The main hall of the Palais des congrès in Paris is an enormous space. For fans of trivia, it was the venue for the Eurovision Song contest in 1978. The 3000 plus delegates at the Quality Forum may have been there for a very different reason, but there was something about the design of the building and the international mix of the delegates, that kept nostalgic thoughts of the 1970’s returning to my mind (Israel won Eurovision that year, if you are interested).
This was my second visit to the Forum – my first was 6 years ago, the year that the 1000 Lives Campaign was launched, and it struck me how even 2008 is starting to feel like a long time ago. Caught in the cycle of daily work it is easy to fall into the trap of thinking that nothing much changes about the issues we confront and the opportunities we have to change them. Having the opportunity to take a step back and take a different view of your own work context was a good reminder of how mistaken that is.
One obvious change was the sight of hundreds of screens glowing in the auditorium as delegates recorded notes, photographed presentations and exchanged views on Twitter. Six years ago, sharing of information and contacts was still mediated through business cards and ‘stuff’ collected from exhibitor stands, but in the meantime, interaction has decisively moved online. It was salutary to reflect on how far the use of IT in clinician/patient communication is lagging behind the ways most of us now interact in our daily lives. Tom Delbanco’s presentation on open notes, shared between clinician and patient was a good example of how we might catch up, and a good stimulus for ideas we might try in Wales.
However, despite the stimulation of the conference, the learning that had most impact on me during those three days did not stem from a conference session at all: The timing of the publication of the Health Foundation and Nuffield Trust report comparing performance of the NHS in the four home nations may have been coincidental, but it felt significant, reading it across the Channel in France. What struck me was not that any service was shown in a particularly positive light, but that we are all making significant progress together. Yes, it highlighted some issues where we in Wales have a lot to do; but as far as core safety and experience indicators are concerned, it looks like all four nations of the NHS have been doing something right.
Talking to UK colleagues about the challenges of working on improvement programmes whilst surrounded by major organisational change, I remembered that when the 1000 Lives Campaign launched, we too were just beginning a period of major structural change. Many of us doubted that the Campaign and the methodologies that supported it would survive the change process. However, far from losing direction, the focus on patient safety and systematic improvement has started to become a routine part of organisation life. And judging from posters and presentations at the conference, experience is similar across Europe and beyond – similar interventions, similar methodologies, similar results.
So, six years on from the 1000 Lives Campaign, I might conclude that we are not doing anything particularly special in Wales. However, it does look as if we are keeping pace with a wider improvement movement. The introduction of Prudent Health Care looks to be right on target for where some of the most interesting innovation is now happening – particularly in changing the relationship between patients, the public and clinical services.