Quality and Safety

The role of the Quality and Safety Team is to support the Clinical Divisions to provide a safe, effective and efficient service to our patients and their families.

Find out about the ways we are improving quality and safety across the Trust:

Quality & Safety Strategy

Waste is an ongoing problem in the NHS, and can eat away at money, time, and resources. Here is how we will reduce waste in the coming years. 

No Waste, No Waits, Zero Harm

We can move towards No Waste, No Waits and Zero Harm by working together. Everyone has their own expertise and experiences and the Quality Improvement Team uses these to make lasting and effective changes at Great Ormond Street Hospital.

No Waste

Waste is an ongoing problem in the NHS: money, time, resources – it can all be used better. We know this. Working more efficiently means working safer, thinking differently. Everyone knows that there is less money about so it’s vital that we explore new ways to improve what we do and how we do it.

No Waits

Nobody likes to wait.  We understand the frustration that waiting can cause. We seek to identify the causes fo delays.  We aim to fix the underlying problems, not the symptoms.  This can involcve a fundamental redesign and a change in culture.  We’re always looking at ways to make sure you get the right treatement at the right time from the tright team.

Zero Harm

We all need to be concerned about safety all of the time. We also need to be constantly aware of the potential for harm and learn from our experiences. It is our responsibility to ensure the safety of all our patients, families and staff. Zero harm is aspiration.

Clinical Audit

What is Clinical Audit?

‘Clinical audit is a way to find out if healthcare is being provided in line with best practice quality standards and lets care providers and patients know where their service is doing well and where there can be improvements. The aim is to allow quality improvements to take place where it will be most helpful and will improve outcomes for patients.’ (NHS England)

Clinical Audit at GOSH

The primary purpose of Clinical Audit at GOSH is to support the Trust Strategy to ‘Achieve the best possible outcomes, through providing the safest, most effective and efficient care’.

At GOSH we use clinical audit as a way to provide assurance about the quality of care provided and identify areas where quality improvement is required.

A central clinical audit plan prioritises audits to support learning from incidents, risk, patient complaints, and to investigate areas for improvement in quality and safety. In addition to this priority plan of audit, support and governance is provided for clinical teams to do clinical audit that supports the quality of care at GOSH.

For more information please contact:

Andrew Pearson, Clinical Audit Manager

Quality and Safety Team, Great Ormond Street Hospital, Great Ormond Street, London WC1N 3JH

Tel: 020 7405 9200 Ext: 5892

Quality Improvement

The Quality Improvement (QI) Team work to support, enable and empower individuals and teams across GOSH, to improve the quality of care we deliver to patients.

We provide expert QI advice, coaching and support to Trust-wide projects, and deliver a mentoring service for clinical and non-clinical staff to support local improvement initiatives. We also offer a variety of free learning opportunities including face-to-face training, e-learning modules and bespoke training sessions.

All our work is underpinned by the Institute for Healthcare Improvement (IHI) ‘Model for Improvement’ (1), which is a framework used to develop, test, implement and measure change. At GOSH, ‘Quality’ is defined using the Health Foundations six Factors (2): Safe | Effective | Person-centered | Timely | Efficient | Equitable

If you have any questions, or would like any further information, then please don’t hesitate to contact us via email at GOSH.QI@gosh.nhs.uk

  1. How to Improve. 2018. How to Improve. [ONLINE] Available at The Institute for Healthcare Improvement website.
  2. The Health Foundation. 2018. The Health Foundation. [ONLINE] Available at: The Health Foundation Website.

Find out more about the work of the QI team

Complaints Team

The Complaints Team manage all formal complaints and are there to support patients and families through the complaints process. The team is dedicated to listening to patients and families and ensuring that their concerns are investigated openly, thoroughly and responded to in a unbiased and timely manner.

The Complaints Team is committed to learning from complaints and ensuring that appropriate actions are taken to try and prevent the same, or similar, thing occurring again. The outcome of any investigation, along with any resulting actions will be explained to the complainant and they will be given the opportunity to meet with a member of the complaints team and, where appropriate, staff involved in their complaint.

The team is here to help and can be contacted by:

Phone: 020 7813 8402
Email: complaints@gosh.nhs.uk

They are also happy to meet with patients and families and should be contacted directly to arrange this.

Who are the complaints team? 

  • Donna Robinson, Lead for Complaints
  • Esher Bhamrah, Complaints Officer

Safeguarding children declaration

Great Ormond Street Hospital NHS Foundation Trust (GOSH) is fully committed to ensuring that all of our patients and their families are cared for in a safe, secure and caring environment. There is strong commitment to ensuring that structures and governance arrangements for safeguarding are robust.

The protection of vulnerable children and adults at risk from abuse and neglect is fundamental to delivering health and wellbeing and core to delivering the quality agenda.

As a result a number of safeguarding vulnerable people arrangements are in place.

These are detailed below:

  • GOSH meets statutory requirements in relation to Criminal Records Bureau checks – all appropriate staff employed at the Trust undergo a check with the Disclosure and Barring service prior to employment and those working with children undergo an enhanced level of assessment.
  • All of the Trust’s Safeguarding Children and Adults policies and systems are up to date, robust and are reviewed on a regular basis, ultimately by the Trust Board. The latest review was approved by the GOSH Policy Approval Group in December 2018 and is in line with national guidance. Policies and procedures are available to staff through a dedicated safeguarding intranet site and the Trust intranet policy library.
  • The Trust has a system in place for flagging children who are subject to a Child Protection Plan. All parents and carers will be routinely asked if they have an allocated Social Worker or have involvement with Children’s Social Care as part of health assessments. The Trust is working towards the implementation of the national Child Protection Information Sharing System (CP-IS) with an anticipated implementation by October 2020.
  • The Trust has a process in place to follow up patients who miss any appointments within any speciality to ensure their care and ultimately their health is not affected in any way.
  • The Trust has a robust strategy in place with regard to delivering safeguarding training to ensure that staff are trained to the appropriate level required for their role. The competencies are in line with the intercollegiate document ‘Safeguarding children and young people: roles and competencies for health care staff’ (January 2019 - available on the Royal College of Nursing website)
  • Compliance training figures:
    • Level 1 94%
    • Level 2 92%
    • Level 3 80%
    • Level 4 100%
  • The Chief Nurse is the Executive Lead for Safeguarding Vulnerable People and chairs the Strategic Safeguarding Committee (SSC).
  • The Trust has Named Safeguarding Professionals who lead on issues in relation to safeguarding.
  • In addition, there is an Operational Lead for Safeguarding Adults.
  • They are clear about their role, have sufficient time and receive relevant support, and training, to undertake their roles, which includes close contact with other social and health care organisations.
  • The Trust has a Safeguarding Team comprising:
    • Head of Safeguarding and Named Nurse - 1 x full time post (1 WTE)
    • Named Doctor - 0.6 whole time equivalent (0.6 WTE)
    • Senior Safeguarding Nurse Specialist and Operational Safeguarding Lead for Adults - (1 WTE)
    • Safeguarding Nurse Specialists - (1 WTE and 0.8 WTE)
    • Administration Support - 1 x senior post (1 WTE) and 1 x team administrator post (1 WTE)
    • NB: (1 WTE = 37.5 hrs per week)
  • The Trust Board takes the issue of safeguarding extremely seriously and receives an annual report on activities and compliance for safeguarding vulnerable people. The last Annual Report was presented to the Trust Board in May 2018 – the board paper can be found here.
  • The Trust has a robust Safeguarding Work plan which includes the strategic and operational recommendations required to be completed by the Safeguarding and Social Work Services in relation to training supervision and policy development. An audit programme in place to assure it that safeguarding systems and processes are working. Local audits are monitored quarterly by the SSC and are shared with Camden Safeguarding Children Board (CSCB) via the CSCB Quality Assurance sub-group, and annually as part of the GOSH Safeguarding Children & Young People Annual Report. The Trust participates in multi-agency audits with partner agencies.