After two years of connecting remotely, the International Forum on Quality and Safety in Healthcare took place in person in Sydney in July. Our Medical Director, Dr Darren Kilroy gives his reflections on the event where he presented his session on ‘Rethinking Governance, Risk and Compliance in the context workforce pressures and the care backlog’.
Dr Darren Kilroy, Medical Director (International), RLDatix writes:
Beyond vision or aspiration
The conference theme for this year’s much-anticipated International Forum promised excitement and challenge in equal measure: “New Horizons – Quality Improvement shaping the Future” went, for me, beyond vision or aspiration. Here was a statement of intent and of purpose as we face the reality of improving healthcare in the post-pandemic world. It was therefore particularly rewarding for us to participate in the event and to encourage dialogue and debate on that most central element of moving toward that horizon, the provision of a skilled and effective workforce with which to tackle what is there to be done, and the most effective governance arrangements to inform that provision now and in the future.
We know that safe and effective patient care demands a safe and effective workforce and we also know that the training, deployment, welfare and support of staff is fundamental to everything else. What remains, however, our biggest challenge is the recruitment of people into the roles that are so desperately needed. To bring a global and evidence-based perspective to the scale of the issue, we were delighted to be joined for our conference session by Dr. Mark Britnell. Mark has a long association with RLDatix, having himself spent many years in executive roles within the NHS before going on to work worldwide with KPMG in the pursuit of knowledge and the provision of leadership, relating to the thorniest problems facing health and care today.
Quality is in retreat and now is the time to march towards it
It came as no surprise, therefore, to see so many delegates joining us for what proved to be a hugely entertaining, informative and inspirational afternoon in the company of professional colleagues from Australia, New Zealand, the Pacific and beyond. Little time was wasted in a broad agreement that workforce challenges posed the biggest threat to quality care. In fact, Mark was able to give us early news of a forthcoming and wide-ranging report, “Quality in Retreat”, that sets out in no uncertain terms what the impact of the workforce challenge truly is for real-terms quality care. And that impact is staggering. A comprehensive re-imagining of healthcare provision as a wealth-creator, not a wealth-detractor, at governmental level is required. The investments in recruitment and training of staff in sufficient numbers to actually provide the care we know is needed should be approached as positives for the prosperity of a nation, not a drain on resources. A paradigm shift of some proportion, and one that has historically seemed almost too big a hill to climb.
Actioning learnings from the COVID-19 pandemic
This got to the essence of the session. We saw changes and improvements happen at an extraordinary scale and pace during the depths of the pandemic. How can we harness the opportunity to create more agile systems that combine rapid evidence-generation with clinician expertise, and apply these to the issue that eclipses all others in patient care, that of workforce?
Given the opening context of Mark’s work, we were then able to draw upon real examples of rapid and radical changes to governance, risk and assurance that had been made during the pandemic and use these as emergent evidence that it is indeed possible to take action right now. We discussed how it is possible to re-deploy an entire clinical workforce based on a skills matrix and supported by comprehensive engagement, and task them with the provision of care in a very different yet very rewarding way. We learnt how this was supported by patient-level evidence of an actual improvement in key quality metrics; moreover we saw that the governance processes wrapping around this new way of working were a light-touch yet absolutely able to satisfy the assurance and regulatory requirements of a Board.
From there, Mark brought us back round to the opening hypothesis – the global workforce crisis is well rehearsed; the impact on quality patient care less so, but now laid out starkly in new evidence. Through our closing questions and answers, we were able to explore the implications of this in our various roles and agree on some of the key take-away messages that will inform all that we do this year and beyond. We must act assertively and harness our years of clinical experience to advocate for real change based on our lived experiences in the pandemic; we must seek out ways to reduce the burdens of assurance bureaucracy by emphasising the benefits of professionally-rooted reassurance and narrative; we must not allow the old ways to re-emerge as we try to hold fast to the new ways. But most of all, we must work collectively and supportively if we are to really make a difference and realise this new horizon: making care safer, together.
Have your say
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Thanks to everyone who came to our session, it was great to see such a busy room with an honest and stimulating dialogue across the floor. Now truly is the time to be brave, to act and to cut through bureaucracy in the pursuit of a sustainably safe health & care model worldwide. https://t.co/Ln8KszCvbc— Darren Kilroy (@DrDKilroy) July 25, 2022
About the Author
Dr Darren Kilroy
Medical Director, International, RLDatix Australia
Dr Darren Kilroy: @DrDKilroy
Darren trained in emergency medicine in the north west of England as well as Australia and, following an initial subspecialty interest in medical education, worked in several leadership roles in Greater Manchester alongside his consultant post.
He holds a Masters in Healthcare Business Administration from Keele Business School and his PhD thesis examined the sociological aspects of medical training in the UK. He also sits on NHS Employers’ Medical Workforce Forum and advises NHS Improvement in relation to bank and agency pay in healthcare.
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