The Loop

Co-designing maternity investigations systems using a Human Factors approach - a Staffordshire University led project.

CEO: Jon Wilks, Chairman: Roy Lilley, Strategic Advisor: Shane Tickell, Director of Social Care: Susan Jones, Membership Manager: Emma Caton, Operations Manager: Jade Maloney, Social Media Administrator: Rachel Jury, Operations Administrator: Charlotte Joseph, Digital Content Consultant: Luke Farmer

Giving undertakings at press and party conferences is one thing; delivering on them quite another when the difficulties are so profound. Waitlists will dominate his intray, and further down will be the mess that is primary care (we will shortly publish our report on the future of the sector), how the regulatory framework will be adjusted and how the workforce plan will be afforded and delivered. And, all the while, the parliamentary clock ticks down, the junior doctors industrial action persists, social care deteriorates, and the public frustration grows. It is not a job for a feint heart, and I wish him well. As I do for his counterparts in the other devolved nations.

It’s tempting to focus this new Loop editorial on the macro landscape of health and social care but I’m not going to. Most of you reading this have little or no control over what Wes Streeting, Eluned Morgan, Neil Gray or Mike Nesbitt will do next, and you are more likely to be focused on the issue in front of you right now. Furthermore, that is absolutely the right thing for you to be doing – the NHS and social care is a whole system whereby every element, big or small, makes some form of contribution and the daily running of that system needs every bit to run smoothly. In other words, you and your team matter, irrespective of your function, from catering to finance.

The tricky times persist. Wes MP, the new Secretary of State & Social Care in England, inherits challenging landscape that demonstrably improve if his are to go into the next election degree of voter approval.

In the whole system, the contribution of every individual and team must be understood and valued. Consider your current modern car. It will contain between 70 and 100 electronic control units constantly monitoring every aspect of the car’s engine management, braking, air conditioning and more. The average modern car requires over 100 million lines of computer code in order to start, pull away, stop and keep you safe whilst doing so. And if one of those develops a problem then, at the very least, you’ll get one of those annoying lights, or a call to the AA will be required. Years ago, if your car developed a fault it would be taken into the garage where a mechanic would put it on the hoist and physically inspect it with a torch to find the issue in need of repair. Today, they will hook the engine management console up to a diagnostic software system and tell you what’s gone wrong –sometimes from a different country!

Wes Streeting State for Health inherits a very that he must his Labour party election with any

I guess what I am saying is, don’t worry about the big stuff – that will take care of itself. Concern yourself with the here and now of you and your team’s core function. Provide nurture, support, and encouragement to make sure that your light doesn’t appear on the dashboard or in the diagnostic software. You’ll be all the more successful in achieving that if you and your team have a clear vision of what you are trying to achieve and concentrate on helping each other to achieve that, consistently, day after day. Might I suggest that the political powers that be adopt a similar approach?

Have a great Summer and thank you for the brilliant work you are all doing.

Chief Executive

Effective Leadership in Healthcare

The success of the organisation is related to a wide range of factors, including mission and strategy, culture, systems and processes and there is a necessity for all these areas to be addressed in leadership as the most influential factor shaping organisational culture.

Dr Wioletta Domanska-Zielinska, FHEA, Arden University,

The aims and objectives of organisation cannot be transpired without effective leadership, and the fundamental need for its development. This helps to clarify the specific skill set a leader requires to possess to meet the challenges of this influential role. One of the key challenges in the healthcare sector is to nurture cultures, that ensure the delivery of continuously improving high-quality, safe, and compassionate health care.

The development of leadership behaviours, strategies, and qualities is fundamental. Developing suitable candidates with the desirable skills and values has been recognised as the primary course of action to ensure the sustainability in delivering healthcare services, and the effective leaders are needed at every level and in every area to ensure the delivery of the highquality compassionate care.

Effective leadership constitutes of many attributes, skills, and the ability to assess individual competencies, selfawareness, and attitudes as part of the organisational transition process. Leadership skills are essential to work in a dynamic healthcare environment, where populations are exposed to threats from communicable and non-

communicable diseases and experiencing diverse healthcare issues. Meeting their needs by an overstretched public health system and the rising costs of providing healthcare, the numerical shortage and poor distribution of healthcare providers often become unmanageable.

Thus, constant changes in the business environment and leadership development have become an important part of the vision and mission of any organisation, since leadership is influencing the quality of care.

It is not only the matter of appointing an excellent, high performing leader, who is able to inspire others, but as organisations grow, often their values and ethical principles become subsidiary, thus value-based leadership could be a panacea to rescue healthcare. Leaders following this approach emphasise principles such as integrity, empathy, transparency, and social responsibility to guide behaviours and interactions.

Their goal is to create a much needed in healthcare positive organisational culture, where stakeholders' interests are aligned, and based on a solid foundation of shared values and ethical conduct a long-term success can be fostered.

wanted to pursue, as it would limit my availability to be allow me to balance my responsibilities at home with discovered the world of flexible and remote working.

The opportunity to work remotely with flexible hours was several advantages that made it an ideal choice for me. around my children’s school schedule and be there for with my older children and didn’t want to miss with my youngest

Embracing Flexible and Remote Working

Working from home eliminates commuting costs and daily meals. Remote working allows for a better balance reducing stress and increasing overall satis faction. Additionally, environment, I find I can focus better and be more productive

Once I secured a remote job position working for Nottinghamshire create a productive work environment at home. Setting between professional and personal life. Estab lishing a consistent with my tasks while being available for my children.

For the past 19 years, my primary focus has been on raising my children and managing our household. Every day was a new adventure, from school dropoffs and pick-ups to making sure homework was done, meals were prepared, and everyone was happy and healthy.

The transition from a stay -at-home mum to a remote worker convenience of remote work have allowed me to contribute for my children. This balance has not on ly alleviated sense of fulfilment and accomplishment. For anyone working opportunities could be the perfect solution to achieving

Nicole Bentley, Administrator, Nottinghamshire Care Association

As a stay-at-home mum, I dedicated myself to ensuring my children had the care and attention they needed to thrive. However, with my youngest child now well established in primary school and the cost of living continually rising, I realised it was time for me to re-enter the workforce.

Returning to work after nearly two decades was a daunting prospect. A traditional job was not an option I wanted to pursue, as it would limit my availability to be there for my children. I needed a solution that would allow me to balance my responsibilities at home with the financial needs of our family. That's when I discovered the world of flexible and remote working.

The opportunity to work remotely with flexible hours was a perfect fit for my situation. Remote working offered several advantages that made it an ideal choice for me. Being able to set my own hours means I can work around my children’s school schedule and be there for important events and activities, which I never missed with my older children and didn’t want to miss with my youngest child.

Working from home eliminates commuting costs and reduces expenses related to professional attire and daily meals. Remote working allows for a better balance between professional responsibilities and family life, reducing stress and increasing overall satisfaction.

Additionally, without the distractions of a traditional office environment, I find I can focus better and be more productive in my tasks.

Once I secured a remote job position working for Nottinghamshire Care Association, the challenge was to create a productive work environment at home.

Setting up a specific area for work helped create a boundary between professional and personal life. Establishing a consistent work routine ensured that I stayed on track with my tasks while being available for my children.

The transition from a stay-at-home mum to a remote worker has been a rewarding journey. The flexibility and convenience of remote work have allowed me to contribute to our family’s finances while still being present for my children. This balance has not only alleviated the financial pressures but also provided me with a sense of fulfilment and accomplishment.

For anyone in a similar situation, exploring flexible and remote working opportunities could be the perfect solution to achieving both personal and professional goals.

Are you Curious about Care?

The struggles of recruiting a good social care workforce are no secret. While care work is a values-based occupation, identifying whether people have the right values for the job can be very difficult. Curious about Care is a free resource designed to address this challenge by helping in-home care providers to embed values in their recruitment process.

Dr Mark Wilberforce Reader in Social Care, University of York & Leadership Fellow of the NIHR School for Social Care Research

Curious Care?

Developed during research led by the University of York, Curious about Care is an evidence-based quiz which places applicants in the shoes of care workers and asks them how they might respond to different dilemmas.

The quiz uses “Situational Judgement Tests'' which are a widely-used technique for supporting recruitment to valuesbased professions. Coproduced alongside older people and their families, the quiz takes a person-centred approach with a scoring system set by those with lived experience.

Using Curious about Care is simple:

1. Head to www.curiousaboutcare.org.uk and choose the scenarios that best suit your organisation’s clients.

2. You will receive a simple weblink that you can then send to as many different candidates as you want. The same weblink is used for every candidate.

3. When any candidate complete the

quiz, you will receive a detailed report highlighting how well their values and instincts match care work, together with their answers and scoring guide.

This report can then be used to inform an interview with the candidate or in identifying training needs.

The evidence-base for Curious about Care is what makes it stand out. Based on rigorous research published in leading international journals, scoring well on Curious about Care indicates that the candidate likely holds crucial personality attributes that makes them a good match for care. High scorers also tend to be more satisfied in care work (so we hope they will stay!).

The University of York team is always eager to speak to providers seeking to adopt Curious about Care. You can email them at curious-about-care@york.ac.uk

As an RCUK Course Centre, Staffordshire University delivers a comprehensive range of accredited courses within our Centre for Health Innovation designed to combine first-class nationally leading clinical simulation skill labs with research and education excellence.

e-ALS (Advance Life Support) Course is a one-day adult focused course that blends e-learning with face-to-face practical learning and assessment. eALS covers the essential life support skills needed to manage a deteriorating adult patient in an emergency, including cardiac arrest.

e-ILS (Immediate Life Support) Course is a half-day adult focused course that blends e-learning with face-to-face practical learning and assessment. eILS includes essential life support skills that healthcare professionals and first responders will need to manage a sick adult patient in an emergency situation, including cardiac arrest. (Immediate Life Support, can be offered as a full face-to-face full-day course)

PILS (Paediatric Life Support) Course ; is a one-day face-face paediatric focused course. PILS is designed to support healthcare professionals to manage paediatric patients in an emergency, including choking and cardiac arrest.

e-ILSi Immediate Life Support Instructor Course : is a one day face-to-face specialist instructor course to enable ILS/PILS providers who have been nominated as having instructor potential to teach on ILS/PILS courses.

DENTAL PRACTITIONERS WHO SUCCESSFULLY COMPLETE THE RCUK ACCREDITED COURSES CAN BE SUPPLIED WITH AN ADDITIONAL CPD CERTIFICATE.

For further information email@ resus@staffs.ac.uk Website : www.staffs.ac.uk

From the Emergency Department to Higher Education

This article explores the motivations and challenges I’ve faced and experienced as an emergency department nurse, who has chosen a new focus in higher education.

Elizabeth Isaacson, (she/her) Senior Lecturer - Resuscitation Lead School of Health, Education, Policing and Science, Staffordshire University

The transition from a high-intensity environment of an emergency department (ED) to the structured realm of academia is a remarkable journey and this journey was significantly influenced by the Resuscitation Council UK (RCUK) and the externally accredited courses that I now teach.

As an experienced Emergency department nurse, working within a Resuscitation team I needed to gain and maintain specific externally accredited qualifications. It was during an Advance Life Support course that I enjoyed and attained clinical skills, experience, and subject knowledge where I was identified as having instructor potential.

I then started the rigorous training and learning the teaching methods and modalities required to teach healthcare professionals as a fully qualified and accredited RCUK instructor. It was only through achieving instructor qualification and regular teaching on the accredited RCUK educational courses that I realised that I really enjoyed teaching, so much so, that I also undertook an MA Education degree, and when an opportunity arose, applied, and was appointed to a senior lecturer post at Staffordshire University.

The shift from the chaotic and busy emergency department to a higher educational setting has enabled me to combine my past clinical experiences with my educational knowledge to create real world learning environments where learners can make quick decisions, multi-task and begin to handle high stress situations in enriched learning environments which the textbook alone cannot provide. The adjustment period was not initially easy going from a fast

pace clinical environment to the calm structured curriculum led way of academia. However, this move has enabled me to enjoy a more balanced work-life, continue my own professional development and offers the opportunity to for me to impact and shape the next generation of healthcare professionals.

Experienced nurses who step into higher education, bring with them practical knowledge, a passion for teaching, and an unwavering commitment to shaping the future of nursing. The Resuscitation Council UK’s externally accredited courses played a pivotal role in my career path and the decisions I made as well as my decision to gain more qualifications and a subsequent MA in Education, both providing the necessary training and credentials to facilitate this career shift.

Nurses working in Higher Education institutions are critical to the future of healthcare professionals delivering high quality patient care and allows experienced nurses to continue their passion for healthcare in a physically less demanding environment whilst calling upon their valuable clinical experience.

Those who have thrived amidst the chaos of the ER are well-equipped to inspire, demonstrating that profound lessons often come from unexpected places and experience. Whilst the journey from the emergency department to the lecture hall presents new challenges to experienced nurses, it also offers opportunities for growth, impact, and renewed purpose. I look forward to the challenges and opportunities ahead.

Accelerating Innovation for a Healthier World

As a global human data science company IQVIA is at the forefront of unlocking the potential of health data to drive key advancements for future health improvements and delivering transformative benefits to improved population outcomes.

Global Public Health

Ensure equity in health across the globe, both from a medicines and a systems perspective

• 11 Government sponsored strategic health initiatives & consultation engaged with by IQVIA UKI in 2023

• 600k participants in the national COVID-19 Infection Survey

Clinical Research

Develop new medicines and prove they are safe, effective and valuable to patients

• 5M+ laboratory tests performed per year from our Livingston Laboratory

• 10,000+ patients in UK clinical studies in the last year

• 350 clinical trials delivered by IQVIA at any point of time (20% of UK commercial trials)

IQVIA has been selected for the NHS’s Privacy Enhancing Technology (NHS-PET) contract, applying our industry leading privacy analytics solution to this platform to ensure that NHS organisations meet the highest technical standards of security for managing patient data.

FORTUNE 500’s “World’s Most Admired Companies,” Ranked #1 in Healthcare, Pharmacy and Other Service for the Second Consecutive Year.

Harness digitisation of healthcare to accelerate transformation

Improve health outcomes for patients and populations

Enure population health and economic sustainability of healthcare systems

Healthcare Systems

Support healthcare systems to ensure patients receive the best care, outcomes and research possible

• 200+ NHS organisations that use our PROMs/PREMs surveys

• 95% NHS organisations use one or more of our services including costing, coding, benchmarking and data warehousing

• 750k NHS staff surveyed regarding their working conditions

Value, Access & Commercial

Demonstrate the value of medicines, launch effectively and ensure uptake to reach the right healthcare professional and patient at the right time

• 99% Rx data of acute UK hospitals: 82% of retail pharmacies; 96% of wholesaler medicines supply

• 4M+ patient engagements successfully delivered through home services, nurse clinics and remote call centres

• 300k patient records used in observational research for real-world evidence generation annually

IQVIA can deliver these solutions individually or can bring them together into a wider value-adding service.

X: @IQVIA_UK

LinkedIn: IQVIA UK & Ireland iqvia.com/uk-nhs-solutions

Is international recruitment still viable?

The last few months have been a period of change around international recruitment.

Not just the Immigration Rules but the mood music from government around immigration too. Providers have been left feeling overseas recruitment is off the table, is that really the case?

The short answer is ‘no’.

Hundreds of changes were made to the Immigration Rules but for health and social care providers, it all boils down to 4 new rules:

1. Pay – pay rates for overseas care workers rise £11.90/hr but not to the new £30kpa+ rate that applies to other jobs. Nurses pay remains in line with the NHS.

2. Dependents – carers and seniors can no longer bring dependants to the UK.

3. CQC – only CQC registered providers can bring carers to the UK.

4. SOC codes – new SOC codes for carers and senior carers and a reboot of the SMS to allow these to take effect.

And of course, there are changes to UKVI processes meaning providers have to share more evidence to get a Sponsor Licence or COSs.

So, is it still viable?

For some, the pay uplift alone means a hard no – the new rate isn’t affordable or would mean paying overseas workers more than UK workers. But in many areas, pay already exceeds the new rate and recruitment is tough, so bringing in people who’ll stay is a no-brainer.

Helpfully, government didn’t dramatically increase the costs of bringing in new health and care workers. The exemption from the Healthcare Surcharge continues and the Immigration Skills Charge is unchanged. The extra £40 for a COS probably isn’t a deal breaker. Visa fees, however, more than doubled to £551. These are usually paid by the candidate but employers who choose to reimburse them should factor this into their calculations.

The ban on dependants is the headline grabber but the effect of it is hard to gauge. People with skills, experience and qualifications want to come to the UK but there is a sense it is a less welcoming environment.

It seems candidates from South Asia and West Africa in particular are most concerned about this change, visa applications falling dramatically since the changes came into effect.

It probably came as a surprise that there were any non-CQC registered providers out there! But this change, while a little late is essential to protect overseas workers and level the playing field for responsible, properly regulated providers.

A major plus, since the changes is a more responsive UKVI. Applications for licences and COS are being processed quickly and the requests for additional information are becoming more familiar and easier to manage.

Rick Canavan, Director & Co-owner, BA Healthcare

The overall effect of the changes then is not what it seems. The changes don’t fundamentally change what employers can do or what it costs.

Would you like to understand what the changes mean for you? Or find out how our approach to international recruitment could help you build a sustainable, diverse team? Email us at uk@ba-healthcare.org to start the conversation.

Co-designing maternity investigations systems using a Human Factors approach - a Staffordshire University led project.

Staffordshire University have recently been successful in securing funding from The Health Foundation Q Exchange 6 funding call.

The team plan to deliver an innovative project working with Human Factors experts and maternity providers to co-design maternity investigations systems using a Human Factors approach.

maternity systems Factors Staffordshire project.

Lizzie Crisp, Al Ross, Paul Bowie and Sarahjane Jones

So why is this work important?

Despite improvements in mortality, systemic concerns continue to be noted in maternity services in the UK and worldwide. Recent independent maternity reviews indicate that, despite the introduction of PSIRF, local systems and processes for responding to maternity safety incidents remain inconsistent (e.g. cursory, not multidisciplinary and failing to identify underlying systemic failings) and are rarely subject to interdisciplinary efforts to support improvement efforts.

Human Factors & Ergonomics (HFE) takes a systems approach to improvement and applies tools, methods, and techniques to design optimal systems for users’ capabilities to enhance organisational outcomes. To our knowledge maternity investigation procedures, processes and models have not been subject to a systematic HFE assessment. This can add key value across the country in improving these vital management systems so that they are designed for users and clients alike.

Our project aim

This project aims to collaborate with local partners to co-design local NHS trusts governance practices in response to patient safety incidents using a Human Factors approach. This will enable the project team to produce a guide that could be deployed and provide NHS trusts with an evidence-based approach to improve local responses to patient safety incidents. It is anticipated that improvement in local governance systems and processes will result in a more positive learning culture with a view to reducing avoidable harm.

Our project delivery plan

A team of HFE and independent maternity investigator experts will conduct an innovative design review of NHS Trust governance systems and processes using key principles of Organisational Ergonomics. We will work with system users to understand if current practices systematically examine safety incidents, identify systemic concerns and share learning appropriately. We will apply evidencebased Ergonomic principles and the review findings will then be synthesised in a guide to support maternity services to practically deploy and operationalise a system-based approach to learning from patient safety incidents. Clinical partners will be fully involved to improve the service to the ultimate benefit for patients and families. We believe our key output delivers a ‘pathway to impact’ in that it can be deployed by governance teams across and possibly beyond the UK.

Our broader commitment to maternity safety

Our team at Staffordshire University are passionate about committing to working towards safer maternity care. We have recently had a paper accepted for publication conceptualising near misses in maternity care, and we are also working towards making a number of grant applications with a focus upon maternity safety. We are always keen to talk “all things maternity safety” with fellow IHCSM members so please do feel free to reach out!.

What do you want from your healthcare data?

We process and store patient data, from any supplier, and in any format, to provide a single instance of cleansed and normalised data; that’s currently 110TB, and growing daily, of patient data relating to almost 16 million individuals.

Any coded data (SNOMED CT, CTV3, Read2, ICD -10, OPCS-4 or any national/local code system), in any format (CSV, HL7V2...), mapped to a common ontology and model, stored in a secure database, and then made available to you.

Your data, your knowledge. Your patients, your clinicians. Your region, your ICS.

We collect once, and use many times for real time:

Population Health ✓

Planning ✓

Research ✓

Direct Care ✓

Projects that use our data service include:

Managing Your

Some days, we wake up, and just immediately feel defeated by the world around us. Maybe a little grumpy, fed up, tightly wound.

We might even describe these feelings, especially if we notice them in those around us, with a famous phrase: that person has gotten out of the wrong side of bed this morning.

The first step to shifting your mindset is to accept that you are a priority. Caring about ourselves is paramount, to be able to even consider supporting those around us. Consider yourself as your most valuable asset, and your health as an integral part of living well. We can and will find small solutions everyday to enrich our own lives, as well as those we interact with, through how we think.

1. Taking care of yourself by learning about your responses to certain situations, honouring those reactions by reflecting on them, and at times challenging any thoughts surrounding your day, is a strong start. If you notice any thoughts that feel defeatist, attempt to flip them around. Consider thoughts such as ‘I’m always failing’ and challenge yourself to view this as something such as ‘I faced a challenge and I can learn from this’ instead.

2. Alongside learning about yourself, we can prioritise our mindset through

self-care practices as well. Biologically engineering yourself into a positive mood, by exercising for joy, or engaging in activities that make you smile, can help to make the above step a little easier

3. Be patient. You will still have days when you become swallowed up by the unchecked thoughts. Working towards a resilient, balanced, and hopefully content mindset is a continuous process that will not be linear. If you feel yourself become weary, unmotivated, and unsure of where to turn to – someone will always be there to help and talk things through if you’d like to. Involving others in your journey is a conscious choice, that if made, may help you greatly.

If this resonates with you and you are an IHSCM member, you have access to Hapstar here: https://platform. hapstar.app/signup/ihscm

Your Mindset

Takeaways

• Acknowledge and Accept Emotions:

Recognize that it's normal to wake up feeling defeated or in a bad mood without an apparent reason.

Accept these feelings without judgment to prevent them from overwhelming you.

• Identify Patterns and Intervene Early:

Notice if negative feelings become consistent and take proactive steps to address them.

Understand that mindset is one of the few things you can control, and actively working on it can prevent burnout.

• Practice Gratitude and Positivity:

Focus on what you are grateful for each day to shift your mindset towards positivity.

Set daily intentions to guide your actions and maintain a proactive approach to your day.

• Be Patient with Yourself:

Understand that developing a resilient mindset is a continuous, non-linear process.

Allow yourself to have bad days without guilt, knowing that progress takes time and effort.