Group of people in atrium

Clinical governance: creating a learning culture

Group learning

At AXA Health our priority is to ensure that all care delivered through our plans is the safest and most effective possible.  

There is a vast amount of evidence showing that, where you have a clinical setting with a culture which is transparent, which is learning, which is supportive, you get a much safer environment. What we’re trying to do at AXA Health is to support that culture, so that people aren’t penalised when things go wrong, where we can help people learn – from excellence, as well as from mistakes; and from other industries where safety is prioritised, such as the aviation sector.  

Data tables on screen

Data can identify good practice as well as bad, and so we use all the sources of information and data available to us to keep pushing towards ever safer, ever more effective care. I want to focus on people doing things really brilliantly, so we can say to our providers: ‘We can now benchmark you, we can see you’ve got the lowest rate of reported VTE – how have you done that, what have been those interventions?’ Or, ‘You’ve got the best outcomes for this, is that around your MDT, what have you done, can we share that with other providers?’ 

There’s a real momentum building within independent healthcare, with our providers increasingly keen to share learning which will continuously improve standards across the sector. It’s exciting to be a part of that.  

Dr Richenda Tisdale, Deputy Chief Medical Officer

Learning from excellence

Private healthcare tends to pay for the procedure, not the MDT reviewing that procedure. Nevertheless, clinicians have a responsibility to foster MDT working in the private sector, in order to deliver the tangible, measurable improvements in patient safety that we know are the result. 

We’ve worked with a few different providers who’ve found innovative ways to create a private MDT function. Virtual working, for example, allows you to work on your phone, and with people in different locations. We hope to encourage providers to agree a practical way forward for private MDTs, which we can then endorse and promote.  

Learning from mistakes

We have occasionally come across providers who have a very defensive culture, who don’t want to share details of their internal reporting.

But the majority of providers are the exact opposite, very happy to show us how they have responded to, and learnt from, any criticism from the regulator, for example.

We know that our providers work hard to meet and exceed regulatory standards, and an inspection offers them an opportunity to get insight into any areas which require fortifying or additional work.  

Learning from other sectors

In 2022 our clinical governance team received training in incident investigation from a company with a background in military aviation safety.

We're looking at how we handle investigations internally and where this overlaps with external investigations. We’re investing in this training to support a learning culture within AXA Health itself. 

Dr Richenda Tisdale studied Medicine and Neuroscience at Imperial College, London, obtaining her Master of Laws from Cardiff University. Following clinical ophthalmology practice in the NHS she worked for medical defence organisations including the MDU and the Medical Protection Society. She was Deputy Director at the Royal Cornwall Hospitals NHS Trust before joining AXA Health, where she focuses on clinical governance and patient safety in her role as Deputy Chief Medical Officer.

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