Autumn In-Brief 2018 V10 FINAL - Page 1

The root cause issue - Autumn 2018
Welcome to In-Brief
Welcome to our autumn 2018 edition of Niche In-Brief; our subscription-only collection of insights and articles from our
practitioners and partners. In this edition we are exploring a range of topics from supporting you with co-production to
understanding the methodology around root cause analysis techniques. Staying with root causes (no pun intended) we
hear from our guest contributor, Edmund Bailey, who talks to us about dental Never Events and how to improve
systems and processes to mitigate the risks of these occurring. Our lead article, however, is about our much loved
national institution of PALS. We question the relevance of this service in 2018 and how far away it has drifted from its
original intention. Enjoy this article and we will see you again in 2019! Sounds too early to say but have a great
Christmas and New Year from the Niche Team.
In this edition:
Are we still PALS?
Pages 1-3
Dental Never Events
Page 4-5
Root Causes
Page 5
Community services
Page 6-7
The ‘lean’ in clean
Page 7
Personality Disorders
Page 8-9
The principles of coproduction Page 10-11
Does clinically led mean
well led? Page 11
Are we still PALS?
In 2002 Tony Blair was in the
midst of his stomping reforms, it
was the Queen’s Golden Jubilee,
Arsenal won the FA Cup, the
Queen opened the
Commonwealth Games in
Manchester, BBC 6 music was
launched and S Club 7 won Best
British Single at the BRIT awards.
In the feverish high of New Labour
the government also decided that
it was time to break down the
walls of the old NHS and to create
a new landscape of patient
In 2002 the Patient Advice and Liaison Service, known as PALS, was formally
launched to the NHS to bridge the gap between services and service-users,
empowering patients and enabling the prompt resolution of issues.
Jump forward almost two decades into the increasingly litigious world of
healthcare, and the often increasingly vexatious relationships between the
public and their services. This, combined with ever-smaller budgets for nonessential services means that PALS has been through several identity crises
particularly over the last 10 years. At points PALS has almost come off the
agenda completely for some organisations who have moved to ‘integrate’
PALS into the complaints department (and yet those complaints keep coming).
Is PALS still relevant in today’s NHS? Does it have the power and scope that it
used to or does it now exist simply to supplement the ‘fire-fighting’ which is
endemic within the NHS of today?

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