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Professor Aled Jones

Professor Aled Jones

Professor: Patient Safety & Healthcare Quality; Research Theme Lead - OSDO (Co-Lead)

School of Healthcare Sciences

Email
jonesa97@cardiff.ac.uk
Telephone
+44 (0)29 206 88570
Campuses
12.06, Eastgate House, Newport Road, Cardiff, CF24 0AB
Welsh speaking
Users
Available for postgraduate supervision

Overview

RESEARCH SUMMARY

My research focuses on two specific dimensions of healthcare quality, namely patient centeredness and patient safety. Two particular areas of patient safety are of interest, namely employee “speaking up” (also referred to as whistle-blowing/raising concerns) about poor patient care and other breaches to patient safety, and safe nurse staffing levels. As a researcher whose aim is to practically inform the work of healthcare practitioners, policy makers and academics, I was particuarly delighted to be nominated and subsequently awarded the 2018 Royal College of Nursing Wales Nurse of the Year Award for "Supporting Improvement through Research" (see here).

In 2019 I was appointed the Health Services Research Specialty lead for Health & Care Research Wales (see here for more information). In undertaking the role I hope to create opportunities for health services researchers within Wales to network and share successes and challenges of undertaking projects, capturing meaningful research impact and generating research income. I also aim to review and improve opportunities for health services researchers to inform and guide policy makers and decision makers in Wales and elsewhere in the UK.

“Speaking up” about safety concerns and poor care

I am interested in understanding more about how workplace cultures restrict or enhance the act of speaking up by employees. A further question of interest is what interventions can be designed and implemented to help employees to speak up and to respond to speaking up by colleagues. I mostly use qualitative research and sociological approaches and theories to better understand speaking up in the workplace. Information about my current research projects can be found under the "research" tab above.

Practical application of research findings to improve practices is currently underway at various NHS sites. I also advise the Welsh Government group on "Raising Concerns", NHS England culture working group and am a current member of the United Nations Expert Group informing the development of Whisteblower Protections in the Health sector (see UN report here). 

Safe nurse staffing

There is a clear association between registered nursing staff levels and patient safety outcomes. However, important questions remain about the effective deployment of nurse staffing and associated resources. Research into nurse staffing for Welsh Government (see here) has been completed and I am a member of the NHS Wales Nurse Staffing Group, see here for further details of key note address at the 2017 Nurse Staffing Conference in Cardiff.

Patient Safety and Healthcare Quality

I have also published widely on patient safety communication and aspects of patient centred care in areas such as midwifery, primary care, mental health and children's care.

TEACHING SUMMARY

I teach on aspects of health policy, complex systems and the interface between policy/systems and the delivery of safer and improved quality of care to patients.

  • HCT 203 Public Health, Health Policy and Health Economics (Masters module);
  • NRT 073 Patient Safety & Clinical Risk (Masters module); 
  • HCT 118 Research methods (Masters module);
  • NRT 150 Transforming Care through Leadership (Masters module);

in addition to a range of pre-registration nursing and midwifery Quality and Safety Teaching.

Biography

ACADEMIC POSITIONS

2019 to current Professor of Patient Safety & Healthcare Quality, School of Healthcare Sciences, Cardiff University

2017 to 2019 Reader, Patient Safety & Healthcare Quality, School of Healthcare Sciences, Cardiff University

2011 to 2016 Senior Lecturer, School of Nursing and Midwifery Sciences, Cardiff University

2009 to 2011 Director of Postgraduate Studies, School of Healthcare Studies, Swansea University

2007 to 2009 RCBC Post-Doctoral Fellow & Lecturer, School of Healthcare Studies, Swansea University

1997 to 2007 Tutor/Lecturer School of Healthcare Studies, Swansea University

Other roles

2020 to current Specialty Lead for Health Services Research, Health & Care Research Wales

Honours and awards

Award

Institution

Date awarded

Nurse of the Year “Supporting Improvement Through Research”

Royal College of Nursing Wales

2018

Promoting Clinical Research and Application

NHS Wales Annual Awards

2012

Best paper award “Patient Safety” stream; Pan-Pacific Healthcare Research Conference

Hong Kong University

2007

Honorary Senior Lecturer

Hong Kong University, Department of Nursing

2007

Speaking engagements

Key note presentations at international conferences, including in Canada (2009), Hong Kong (2013), Ireland (2014) and Taiwan (2015). In 2019  key note speaker at a "speak-up” symposium hosted by the Royal Society of Medicine and as conference Chair (and keynote speaker) at an international patient safety conference.

Committees and reviewing

Grant reviewer: Health & Care Research Wales; NIHR (various programmes); ESRC; Swiss Science Foundation

Board member Health & Care Research Wales “Research for Patient & Public Benefit” (RfPPB) funding programmeJournal Reviewer: Range of international journals including BMJ, BMJ Quality & Safety, Journal of Advanced Nursing, International Journal of Nursing Studies, Sociology of Health & Illness, Social Science & Medicine.

Publications

2021

2020

2019

2018

2017

2016

2015

2014

2013

2012

2011

2010

2009

2007

2006

2003

2001

Teaching

Teaching

I teach on aspects of health policy, complex systems and the interface between policy/systems and the delivery of safer and improved quality of care to patients.

  • HCT 203 Public Health, Health Policy and Health Economics (Masters module);
  • NRT 073 Patient Safety & Clinical Risk (Masters module); 
  • HCT 118 Research methods (Masters module);
  • NRT 150 Transforming Care through Leadership (Masters module);

in addition to a range of pre-registration nursing and midwifery Quality and Safety Teaching.

RESEARCH TOPICS

Employees “speaking up”, raising concerns and whistleblowing 

Employees who “speak-up” or “raise concerns” about problems with healthcare services are often referred to as “whistleblowers”. Although whistleblowing makes an important contribution to patient safety in the NHS, whistleblowers have not always been treated well, often suffering professional and person reprisals from colleagues and the public for their efforts. The Francis Report in 2013 into serious patient care failures at Stafford Hospital is one of many inquiries into poor practice in the NHS which describe how whistleblowers were often ignored and mistreated by colleagues to the detriment of safe patient care.

Our research has explored the influence of workplace culture on employee speaking up. We want to better understand how the conditions and circumstances within organisations can encourage or deter staff from speaking up. Related to this, we also want to better understand the organisational response to concerns when raised –why is it that so many organisations respond so badly when employees speak up, even though organisations encourage this behaviour?

We have used qualitative social science approaches to better understand some of these questions. Our studies have been undertaken with staff from a range of professions and at different levels within the organisational hierarchy, from students and junior workers to executive level nurses.

Evaluation of the implementation of Freedom to Speak Up Guardians in NHS England (funded by the NIHR HS&DR programme 16/116/25) - final report under review

‘Freedom to Speak Up Guardians’ are a new role in NHS England introduced in 2016 designed to help staff to ‘speak-up’ about workplace concerns. In the NHS, the urgent need for a change in workplace cultures in relation to openness and learning from employee concerns have resulted in a raft of policies and measures seeking to provide legal, structural and social foundations for culture change. Among the policy initiatives is the ‘Freedom to Speak Up Review’ (Francis, 2015) and its formation of the Freedom to Speak Up Guardian (FTSUG) role and the ‘National Guardian’s Office’ as a means of normalising the raising of concerns.

The Review describes the FTSUG role as: ‘a key component in keeping watch over the way concerns are handled, providing support to those who need it, and ensuring the patient safety issue is always addressed. The climate that can be generated by these measures will be one in which injustice to whistleblowers should become very rare indeed, but is redressed when it does occur’ (p.198).

For further information about this project please see the project website by following this link

Research impact: Freedom to speak up safely with Cardiff and Vale University Health Board (funded by ESRC/Cardiff University Impact Acceleration Award).

In the summer of 2016 Cardiff and Vale University Health Board launched their Freedom to Speak Up Safely (F2SUS) initiative. The initiative is designed to support employees to raise and respond to concerns about any issue that deflects from the organisation’s aim to deliver consistently excellent care. Our research and expertise in this area of practice contributed directly to the design and implementation of the F2SUS initiative

Please see the following links for further information.

https://youtu.be/hRYdKkZDoyM

More information available at the following website:

www.cardiffandvaleuhb.wales.nhs.uk/freedom-to-speak-up

Other Patient Safety & Healthcare Quality current projects: 

Pro-Judge: An Ethnographic Examination of Nurses' Professional Judgement in Nurse Staffing Systems in England and Wales - funded by the RCN Foundation led by Prof. Davina Allen

Aim of this study is to better understand the role of nurses’ professional judgment in nurse staffing systems via qualitative comparative case study design of nurse staffing systems in England and Wales.

Data will be collected through a variety of sources: individual interviews, observations of relevant meetings and analysis of key documents. Data generation will be informed by science and technology studies and practice theories.

Ensuring adequate numbers of nurses are available to care for patients in response to shifting demand is an international policy priority. Emerging evidence on the use of formal workforce planning methodologies across the developed world highlights both the centrality of nurses’ professional judgement in nurse staffing methodologies and the urgent need for theoretically informed research to better understand and conceptualise its contribution to decision-making. This study is designed to address this gap in understanding. It takes advantage of nurses’ experiences of managing the service and staffing impacts of the Covid-19 pandemic and differences in strategic approaches to nurse staffing systems between England and Wales.

The research will:
  • make visible the knowledge and skills that underpin professional judgement in nurse staffing decisions and provide a conceptual language with which to articulate this;
  • lay the foundations for evidence-based programmes of nurse education and continuing professional development;
  • furnish the evidence to inform the development of nurse-led decision support tools to augment professional judgement; and
  • generate wider insights into the effectiveness of nurse staffing systems in practice.

Full protocol can be accessed here 

Understanding how to facilitate continence for people with dementia in acute hospital settings: raising awareness and improving care (funded by the NIHR HS&DR programme 15/136/67) led by Dr Katie Featherstone - final report under review

Enhancing the opportunities for people living with dementia to keep control over their most private of functions can enhance independence, rehabilitation, and reduce the length of inpatient stays (Morris, 2005). Incontinence is also highly discrediting (Brittain & Shaw, 2007; Kelly, 2009) and combined with dementia it increases stigma and produces a powerful attack on social status (Herskovits & Mitteness, 1994; Bamford et al, 2012). Yet there is a disparity between policy recommendations to improve care for people living with dementia within the acute hospital and their implementation. Despite the growing population of people living with dementia and the importance of continence care (DuBeau, et al, 2009), little is known about the appropriate management, organisation and interactional strategies for people living with dementia in acute hospital wards (Royal College of Physicians, 2012). In response, this ethnography will provide a detailed examination of the organizational and interactional factors that influence the management of continence care and add to understandings of the impact of these practices on notions of personhood and dignity for people living with dementia and those who care for their most basic bodily needs. Quality of care does not only encompass effectiveness, but humanity and equity. This study brings rigour to all of these aspects of acute hospital care. An initial systematic narrative review (Popay et al, 2006) will identify successful strategies used in other care settings that could inform innovations. Data collection (observation, ethnographic and in-depth interviews) will be in wards that exemplify the challenges for wards of caring for a large number of people living with dementia within 3 acute hospitals (1x MAU and 1x general medical, total: 6 wards).

For further details please see here

Quality-Assured Follow up of quiEscent Neovascular agE-relaTed maculaR dEgeneration by non-medical practitioners: a randomised controlled trial The FENETRE study funded by the HTA (17/85/05) led by Dr Konstantinos Balaskas, Moorfields Eye Hospital

In this large, multi-site prospective study funded by the NIHR, we will look at how care for patients with stable AMD can be devolved to community optometry practices. We will explore the role of digital technologies and artificial intelligence decision support to facilitate the process of monitoring patients with stable AMD closer to home, reducing the pressures on busy hospital-based eye clinics. Cardiff University are leading on the mixed-methods qualitative process evaluation phase of this trial, focussing on the workforce adaptations related to the intervention. Further information available here and here

Supervision

I have supervised 10 PhD completions with 14 completions as supervisor of MSc research dissertations.
PhD external examiner duties have been undertaken at the Universities of Bath, Northumbria, Bangor, Chester and Salford, in addition to being external examiner of the University of Buckinghamshire’s Professional Doctorate.

I am interested in supervising PhD students who would like to explore patient safety and quality improvement in health and social care contexts. Applications are particularly welcomed that focus on

  • Raising concerns/speaking-up/whistleblowing by staff about failures in care - for example, what are the barriers and facilitators to effective "speaking up" by staff? What interventions/initiatives can be developed to promote speaking up culture in the workplace?
  • Workplace culture and patient safety - for example, how does workplace culture affect healthcare workers understanding of patient safety and their safety practices?
  • Optimal deployment of staffing levels - for example, projects that consider nurse staffing levels and the effects on patient outcomes (e.g. safety outcomes) and staff outcomes (e.g. retention of staff, staff well-being).

Current supervision

Judith Benbow

Judith Benbow

Research student

Marianne Hamer

Research student

Patricia Brown

Research student

Rene Mifsud

Research student

Isabella Tetteh

Research student

Aseel Dardur

Research student

Hamza Jaber

Research student

alt

Sara Pocknell

Research student