Dr Nick Broughton, Chief Executive Oxford Health NHS Foundation Trust, OAHP Board Member.
Innovation Perspectives is OAHP’s Q&A series with health and care thought leaders. Here we chat with Dr Nick Broughton, Chief Executive of Oxford Health NHS Foundation Trust and OH’s representative on the OAHP Board. Nick shares his perspective on building an inclusive research and quality improvement culture and how new ways of working can improve NHS resilience.
“We need to ensure that we give our clinicians and allied health professions the ring-fenced time to engage in research.”
Research is one of four strategic priorities in the Oxford Health NHS Foundation Trust 2021 – 2026 strategy. What is the Trust doing to build an inclusive research culture that supports the adoption of new innovations into clinical practice?
Our plans build on foundations that we have put in place over the last few years in terms of research infrastructure, including hosting several NIHR centres and our strong academic links with a variety of organisations, such as the University of Oxford.
One of the things we are taking forward is a whole organisational development piece focused on culture. A key component of this is to embed research across the organisation so it is front and centre of how we deliver services and clinical practice. The recently launched Brian Health Centre is a great example of how research can be integrated into day-to-day clinical care, and so we are building on models like this with the expectation that research becomes a golden thread running through the organisation.
Linked to this, we need to ensure that we give our clinicians and allied health professions the ring-fenced time to engage in research. We are taking this forward through job planning, backed by the Trust’s Chief Medical Officer and Chief Nursing Officer.
All of this comes down to leadership and continually highlighting why research is important and why we want to be one of the largest research active and leading NHS organisations in terms of our research activity and our research portfolio. To lead this agenda, we have recently appointed a new director for Research and Development who will work in conjunction with the Chief Medical Officer, who has executive responsibility for research across the organisation.
How can health and care staff be best supported and empowered to get involved in quality improvement initiatives, particularly those who have little or no experience of research?
We see research as a component of quality improvement (QI). In addition to pure research, we have had a QI programme with dedicated resource in place for the past four years. We’re keen to really accelerate and expand this programme and to make it part and parcel of how the trust operates, not just clinically but also in terms of all our back-office functions, such as recruitment, IT and estates.
All of this comes down to culture and developing both a strong QI ethos and a clear expectation that QI features prominently in how we go about delivering services and care. We would like to see colleagues at every level of the organisation engaged in QI activity on a regular basis, either leading projects or just participating in projects. Some may be fully trained QI trainers others may just have a cursory knowledge of QI.
The best organisations as we see it are characterised by a particularly strong QI culture and focus, with QI being absolutely essential to how people work and how the organisation operates. This is the mindset we are working to develop across Oxford Health.
How can the region’s NHS services be more responsive and resilient to the next health crisis, and how can university and NHS partnerships support this?
We need to learn from what’s happened over the last couple of years and embed some of those changes and make them customary practice. Certainly, during the pandemic, we were able to operate in a far more agile way than perhaps traditionally has been the case, particularly in terms of embedding innovation, for example digital solutions to provide remote consultations. We don’t want to lose that. We’re very keen to harness such technology to free up the time of our clinicians, because our workforce is our greatest asset and they face huge pressures. It’s clear that we need to think differently about how we deliver services, and we need to be using clinicians’ time as efficiently and productively as possible. This is where the digital agenda comes into play.
Additionally, we need to make sure that services are more resilient with more capacity and capability. Take winter planning as an example, we should not have to regularly plan each winter for the increase in demand that we’ll see in the winter months because we’ve known for decades that we’ll see such an increase in demand. We should have more resilient and robust models of service delivery that we can flex according to peaks and troughs in demand.
Developing these improved services relies in part on collaborative working with other healthcare organisations and colleagues in the social sector, working together to consider how we join up services, utilise resources, realise economies of scale, and build on some of those innovative service models that we developed during the pandemic.
The vaccination programme is a case in point, it was delivered through truly integrated partnership working involving a variety of different organisations including local authorities, healthcare trusts, third sector organisations and GP practices. It is a great example of how the system came together, how it coalesced to meet a challenge and how it was able to innovate and develop a new model of service delivery in an incredibly short space of time.
What joint clinical research initiatives would you like to see developed over the next 5 years?
Our trust’s academic relationships are really important. These are hugely valuable partnerships which been developed over many years and we’re keen to build and expand on them. From my perspective, it’s important that we use this capability to address some of the key operational challenges and risks that we’re facing as an organisation. I would like us to focus some of this capability on developing better models of service delivery with the strongest possible evidence base and looking at how we can address our workforce challenges through more innovative services and types of roles. We could also look to other countries and nations to identify best practice outside these islands and consider how this can then be lifted, shifted and embedded in our particular systems.
How do you see our region’s research assets supporting the developing research and innovation agenda across the BOB Integrated Care System to tackle the region’s complex healthcare challenges?
We have a huge amount of research infrastructure across the BOB Integrated Care System, including a number of universities that train virtually every type of health care professional imaginable, including the University of Oxford with what I understand is the world’s highest-ranked medical schools. I think this should be a real strength and a unique selling point for us, since these are assets that many other systems just don’t have.
There is potential to align this academic capability with the BOB Integrated Care System and the work of Oxford Academic Health Partners to address many of our current operational challenges, like retaining and recruiting staff, growing our own workforce, and helping to create job plans that are stimulating, interesting and varied for health care professionals from all professional backgrounds.