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Success factor 9: Continuous learning and curiosity

They learned from mistakes and were always looking for the next thing that they could improve.

Using training and feedback

The Christie NHS Foundation Trust, specialist cancer centre.

All staff must do equality and human rights training; by December 2016, 95% of staff had completed it.

Patient and staff feedback is seen as essential to improving care quality:

  • all surveys include equality monitoring - the disclosure rate has improved (97% of staff disclosure their ethnicity and 80% their sexual orientation)
  • professional interpreters are readily available
  • the trust responds - for example, by improving interpreting and translation services after a Deaf patient's complaint


  • 95% staff believe the trust provides equal opportunities for career progression
  • 9.7 out of 10 patients said they were treated with dignity and respect (2015 national patient survey).

Jackie Bird, Executive Director of Nursing and Quality: "The biggest challenge has been to ensure consistent and understandable messages are heard throughout the trust and that staff have named colleagues to go to."

"Our top tip is to engage early and to not invest in one person/one role. Try and make it everyone’s business."

Supportive, no-blame culture

The Doc's Surgery, city-centre practice with 7,500 registered patients.

There is strong support for staff:

  • communications include a daily coffee time debrief for clinicians and a monthly practice meeting for all staff
  • there is a space for partners / leaders to disagree – supported by a negotiated agreement
  • all staff are encouraged to get it right first time, so patients only need to say something once
  • they foster a learning environment with no blame – when things go wrong they view this as a learning opportunity

Staff engagement and learning

Herstmonceux Integrative Health Centre, a rural health care centre with 4,200 registered patients.

The practice supports staff learning about and developing an approach to tackling social issues that impact on health. They seek out evidence-based research and have set up a practice book club for staff to read recently published work that could benefit patients. This has led to high levels of staff satisfaction.

Dr John Simmons: Do you want to be doing what you are doing today in 5 years’ time? If not, get involved in creating the right health movement for your patient population, exciting, innovative, community health care that is as empowering for your patients as it is for you.

Technical innovation to improve communication

Style Acre, supported living service for people with learning disabilities and autism.

They go to exceptional lengths to identify innovative and creative methods to support people's communication needs. For example, they worked with IT specialists and the NHS to identify the most effective system for a person who was unable to communicate their needs. After significant research and trials, this person could communicate using pre-set phrases using new communication technology. For the first time they were able to tell staff that they needed pain relief.

Helping people to communicate their needs better is a fundamental way of making sure that people’s human rights are met.

Treloar college, residential further education college for students with a physical disability.

They encourage student independence by providing and adapting technology to maximise young people’s independence. For example, at least one student was able to send a text message to their family completely independently for the first time with technology the college provided. The college also worked with other organisations to define, share and promote best practice. Staff have undertaken research and published articles, for instance on the subject of adapting assistive technology to students' individual needs.

Working with groups who are not yet using the service

St Ann’s Hospice provides end of life care in Salford

The practice development manager chaired a meeting with a local transgender group. They learned of people’s concerns and anxieties. These included end of life medication, hormone replacement, body image, family complexities and documentation.

In response, St Ann’s now gives transgender people advice and guidance on these issues.

Also, the transgender group looked around the hospice and were interested in volunteering opportunities. This led to training for hospice staff about transgender people at the end of their life and transgender people living with dementia.


Last updated:
29 October 2018


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