Southern health NHS foundation trust: winner, leadership award

Clinical psychologist Claire Corbridge brainstorming examples of how to deliver integration at a Going Viral session. Photograph: Southern health foundation trust

Southern health NHS foundation trust is one of the largest mental health and learning disability trusts in England. It has a staff of 9,000 working across 150 sites, spanning five counties and was created following the merger of Hampshire partnership NHS foundation trust and Hampshire community healthcare NHS trust in 2011.

A key challenge for the new trust was how to ensure that everybody felt part of the same organisation and shared the same values, behaviours and goals. Part of the solution was its Going Viral leadership development programme which, since its launch in June last year, has coached, developed and supported 550 staff. Another 240 will join the programme this autumn.

Richard House, interim head of leadership and management development, says Going Viral has its roots in the trust's organisational and people development strategies which define the attitudes, values and behaviours expected from its workforce in achieving its core aims. He says: "The NHS Constitution goes some way towards doing that but it isn't specific about behavioural expectations."

The Going Viral programme has three modules that tie in with the trust's core objectives – how to redesign services to improve quality and provide better value for money; how to integrate health and social care with partners and how to provide better outcomes and experiences for patients. The course, which takes place over six months, is delivered in nine-and-a-half day sessions. The learning groups are deliberately made up of staff from different departments so they can develop together.

House says the programme is different from others because it does not select employees according to their NHS banding, but by the amount of influence and responsibility they have. He says: "We have tried to include people, not by their pay band or whether they have management responsibility, but by how influential they are in their multi-disciplinary team. For example, a consultant physician who is only responsible for him or herself."

The programme was introduced before the publication this February of the damning Francis report into the Mid Staffordshire NHS foundation trust.

That report identified how an "insidious negative culture" and "disengagement from managerial and leadership responsibilities" contributed to Mid Staffs' failings. Going Viral, says House, is confronting those leadership challenges identified by Francis.

He says: "I think people feel more listened to and empowered and involved in the processes and realise what is expected of them. It's been transformational for people. One medic said to me 'I wanted to hate the programme and went in with that attitude; but I realise now it was one of the best learning opportunities I have ever had.'"

Health Education England and other trusts from around the country have already taken an interest in Going Viral. The trust, which has its headquarters in Southampton, is organising an open event for later this autumn about the leadership programme and how it fits into its organisational development work. House says: "This is too important not to share with others – to enable them to take on this grand scale change."

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Office of the Chief Scientific Officer: winner, workforce innovation award

The new electron linear accelerator facility, which offers an independent radiotherapy calibration service and a unique research facility.

The NHS's healthcare scientists punch above their weight. Although they account for just 5% of the health service workforce, their work is linked to 80% of patients' clinical diagnoses.

Historically though, the career paths and education and training of the 50,000 NHS scientists who come from 45 different scientific backgrounds, has been adhoc.

But now the healthcare scientists have their own defined career paths, which can take somebody starting off in a staff support role right to the top to become a consultant clinical scientist.

The pathways, backed up by a training and education framework, are part of Modernising Scientific Careers (MSC), which has already been three years in the making and is still being implemented. The intention is that, once fully introduced, healthcare scientists will be a sustainable and flexible workforce that can meet the future demands of the NHS and respond to changes brought about by science and technology.

Chief scientific officer professor Sue Hill says: "We recruit some of the best science graduates in the country but we were not developing them to their full potential.

"I think we now know the value of healthcare scientists working in the health system – we have pulled this valuable resource out of the shadows and placed them centre stage so that their knowledge, skills and expertise is more explicit and they can fully make their contribution.

"I think through this programme we have also ensured the sustainability and fitness for purpose in the future of the healthcare scientists' workforce to respond in a health system which is going to be driven by science and technology."

The MSC allows scientists to move between different scientific specialities, broadening their experience and creating a more flexible workforce.

MSC, which has been described as an ambitious and "complex workforce change programme", had to take into account NHS staff and patients, as well as all four UK countries, two Whitehall departments, the higher education sector, professional bodies, the royal colleges and sector skills councils.

Hill says one of the key obstacles was building new relationships with higher education: "We had to enter into and establish new partnerships between higher education and the NHS in particular, which weren't there before.

"We also had to make sure that people understood what they were letting go of, what they had before, and how this would be better and more flexible and was more about the future."

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Portsmouth hospitals NHS trust: hospital admissions award runner-up

An initiative by the diabetes inpatient team has cut hypoglycaemic episode admissions by nearly 20%. Photograph: Portsmouth hospitals NHS trust

A hospital has seen a 33% drop in the number of diabetes patients calling 999 or turning up at A&E following a hypoglycaemic episode, while admissions fell by nearly 20% following an initiative that helps patients manage their care better and educates GPs about best practice.

The diabetes inpatient team at Portsmouth hospitals NHS trust wanted to tackle the recurring number of diabetes patients being admitted to hospital following a hypoglycaemic event.

It decided that a diabetes consultant and specialist nurse would visit every GP practice in the district twice a year to discuss diabetes management and spread best practice. Educational events were also held at local nursing and residential homes to help improve diabetes management.

A new telephone hotline was set up with South Central Ambulance Service for paramedics to call the hospital inpatient team if they had treated a hypoglycaemic patient. That patient would then be contacted by the team within 24 hours.

Any diabetic patient admitted to hospital following a hypoglycaemic event was given advice about managing their care to prevent another attack.

After the project was launched, the number of hypoglycaemic people arriving at A&E or being seen by a paramedic between November 2011 and November 2012 was 83 – a drop of 33% compared to the previous 12 months. During the same period the number of hospital admissions fell by nearly 20% from 85 to 63.

Dr Partha Kar, the trust's diabetes clinical director, says: "As far as we are aware our pathway is the first to show discernible benefits of hypoglycaemic admissions thereby showcasing how a simple innovative approach can help patient care. The pathway can achieve little unless dovetailed with educational support for primary care which has formed the crux of the local model of diabetes care."

The initiative is part of the trust's Super Six Diabetes model of care designed to move more care away from hospital into the community.

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National blood service, Oxford University hospitals NHS trust: technology innovation award runner-up

Oxford University hospitals NHS trust uses handheld computers at the bedside to scan the identity barcode on a patient's wrist band.

Introducing an identity barcode on a patient's wrist band, using handheld computers at the bedside, electronically controlling the temperature of blood fridges and tracking stock have improved patient safety Oxford University hospitals NHS trust's national blood trust and saved £528,000.

The trust wanted to reorganise its bedside and laboratory transfusion service in order to reduce the number of deaths from "wrong transfusion" – the second most frequent cause of death from transfusion reported to the UK's serious hazards transfusions scheme. In the past 15 years, errors in the UK transfusion service were responsible for 27 deaths and 120 cases of major morbidity.

Oxford hoped that by using technology it would also reduce the amount of time staff spent checking blood, reduce blood wastage and the inappropriate use of supplies, as well as speed up the supply of blood in emergencies.

Consultant haematologist professor Michael Murphy says: "For many members of the public or patients to think a process that is so important is relying on bits of paper and people looking at long numbers, is just unbelievable."

Today transfusion patients are identified by a barcode on their wrist band, which is scanned by a nurse at the bedside using a handheld computer. The nurse also scans his or her own barcode before following the transfusion process written on the computer screen.

There is now a complete electronic audit trail of blood supplies after the blood bank IT system was linked to others in the trust, which has led to significant improvements in blood sample collection, the collection of supplies from fridges and the transfusion-related admin.

Paperwork has been cut by 52 minutes per patient and the bedside transfusion process now requires one nurse instead of two. The initiative is recognised as an exemplar NHS evidence, quality, innovation, prevention and productivity project. The Oxford team wrote a national specification for the electronic transfusion service for the former National Patient Safety Agency.

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Moorfields eye hospital: service delivery innovation award runner-up

Nurses at Moorfields administer a third of all eye injections. Photograph: Moorfields eye hospital

Nurses at Moorfields eye hospital NHS foundation trust in London have been trained to give eye injections to patients in a groundbreaking move, which is changing professional practice and benefiting patients.

The hospital decided to teach senior nurses how to administer the drug Lucentis as an injection in the eye because of increased patient demand, following new national clinical guidelines and a lack of ophthalmologists to carry out the procedure. New guidelines from the National Institute for Health and Care Excellence (Nice) recommended that Lucentis should be injected into the eye to treat patients with diabetic maculopathy.

The decision put more pressure on the hospital because its doctors were already busy administering 10,000 Lucentis eye injections every year to patients with the wet form of age-related macular degeneration.

Moorfields decided to train its senior nurse to give the eye injections, even though it was opposed by the Royal College of Ophthalmologists because Lucentis is only licensed in the UK to be administered by a doctor.

Hospital lawyers were consulted and a special patient consent form was drawn up. The NHS Litigation Authority also guaranteed the nurses the various liability cover they needed.

So far, 15 Moorfields nurses have given 3,000 eye injections, representing 33% of the hospital's eye injection workload. Moorfields has also been able to run 15 extra eye injection sessions a week because of the new skills mix.

Moorfields fellow Joanna DaCosta says: "This model of working is instrumental in removing professional barriers, increasing job satisfaction and providing a cost effective healthcare system."

The success of the initiative is illustrated by the decision in May taken by the Royal College of Ophthalmologists to issue new guidelines that non-medically trained professionals can administer eye injections, provided they have appropriate training and supervision.

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University College London hospital: workforce innovation runner-up

University College London Hospital's training programme helped staff identify weaknesses in their clinic’s processes.

A leading London teaching hospital is giving staff the power to decide how outpatient clinics are run, which is transforming services, reducing waiting times and improving the patient experience.

University College London hospital sees more than 800,000 people in outpatient clinics every year.

But it realised it had to improve the system after a questionnaire revealed 47% of outpatients ranked the service they received as "not at all" or "fairly" well organised, and 59% complained that they had to wait at least 30 minutes before they were seen in a clinic.

The trust's quality, efficiency and productivity team designed a 24-week staff training programme which, with the support of service improvement coaches, aimed to help clinic staff identify where there were weaknesses in their clinic's processes and procedures and to come up with solutions to solve the problems.

So far the team has worked with 31 different multi-disciplinary staff teams and 300 outpatient clinics.

The results are impressive. The endocrinology clinic has halved waiting times to 45 minutes by staggering patient arrival times and realigning clinic templates. The musculoskeletal clinic has cut its waiting list from 15 weeks to seven by pooling its booking queues system.

The introduction of a 24-hour telephone advice line in maternity has reduced clinic waiting times, taken the pressure off labour wards and improved the experience of patients.

Louise Molloy, productive programme manager, says: "In essence, this programme gives teams the permission to focus on and improve their services.

"It allows them to take all those things that they see are not working and bring them together with the right staff, and working with a professional coach, to develop a programme of work to solve those problems."

At least 80% of outpatient clinics are scheduled to go through the process by 2015.

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