Mid and South Essex NHS Foundation Trust (MSEFT) is a merged organisation that delivers acute services to a population of 1.2 million people across central and south Essex via three primary sites: Basildon University Hospital, Broomfield Hospital and Southend University Hospital. In 2021, the organisation began its quality improvement (QI) journey.
Prior to 2021, and before the merger of three individual trusts and smaller sites to form Mid and South Essex NHS Foundation Trust, QI capacity was limited within each organisation. A programme director and a supporting team of no more than four was in place respectively in the individual trusts and Quality, Service Improvement and Redesign (QSIR) training had been established for staff with basic effectiveness. Once the organisations merged, it became clear that a standardised and consistent approach to continuous improvement would need to be developed and implemented across the newly formed trust and its sites for the best improvement outcomes.
In 2021, a business case to develop improvement capacity across the organisations, including expanding their individual improvement teams and embedding QSIR training as their joint QI methodology, was successful. The case was built on the urgent need for quality and safety improvements across services which were, at the time, experiencing challenges. Equally, as part of the business case, the team aligned their improvement priorities with the strategic aims of the organisation. This ensured that there was ongoing focus on the issues which matter to the organisation to support measurable benefits to patients and the quality of care they are receiving. All QI projects are now linked to at least one of the following strategic aims:
- We will put the patient first at MSEFT; caring for patients and valuing our people, our care is delivered by skilled and empowered staff.
- We will plan and provide enough of the right capacity to treat all our patients – both physically and virtually, working with our system to do so.
- We will design and implement the best model of care for patients receiving medical care in our hospitals, across professions, and by developing new roles.
- We will develop a quality learning system using evidence to improve safety and increase visibility, equity and effectiveness of care.
- Improving value in all we do and maximising the digital opportunities.
The team have been able to draw on the national body of evidence for QI as a strong route to improving standards of care, as well as the positive experiences and changes in culture, patient experiences and outcomes seen more locally in organisations that had already championed it. The improvement team's role in restoring services post Covid-19 and the success and achievements they had been involved in at pace also raised the profile of QI as an effective tool for change.
With the funding for this work now in place, teams have begun to evolve, and an associate clinical director for improvement has been brought into post. Transformational work around aligning services across the trust has highlighted issues around quality and safety that needed to be addressed. Clinical teams have become more engaged in supporting change, and greater focus has been given to facilitating frontline QI interventions in response to concerns raised by clinical teams.