Blog: Safety Culture Programme helps St Austell Healthcare make improvements in challenging times

We spoke to Alistair Lockwood at St Austell Healthcare about how using the SCORE Survey, sponsored by the South West Patient Safety Collaborative (SW PSC), helped them to introduce new practices and make improvements during a challenging time.
Alistair tells us a bit about the background to the practice’s work with the SCORE Survey: “St Austell Healthcare has high levels of long-term unemployment, socioeconomic deprivation as well as a high prevalence of chronic disease and obesity. When a large local practice closed in 2014, it put the remaining three practices under pressure. We have since merged these three practices and accepted patients from the failed practice, so now cover a population of around 31,800 patients. We used the Primary Care Home framework to help redesign services and St Austell Healthcare is one of 15 national test sites for the Primary Care Home pilots.”
Alistair continues: “We first came across the SCORE survey when I attended the Patient Safety Officer training, run by the Institute for Healthcare Improvement (IHI) and funded by the SW PSC back in November 2015. I was really inspired by the quality messages during the forum and, having heard about the culture survey, was keen to try this out in the first instance to see how it could help us through some fairly challenging times. We have now just completed the third cycle of the SCORE survey, assisted by the SW PSC and we have clearly documented the hugely positive impact this has had on the practice. It has allowed us to provide system-wide change and a redesign of how we work. We think that our SCORE story may be of help to other practices and settings who are in similar situations, or merging or federating.
Our first survey took place fairly swiftly after the IHI course in January 2016 and was the start of a really interesting process in which we have learned so much. Our first survey got a 60% response rate and we are now at a 74% response rate for our third survey. The review and debriefing took place fairly soon after the survey, and pulled out some really interesting areas for focus, and we were able to implement the first round of changes quickly. Our model since then has been fairly similar, as we found it was really effective to get the team to open up and share their thoughts on a regular basis. We found that the more that we spoke to people, the more open and forthcoming people were.
The first round of debriefing showed us a resounding message that some cohorts within the team felt that they were not being listened to. We started working with the nurses, with 20 minutes per person and this led to us changing the structure of our management team which has been really impactful.
Results from our second survey in early 2016, which was run by the expert team at the SW PSC, led us to aim to reduce silo mentality and break down barriers, while further developing and supporting managers and leaders to be autonomous. We also wanted to continue to encourage listening, regular feedback and a more cohesive approach with less conflict.
The areas that have been focussed on since February 2016 have shown massive improvement which is really encouraging. We have been able to empower local leadership with matrons, site managers and other local leaders. We have also seen more cohesion within the nursing team, with regular meetings and the development of a matron role.
Staff have recognised that this is a safe environment and that we listen to what they want to do. Because we are not an NHS body, we can be quite agile and we are able to implement changes at the next meeting.
I’m really fascinated to see what will come out of round three of the survey – it’s been genuinely so useful.”
For more information on the SCORE survey, please contact patientsafety@swahsn.com