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Good family engagement in NHS death investigations

Date post: 21-Jan-2018
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Good family engagement in NHS death investigations
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Good family engagement in NHS death investigations

How do you involve families in learning from deaths?

•  Measurement •  Strengths •  Weaknesses •  Worries/concerns

•  Ideas

Your current practice

•  How do you know how you perform? •  What do you think your trust does well? •  What do you think your trust needs to

improve? •  What most concerns or worries you about

engaging families?

Future changes •  DH Guidance (1st Edition)

CQC Deaths Review

‘Many carers and families do not experience the NHS as being open and transparent and that opportunities are missed to learn across the system from deaths that may have been prevented. Many of the NHS staff we heard from shared this view, together with a commitment for this to change’ p2

‘Those working in health and social care have a moral responsibility, and a legal duty, to be open and honest… some families described incredibly kind and compassionate care by individual members of healthcare staff. Yet the same families also reported being ignored by others and feeling that their questions were left unanswered’ p4

‘Across our review, we were unable to identify any trust that could demonstrate good practice across all aspects of identifying, reviewing and investigating deaths and ensuring that learning is implemented’ p6

Family and carer involvement

•  Poor experience of investigations, not consistently treated with respect and honesty despite many trusts stating they value family involvement and have policies and procedures in place to support it

Family and carer involvement

•  Families not routinely told what their rights were or how to access support/advocacy

•  Extent involved varies considerably; not always kept informed

•  Frequently not listened to; some cases involvement is tokenistic and views of family/carers not given same weight as clinical staff

Family and carer involvement

•  The NHS underestimates the role that families and carers can play in helping to fully understand what happened to a patient. They offer a vital perspective because they see the whole pathway of care that their relative experienced.

Tuesday’s Conference Chat

Table feedback

•  Initial contact and notification of death •  Involvement in investigation process •  Reporting and learning •  Scrutiny •  Communications •  Service development and training

What good looks like for families

•  Compassion and humanity •  Honesty and detail •  Support, family liaison and advocacy •  Genuinely equal value placed on family

perspective – actually involving families •  Ethical practice •  Focus on change and removing risk

Practical steps •  Acknowledgement •  Saying sorry, being human •  Share information fully •  Listen and answer questions •  Be honest •  Don’t send letters on a Friday

Practical steps

•  Respect and bin bags •  Counselling and bereavement support •  Advocacy and investigation support •  Harness family experience for

improvement work/supporting Board •  Document successes •  Monitor over time, consider impact

Thank you

Twitter: @GeorgeJulian Email: [email protected] Blog: www.georgejulian.co.uk/blog


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