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Sign up to Safety


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Sign up to Safety’s three-year objective is to reduce avoidable harm by 50% and save 6,000 lives. It is designed to help realise the ambition of making the NHS the safest healthcare system in the world by creating a system devoted to continuous learning and improvement. Sign up to Safety aims to deliver harm-free care for every patient, every time, everywhere. It champions openness and honesty and supports everyone to improve the safety of patients.


NHS England is now nationally responsible for patient safety within the NHS. Their goal is to drive improvements in patient safety through providing resources, incident reporting and learning and through national campaigns such as ‘Patient Safety First.’

Sign up to Safety is a new national patient safety campaign that was announced in March by the Secretary of State for Health. It launched on 24 June 2014 with the mission to strengthen patient safety in the NHS and make it the safest healthcare system in the world.

Bedford Hospital has developed a plan (pledges) that describes what we will do to reduce harm and save lives, by working to reduce the causes of harm and take a preventative approach. Our pledges have been developed around national safety initiatives and is driven by our Quality Improvement Strategy 2015-18. The five pledges are set out below.

Details of the organisations that have signed up can be accessed at www.signuptosafety.nhs.uk. Those organisations that sign up to the campaign can draw on a variety of expert support to help ensure that they realise the ambitions described in their plans.


Pledge 1 – Put Safety First

Commit to reduce avoidable harm in the NHS by half and make public our goals and plans developed locally.

Progressively reduce avoidable harm. We commit to progressively supporting the development of safety projects that will:

  • Improve our mortality rates to the top 25% of safest hospitals
  • Increase the number of patients who receive harm free care to more than 95%
  • Reduce the number of MRSA blood infections to zero each year
  • Sustain low levels of clostridium difficile
  • Reduce the number of cardiac arrests by 20%
  • Reduce number of grade 2 pressure ulcers by 50%
  • Eliminate all grade 3 pressure ulcers
  • Reduce the number of patients who suffer harm from falls by 20%
  • Zero avoidable VTE
  • Improve discharge communication with the wider team

Improve clinical systems:

  • A priority is to develop clinical information technology systems so they meet the needs of the user and contribute to safer practice and more effective communication

Pledge 2 – Continually Learn

Make organisations more resilient to risks, by acting on the feedback from patients and by constantly measuring and monitoring how safe their services are.

Develop effective and innovative ways to share and learn from patient safety incidents and public experience. Bedford Hospital aims to be open and accountable to the public and patients and always driving improvements in care. In the spirit of openness and transparency, we pledge to publish a set of patient outcomes, patient and staff experience measures so that patients and the public can see how we are performing in these areas on our website monthly. We will:

  • Improve inpatient survey scores to show that patients are involved in choices about their care
  • Patients report and increased satisfaction in being treated with dignity
  • Each ward / department will have an identified Dignity Champion as a resource for staff, patients and relatives
  • Staff Friends and Family Test shows that staff feel valued as part of the care delivery team
  • Ensure that clinical leadership development includes setting the quality agenda and quality improvement
  • 95% of staff have an appraisal in which goals are aligned with the Trust’s vision and values
  • 95% of staff access induction which reflects the organisation’s vision, values and strategy
  • Implement annual staff awards for quality
  • Ensure that the Trust Board is visible and can be challenged through different channels
  • Recommendations from Freedom to Speak Up are implemented in order to create an honest and open reporting culture
  • There are clear systems for reporting and learning from incidents

Pledge 3 – Honesty

Be transparent with people about their progress to tackle patient safety issues and support staff to be candid with patients and their families if something goes wrong.

Be open and honest about patient safety issues and avoidable harms by:

  • Sharing our Trust Board reports on our website and will pledge to develop further safety information about harm and mortality and make this available
  • Continue to invite partners to participate in Internal Compliance Reviews
  • Continue to implement the new duty of candour requirements and review our approach to support staff to ensure that implementation is effective
  • Work with key stakeholders to support internal and external surveillance of our performance on patient safety and quality
  • Listen to and engage with our staff and patients through patient feedback sources such as Listening Events
  • Carry out root cause analysis investigations where serious incidents occur and share these with the patient and / or their carers
  • Offer face-to-face meetings with clinical and senior management staff to better understand the care and treatment that has been provided and learn from it
  • Keep the patient voice at the forefront of our business by ensuring a patient story is heard at the Trust Board every month
  • Continue to encourage staff to speak up if they have any concerns about the quality and safety of patient care

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.

We pledge to be an active participant in regional and local safety collaborative to improve care. We will participate in regional and national quality and safety programmes to review and improve the care we give to patients. We will work with others to develop and improve understanding of measuring and monitoring safety and we will continue the collaborative and work with our commissioners and local Community Healthcare to reduce harm from pressure ulcers and supporting complex discharges and acute care in community settings.

We will share our safety plans with the public, our patients, staff and our partners. The Trust will improve communication between hospital, primary care and other partners as patients move between different settings. We will work across healthcare via our transformation programme to ensure patient focused integrated care pathways deliver safe and effective care.

Pledge 5 – Support

Help people understand why things go wrong and how to put them right.

Develop our safety culture over the next three years. We will seek to ensure continuous quality improvement is a core value of the organisation and our staff. This means that our staff must respond well to change and embrace initiatives, be open to new ideas and encourage forward thinking and taking ownership for continuous learning and self-development. We are committed to ensuring that our workforce has the capacity and capability to deliver quality improvement. We have started this work and have now recruited ‘Safety Leads’ and ‘Safety Champions’ who provide the driving force to improvements at a ward and team level. Our Safety Leads have the opportunity to report any challenges and seek support from Trust Board members. Safety Leads access the Safety Development Programme which we have commissioned from the University of Bedfordshire. The Trust also seeks to understand Human Factor Theory and embed this within our training programmes.

We are committed to the development of a safety improvement plan to support our Sign up to Safety pledges. Our actions include:

  • Developing a Trust wide quality improvement capability approach that supports teams to lead and manage their own improvement work with a focus on coaching in quality improvement methodology
  • Developing a Patient Safety brief to encourage involvement and understanding of our safety work
  • Ensure on-going improvement in the quality and safety of patient care through our Clinical Quality Strategy
  • Ensure our staff understand their responsibilities for patient safety through our core values framework
  • Continue to deliver root cause analysis investigation training to middle and senior managers
  • Continue a programme of incident investigation and risk management to all department and front-line managers
  • Routinely monitor the quality of care being provided across all services
  • Challenge poor performance or variation in quality
  • Incentivise and reward high quality care and quality improvement

Safety Collaborative

A National Co-ordinating and Support Group has been established to guide the work of the campaign. A regional patient safety collaborative led by Academic Health Science Networks will work across whole local systems and all healthcare sectors to deliver locally designed safety improvement programmes drawing on recognised evidence based methods. We are working with Oxford Academic Health Science Network on two safety projects around pressure ulcer reduction and catheter acquired infection reduction.

Associate Director of Nursing Rosslyn YoungQ Initiative

Q is an initiative led by the Health Foundation and supported and co-founded by NHS England which connects people skilled in improvement across the UK. A small number of participants, including Associate Director of Nursing Rosslyn Young from Bedford Hospital (pictured), have been appointed to form a founding cohort and help design, refine and test Q during the remainder of 2015. This design process will inform a wider recruitment campaign which will start in 2016.

Q will make it easier for people from all parts of the healthcare system with expertise in improvement to share ideas, enhance their skills and make changes that bring tangible benefits for patients. Through Q, a diverse range of people, from frontline clinicians, managers and researchers to policy makers, patient leaders and those bringing expertise from other industries are being brought together to radically expand and accelerate improvement to the quality of care. The aim is to connect a critical mass of people with around 5,000 participants by 2020.


A new Safety Action for England team will be developed to provide short term support to individual Trusts in the area of patient safety. SAFE will provide Trusts with a clinical and managerial resource to help develop organisational and staff capabilities to help improve the delivery of safe treatment and care. SAFE will be piloted later this year and could help to support signed up organisations, and others, who require additional help.

Safety Website

A new set of hospital patient safety data is now available on NHS Choices, enabling Trusts to be compared against each indicator. Putting key safety information into the public domain supporting transparency and helping patients to make informed choices about their care and exercise their right to challenge their local healthcare providers on safety issues. Organisations that have signed up to safety can use this public data to inform their plans and conversations within their local communities.