In his ground-breaking publication on patient safety (A Promise to Learn, A Commitment to Act, 2013), Dr Don Berwick laid down a radical challenge:
“The most important single change in the NHS… would be for it to become, more than ever before, a system devoted to continual learning and improvement of patient care, top to bottom and end to end.”
This is not simply a challenge to how we use improvement and safety processes to drive change. It goes far wider. It calls on us all to examine our culture, our behaviours and ‘how we do business’ in the NHS.
Continual learning and improvement of patient care requires us to reassess how the NHS builds relationships with people and communities. In 2018, I had the opportunity to support the co-design and facilitation of the Empowering People and Communities Taskforce. Chaired by Lord Victor Adebowale with close involvement from Michelle Mitchell, the Taskforce was a 12 month time-limited body, reporting directly to the NHS England Board. Its founding purpose was to renew and grow inclusive partnerships between NHS England and patients (experts by experience), representatives and our voluntary and community sector partners.
The Taskforce realised this aim by:
- Convening a series of workshops on priority themes relating to the Five Year Forward View (all of which have since emerged as key themes in the NHS Long Term Plan).
- Driving diverse and inclusive engagement in the conversations online, through a series of Tweet-chats, social media discussions and blogging opportunities.
- Involving more than 200 people in face-to-face discussions, followed by opportunities to refine draft recommendations that were then made to the NHS England Board.
Dr Neil Churchill, whose team oversaw the work and commissioned NHS Horizons’ involvement, recently described the specific impact of the Taskforce on healthcare policy, use of language in reports to NHS England’s Board, and more widely. In his blog, Neil wrote:
“The Taskforce has given us invaluable insight about what’s working in our national programmes of work and what we need to do better.”
This point is central. The Taskforce was as much about continual learning for all of us involved as it was about securing commitments to action from the Board. While far from perfect (no engagement initiative is!), we evolved the Taskforce with participants over the 12 months so that each discussion maintained a focus on people most in need of support, with citizens who are marginalised and often overlooked in conversations.
The workshops and tweet chats enabled us to co-produce, with participants, practical and actionable recommendations for the NHS England Board (for instance, on how to progress co-production in NHS commissioning). And the Taskforce’s cumulative recommendations provided a vital commentary and context for the proposed changes to the NHS that are now described in the Long Term Plan.
That work continues with the new NHS Assembly. The Assembly will be formed of around fifty individuals, drawn from national and frontline clinical leaders, patient leaders, staff representatives, health and care system leaders and voluntary, community and social enterprise sector leaders, who will bring their experience, knowledge and links to wider networks to inform discussion and debate on the NHS’ work and priorities.
NHS England is now seeking expressions of interest from people who would like to become members of the NHS Assembly. The closing date is 6th March 2019.
My hope is that many of those who participated in the Taskforce will carry that work forward into the Assembly. The NHS needs their experience and insights so that we can all continue to learn and improve. Only then will we stand a chance of meeting Dr Berwick's compelling vision of a health and care system devoted to continual learning and improvement of patient care, top to bottom and end to end.
To learn more about NHS Horizons’ work on the Taskforce, please click here.
To find out about the new NHS Assembly, and to express an interest in becoming a member, please click here.
Dr Neil Churchill’s blog, which describes the impact of the Taskforce to date, is available here.