Trust Board 3 September Title of Paper: National children s inpatient & day case survey- 2014/15

Transcription

1 Trust Board 3 September 2015 Title of Paper: National children s inpatient & day case survey- 2014/15 Agenda Item: 12/29 Lead Executive: Author: Trust Objective: Tracey Carter, Chief Nurse & DIPC Jo Fearn Head of Nursing - Paediatrics Tick as appropriate: Achieving continuous improvement in the quality of patient care that we provide and the delivery of service performance across all areas; Setting out our future clinical strategy through clinical leadership in partnership and with whole system working; Creating a clear and credible long term financial strategy. Purpose: To report on the results of the national Children s survey results To report on the overall national Trust ranking in the CQC results To reflect on the priorities and concerns of the patients feedback To provide an update on any actions to take forward To report at result comparisons with other local Trusts Please add which panel and/group that the paper has been previously discussed: Panel Committee Name: TLEC Date: 18 July th July 2015 Patient Safety, Quality & Risk Committee Benefits to patients and patient safety implications To improve the patient experience by listening to their feedback and acting on the learning. Risk implications for the Trust Failure to achieve a good patient experience Reputational risk We will not meet our statutory requirements If we do not listen to and act upon the views of our service users we will not meet their expectations or needs. To ensure all actions are taken forward in order for Children s Services to learn to from these results. Mitigations actions (controls) 1

2 Links to Board Assurance Framework, CQC outcomes, statutory requirement The Care Quality Commission (CQC) Essential Standards for Quality & Safety: Outcome 1: Respecting and involving people who use our services. Legal implications (if applicable) Financial implications (if applicable) Recommendations (delete as appropriate) The Board is asked to note the contents of the report. 2

3 Agenda Item: 12/29 Trust Board meeting - 3 September 2015 National children s inpatient & day case survey- 2014/15 Presented by: Tracey Carter Chief Nurse & Director of Infection, Prevention and Control 1. Purpose 1.1 This paper provides a summary of the findings from the National Children s Survey carried out by the Picker Institute (Europe) Ltd, together with the final results from the Care Quality Commission (CQC). This is a mandatory annual survey carried out by the Trust using patient samples from 20 th August 2014 to 20 th September 2014 (this timeframe was stipulated by the Care Quality Commission due to opt out posters not being available and displayed in time for the beginning of August 2014). 1.2 The final results and the embargo were lifted on the results of this national survey and published by the Care Quality Commission (CQC) on 1 st July Background: Picker Institute Europe: 2.1 The Picker Institute National Children s Survey looked at the experiences of 420 children and young people who received inpatient or day case care (only 415 were eligible for the survey). The paediatric inpatients and day case patients sampled for the survey were all discharged from West Hertfordshire Hospitals NHS Trust from 20 th August 2014 to 20 th September Of these patients, 292 were aged 7 years or under at the time of sampling, and their parents/carers were sent the parent s version of the questionnaire. The 67 patients aged 8-11 years were sent the children s survey and 61 patients aged years were sent the young person s survey. Of these, 113 returned a completed questionnaire. This gave the Trust a response rate of 27%. The response rate across all 69 NHS Acute Picker Trusts was also 27%. 2.2 Key facts about the 113 patients who responded to the survey: 68% of returned questionnaires were the parent/carer version (0-7 years), 16 % were the young person s questionnaire (12-15 years) 57% admissions were emergency whereas 43% of attendances were planned 54% has a procedure or operation during their stay 58% of young patients were male; 42% were female 3

4 84% stated their ethnic background as White; 5% Mixed; 7% Asian/Asian British; 4% Black/Black British; 1% Other ethnic group. Care Quality Commission: 2.3 The CQC conducted its first national children s survey involving 19,000 children and young people who received inpatient or day case care in 137 NHS Acute Trusts. Key Findings Linked to the 2012 and 2014 Picker together with the CQC 2014 National Comparisons: 2.4 In comparing in results from the Picker 2012 and those of the 2014 survey the Trust has significantly improved. Our services also compared favourably when compared with the findings from the CQC survey. The Trust has IMPROVED significantly on the following questions: CQC National Comparisons (2014) Hospital room or ward not clean 8 % 3 % 8.7/10 (P/C) Parent did not feel that child was always safe on the hospital ward Child not always given enough privacy when receiving care and treatment (parent s/carer s view) Child not always given enough privacy when receiving care and treatment (children/young person s view) 20 % 9 % 9.5/10 (Pt) 36 % 12 % 9.3/10 (P/C) 29 % 12 % 9.3/10 (Pt) Parent told different things by different people 39 % 25 % 8.6/10 (P/C) Parent not able to stay overnight but wanted to 7 % 0 % 7.6/10 (P/C) Child not fully told what would be done during operation Parent not given enough information about how child should use the medicines Parent did not receive written information but would have liked it 34 % 13 % 9.5/10 (P/C) 15 % 3 % 9.6/10 (P/C) 22 % 13 % 7.9/10 (P/C) Parent felt that they were not always listened to 30 % 14 % 9.2/10 (P/C) NB P/C indicates views of parent and carers; Pt indicates views of patient, i.e. child or young person. 2.5 The Trust did not show that it was significantly worse on any questions in the 2014 Children s survey, when compared to the 2012 survey results. None of our results were significantly worse than the Picker or the CQC National. 4

5 Comparison with other Picker Trusts: 2.6 In reviewing our results alongside the other Trusts in the Picker survey, our services did significantly better in the areas identified in the table below. Our services also compared favourably when compared with the findings from the CQC survey. In two questions on the CQC survey we performed BETTER than the national. The Trust was significantly BETTER than the Picker for the following questions: Trust Picker CQC National Comparisons (2014) Planned admissions: not given choice of admission 36 % 55 % *N/A (P/C) date Things for child to play with on ward were not fully 19 % 30 % *8.9/10 (P/C) appropriate Staff did not play with child but parent would have 14 % 25 % *8.3/10 (P/C) liked this Staff did not agree a plan with parent for their child's care 6 % 10 % 9.5/10 (P/C) BETTER Parent did not receive clear answers to questions 5 % 12 % *N/A (Pt) before the operation or procedure Parent felt that they were not always listened to 14 % 26 % *9.2/10 (P/C) NB P/C indicates views of parent and carers; Pt indicates views of patient, i.e. child or young person. 2.7 The table below identifies areas where our services performed less well when compared to other Trusts who participated in the Picker survey. However, when comparing the same findings with those of the CQC findings, we performed either * ABOUT THE SAME or BETTER. The Trust was WORSE than the Picker for the following questions: Trust Picker CQC National Comparisons (2014) Hospital did not fully tell child what would happen to 31% 21% *N/A (Pt) them in hospital Not enough age-appropriate things for child to do on 82% 76% *8.4/10 (Pt) the ward Staff did not always talk to child about their care in a way that they could understand 28% 17% 8.4/10 (Pt) BETTER Staff did not fully talk to child about their worries 27% 24% *8.4/10 (Pt) Staff did not do everything they could to help ease 27% 25% *N/A (Pt) their child s pain Child not fully told what would be done during 13% 9% *N/A (Pt) operation Staff did not fully explain to parent how the 20% 18% *8/10 (P/C) operation had gone Parent not told what to do or who to contact if 26% 24% *8.4/10 (P/C) worried when home Overall: child rated experience as 7/10 or less 14% 13% *8.5/10 (Pt) 5

6 NB P/C indicates views of parent and carers; Pt indicates views of patient, i.e. child or young person. 2.8 The Trust did not perform worse when benchmarked against the national on any questions in the CQC 2014 Children s survey. 2.9 Comparison with local Trusts in regard to the two questions where West Herts scored significantly BETTER: QUESTIONS: WHHT MILTON KEYNES E & N HERTS HILLINGDON BUCKS L&D Staff did not 9.5/10 8.5/10 8.0/10 9.2/10 8.4/10 8.6/10 agree a plan with parent for their child's care Staff did not always talk to child about their care in a way that they could understand 8.4/10 No score recorded No score recorded No score recorded 9.3/10 7.3/ Have we improved since the 2012 survey? 3.1 As identified above, there is significant evidence to support the fact that progress has been made towards improving the child and family experience in our inpatient and day care services. The main themes of improvement relate to the ward environment, communication with parents/carers and information given to children and families regarding their operation/procedure. 4.0 Next Steps: 4.1 The findings from the Picker and CQC national Children s surveys will be developed into an action plan and subsequently shared at the Quality & Safety Group, Divisional Management Panel, the Paediatric Liaison Group and the clinical/multi-disciplinary teams. Assurance will be sought through the Safety & Quality Committee. 4.2 The Action Plan will highlight the areas that Children s Services will concentrate on initially to ensure immediate action to bring about further improvement for our children and families. 4.3 Monitoring of complaints and incidents on Datix will also provide an indication of the quality and communication with parents to continually improve the patient experience. 5. Recommendations: 5.1 The Trust Board is asked to note the contents of this report Tracey Carter Chief Nurse & Director of Infection/Prevention Control August