Can BAPAM help your organisation ensure quality of clinical services for performing artists?
Performing arts organisations and businesses which commission or provide health services for artists, or are considering doing so, should comply with quality standards for healthcare to ensure the best service for beneficiaries, use resources effectively and help to manage any liabilities if things should go wrong.
We have just published a new Clinical Governance Toolkit which is available as a free resource.
BAPAM is a clinically led organisation working in the performing arts sector. We have a clinical governance framework in place and are registered with the Care Quality Commission (CQC).
We are available to:
Discuss quality issues in relation to an existing or planned service
Develop policy documents and reporting systems that allow you to continually monitor the quality of service delivery
Support the scrutiny of your service
We spoke to Dr Penny Wright, BAPAM Honorary Medical Director, to help demystify the topic of clinical governance.
Why is clinical governance important?
It’s a way of guaranteeing the quality of clinical services for patients: I think it’s most important to look at clinical governance from the patient’s point of view in the first instance. Patients often feel vulnerable when coming through the door, so they need to know they’re getting a service that is expert, that is going to come up with the right answer to their problem, backed up by evidence, in an environment which is caring and respectful of them, and where any risk is minimised. From the point of view of those us who are delivering those clinical services, the doctors and other clinicians and the organisations that they work for, making sure that services are of a high quality is also important: if we provide services that are either not of a good quality or not the right services, the ones our patients need, we’re risking the patient getting poor care and we’re risking wasting money and time. There are assumptions that because healthcare practitioners like doctors and nurses are caring and expertly trained, we always provide a good service, but we don’t actually know that (or even know what a ‘good service’ is) if we don’t monitor it and ask questions about how it could be better. Sometimes asking clinical governance questions can be very unpopular! But in the end, asking how we clinicians know that we are doing the right things – and whether we could do better – is in everybody’s best interests.
What does it mean for Performing Arts Medicine providers?
Providers such as BAPAM need to make sure that the service they’re providing is actually effective at treating performers, as they obviously have very special needs and issues. For example, there’s no point in providing performers with physiotherapy advice geared towards sedentary office workers. For care to be effective, providers first need to look at the quality and expertise of the people delivering it: the clinicians that you work with need to be well trained and they need to understand performers in order to provide all the right advice. It’s also about using an evidence base: if you provide a particular form of treatment to a performer, how do you know that it’s the right treatment, that it’s going to help? Underpinning everything has to be this constant questioning, which is ‘how do we know what is the best thing to do for this patient?’ So the evidence base I would say is part of clinical governance. In addition, for whoever is funding the service, “clinical effectiveness is cost effectiveness”, a treatment which works is also likely to be worth the money that it costs.
What does clinical governance mean for patients?
It provides reassurance that the care they’re getting is the right care for them; that it’s delivered in a way which is respectful and professional; and by people who have been appropriately trained. So in a way it is all about standards and, for performers, it’s about receiving career-specific care which is relevant for them in an environment where they feel more understood than they might do in the busy NHS, or in non-specialist freelance or private services.
How can an individual practitioners ensure clinical expertise when working with performers?
I think it’s a combination of training and experience. From the point of view of training, it doesn’t just mean going to conferences and training days, reading journals and things like that, it’s also about networking with specialists in the field and asking advice and learning from them. At BAPAM clinics, our clinicians are always happy to have colleagues sitting in with them. In Performing Arts Medicine in the UK, formal learning opportunities are currently limited but they are out there: there are courses and training days such as those we run at BAPAM, and there are a limited number of specialist journals, or relevant articles in general journals. There are also academic courses that people can go on, like the Performing Arts Medicine MSc at UCL. However, if you’ve got good basic clinical skills in your own area of practice you will also learn simply from seeing lots of performing arts patients: for instance you will learn about problems affecting clarinettists if you see a lot of clarinettists (with their instruments if necessary) and you’ve got the basic skills to ask the right questions about what’s happened to them and why.