CCC Sign Up To Safety Action Plan Pledge 1: Put Safety First Commit to reduce avoidable harm in the NHS by half and make public the goals and plans developed locally Reducing harm to our patients is a core part of our Quality Strategy. We pledge to continue the focus on reducing harm to our patients in a number of ways. Safety Thermometer for Radiotherapy. The NHS Safety Thermometer allows teams to measure ‘harm’ and the proportion of patients that are ‘harm free’ during their working day. At CCC we use the Classic NHS Safety Thermometer in our in-patient wards (including monitoring the number of days between each harm event) and the Medicines Safety Thermometer which is mainly used in ward areas and day case chemotherapy. We pledge to develop a bespoke Safety Thermometer for use in radiotherapy which is a large part of our treatment delivery to patients in our care as this area is not covered by the national Safety Thermometers. Medicines Safety Action Plan: Our new medicines safety service promises to deliver improved medicines safety at CCC through innovation in practice, education and implementation of harm free care initiatives.

The initial focus of the harm free care programme is reduction and prevention of chemotherapy induced nausea and vomiting (CINV), a condition which causes particular distress to cancer patients. A pro-active identification of high risk patients plan and earlier intervention scheme are soon to be put into action under the supervision of the medicines safety team. The next area of focus for harm free care is increased drug allergy awareness for the trust in cohesion with new NICE guidance. Innovation in reporting is another key area of interest for the medicines safety service, presently through improved an error coding project and involvement in the establishment of the northwest regional MHRA Yellow card group. The medicines safety group (a collection of staff and lay members from a variety of backgrounds) will continue to monitor errors and introduce further innovative schemes in practice to prevent medicines safety errors. The medicines safety team is committed to the continuation and enhancement of medicines safety education at CCC. The medicines safety team has taken the lead in revamping of the medicines safety teaching in core skills for all staff and in depth training in high risk medications such as insulin. Further roll out of education to student staff members in the future intends to in grain in these staff the importance of medicines safety from very early in their NHS careers. CCC is fully committed to medicines safety for the improvement of patient care and will be at the fore front of medicines safety both locally and nationally through the medicines safety service.

Pledge 2: Continually Learn Make organisations more resilient to risk, by acting on feedback from patients and by constantly measuring and monitoring how safe services are. We aim to continuously learn from our staff and our patients to improve care and safety. We will build on our current systems to further embed a culture of learning. Safety Culture We have conducted our first Safety Culture Survey in August 2014. We will ensure we act on the feedback from all staff and will continue to conduct these surveys at least twice a year across the Trust and more frequently in departments where we need to focus on improvement.

As a result of our first Safety Culture Survey we will introduce new systems to improve feedback on incident reports and investigations. We will also focus more on investigating near misses.

Pledge 3: Honesty Be transparent with people about progress to tackle patient safety issues and support staff to be candid with patients and their families if something goes wrong. High Quality and Safe Care Quality and Safety is at the heart of what The Clatterbridge Cancer Centre NHS Foundation Trust aims to achieve for all the patients in our care. We are committed to being transparent about the quality and safety of our services. We believe that the public have a right to know about how their specialist cancer centre is performing in the areas that are important to them. We have developed a ‘High Quality & Safe Care’ section on our public website which includes information on key areas of quality and safety such as harm free care, waiting times, complaints, cleanliness, and patients and staff opinion of our hospitals. This information can be found under the following headers:     

Safe - Open and honest care, safety thermometer, medicines thermometer, healthcare associated infections, patient led assessment of the care environment, incident reports Effective - Compliance with patient risk assessments, 30 day mortality post treatment Caring - Ward nursing staff levels, patient feedback Responsive - Compliance with cancer waiting times Well led - Integrated performance report, staff feedback, nursing care indicators, quality accounts

We will build on the amount of information that we provide including feedback from patients and the public via a web questionnaire to ensure that the information is what patients want to see and that it is easy to understand. We will further develop this website to include benchmarks of how we perform against other Trusts.

Transparency of Care We are committed to ensure that patients who use our services can easily see information about how we are performing and developing. Wards currently display a large amount of information. We are committed to reviewing and further developing this information to ensure it is comprehensive, is easily understandable and meets patients’ needs. We will work with our clinical experts, ward leaders and our Patient Council to achieve this. We will look to roll this out to other clinical areas. We have a programme of videoing patient stories and presenting these at each Public Board Meeting. We will further develop this programme in conjunction with our public Governors and will roll out the use of patient story videos to all clinical departments.

Pledge 4: Collaborate Take a leading role in supporting local collaborative learning, so that improvements are made across all of the local services that patients use Patient Pathways We will fund and recruit a Cancer Pathways Project Manager for Network Cancer pathways will lead a project to review and improve cancer pathways across the Cheshire & Merseyside network of cancer services. This will involve complex analysis of cancer pathways, comparison with national best practice, development of recommendations to improve the cancer patient’s journey through the health and social care system, reporting the recommendations to participating hospitals and working with managers in acute hospitals to ensure that recommendations are implemented. Patients at the Heart of Safety Patients are at the heart of the care and treatment that we provide and will experience and see things in a different way to staff. We will work with patients to improve safety including implementing a system where we encourage patients, carers and visitors to be able to easily report any safety concerns that they have.

Pledge 5: Support Help people understand why things go wrong and how to put them right. Give staff the time and support to improve and celebrate the progress Training and Development As a result of our first Safety Culture Survey we will introduce Health and Safety briefings for staff in all departments focusing on key health and safety themes throughout the year. We will support staff to improve safety by implementing a new Patient Safety Training Programme. This will include:  

Root Cause Analysis Master Class for staff who investigate safety issues Develop a programme of training in Human Factors for Healthcare

As a result of our first Safety Culture Survey we will review our processes and systems for providing support for staff who raise concerns or are involved in an incident, complaint or claim.