Meeting with Simon Hamilton MLA

On Wednesday morning I met with Simon Hamilton MLA, the Assembly Private Secretary to the Minister of Finance and Personnel who is set to succeed Sammy Wilson MLA in the role in 2013.

This meeting came about through my involvement in healthcare social media.  Simon and I crossed tweets when I was live tweeting at NICON 2013 and he was tweeting from an accountancy conference.  We were both tweeting about innovation and I told him the Minister for Health, Edwin Poots had just given his support for risk taking and innovation in healthcare.  We exchanged tweets and emails and a meeting was set up.

It was interesting going for a meeting with a politician in parliament Buildings at Stormont.  I’ve been in the building a couple of times before and I’ve even had a tour, but it was a different experience being there during business hours.  The first thing that struck me was how busy it was with people coming and going, meeting MLAs and Ministers.  It shouldn’t have been a surprise when I think about it, but it was interesting to observe first-hand.

View from Parliament Buildings this morning.

It turns out Simon and I live not too far from each other and he knows the town where I live well so we had a chat about people and places we have in common before we got down to business.  We discussed how innovation could be funded within the public sector given the requirement for scrutiny and governance when public money is involved.  We also talked about leadership in the health service, the TYC change agenda, the recent announcement of new health centres in Newry and Lisburn, and how we can engender a culture of enterprise, innovation and entrepreneurialism in the health service and wider public sector.  It was a frank and useful conversation.  Simon came across as intelligent and knowledgeable and was open to challenge and suggestions.  I was encouraged to see that he is driven by the desire to make Northern Ireland a better place for everyone, because I believe this is a very good country that can be great.

Simon gave a great TEDx talk at Stormont which you can check out here


Briefing from Robert Francis QC

On Wednesday afternoon I attended a briefing with Robert Francis QC at the Templeton Hotel in Templepatrick.  It was a privilege to hear him speak in person.  The first thing that struck me was how he seemed deeply personally affected by the evidence he had heard.  The patient and relative stories he shared were truly horrifying.

Robert Francis QC takes to the podium #niconfrancis

I haven’t had time to Storify tweets from the event but some key messages were:

  • Florence Nightingale wrote 150 years ago that the first principle of hospitals is they should do no harm – this is still a fundamental principle
  • We need to listen to those who complain more than those with good things to say
  • The CEOs office was at the farthest possible location from the front door and where the business of healthcare was being carried out and was symbolic of the disconnection of those running the hospital from what was happening on ‘the shop floor’
  • There were plenty of early warning signs at Mid Staff that warranted closer investigation
  • There seemed to be a learned helplessness amongst clinical staff – they said they were trying their best but ‘make do and mend’ was the Stafford way
  • We don’t need to wait for government policies and guidelines to learn lessons form the inquiry report and change our practice – we can see clearly what went wrong and we should use these lessons to change practice immediately, both as organisations and as individuals
  • Trainees are the eyes and ears of the hospital and agents for safety, quality & learning.
  • The word complaint is adversarial and not helpful. We want feedback, even when its bad.
  • Targets can have unintended consequences – give a manager a target and that’s what he’ll achieve – hitting the target but missing the point

Following Robert Francis, Hugh McCaughey (@HughMcCaughey), Chief Executive of South Eastern HSC Trust (@setrust) gave an excellent talk about the NI Quality and Safety journey with some candid details from his own Trust.  His ‘Great Conundrum’ slide (below) was particularly poignant.

The Great Conundrum - great slide from @HughMcCaughey @setrust #niconfrancis


Regional Hospital at Night Meeting

On Thursday afternoon I attended the Regional Hospital at Night meeting.  This is an excellent example of teamwork and collaboration.  All of the clinical leads and clinical nurse co=-ordinators form the 5 acute Trusts have set up this quarterly meeting where they can come together to share challenges, solutions, and innovations.  They have a strong patient-centred and quality improvement ethos and its a privilege to be invited along to feed into their meetings.  Their current focus is the RQIA Review of Hospitals at Nights and Weekends which is due for publication soon, and they are already discussing how they can respond to and implement the anticipated recommendations.


Communication and Engagement

On Friday afternoon I met with Emma Holden, Assistant Director, TYC.  We discussed the ongoing communication and engagement required to ensure patients, staff and the public are informed about the change agenda.  They have put a huge amount of effort into this so far and much more will be required as the change proceeds.  It is very complex, but it’s good to see the intellect, energy and enthusiasm behind the scenes.


Medical and Clinical Leadership

Later on Friday afternoon I met with Christine McGowan, Principal Consultant, and Katrina McMahon, Business Manager at the HSC Leadership Centre.

Christine is leading on the medical leadership programme for the leadership centre and so we know many of the same people.  We discussed what is required to grow medical leadership capacity in the HSC and how to engage doctors in leadership and change.  I suggested that form may not follow function and many of the best leaders are not in leadership positions.  Many of them may not even want traditional medical leadership positions.  Perhaps a change is required to empower these de facto leaders and harness the energy and enthusiasm they offer.

We also discussed the Leadership Centre’s involvement in this year’s NI Medical Leadership Symposium.  They plan to provide a workshop on lean, tailored for doctors, and we discussed how best to deliver this.