Going back to school at Gloucestershire Hospitals NHS Foundation Trust

Source: NHE March/April 2019

Steve Hams, director of quality and chief nurse at Gloucestershire Hospitals NHS Foundation Trust (GHFT), demonstrates how cultural change has improved care for patients.

Staff have gone back to school as part of a ‘social movement’ at GHFT which is delivering better care for patients.

The trust, which runs Gloucestershire Royal and Cheltenham General Hospitals, is reaping the benefits of launching its quality academy in 2015.

The Gloucestershire Safety & Quality Improvement Academy has developed a continual improvement-aware workforce with the knowledge, skills, and confidence to continually strive for safety and quality improvement and excellence in both clinical and support services.

Through an in-house programme to build capability and capacity for continual improvement, staff can participate in bronze, silver, or gold programmes. The participants learn through practise the knowledge, skills, opportunity, and support to contribute to improved safety and experience of our patients and staff, and make real improvements to the way care and services are provided in the hospitals.

Now the Care Quality Commission (CQC) has recognised the work as “outstanding” practice and referred to it a “social movement” in its recent inspection. The trust was rated as ‘good’ overall by inspectors in February 2019. The inspection showed that 90.5% of services are now rated ‘good’ or ‘outstanding’ compared to 72.5% at the last inspection, reflecting the continuing positive trend of improvements in care. No services were rated as inadequate.

Andrew Seaton, quality improvement and safety director, said: “The academy aims to embed a culture of continual quality improvement within our trust, where staff at all levels have the confidence to highlight areas for improvement and then have the skills, knowledge, and support to be able to implement improvements.

“It is incredibly uplifting to see staff grow as individuals through the learning they do at the academy. In most cases, the students know the solutions but just don’t have the headspace or the confidence to feel that they can act. Through the work we teach them they not only make changes that make a difference to people’s lives, but they also monitor these changes, evaluate them, and make further improvements as necessary.” 

To date, nearly 2,000 staff – almost 30% of the workforce – have been trained or are actively in training at the academy. In its report, the CQC assessed the quality academy as being ‘outstanding’ and that staff regarded it highly, often referring to it as a “social movement.”

The report said: “Staff recognised that quality of care for patients had improved because of quality improvement projects.

“The academy empowers frontline staff and gives them the tools to support a change and implement quality improvements.”

The range of projects undertaken through the academy are wide and varied and include clinical as well as non-clinical.

An example of a QI project

During the 2016-17 flu season, our trust saw a large percentage of positive flu results from patients who had been in the trust for five days or more and who had not been admitted with flu. These were deemed hospital-acquired flu. In addition, it was noted that several bed days had been lost during this season directly as a result of flu outbreaks and hospital acquisitions.

  • Aim: The aim was to reduce the percentage of hospital acquired flu cases by 50% and to reduce the bed days lost as a direct result of flu to 50% as well.
  • Results: 192 patients did not acquire flu (a reduction of over 50% of total flu positives compared with the preceding year) that would have done with the previous year’s approach and a reduction in bed days lost to flu of over 90%.
  • Implications: The benefits of rapid testing for flu for patients were clearly demonstrated. Going forward there is a strong desire to expand upon the service offered last year and have cross site machines.


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