Improvement and innovation are intrinsically linked and are at the heart of health and social care. Improvement through innovation happens across the sector every day. Often, innovations begin with one person’s observation or idea. Supporting staff and colleagues to follow their professional curiosity and develop innovative thinking can lead to improvement across whole systems.
A success story
One example started with the adult continence team at University Hospitals of Leicester NHS Trusts (UHL). It had noticed an increase in toileting-related inpatient falls and asked the question – would reducing caffeine intake reduce the number of falls? Caffeine has a mild diuretic effect and can increase urinary frequency and urgency. Decaffeinated drinks were offered to patients and early results showed a 30% reduction in the number of falls.
Interested by these findings and recognising that falls are the most common cause of injury-related deaths in people over 75, Care England worked with Sarah Coombes, Continence Nurse Specialist at UHL, to find adult social care providers willing to take part in a care home trial.
Stow Healthcare, a group of eight nursing and residential homes in East Anglia caring for more than 350 residents, was the first to trial serving decaffeinated drinks in its homes. Over the six-month trial, the provider observed a 34.72% reduction in toileting-related falls. It has continued to offer decaffeinated drinks as default, with the option of caffeinated beverages available.
This was a small study, but the researchers have suggested that extending it across the sector could save £85m per year in prevented falls and hospital admissions – and, of course, reduce the number of people whose lives are impacted by falls.
Evolving expectations
Our assessment framework encourages improvement through innovation and assesses providers through the quality statements. Sitting under the ‘Well-led’ key question, the learning, improvement and innovation quality statement specifically addresses the way that leaders support improvement:
‘We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research.’
This quality statement describes the expectation that health and social care services embrace innovation as a means of improvement. The origins of the decaffeination trial, where curiosity was encouraged and supported, leading to a tangible difference to people’s lives, is a good example of how to evidence that.
Late last year, we published the results of a project we’d been running to understand the experiences of providers and innovators who have considered developing or adopting new ways of working. As well as looking at the work being done to promote innovation, the project, funded by the Regulators’ Pioneer Fund, considered how to lift barriers to innovation.
In addition, this also helps us to fulfil our purpose: To ensure health and social care services provide people with safe, effective, compassionate, high-quality care and encourage care services to improve. It also helps us deliver on our strategic commitments to encourage and champion innovation that benefits people.
Through the project, we found that innovation does not have a one-size-fits-all solution but depends upon a thriving improvement culture. This is a culture where people feel supported to try new things and have the space to reflect on progress and setbacks. Innovations and improvements might be big or small – the key is the impact they have on people.
We look for learning cultures and their impact through our assessment activity and will continue to amplify examples of innovation that improve outcomes for people using health and social care services.
For more information about the decaffeination trial discussed in this article, read issue 3 of Care England’s Savings, Solutions, and Sustainability publication.
Amanda Partington-Todd is Deputy Director of Adult Social Care at the Care Quality Commission (CQC).
Email: [email protected] X: @CQCProf