Scottish Patient Safety Programme (SPSP)

NHS Lothian, as per NHS Lothian’s Quality Strategy (2018 – 2023), uses a Quality Management approach in all aspects of the work including Safety, which is one of the six dimensions of quality (safe, effective, patient-centred, timely, effective, and equitable care). Patient safety is integrated into pathways, improvements, and networks as part of NHS Lothian’s Quality Strategy 2018-2023. The content of the Scottish Patient Safety Programme (SPSP) is part of this in Lothian.

SPSP is a national quality improvement programme that aims to improve the safety and reliability of care and reduce harm. 

Since the launch of SPSP in 2008, the programme has expanded to support improvements in safety across a wide range of care settings including Acute and Primary Care, Mental Health, Maternity, Neonatal, and Paediatric services

Underpinned by the robust application of quality improvement methodology SPSP has been supported in NHS Lothian since its launch.

It includes:

·       The Essentials of Safe Care

·       The SPSP Programmes of Work

·       Executive Leadership WalkRounds™

The Essentials of Safe Care

As stated by SPSP the Essentials of Safe Care "is a practical package of evidence-based guidance and support that enables Scotland's health and social care system to deliver safe care". This means, "Creating the conditions for safe care for every person, within every setting, every time".

NHS Lothian supports this in all work streams.

Person centred care - Person centred systems and behaviours are embedded and support safety for everyone
Safe communications - Safe communications within and between teams
Safe clinical and care processes - Safe consistent clinical and care processes across health and social care settings
Leadership and culture - Leadership to promote a culture of safety at all levels

For more information, please see NHS Lothian’s intranet page and the SPSP internet

The SPSP Programmes of Work

Deteriorating Patients Programme

This programme is supported by Lothian’s Quality Directorate (Lothian.Quality@nhslothian.scot.nhs.uk or via the intranet contacts page) and directed by the Deteriorating Patient Programme Board. This board reports to our Acute Clinical management Group and on to the Healthcare Governance Committee.

There is a range of mechanisms to triangulate information related to deteriorating patients. These are:

  1. Pareto charts of Cardiac Arrests and Medical Emergencies

  2. External validation data (Quality Directorate)

  3. Ward-based self-audit on MEG (Lothian Accreditation and Care Assurance Standards)

  4. Structured Review of Deterioration (Resuscitation Officer and Quality Directorate supported by the Clinical team)

  5. Significant Adverse Events reviews

  6. Morbidity and Mortality Reviews

  7. Data from local specific quality improvement projects

Improvement projects use the learning and themes to inform change.

Measures include information on reliable:

  • Anticipation (and Treatment Escalation Planning)

  • Recognition

  • Escalation

  • Response

  • Review

  • Communication

NHS Lothian contributes to SPSP’s national programme, Driver Diagram and Change Package.

Falls Programme

The Lothian’s Nursing Quality Improvement and Standards infrastructure, working with multi-professional teams, support this programme.

It is included in the Lothian Accreditation and Care Assurance Standards team, programme management and strategic documents.

Further information is available on the intranet and SPSP’s internet page for the Driver Diagram and Change Package.

SPSP Perinatal and SPSP Paediatrics

Both these programmes are under development by Healthcare Improvement Scotland, for maternity, neonatal and paediatric services. They are due to launch in autumn 2023 for Boards.

Executive Leadership WalkRounds™

The Executive Leadership WalkRounds™ process is one of the activities within the SPSP and is central to creating a patient safety culture. They originated in the Institute for Healthcare Improvement (IHI) and have been adopted and amended for use in NHS Lothian.

Why are WalkRounds™ important?

NHS Lothian has been participating in an extensive programme of clinical visits by our Executive team since 2008, up to March 2020. These WalkRounds™ re-started in summer 2022. WalkRounds™ are a way to connect Executive and Non-Executive leaders with staff in the clinical areas to talk about their ideas and issues about safety. The aim of the WalkRounds™ is to:

  • increase awareness of patient safety issues in order to reduce risk

  • to help support the clinical staff with their daily work

  • create a culture of safety and develop ways to make patient safety a priority

  • educate staff about patient safety

  • allow NHS Lothian to obtain & act on information from staff about patient safety problems and issues

Feedback from clinical staff and the executive team is consistently positive: they are highly valued; excellent, useful, comprehensive conversations; and actions taken by the executive team are reliably completed to benefit patient and staff safety.

 
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