Conference special by Sarah Stephens, Dan Shires and Beverley Chubb
Plenary Sessions
Leadership and Patient Safety
The importance of patient safety and leadership in healthcare was discussed by Dr Kevin Cleary, Director of the National Patient Safety Agency. He said: “Culture is crucially important. If the leadership cannot create the right atmosphere patient safety cannot be improved.”
He went on to say that in general hospitals and hospital staff have the best of intentions and they have good safety systems in place with monitoring and communication helping in the delivery. Those places where there are issues with safety are generally lacking leadership or there is a cultural difficulty with reporting incidents for fear of blame.
Dr Cleary highlighted a specialist reporting system pilot being carried out with the Royal College of Anaesthetists in which senior clinicians are reporting incidents directly to the NPSA and trusts are finding out about incidents they wouldn’t otherwise have known about.
The growing evidence base for safety practices was discussed along with the issues which contribute to safe practices not being implemented even though we know they work.
International Perspective
The global interest in Hospital at Night was highlighted at the conference by Dr Claire Wilkin, HaN project medical lead and Juliet Pellegrini, HaN project nursing lead from the Royal Children’s Hospital in Melbourne, Australia.
They discussed the challenges of a paediatric urban hospital covering a very large geographical catchment area.
HaN is a new project for them and they underlined the key areas of senior management support, leadership and the need to measure activity - key themes throughout many of the workshops at the conference.
Junior doctors top 10 concerns regarding WTD 2009 and HaN from NHS North West
Another way to cut my pay - HaN is quality driven; provides improved patient safety
No benefits to me - HaN is the best way to preserve training in a 48 hour week
Surgeons treating heart attacks = anarchy - Competency based, common sense task assignment
An excuse to remove on-call rooms - Better opportunities, planned breaks and structured naps
Nights are when I learn most - Nights provide a poor learning opportunity with less activity and impaired learning potential
The doctors down the road did it and hated it - Bad publicity amongst juniors who have not yet experienced it
Dumping all the work on the medics -Spread workload more evenly and appropriately across night team
Nurses bossing us around - HaN is true teamwork
What’s wrong with things as they are? - Previously overnight unsupervised work - learning at what cost?
Working Time Directive 2009 
