Courage to put the patient first

1. Courage to put the patient first Owen Williams, CE, CHFT

2. A group of very important people who are or have been a part of CHFT

3. What we can unintentionally do to these people!

4. Why does this happen? The NHS Bermuda Triangle (Baker, Taylor, Jones, 2010)

5. Why does this happen? • We fragment the patient journey through greater emphasis on speciality, institution, regulators et al. • “We hit the target and miss the point” (Paul Jarvis, CHFT Consultant) • This means we struggle to envisage or respond differently to the following:- • A 40 something went to A&E and had a CT and MRI scan; An 80 something had 2 outpatient appointments one for neurology, one ophthalmology; A 30 something had a gastro OP; One teenager went to A&E; Another had a gastroenterology and Dermatology procedure; and a child was seen by community integrated services.

6. Why does this happen? • Limited understanding and prioritisation of the door to door patient journey and seeing this journey as a system opportunity. • “A system must be managed. It will not manage itself…components become selfish, competitive, independent profit centres, and thus destroy the system” – (Deeming, The New Economics, 1994). • “If we always focus on exceptions – when something goes wrong – we will never focus on the rule” – (Baker et al, Making Hospitals Work, 2009). • “Your hidden rules are thoughts that are so familiar you have stopped noticing them” – (Corbet and Roberts, From Know How to Do How, 2013). • “More than four out of five nurses have concerns about dangerous shortcuts, incompetence, or disrespect” – (Maxfield et al, The Silent Treatment, 2010).

7. CHFT Journey

8. Patient Led Productive Patient Time?

9. Patient Led Aim to make this journey time as caring and productive for patients by managing the whole journey and not just its parts. Prevention Diagnosis End of Life Start of Life Rehabilitation Treatment

10. Time to get back in focus what really matters

11. Thank you for listening