Job summary
The post holder will provide support to the Quality Governance Business Partners regarding all aspects of clinical quality, risk management and governance processes.The post holder will work as an integral member of the Corporate Quality Governance Team and be supported by the corporate specialists in patient safety, clinical effectiveness, legal services, complaints, clinical audit and compliance to enable learning to occur and improvements to be embedded.The post holder will support the implementation of the Patient Safety Incident Response Framework (PSIRF). They will use their knowledge and expertise to ensure improvement and assurance is understood, recognised, and used to improve the outcome for our patients.The postholder will support and provide guidance and training on Incident Investigations and other learning responses / reviews as relevant. They will promote patient safety thinking, systems thinking and knowledge of human factors in order to develop understanding beyond why things go wrong into examining why things routinely go right and how that can be maximised .Actively seek and identify opportunities for quality improvement to improve safety and efficiency to ensure high standards of careThe postholders time will be partly allocated to quality governance with the remaining time allocated to improving patient safety, to support the delivery of PSIRF and quality improvement work streams.
Main duties of the job
The role of the Senior Quality Governance Manager is multifactorial but key duties include:
Manage incidents to validate and quality check the incident management system. Escalate incidents of concern to the Quality Governance Business Partner, Corporate Patient Safety Team and Care Group Triumvirate as appropriate.
Support the embedding of a systems- based approach to learning in line with PSIRF and support the inclusion of those affected by patient Safety Incidents in the process.
Participate in learning responses and up date the incident management system to identify the learning and how it has been shared.
Live the Trust Values, fostering a culture of high reporting and early engagement to respond to incidents and patient safety events in a timely way.
Create reports for compliance data and to reflect themes and safety risks. Support in the monitoring of actions to reduce risks and escalate areas of concern.
Access the performance indicator dashboards to ensure compliance for KPIs including Duty of Candour.
Ensure learning from data review and analysis is shared across the Care Group and Trust as appropriate.
Participate in the delivery of training with the team.
Identify quality improvement opportunities.
About us
We are one of the largest hospital trusts in England, with five hospitals and community clinics serving a local population of around 800,000 people. Our vision is 'great healthcare from great people'. Everything we do is guided by our values: 'People feel cared for, safe, respected and confident that we are making a difference'. We have a new way of working at East Kent Hospitals, called 'We care'. It's about empowering frontline staff to lead improvements day-to-day. We're looking for compassionate people to be part of our improvement journey for the patients, families and carers we care for every day.
Please note that if you require a Certificate of Sponsorship to work in the UK you must declare this on your application form, even if you currently have a certificate of sponsorship or a work permit for another role and are already working in the country. Please note we are only able to sponsor candidates on a Skilled Worker Visa applying for roles Band 5 and above.
Job description
Job responsibilities
Support the Quality Governance Business Partners to work with their allocated care groups to deliver quality governance within the care group. Connect people with curiosity, purpose and impact, demonstrating integrity, consideration and challenge.Support in the development, implementation and sustainability of: The Trust's Integrated Governance, Assurance and Safety agenda; the Patient Safety Incident Response Framework; and a Just and Learning Culture.To ensure that learning from adverse events, safety alerts and from positive practice is shared across the organisation to facilitate a culture of learning and improvement across the care groups.Deliver and contribute to the Trust training programme relating to PSIRF, Human Factors, Duty of Candour and Incident Management. Provide monitoring and escalation of training compliance across the organisation.
Ensure that incidents reported on the Trusts incident management system are validated and quality checked. Ensure that areas of high risk and high patient impact are escalated within one working day to the relevant clinical staff, care group triumvirate, specialists and Quality Governance Business Partner.Work in collaboration with the Corporate Patient Safety Team in the implementation of PSIRF and support a systems-based approach to learning from patient safety events.Support a variety of learning responses under PSIRF within the Trust and ensure compassionate engagement with those affected by patient safety events is maintained.Promote a culture where staff are confident in reporting incidents and being part of a learning response. Address and escalate when the Just Culture Guide and our Trust Values have not been adhered to.Have oversight of the Care Group incident closures, providing guidance and support to relevant staff where required, to ensure that timely management and closure of care group incidents is undertaken by the appropriate staff.Actively contribute to the senior management team within the Quality Governance & Patient Safety team, setting standards of practice, behaviour and leadership.
2. Risk ManagementContribute to the analysis of risk and compliance data dashboard by providing reports on data with recommendations to the lead clinical staff and care group governance meeting to address identified deficits in safety and/or compliance and ensure agreed actions are completed. Escalate to the care group triumvirate and Quality Governance Business Partner issues and risks of concern.Work collaboratively with care groups to enable the identification of safety risks through adverse incidents, learning from deaths, complaints, legal claims, H & S risk assessment, risk registers, CQC reviews and other methods of risk identification (e.g., safety alerts, NICE, GIRFT, etc). Ensure the care group triumvirate has processes to monitor the completion of any actions to mitigate identified risk, escalating any concerns in a timely manner.
3. Governance and QualityContribute to and support delivery of quality improvement projects related to PSIRF and patient safety.Access the performance indicator dashboards and produce required reports and associated recommendations in accordance with agreed quality governance arrangements.Promote and support in the review and analysis of care group patient safety data and intelligence, to identify themes and trends. Share information to inform on Trust projects/initiatives as directed that produce change and learning to reduce clinical risk.Provide support to the Quality Governance Business Partners and Care Groups on matters relating to risk and patient safety.
Monitor the completion of improvement plans arising from incidents and patient feedback with respect to agreed timescales and that evidence is recorded and where applicable submitted to the relevant groups. Escalate non-compliance within and external to the care group as appropriate.Monitor compliance with the Duty of Candour in respect of patient safety incidents, providing support for clinical staff and ensuring that the duties of the Trust are met. Escalate non-compliance within and external to the care group as appropriate. Work with the care group triumvirate to ensure staff are aware of and complete their professional and statutory requirements in relation to Duty of Candour.Support clinicians with patients and/or their relatives to outline the processes for investigation and discussing investigation findings.To participate in the preparation for any external regulatory visit by CQC as required.To manage and comprehensively respond to enquiries from a range of external organisations and sources including; CQC, ICB, NHSEI, Freedom of Information and other Healthcare providers.Attend relevant management meetings across the Trust as required.
Job description
Job responsibilities
Support the Quality Governance Business Partners to work with their allocated care groups to deliver quality governance within the care group. Connect people with curiosity, purpose and impact, demonstrating integrity, consideration and challenge.Support in the development, implementation and sustainability of: The Trust's Integrated Governance, Assurance and Safety agenda; the Patient Safety Incident Response Framework; and a Just and Learning Culture.To ensure that learning from adverse events, safety alerts and from positive practice is shared across the organisation to facilitate a culture of learning and improvement across the care groups.Deliver and contribute to the Trust training programme relating to PSIRF, Human Factors, Duty of Candour and Incident Management. Provide monitoring and escalation of training compliance across the organisation.
Ensure that incidents reported on the Trusts incident management system are validated and quality checked. Ensure that areas of high risk and high patient impact are escalated within one working day to the relevant clinical staff, care group triumvirate, specialists and Quality Governance Business Partner.Work in collaboration with the Corporate Patient Safety Team in the implementation of PSIRF and support a systems-based approach to learning from patient safety events.Support a variety of learning responses under PSIRF within the Trust and ensure compassionate engagement with those affected by patient safety events is maintained.Promote a culture where staff are confident in reporting incidents and being part of a learning response. Address and escalate when the Just Culture Guide and our Trust Values have not been adhered to.Have oversight of the Care Group incident closures, providing guidance and support to relevant staff where required, to ensure that timely management and closure of care group incidents is undertaken by the appropriate staff.Actively contribute to the senior management team within the Quality Governance & Patient Safety team, setting standards of practice, behaviour and leadership.
2. Risk ManagementContribute to the analysis of risk and compliance data dashboard by providing reports on data with recommendations to the lead clinical staff and care group governance meeting to address identified deficits in safety and/or compliance and ensure agreed actions are completed. Escalate to the care group triumvirate and Quality Governance Business Partner issues and risks of concern.Work collaboratively with care groups to enable the identification of safety risks through adverse incidents, learning from deaths, complaints, legal claims, H & S risk assessment, risk registers, CQC reviews and other methods of risk identification (e.g., safety alerts, NICE, GIRFT, etc). Ensure the care group triumvirate has processes to monitor the completion of any actions to mitigate identified risk, escalating any concerns in a timely manner.
3. Governance and QualityContribute to and support delivery of quality improvement projects related to PSIRF and patient safety.Access the performance indicator dashboards and produce required reports and associated recommendations in accordance with agreed quality governance arrangements.Promote and support in the review and analysis of care group patient safety data and intelligence, to identify themes and trends. Share information to inform on Trust projects/initiatives as directed that produce change and learning to reduce clinical risk.Provide support to the Quality Governance Business Partners and Care Groups on matters relating to risk and patient safety.
Monitor the completion of improvement plans arising from incidents and patient feedback with respect to agreed timescales and that evidence is recorded and where applicable submitted to the relevant groups. Escalate non-compliance within and external to the care group as appropriate.Monitor compliance with the Duty of Candour in respect of patient safety incidents, providing support for clinical staff and ensuring that the duties of the Trust are met. Escalate non-compliance within and external to the care group as appropriate. Work with the care group triumvirate to ensure staff are aware of and complete their professional and statutory requirements in relation to Duty of Candour.Support clinicians with patients and/or their relatives to outline the processes for investigation and discussing investigation findings.To participate in the preparation for any external regulatory visit by CQC as required.To manage and comprehensively respond to enquiries from a range of external organisations and sources including; CQC, ICB, NHSEI, Freedom of Information and other Healthcare providers.Attend relevant management meetings across the Trust as required.
Person Specification
Training and Qualification
Essential
- Registered with relevant professional organisation, either Nursing & Midwifery Council (NMC) or Health & Care Professional Council (HCPC) OR BSc degree qualification or equivalent in a health care or patient safety related discipline
- Previous approved training in patient safety, investigation and report writing e.g. HSSIB, or other approved training provider
- Previous experience working a governance related role
- Ability to fluidly use the functionality of an electronic database system e.g. Incident management software
Desirable
- Risk management training
- Governance training
- CPD in relation to patient safety and quality governance
Clinical Skills and Experience
Essential
- Person centred approach
- Clinical credibility and knowledge of evidence based clinical practice
- Excellent written, verbal and interpersonal communication skills
- Coaching and facilitation skills
- Ability to build and maintain effective working relationships with staff at all levels
Governance
Essential
- A comprehensive understanding of the Quality Governance agenda
- Proven experience and ability to produce and create letters, reports, recording systems
- Skilled in undertaking system focused patient safety learning responses e.g. PSII, AAR, MDT review, etc.
- Understanding of the principles and purpose on the NHS Patient Safety Strategy including PSIRF
Desirable
- Understanding of Health and Safety management
Personal and professional attributes
Essential
- Ability to handle difficult situations with tact and diplomacy
- Ability to manage conflicting and complex issues
- Ability to work in a fluid and dynamic environment
- Ability to prioritise workload and cope calmly under pressure to ensure deadlines are met
Other requireiments
Essential
- Good IT skills
- Good understanding of incident management reporting systems
- Good working knowledge of the Microsoft suite to produce reports, presentations and spreadsheets
- Basic understanding of data analysis techniques
Person Specification
Training and Qualification
Essential
- Registered with relevant professional organisation, either Nursing & Midwifery Council (NMC) or Health & Care Professional Council (HCPC) OR BSc degree qualification or equivalent in a health care or patient safety related discipline
- Previous approved training in patient safety, investigation and report writing e.g. HSSIB, or other approved training provider
- Previous experience working a governance related role
- Ability to fluidly use the functionality of an electronic database system e.g. Incident management software
Desirable
- Risk management training
- Governance training
- CPD in relation to patient safety and quality governance
Clinical Skills and Experience
Essential
- Person centred approach
- Clinical credibility and knowledge of evidence based clinical practice
- Excellent written, verbal and interpersonal communication skills
- Coaching and facilitation skills
- Ability to build and maintain effective working relationships with staff at all levels
Governance
Essential
- A comprehensive understanding of the Quality Governance agenda
- Proven experience and ability to produce and create letters, reports, recording systems
- Skilled in undertaking system focused patient safety learning responses e.g. PSII, AAR, MDT review, etc.
- Understanding of the principles and purpose on the NHS Patient Safety Strategy including PSIRF
Desirable
- Understanding of Health and Safety management
Personal and professional attributes
Essential
- Ability to handle difficult situations with tact and diplomacy
- Ability to manage conflicting and complex issues
- Ability to work in a fluid and dynamic environment
- Ability to prioritise workload and cope calmly under pressure to ensure deadlines are met
Other requireiments
Essential
- Good IT skills
- Good understanding of incident management reporting systems
- Good working knowledge of the Microsoft suite to produce reports, presentations and spreadsheets
- Basic understanding of data analysis techniques
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).
Additional information
Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).
From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).
UK Registration
Applicants must have current UK professional registration. For further information please see
NHS Careers website (opens in a new window).
