Quality and Safety

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.

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

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

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

Find out more about the work of the QI team

The Complaints Team manages 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  

Section 11 of the Children Act 2004, places duties on a range of organisations, agencies and individuals to ensure their functions, and any services that they contract out to others, are discharged having regard to the need to safeguard and promote the welfare of children.

Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) ensures the adherence to these duties to safeguard our children, young people, adults and their families, by having robust and contemporaneous systems and processes in place.

Safeguarding governance

The Trust’s safeguarding governance structure is in line with NHS England & Improvement Safeguarding Accountability & Assurance Framework (2019). At Board level, the Chief Nurse is the Executive Lead for Safeguarding children, adults at risk and Prevent, and in addition there is a Non-Executive Director with the safeguarding portfolio. The Chief Nurse is a standing member of the Camden Safeguarding Adults Board (SAB) and Camden’s Safeguarding Children’s Partnership Executive Board (LSCP).

The Board reviews safeguarding, via quarterly reports to the Quality, Safety and Experience Assurance Committee; annually, the Trust Board will receive a Safeguarding Annual Report. The Chief Nurse receives assurance quarterly via the Strategic Safeguarding Committee, which is attended by the Designated Safeguarding Professionals from NHS North Central London Integrated Care Board (NCL ICB).

The Trust’s safeguarding arrangements are led by the Consultant Nurse Safeguarding/Named Nurse, Named Doctor and Named Lead for Adult safeguarding and Mental Capacity Act (MCA). The Safeguarding Service includes a substantive skill mix team of subject matter experts.

The Safeguarding Leads represent the Trust at partnership committees and subgroups for Camden’s SAB and LSCP; the Safeguarding Service is actively involved in partnership working within Camden and local agencies, in relation to the development and provision of multi-agency arrangements. The partnership working extends to the national and international tertiary multi-agency work to safeguard and protect adults and children.

Safer recruitment

In line with Working Together to Safeguard Children (2018) and the London Safeguarding Children Partnership’s London Child Protection Procedures guidance on People in Positions of Trust, the Trust has a robust Safer Recruitment policy and Allegations against Staff and Volunteers (ASV) policy in place. The ASV process acts immediately when allegations are made. The designated safeguarding lead (Nurse Consultant Safeguarding/Named Nurse) for the Trust, will report and liaise with Camden’s Local Authority Designated Officer (LADO), as well as the Designated Safeguarding Professionals. The Lead also escalates to the Executive Lead for Safeguarding (Chief Nurse) and where appropriate to the regulatory bodies.

Safeguarding training

The Trust ensures that mandatory training is effective and in line with the Intercollegiate Document - Safeguarding Children and Young People: Roles and Competencies for Healthcare Staff (2019), and Adult Safeguarding: Roles and Competencies for Health Care Staff (2018).

Systems and processes

The Trust ensures policies and procedures are in line and contemporaneous with national legislations, including Working Together to Safeguard Children (2018), the London Safeguarding Children Partnership’s London Child Protection Procedures and the Royal College of Paediatric & Child Health’s (RCPCH) safeguarding procedures.

The Trust was one of the first scheduled care centres to implement the national Child Protection Information Sharing System (CP-IS), which ensures the flagging of children who are subject to a Child Protection Plan or are Looked After Children. 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 their health assessments.

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.

Adult dafeguarding

Policies, arrangements and records are in place, to ensure consent to care and treatment is obtained in line with legislation and guidance, including the Care Act (2014) Mental Capacity Act (2005), Deprivation of Liberty Safeguards (DoLs) and in preparation of the implementation of the Liberty Protection Safeguards.

Updated in July 2022.

Tracy Luckett, Chief Nurse and Executive Lead for Safeguarding.