The IQILS team sat down with Dr Sarah Clark, consultant hepatologist, based at St George's University Hospitals NHS Foundation Trust, on embedding IQILS within their service after being awarded accreditation in April 2022. 

Engaging with the IQILS accreditation pathway was a significant driver in reflecting on our Hepatology Service at St George's Hospital, allowing us to identify our strengths, and the areas in which we could improve. Throughout the process, the whole team worked together to identify and take forward the service developments we felt would enhance the quality and safety of patient care, staff experience, the accreditation process provided the focus that we needed to achieve this. We made it a priority to involve every member of staff in the department in the process, from administrative and managerial colleagues, to Allied Health Professionals, nursing and medical staff. Thus staff level valued, all opinions are heard, and decisions and developments made together, as a team.

Following the initial work, we put in to achieve accreditation of our hepatology service, the requirement to consistently embed good practice and evaluatuation of our service into our daily activity has led to a more formal series of hepatology meetings. These allow us to track our progress as a team, provide updates at a subspecualty level, make plans for clinical and research developments, and raise concerns. We also have a patient representative at this meeting who contributes significantly to our discussions, providing insight into the patient perspective, a development that occurred directly as a result of using IQILS.

Working through the different domains of the IQILS standards, especially when applying for level 2, made us reflect om what our hepatology service offered and where we would like it to be. Achieving full accreditation was a huge piece of work, but there was a real desire within the team to develop and expand our serivce, and everyone in the team was fully committed to this process. We were lucky to have a project manager assigned part time to our team to assist with the accreditation process and evidence gathering. Their support was invaluable and is something that supported when moving forward with level 2. 

One area of our service which IQILS really brought into focus was patient engagement. As part of the assessment process we were asked to demonstrate that we are trying to develop a service with patients at the heart of it. Consequently, we have established a patient liver forum, to hear from our patients about their experiences of the service, and for us to provide education in requested areas related to hepaology. This has been running for more than three years and has proved hugely sucsessful, with 60 people attended our last meeting in-person and another 60 attending online. We try to include a broad scope of content, for example recently a dietician spoke to the group and one of our trainees discussed research projects. While improving patient engagement was always a goal of the team, it was something that we had not achieved before engaging with the IQILS process. Our provision of patient information leaflets in clinic, promotion of research and gathering feedback has also all improved by making us consider more closely what we are offering patients. 

Staff development is a part of IQILS and has ensured we look to support our staff in a range of educational activites, setting up an educational programme on our liver and GI ward and supporting staff to attend liver related courses. Two of our Band 5 ward nurses attended BASL Annual Meeting last year, and we have secured group nurse membership for our ward. Working through the IQILS process has proved to be useful professional development for some our colleagues, supporting skills in communication, writing IT and leadership.

In order to maintain accreditation, services are required to complete an annual review, which involves time, effort and coordination, in particalur, related to the yearly audit of our in-patient care. If compels us to reflect as a team on the achievements over the previous year and share ideas on what we would like to achieve in the year ahead, ensuring continuos development of the service. the process has encouraged us to be more explicit in documenting our departmental strategy, this being shaped by the whole MDT.

To conclude, participating in IQILS accreditation has been hard work but undoubtedly worthwhile. I strongly believe that engaging with IQILS has helped develop our hepatology service's identity and significantly raised the profile of our service within the Trust. The independent assessment and guidance the IQILS team offer can provide a significant lever for change within your organisation, which we all recognise can be challenging in the current climate. We have certainly seen the benefits to patients and staff as a result, all of which inspires us to keep improving. 

We would like to thank Sarah and the hepatology team at St George's University Hospital and are proud to have the service as part of the IQILS community.