“Always Events” (R) a review

On getting it right for every patient every time.


A fascinating day of OD theory, good practice and case studies – plus some hard core social science…

…where else would you find Captive Health’s Andrew Cockayne on a rainy Tuesday afternoon than speaking at the UK’s first ever conference on Always Events? Registered as a trade mark by IHI, Always Events (R) are a simple way of engaging staff and changing the narrative in a healthcare setting.

Andrew opened his talk with these remarks “it effects how we think, and engages peer pressure to encourage  people to do the right thing. Because if we ‘always’ do these things, then they become part of ‘how we do things round here’. And over time it becomes unacceptable not to do them.”

So here we have a powerful staff engagement tool, focussed on the patient experience.

Highlights of the day were perhaps:

  • Neil Churchill, Dir of Patient Experience for NHS England confirming that there a will be no nationally prescribed set of always events.
  • Pedro Delgado of IHI giving us a toolkit to take away and make our own.
  • Gregor Smith, the Scottish Government’s Senior Medical Officer for Primary Care showcasing his work developing Always Events for primary Care
  • John Bellerby, Quality Improvement Lead at Salford Royal Hospitals NHS Foundation Trust and Umesh Prabu Clinical Director at Wrightington Wigan and Leigh NHS FT talking about their respective improvement journeys.


So what do we take away?

1) Patient involvement really matters. At the bedside, in your planning, in co-production, in the big and the small things alike.

2) You need to focus on the things that matter to patients: individually, service-wide and organisationally.

3) You’ll need different tools and techniques to get it right at each of those levels.  At service level, providing staff with a set of expected behaviours or things that should always happen is really really important.

4) Any pretext to employ good management practice and manage change well is valid. Find ways of making it yours, empower staff and focus on the results for patients – from start to finish.

5) Then repeat.  You have to make continuous improvement part of your culture.


So, stepping back and reflecting after a day packed with insight and charged with positive energy, it is hard not to conclude that we’ve been here before. That’s not cynicism, it’s pragmatism.

Because high performing organisations listen to their service users, generate insight from what they hear (by means of good user involvement if possible), use it to drive change, in doing so communicate well with staff and manAge them supportively through change, then celebrate the results while re-focusing on the next challenge.

“Always Events” may be just another fad. But so what? Let’s be true to the principles and make it so.