On the 5th March I attended the Society for Academics in Primary Care (SAPC) regional conference to present my work on “non-clinical patient needs: mapping diversity in primary care” a parallel session. Dr Alf Collins, Consultant in Pain Medicine at Taunton and Somerset NHS Foundation Trust, and Professor Nigel Mathers were the keynote speakers in attendance. Their talks focused on patient-centred care and, in particular, its influence in the management of long term clinical conditions. Dr Collins talked about the three principles deemed necessary for the personalisation of care: coordination of care, the engagement of patients in decision-making and thirdly, the supported self-management of care for individuals. He described how a fine balance of all three is something that the UK health system is already working towards but that it requires cultural changes within the system for it to work effectively. Following on from this, Prof. Mathers elaborated on the components needed for true patient ‘activation’; the combination of knowledge, skills and confidence which will allow patients to actively and safely manage their health.
Poster viewing sessions were scheduled throughout the day and I found one particular study’s poster quite relevant to the work that I have been doing over the past six months. It was on the feasibility and acceptability of Clinical Commissioning in general practice, drawing on evidence from interviews with GP’s, some of whom were saying that it was not their place to do so and that they had entered into the profession to help to care for people, not to ‘population-manage’ or budget for services. This was of particular interest to me as it provided a possible explanation as to why some of the practitioners I had interviewed responded apathetically to mapping out their population’s needs even though after recognising the benefits of such mapping for their patient population (i.e. informing commissioning decisions with cost implications)
Being the first presentation that I have delivered in front of an audience of health care professionals with academic interests, the planning was slightly more challenging than usual! But having the chance to run-through the presentation beforehand and to receive feedback from the SAPPHIRE group helped me to make the final adjustments. On the day it was well-received and I think it has given me the confidence to do something similar on an even bigger stage!
I attended a seminar today by Prof.Mary Dixon-Woods entitled “What do we know about how to improve quality and safety in hospitals, and what do we still need to learn?”Prof. Dixon-Woods talked about ways of avoiding preventable minor disasters resulting in fatalities within hospitals. One suggestion was the standardisation of hospital medical equipment was suggested to minimise errors in their usage. It all came down to the triage between intelligence (the investigation into the quality and safety, and the ways to improve the two), hospital systems and the culture and behaviour within hospital care. I think that changing the culture and behaviour within a healthcare environment is the foundation for any improvement in the quality and safety of care. Intelligence alone isn’t helpful if the attitude to implement positive change is lacking among staff on different levels. But it is difficult and definitely something that will not happen over a short time-span. There’s a piece by Prof. Dixon-Woods and others further discussing the topic called “Overcoming challenges to improving quality” and I’ve linked to the summarised version from the Health Foundation.
On Friday 28th September, I attended a presentation on the Scottish Sepsis VTE Collaborative – a national quality improvement programme led by Healthcare Improvement Scotland. The presentation was delivered by Kevin Rooney, a professor and clinician from Scotland.
Sepsis and VTE have been seen as illnesses associated with the elderly, but this presentation highlighted that this simply wasn’t always the case. Many people have been misdiagnosed with other conditions due to a combination of the lack of awareness of the widespread nature of the illness, and the absence of a systematic, diagnostic Sepsis checklist on a more clinical level. Kevin Rooney has worked to develop a checklist and has implimented it to a great level of success judging by his initial results.
The presentation was very informative as I was previously unaware of very high mortality rates from the contraction of Sepsis. It was brilliant to see how Kevin Rooney has proactively led the implimentation of changes in procedures to reduce the lives lost within the hospital he is working at. There plans to continue spreading information, raising awareness, and positively impacting other hospitals, first in Scotland and hopefully across the UK too. I thought it was great example of how an individual’s passion for better healthcare can save lives.