hand is the main route of infection and Sheldon delivered this very serious message, in an entertaining way.

Chris Fuller described HHOT – the hand hygiene observation tool and Professor George Hanna told us about the checking procedures developed by his team for naso-gastric tubes. Dr Rebecca Lawton highlighted the success and lessons learned in evaluating non-luer spinal connectors.

While risk metrices represent risk and are almost universal in healthcare, Professor John Clarkson highlighted their limitations - they lack a systematic approach. And this is why he and his team are developing a toolbox for healthcare, that will include risk assessment models and tools and a process for escalating the higher risks.

Dr Karin Lowson’s insight into single hospital rooms, was topical and revealing. Patients in single rooms are more satisfied. They are less likely to acquire infection experience medication errors during their hospital stay. That said, some patient in single rooms are more likely to die and experience depression. And the risk of an adverse event and length of stay are about the same for patients in wards and in single rooms.

Much has been said about enhancing the patient safety agenda on the curricula of healthcare professionals. And recommendations as to this an be achieved, were provided by Dr Pauline Pearson and Professor Amanda Howe.

Professor Ian Watt gave an overview of how patients can ensire that clinicians deliver safe patient care – by making sure that the treatment is appropriate for them, that the treatment is as planned and in accordance with the appropriate protocol, and identifying how the health system can be made safer.

Dr Ken Catchpole shared his line of enquiry in operating theatres and elsewhere in healthcare. And he has four key questions. Is the healthcare team’s approach consistent with achieving high standards of care. Is what they are doing acceptable for Ken and his family. Does what the team are doing have to be like this. Is this the best it can be? Simple questions, revealing answers.

And Professor Mary Dixon-Woods outlined six rules for governance in operating theatres. The organisation is geared to promote patient safety. Protocols are deployed appropriately and everyone serves their spirit. Optimum communication. Minimal distraction and interruption. Effective authority and accountability. Reporting patient safety incidents.

Professor Justin Waring is in the process of summarising the outputs from the PSRP under the broad headings of the nature of patient safety, sources of risk and safety, and identifying the future direction for research.

And Martin Fletcher was the final speaker, talking about the science of safety. The NPSA Chief Executive sees the patient safety research agenda developing by networking the researchers, funding more PhD students and running another UK patient safety research conference.
Some of the many highlights for me were hearing about the science of safety, Ken Catchpole’s approach to enquiry in patient safety, how patients can be more assertive, updating the curricula, design of hospitals and non-luer spinal connectors, prospective analysis, competency based training in naso-gastric tubes and handwashing, observing hand hygiene, the benefits and weaknesses of focusing on improving culture and CHUMS.

With many thanks to Sir Liam Donaldson, Professor Lilford, the PSRP team and all of the researchers for making this fantastic conference a reality.

Posted in NHS, Safety, Patrick Keady, Public Health, Governance, Recommended, Personal Development, Health and, Patient, Legislation, Strategy | Print | No Comments »

08/12/2008 by Patrick Keady.

I received a phone call today from a Company that is undertaking research on behalf of the Department of Health. And they wanted to know what I thought of the Department’s website, www.dh.gov.uk

An interesting question. I am happy with the credibility and content of the website but my only gripe is that some information could be easier to find.

Then I was asked to suggest the sorts of changes that would entice senior people in NHS Organisations to access the website more frequently. My guess is that www.dh.gov.uk could take more of the initiative. With weekly or daily emails, podcasts, text messages and more RSS feeds.

It could include sharing buttons on its webpages so that readers have the opportunity to recommend the pages that they like best - twitter, delicious, stumble and others.

But perhaps the single biggest change that the website could make is to be the ‘click of choice’ to getting information on the NHS. I gave the example of the Annual Health Check, where some information is on www.dh.gov.uk, www.healthcarecommission.org.uk, www.npsa.nhs.uk and on the websites of PCTs and Trusts. In other words, www.dh.gov.uk could enhance the value of the information already on its site by providing links to related information on other websites.

In response to my views on the homepage, I believe that the colours are appropriate, with green meaning health and burgundy representing seniority, the Board if you like.

And in terms of layout, it could ‘borrow’ elements of the style of www.bbc.co.uk which is easy to navigate, uses more colour and changing pictures.

Overall I’m happy with www.dh.gov.uk and I’m delighted that the Department of Health has chosen to incorporate views from it’s website users, before it launches the new upgraded www.dh.gov.uk

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21/11/2008 by Patrick Keady.

While it seems obvious now, I’d never thought about equality and diversity like this before. Today I learned that equality and diversity affects all of us. Whether its because of gender, race, sexual orientation, bullying, home circumstances, nationality, disability, harassment, age, sickness absence etc.

Run by the Garnett Foundation, today’s session was all about exploring equality and diversity in relation to recruitment and selection. Using a range of interactive approaches, we practised and developed our interviewing skills. While professional actors played a number of diverse parts.

During lively interactive workshops, we explored staff retention and working cultures that foster inclusion and diversity. The training event provided a safe learning environment to highlight areas for improvement in our knowledge and understanding and also to share learning.
While I had heard a lot about the Garnett Foundation,  today’s training session met my expectations, and more.

Posted in Governance, NHS, Safety, Patrick Keady, Legislation, Patient, Strategy, Personal Development, Health and, Uncategorized | Print | No Comments »

12/11/2008 by Patrick Keady.

NHS Live has done it again! They promised lots. And then they’ve delivered so much more. Their latest outing, NHS Innovation Live, took place today at the Queen Elizabeth II Center, London.

Designed as a platform for sharing and celebrating some of the many achievements in today’s NHS, the event was hosted by Kathy Sykes, Professor of Sciences and Society at Bristol University and a Trustee of NESTA (National Endowment for Science, Technology and the Arts). Kathy has a knack for being in the right place at the right time. Not a stranger to the media, I like her balanced approach. Kathy is open to the people that she meets, while not loosing sight of the scientific rigour that she has been immersed in throughout her career.

Gill Hicks gave today’s keynote address. Gill lost both of her legs from below the knee on 7th July 2005. Gill told us about the hour or so that she was trapped in a London Underground carriage, her three cardiac arrests before she got to hospital, the make-shift stretcher used to get her there, the Paramedic who challenged discussions to pronounce Gill dead, the Consultant that told her ‘you will get better’, the nurse who got her to the hospital hairdresser just a week after the bombings, the cafeteria staff that chatted with her every morning, the physio who coached her back to her independence and the many other NHS staff that helped her through her recovery.

Interlaced with lots of humour about being Australian and some of the funnier experiences during her recovery, Gill held the mirror up to the 600 delegates at NHS Innovation Live. And what the delegates saw in the mirror, was a former NHS patient that was truly grateful for the services that the NHS provides. What they saw in the mirror was more than sufficient for many of the delegates that had travelled from near and far. And there was so much more to come.

They had many choices. Which two of the twelve breakout sessions would they attend. Did they want to learn how to release the innovator In themselves, or how social innovation can create a new model of health for men. Or maybe they wanted to know more about how Royal Bolton Hospital adopted LEAN Thinking. For the geeks, they could hear about generating and using patient stories to improve the NHS via Web 2.0 technology. Performance people could hear how an SHA is intelligently using information to the manage performance of its PCTs and Trusts. Other choices included how social and cultural background contributes to health beliefs and attitudes to mental distress, the excitement of setting up a social enterprise organization, how to nurture an idea and transform it into something really tangible and effective, exploring the role of charities and other third sector organisations in health innovation, using observation to find out what people do and how they carry out their work, improving understanding and the experience of patient and staff, and understanding mental illness from the perspective of service user.

Yet another excellent NHS Live event – well done to the NHS Live team. Why not sign up for their next event. Its free and they’re at www.nhslive.nhs.uk

Posted in Recommended, NHS, Patient, Personal Development, Strategy, Uncategorized | Print | No Comments »

11/06/2008 by Patrick Keady.

I was interviewed today. About what it was like to be an NHS manager in the 1990’s.

The interview was recorded. With just one day’s notice, preparing for the interview, was interesting. While I knew that there would be three people in the studio – interviewer, cameraman and me - I was aware that a lot more people were likely to see the video. This is when I thought …… oops, gulp, do I really want to participate in the interview! So I realised that I needed a plan. But what might it look like? Well after some thought, these are the actions that I came up with:

1. looking at the interviewer, not on the camera
2. dressing in NHS manager uniform ….. the suit
3. being aware of my posture
4. speaking more slowly than usual, so that I had more time to fully express my thoughts
5. predicting the likely questions that I might be asked
6. identifying the key messages that I wanted to get across about what it was like when I was an NHS manager in the 1990s
7. switching the mobile phone off, removing coins from my pockets and asking that the TV screen set was switched off, so that I could not see myself being interviewed
8. having examples prepared, so that my messages were personal to me
9. expecting the unexpected, flexibility would be a bonus
10. being an active participant - because the camera (and audience) would see everything - posture, energy, facial expression
11. taking a brisk walk beforehand - to get the adrenaline flowing

So did the plan work? While I haven’t seen the video, I was happy with how the interview was managed by the interviewer and cameraman. These guys clearly knew what they were doing. I will post a link on this blog, after the interview is broadcast.

Posted in Wembley, Gas Street Works, Patrick Keady, Safety, NHS, Health and, Patient, Governance, Personal Development | Print | No Comments »

22/05/2008 by Patrick Keady.

In my last contribution (18th May), I concluded that an important challenge for all NHS organisations, is to continue motivating and acknowledging the successes of their employees. But I didn’t suggest how Organisations can make this a reality.

Today I saw an excellent example of how NHS Organisations can do just that. I was one of 600 delegates at the 2008 Patient Safety Congress. An impressive contribution came from a speaker not listed on the programme, the Prime Minister, Gordon Brown.

He acknowledged that NHS staff and partners are not thanked enough for their commitment to patients. Mr Brown reminded us that NHS staff are the pride of the UK. He shared with us how the NHS cared for him , following a rugby injury, sustained at the age of 16. He told us that he was grateful for everything we do. A Consultant Anaesthetist in the audience put his hand up to his eye. The Chief Executive sitting in front of me, cleared this throat.

Mr Brown’s short visit was was unexpected. But his contribution was effective because he acknowledged the commitment of NHS staff and he shared some of his personal experiences with us. Click here to see Mr Brown’s address to the Patient Safety Congress 2008.

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18/05/2008 by Patrick Keady.

After watching the BBC2 programme Wild China, I was left wondering if there are similarities between NHS teams and the fishing team featured in the programme.

The BBC2 programme introduced men in their 70’s and 80’s. They chant and dance on rafts and are assisted by their well-trained team mates ….. a group of Cormorants. Between them, the team catches up to 30 decent-sized fish in a morning.

On Friday morning, the NHS England Chief Executive published The Year 2007/08. In his annual report, David Nicholson confirms that NHS England is on track to reduce waiting times to one sixth of what they were 10 years ago. By the end of 2008 all patients will wait less than 18 weeks from the date that they are referred by their GP, to date that they are treated.

In the opening paragraphs, the Chief Executive mentions that NHS England went through one of its most significant restructures in 2007/08. With the introduction of Modernising Medical Careers, 30,000 NHS Junior Doctors were left to compete for around 23,000 posts. About half of the pre-merger Strategic Health Authority employees have gone. Up to half of the pre-merger PCT employees are no longer there. And in the 2006/07 financial year, 1000’s of NHS Trust employees became surplus to requirements. Do we know where these people today?

NHS England successes during 2007/08 include rates of MRSA bloodstream infections in acute hospitals being reduced by 50%. All NHS patients in England are now free to choose where their elective care takes place. The median waiting time for diagnostic tests is 2.1 weeks, compared with 6.1 weeks in April 2006. All patients wait less than 4 hours in Accident and Emergency Departments.

While these are fantastic improvements, Mr Nicholson adds that more needs to be done. Lord Darzi’s plans for the next 10 years, are being published. They provide an excellent opportunity to bring about real and lasting improvements for all patients in England. The Chief Executive acknowledges that his job - and that of every leader and member of staff in the NHS - is to seize this opportunity and to make it happen.

The fishermen in Western China seize their opportunities too. But the Cormorants on the Lee River are aware. They keep a tally of the number of fish they catch, up to 7. And after that, they expect to be rewarded, or they withdraw. We know that NHS staff are keeping a tally too and that it has far exceeded 7! The reward that NHS staff often want is simply to be thanked for yet another job well done. NHS staff value job security, job satisfaction, good working conditions and appropriate training.

Many NHS organisations are responding well to the expectations of their staff. The NHS is clearly improving its services to patients. But after one of the NHS’s most significant restructures, an important challenge for all NHS organisations is to continue motivating and acknowledging the successes of their employees.

Posted in David Nicholson, NHS, Personal Development, Strategy | Print | No Comments »