National recognition for frontline staff initiatives

NHS Providers has today launched a major new programme of work, Providers deliver, to celebrate and promote the work of NHS trusts and foundation trusts in improving care. Their first report recognises trusts, including Chelsea and Westminster Hospital NHS Foundation Trust, for responding to feedback from the Care Quality Commission (CQC) in a positive and systematic way, encouraging great ideas from staff that have made a real difference to patients and service users.

“We are delighted to have been recognised by NHS Providers, particularly for our commitment to supporting staff-led improvements, and innovation that transforms patient care and patient experience,” says Pippa Nightingale, Chief Nursing Officer, who is featured in the report.

Lesley Watts, Chief Executive, explains: “We are proud of our proactive and open environment, which encourages staff to develop their own ideas and bring them to fruition. We have been developing a pipeline of ‘test and scale’ innovation projects in partnership with our charity CW+ and were excited to officially launch to our CW Innovation programme last month. CW Innovation, which connects the frontline clinical and operational staff with a dedicated innovation manager, aims to build on our proven track record designing and implementing new ideas, technologies, systems and services to make a real and lasting difference to patient care in our Trust and across the NHS.”

CW Innovation includes a pipeline of over 70 ‘test and scale’ innovation projects that have the potential to be rolled out across the NHS stakeholder network. Examples include the mouth care project that features in the NHS Providers new report, the UK’s largest study of wearable monitoring technology, the UK’s first cancer clinic of its kind fast-tracking patients with clinical suspicions of cancer, and the Mum & Baby app that’s now being rolled out across other national NHS maternity centres including the Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System (BOB ICS), as announced earlier this week.

The featured mouth care project was the 2017 winner of CW+’s annual Dragons’ Den style competition, which awards grant funding to innovative staff ideas to improve patient experience. Later today the Trust and CW+ will be announcing the winners of this year’s competition. Stay tuned!

Mouth care: Staff-led clinical practice innovation

For Angela Chick, ward manager, and Ahlam Wynne, specialist nurse, having support from the Trust and funding from CW+ was key to an innovation that has reduced the incidence of pneumonia for people with swallowing difficulties by 67% in 2018, compared to the same period in 2017.

The pair entered the Trust’s Dragons’ Den competition with their idea to improve mouth care initially on their ward which treated a lot of people who’d had a stroke and found it hard to swallow. They knew that the bacteria in a patient’s mouth can, if swallowed, lead to infection in the lungs and, ultimately, pneumonia and even death.

After winning the internal call for innovative ideas to improve care, the nurses set about making changes on the stroke ward. All patients coming on to the ward were assessed, rated low, medium or high risk of mouth infection, and treated accordingly. The nurses worked with the manufacturer of the suction device to design a kit which could hang on the patient’s bed. Because the kit was highly visible and acted as a prompt, nurse compliance increased from 20% to 82% by the end of the three-month pilot.

Compared to the same period in 2017 (Jun–Sep), antibiotic use fell from £5,671 to £1,181 in 2018—a 79% financial saving. The number of cases of hospital-acquired pneumonia (HAP) fell from 30 to 10. And the number of HAP-related deaths fell from 8 to 2.

The nurses have subsequently spread their approach Trustwide. Now staff assess all incoming patients’ mouth care, and the kits are in use for patients who need them.