Letters : Frontline involvement

Dr Dilys Jones is not alone in recognising the frustrations of frontline staff ('Night blindness', page 25, 25 October, ). We know they are best placed to resolve many of the problems that hamper their ability to provide services to a standard they can feel proud of. But they do need to be given the opportunity to do so.

Guy's and St Thomas' Hospital trust has developed a programme aimed specifically at addressing problems locally. Our 'Conduct of Care' programme, based on delivering our code of conduct, encourages staff to take control and responsibility for improving aspects of their service that they are unhappy with.

Facilitators - frontline staff - work with their colleagues to identify an aspect of their service they want to improve and actionplan its achievement.

Most actions in completed projects so far are within the control of the staff involved, requiring little direct management input. The bonus is the improvement to communication and teamworking this brings about.

It is a simple model easily transferable across the whole of the service, and is beginning to make a real impact on the quality of care and the environment.

We still have some way to go to replicate the success across the whole organisation. But we are committed to making the programme an integral part of how this trust works.

Aileen McAllister Core training and projects manager Guy's and St Thomas' Hospital trust Aileen.Mcallister@gstt. sthames. nhs. uk