1. Leadership workshop 29th September 2009
My job has been to try and ensure that the resources are available to you on good practice and learning; to collect, support and try to reflect back to you the progress that we are making.
Some of you have been centrally involved in the Campaign since before it was launched; others have come to it very recently.
In preparation for today, I put together a brief overview of the latest position on the content area from my perspective. I hope you got an electronic version of this in advance, but you also have a copy of it in your delegate pack.
This paper could have been a lot longer, but I realised that if I did, no-one would have time to read it, so I kept it brief. That means that a lot has been omitted – there are links in the paper to other resources (and copies of supplementary info)
Over the next 50 minutes I hope we can take a quick tour together over the interventions within the content area to share learning before you break into your organisational teams to consider progress and planning in more detail.

2. Driver diagram
You will see on the first page of the leadership report a driver diagram of the leadership content area. Driver diagrams have been used a lot in the Campaign to unpack high level aims into action-based do-able interventions. These interventions which need to be taken forward in parallel to achieve the aim.
In order to give some sense of structure, I am going to use the headings of these interventions, but as we go through; and certainly as you discuss together in the breakout sessions, we will be continually uncovering connections, and recognising these as part of the whole.

3. Establish Executive accountability
Establishing an executive lead role for each content area in the Campaign is a task that dates right back to Learning Set 0.
By the time the Campaign was launched, all participating organisations reported that they had got Exec leads in place.
It was only after a few months that we realised how much variation there was in how that had been interpreted - based on local circumstances, resources, individual commitment – you can see this is the review report done by the CGSDU.
One of the challenges I had to wrestle with was to find examples of how it should it look when we get it right.
[Video Clip from Critical care].
Points from video: excellent clinical leadership – but the exec lead adds something practical and meaningful – more than being a figurehead.
(Ask Mark to comment).
(Ask Debbie to comment).
(Ask Caroline to comment).
So we need to think about the support given by engagement with the front line, but also support and challenge through more formal review of progress. We knew this was an area of potential problems, so we adapted the IHI tool, and made it available to see if it would help.
People need to test it.
EMBEDDING THESE PRACTICES WITHIN THE ORGANISATION

4. Number of WalkRounds undertaken
WalkRounds great success.
How many have been on a WalkRound?
Resources available: Testing new environments.
[Care home video]
(Geoff to comment re pharmacy and optometry)
Joint WalkRounds
[Shona Video]
Non-Executive and Non-Officer members
[Philip video]
How you are you going to embed this practice – What part could it play in induction? Board learning and development

5. Addressing culture
Campaign aim – to help you to bring culture issues to the surface, the subconscious assumptions that underpin culture patterns. 2 survey tools.
GP culture. Success – first. Probably a global first.

6. GP survey practice participation rates
>3000 staff. 65% response rate.
Only 20 orgs as Powys – did a paper version. RCT/ Merthyr worked together.
Lot of discussion about how to engage practices and the issue of LES payments. 7 LHB’s achieved .90% participation , 5 of those didn’t link to LES.
(Brendan to comment)

7. Specific issues highlighted in GP survey (feedback from Cardiff)
The risks of leaving notes to communicate with colleagues
Need to adjust rotas to cover periods of greater risk
Staff appraisals overdue
Reluctance to report concerns regarding locum staff
Lack of risk assessment training for staff
Lack of meetings involving all staff
Differing perceptions between different staff groups
Because of the way we set up the survey nationally – guaranteeing that practice level results would not be shared, the feedback that we have centrally about what specific issues came up is limited.
However, I’m grateful to Cardiff LHB for sharing this feedback on issues raised.
Specific safety issues, and wider observationss

8. Feedback on the survey process (Cardiff)
It was a useful tool that highlighted things about the Practice that they did not previously know.
The report was useful for in-house teaching sessions (e.g. on incident reporting).
There was a real value in including ALL staff in the process.
Would like to do the survey again.
Adapted for Dentists, pharmacies and care homes.
One part of bigger endeavour – potential for using other tools, esp MaPSaf.
Adam Southan to comment re building a picture across communities.
Potential for Directors of primary and community care to use the survey as a baseline – as it included questions about engagement with LHB’s.

9. LHB and Trust staff survey
Learning and innovation
Communication and reporting
Senior staff engagement and support
Team working and individual performance
Individual perception of safety culture
Slightly different orientation
Take in issues of staff perception of senior staff/Exec engagement, and also issues relevant to how well the culture is suited to implement the Model for Improvement.
Not all organisations used the tool: ABM had done recent survey; North Wales opted to continue with the SPI tool.
Mike Spencer to comment
Rob Williams to comment

10. Use patient stories
Enthusiasm round this. This isn’t the soft end of the Campaign intervention.
Use IHI primer.
Linking the ‘big dots’.
[Victoria Winckler video]

11. System level measures
There are 2: Harm as measured by GTT (I think someone from each org was in the GTT session this morning, so you can brief eachother)
HSMR’s – we know they will be part of the national performance dashboards. You need to think how they will be integrated with your local dashboards.

12. Orientate Board agendas
This is about more the place of the patient safety item on the Board agenda. It is about the priority of patient safety at an organisation-wide level, and the systems in place to assure the Board.
Our thinking on this has moved on over the last year, and we recognise this as being as much about how your quality and safety committee works as it is about the Board as a whole.
A number of organisations have tested the committee review tool developed by the CGSDU. That tool is now being refined and will be a part of the new governance guidance which is being developed.
You have a copy in your supplementary information.