Aim: To review and revise the process of Health and Safety (H&S) investigation, RIDDOR identification and reporting to the Health and Safety Executive (HSE) to meet the legal requirements. On 30 January 2019 the HSE formally contacted the Head of H&S to raise concerns over the timeliness of RIDDOR reporting. The RIDDOR regulation requires that work related ‘specified’ injuries are reported in 10 calendar days and work related injuries that result in an over 7 day absence are reported in 15 calendar days. HSE communication initiated a focussed review of the H&S investigation process and RIDDOR reporting arrangements. Facilitated process mapping session identified: • delays in receiving incident reports as these were only sent following manager sign off • delays in incident reports being reviewed as this task was the responsibility of the most agile staff • delays in investigation as securing sick notes were not easily available • PDSA principles were used to quickly introduce changes Tools Used: Process Mapping which is usually undertaken with a range of people involved in the process, and enables you to create a visual picture of how the pathway currently works, capturing the reality of the process, exposing areas of duplication, waste, unhelpful variation and unnecessary steps - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-mapping-the-process.pdf. Statistical Process Control (SPC) chart, which is an analytical tool that plots data over time, showing the impact on data when changes are implemented - https://www.england.nhs.uk/statistical-process-control-tool/. Value Stream Mapping is a more detailed process map. It helps staff to understand the steps in a patient journey and the patient experience of the journey. It is used to improve their journey / pathway by eliminating steps that do not add value for them. Patients should be involved in value stream mapping - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-value-stream-mapping.pdf. Lean Transformation (Ohio’s eight wastes) approach is used to help teams examine their own workplace and eliminate activities that do not add value. This can improve patient experience and release time for frontline staff to reinvest in service provision / care giving - https://aqua.nhs.uk/wp-content/uploads/2023/07/qsir-lean-ohnos-eight-wastes.pdf. Project Impact: Timely reporting of RIDDOR incidents has reduced the risk to the organisation of HSE intervention, improved the grip of H&S related incidents and investigation workflow, created a timely response to incidents which will improve staff experience of H&S investigations and created a timely identification of H&S risks and resultant actions to prevent reoccurrence.

Aims Telephone consultations have been in clinical use since the early 1960s and are increasing in frequency and importance in many areas of medicine. With the advent of the COVID-19 pandemic in 2020, the use of telemedicine consultations increased dramatically alongside utilization of other digital technologies. Despite promise and potential advantages for clinicians (including remote working, improved time management and safety) there are known drawbacks to telephone consultations for psychiatrists. This includes limitations to assessments of mental state and risk, with loss of non-verbal communication often cited as a point in favour of more sophisticated technologies such as video calling. By adopting telephone consultations to a greater extent during the initial months of the COVID-19 pandemic in the Coventry Crisis Resolution and Home Treatment Team (CRHTT), we aimed to assess the patient experience in telehealth, through a patient survey. Method After an initial assessment or follow-up consultation with a medical practitioner from the crisis team, patients were invited to take part in a short questionnaire with a member of the administration staff. This consisted of eight questions on a Likert scale and three open questions for comments. Results were collated and analyzed via Microsoft Excel. Result Most patients found the telephone consultations satisfactory, with more than 90% returning positive scores in understanding, convenience and overall satisfaction. All patients felt listened to and that their confidentiality was maintained; with all but one respondent willing to engage in further consultations via the telephone. Negative scores were typically returned for practical telephonic problems including poor signal, interference and background noise. In their comments patients expressed largely positive views about their experience with their clinician; analysis revealed key insights into the patient experience, demonstrating the convenience, comfort and flexibility possible with ‘telepsychiatry’. Conclusion Patient experience of telemedicine in a UK psychiatric crisis team is mostly positive, with clear advantages for both patients and clinicians. Our results show telephone consultations can be expanded to new patient assessments alongside follow-ups, enabling the team to reach a greater number of service users. This includes service users who are housebound due to infirmity, required to shield or have significant anxiety about the pandemic.