Improving Patient Experience: action plan June 2014

Transcription

1 Improving Patient Experience: action plan June 2014 Paper C Patient Experience Strategy Objective Action Success Measure Lead Due Date Discharge process - Patients, families and carers to leave care with confidence the Discharge management group led by Osian Powel adopt a coordinated approach to discharge within the Trust to ensure all elements of patient experience are addressed further actions are planned and added to action plan To be confirmed 2014 information is made available in a format that can be understood work is planned to produce relevant information is in a variety of languages and in an easy-read format Patient information group December 2014 Welcome Pack (WP)includes discharge folder for documenting information on who to contact post discharge contacts audit of WP discharge folder 2014 to establish usage and uptake Margaret Howat July 2014 build on actions from baseline carers audit undertaken during 2013/ to demonstrate improvement to improve numbers of surveys by 10% in each quarter to develop actions incorporating lessons learned and engage carers in the process Margaret Howat/ Karen Gordon March 2015 July

2 Patient Experience Strategy Objective Action Success Measure Lead Due Date Care and Caring Developing caring and passionate staff ensuring patients, families and carers are treated with care, compassion and kindness the Trust to have values based recruitment in place redesign of Trust appraisal inclusive of the Trust Values recruitment process is in place design completed of new appraisal system Implementation of new appraisal Workforce Daniel Waldron September 2014 July 2014 September 2014 quarterly staff cultural barometer including Friends and Family Test establish baseline and develop % target response rate Daniel Waldron July2015 peer to peer values champions training and coaching exemplified behaviours and development dementia awareness training is accessible to all staff support role values champions with programme pilot and Trust role out Trust targets for dementia training are met Daniel Waldron Chipo Takavarasha January 2015 March 2015 service and areas to look at what does good caring look like in my area this will include feedback from service users and patients Feedback from social media and NHS Choices for example toolkit developed for supporting staff to adapt values and behaviours to their working environment pilot in two areas to develop appropriate actions Daniel Waldron Daniel Waldron September 2014 November 2014 look at different ways of involving patients, service users and the local community in service design a work plan is drawn up that sets out options for how this can be achieved Daniel Waldron October 2014 Co-ordinate the patient experience priorities with the relevant work of the Equality Group. the Trust Equality Group to understand linkages and report Trust Equality Group March

3 Patient Experience Strategy Objective Action Success Measure Lead Due Date twice yearly on progress and actions Improving Trust and Confidence in Nurses Nurses and patients work together building a trusting nurse -patient relationship 4 priorities have been identified by the Trust and Confidence in Nurses Workgroup Creating a good first impression -Ward-based professional standard for nurses and nursing assistants -Nursing staff wear prominent name badges Caring and Effective Communication and Interaction -You Said - We Did Boards, inform patients, families and carers of changes made in response to feedback -The ward welcome pack includes photographs to help identify staff, a discharge folder and a copy of the patient menu Improving and maintaining knowledge, skills and competence levels -A clinical leadership programme specific to the revised frequent feedback will included key markers to enable monitoring of the workgroup Standards are in place at the doors on all wards All nurse wear named badges where they can be seen and read boards are visible in service areas and used to feedback to areas timeline developed for boards in community areas the welcome pack is audited and updated if required quarterly all relevant staff have completed the programme Chief Nurse, Heads of Nursing/ Midwifery, Margaret Howat, Chipo Takavarshka Louise Egan Louise Egan Margaret Howat Margaret Howat Chipo Takavarshka September 2014 January 2014 January 2014 August 2014 October 2014 March 2015 December

4 Patient Experience Strategy Objective Action Success Measure Lead Due Date Ward sister /Charge nurse group is developed and delivered for staff on: - acute site - community sites Management of underperforming staff -clear guidelines are developed for staff on highlighting concerns with performance guidelines are agreed and in pace Sarah Webb October 2014 Nutrition and Hydration Patients are given the assistance and encouragement they require to be able to eat and drink and maximise their recovery in a conducive environment Nutrition Steering Group monitors how the Trust meets the five question that underpin the CQC fundamental standards Medirest Operational Group monitors catering performance the nutritional steering initiates and leads on a programme of work designed to monitor progress against the standards performance is monitored monthly and demonstrate improvements Nutritional Steering Group Medirest Operational Review Group August 2104 Monthly 2014/15 recruitment to the volunteer programme is targeted increase the number of Homerton Helper mealtime volunteers to include breakfast, lunch and supper a volunteer is present at meal times in all ward areas during lunch time on the Elderly Care Ward at least two volunteers are present at lunchtime and one at suppertime Volunteer coordinator/ Margaret Howat October 2014 December 2104 Patients are offered a hot drink 7 times per day and say they have been offered enough to drink An audit is carried out to establish a baseline Actions are agreed and an action plan put in place Dietetic Department Nutrition Steering Group Medirest Operational Group July 2104 September

5 Patient Experience Strategy Objective Action Success Measure Lead Due Date Improving Trust and Confidence in Doctors Medical staff and patients build a trusting relationship To work with the new Medical Directorate, Medical Council and medical education on any appropriate actions to promote the giving of information, choice, involvement, engagement and awareness of culture issues Medical Council agrees any further relevant actions and plans Medical Council September

6 Summary of Actions points PATIENT EXPERIENCE & ENGAGEMENT FORUM Action points from meeting held on 19 March 2014 AP Action(s) For Status 1 National Inpatient Survey 2013: presentation of the Homerton results SA April The Inpatient survey results will be published on 8 th April by the CQC (page 4) 2 National Inpatient Survey 2013: presentation of the Homerton results Will pull out the themes from the report to move forward with.(page 4) 3 National Inpatient Survey 2013: presentation of the Homerton results DW to support RJ and work through information for the service.(page 4) 4 Patient Experience and Engagement Strategy DW DW DW May June May Put in patient care term and explanation on the front page of the Patient Experience Strategy. (page 4)

7 Patient Experience and Engagement Forum 19 th March 2014, Conference Room 1, Education Centre, Homerton University Hospital Present: Sheila Adam, Chief Nurse (Joint Chair) (SA) Daniel Waldron, Director of Transformation (Joint Chair) (DW) Rosemary Jawara, CCG PPI representative (RJ) Liz Hughes, Healthwatch representative (LH) Jude Williams, Governor (JW) Talaat Quershi, Governor (TQ) Stuart Maxwell, Governor (SM) Suri Freidman, Governor/ Orthodox Jewish advocate (SF) Lesley Rogers, Head of Healthcare compliance (LR) Sarah Webb, Head of Nursing, CSDO (SW) Joan Douglas, Head of Midwifery (JD) Sharon Roberts, Patient Experience lead ITU (SR) Stella Timms, Ward Sisters/ Charge Nurses/ representative (ST) Lynne de Castro Arenas, Ward Sisters/ Charge Nurses/ representative (LCA) Ruth Stocks, Ward Sisters/ Charge Nurses/ representative (RS) Marion Rabinowitz, Orthodox Jewish advocate (MR) Hilda Walsh, Head of Locomotor Service (HW) Angela Holm, Community Matron/ District Nurse (AH) Louise Egan, Head of Nursing/ IMRS (LE) Debbie James, Head of Outpatients (DJ) Margaret Howat, Head of Patient Experience (MH) Karen Gordon, Head of Quality (KG) Adrian Laugee, Facilities information & Monitoring Manager (AL) Sally Shaw, Head of Advocacy and Children s Therapy Services (SS) Fiona Breen, Service Manager, SWSH (FB) Iyabo Aderotimi, Reception staff lead (IA) Robin Pfaff, Chaplaincy Team Leader (RP) Kim Boakye, Patient Experience and Engagement Coordinator (Patient (KB) Information and PALS) Margaret Bingham-Crisp, Staff Experience Lead (MBC) Lucas Daly, Senior Project Manager, Picker Institute Europe (LD) Minutes: Cindy Hall, Patient Experience Co-ordinator (CH) 1. Welcome Sheila Adam welcomed the members of the forum and introduced the morning presentations and discussions on the National Inpatient Survey for 2013, presentation of results for the Homerton This session would be followed by the introduction of the Patient Experience and Engagement Strategy. 2. Apologies for absence Tracy Fletcher, Dylan Jones, Vanessa Cooke, Iain Patterson, Janice Kelly, Mark Purcell, Jaime Bishop and Lesley Haines provided apologies for the meeting. 1

8 3. Minutes from previous meeting and matters arising There were no previous minutes discussed at this meeting. 4. Terms of Reference: Patient Experience and Engagement Forum setting the framework Sheila Adam There have been many important reports recently to review and digest recently both nationally and locally such as the Mid Staffordshire Public Enquiry, Keogh Mortality Review, the Healthwatch Hackney and the Inpatient Survey. So the question is What are we going to do about it? Moving ahead in context with this requires a different approach and a re-styled governance structure has been developed for the Trust. This will include an Improving patient Safety Committee chaired by SA, Improving Clinical Effectiveness Committee, chaired by Dr John Coakley, Improving Patient Experience chaired by SA and DW as well as the Improving Education and Leadership chaired by DW. These groups will report into the Quality & Patient Safety Board chaired by Tracy Fletcher and this board will report directly to the Board of Directors. The Patient Experience Strategy needed to be reviewed and a new more inclusive approach taken to improving patient experience. This will consist of a quarterly patient experience stakeholder forum to guide the work on patient experience with a monthly delivery group to carry out that work. The stakeholder forum agenda will inform, drive and monitor key components of the patient experience agenda. In addition there will be use of other sources of feedback such as the inpatient surveys, Healthwatch reports and frequent feedback. Information from CQC visits will also be included. The most recent acute hospital inspection from the CQC provided initial feedback on the acute site visit that the Trust is responsive and well led. 5. National Inpatient Survey 2013: presentation of the Homerton results LD presented the Homerton results. The methodology of the survey stays the same each year to allow for comparisons. The baseline number of patients required is 850 at age 16+; it is a postal survey with the use of a Freephone language line. The response rate for the Homerton was 30% with the national average being 46%.The presentation looks only at the Homerton results compared to the other 76 Trusts who use Picker to administer the survey. In April the CQC will publish the results for all Trusts in England. The responses are adjusted and standardised which allows Trusts across England to compare what patients are saying. This allows for the fact be Homerton has a younger demographic that tend to respond less favourably and also accounts in part for the low response rate. The survey asks question asked under eight category headings. Lower scores are better. Overall 63% of people rated care as 7+ out of 10 with 88% saying they always had enough privacy when being examined and treated. In the first section Admission to Hospital there were no significant changes since the 2012 results. In the Hospital and Ward section, the Trust was worse than average on eleven questions. The Trust was significantly worse on the question regarding shared sleeping area with opposite sex with an average of 17% compared to other Trusts with an average of 8%. 2

9 In the Doctors section three questions are significantly worse than average. The patient perception being that Doctors didn t always provide clear answers to questions. The Trust scored 40% compared to a national average of 30%, that patients did not always have confidence and Trust, 26% for the Trust and on the national average 19%. For Doctors talking in front of patients as if they weren t there 32% for the Trust and 24% for the national average. In the Doctors by Speciality section the Trust average for the patient not always having confidence and trust and being talked in front of as if they weren t there 26% and 32% respectively. The figures for General Medicine and General Surgery are at 27% and 36% respectively. The Trust is significantly worse than average on four questions in the Nurses section. These relate to did not always get clear answers to questions for the Trust 47% and the national average 31%; did not always have confidence and trust Trust 39% national average 24%; that nurses talked in front of patients as if they weren t there Trust 30% and national average 19%. The question Nurse sometimes, rarely or never enough on duty for the Trust 53% and the national average 41%. For the area of Nurses by Speciality the Trust the question for nurses: did not always have confidence and trust the Trust average was 39%, for General Medicine it was 35% and General Surgery 46%. The second question for this area was nurses: talked in front of patients as if they weren t there the trust average was 30% with General Medicine 35% and General Surgery 25%. Care and Treatments by speciality the Trust was significantly worse than average in seven questions. HW stated that the perception of patients of their pain levels regarding their levels of pain and the demographic is very subjective. In the section Operations and Procedure the Trust was significantly worse than average on one question which was the surgery risks and benefits not being fully explained with the Trust average at 25% and the national average at 17%. By speciality in this area General Medicine came out at 40% and General Surgery 35%. From the 2012 survey the Trust was significantly worse in eight questions in the Leaving Hospital section. LD stated that the main reason stated for delay in leaving hospital is the wait for medicines. The figures can t reflect other factors that impact on delays such as if there were more patients in the Trust or less staff available on the ward. LD went on to express the importance of focusing on the questions that are key to the patients as identified by Picker. Communication with clinical staff, doctors and nurses: these are the essential changes to make. LH asked if the survey is only available in English and does this affect the response rates? LD said that it was hard to accommodate other languages but there are language sheets and a language line available for patients that want to take part. Seventeen patients used the language line. RJ mentioned that it was a very detailed presentation and therefore moving forward and allowing for the services to digest the information is essential. LD replied that additional feedback would be available as well as the report to take this forward. DW confirmed that the information will be accessible to staff. SA announced that the Care Quality Commission (CQC) will publish an adjusted 3

10 version of the Picker results on 8 th April DW affirmed that the Trust will pull together the themes from the Forum and move forward with them. RJ asked about the information from last year s figures against the national average in order to know about the issues and concerns in driving forward change. DW offered to meet up with RJ to support with this work. SM asked about linking in with Healthwatch comments and the statistical significance of the figures. LD replied that there is a 50% response rate and 5% either side of 45% - 55% so the number has been worked out as statistically significant at 850 for the number of patients to contact as the optimum number for the survey. 6. Patient Experience and Engagement Strategy Daniel Waldron Patient Experience over the next five years has the main aim to ensure that all patients have an excellent experience of all our services through providing person-centred care that takes into account each patient s or service user s needs concerns and preferences. There are two high level success measures with four main objectives that place, quality, culture, patient experience, the Trust values, information and patient choice at the heart of the strategy. There are eight elements of Excellent Patient Experience (October 2011). These elements are: respect; coordination and integration; information; communication and education; physical comfort; emotional support; involvement of family and friends; transition and continuity; access to care. DW asked the Forum what they thought comes under the Framework for other communication? SM believed it was important to include the role of carers, learning disabilities and dementia and how we involve them in terms of patients care and serving the community. DW responded that when the strategy talks of patients it is an inclusive term for carers, families and friends and is explained in the full Strategy document. The new patient feedback system will collate information and data from the community areas as well as the acute site. There will be a clear improvement cycle with local benchmarking and best practice to learn from e.g. Guys and St Thomas Hospital though improvements do take time to embed into the culture. 7. Facilitated Workshop: Developing our patient experience strategy and actions Daniel Waldron and Lucas Daly The feedback from the individual groups has been collated and fed back to Daniel Waldron to be integrated into the reviewed Patient Experience and Engagement Strategy. 8. Any other business LH said that the final version of the Healthwatch report on the Homerton University Hospital will be circulated once completed. 9. Date and time of next meeting 10:00 12:00 18 th June 2014 in classrooms 4/5, Education Centre, Homerton University Hospital NHS Foundation Trust. Please send any apologies or queries to: Margaret Howat, Head of Patient Experience and margaret.howat@homerton.nhs.uk Tel:

11 Patient Experience and Engagement Strategy Consultation Document 1. Summary This document has been developed to facilitate a broad based engagement on the Trust s Improving Patient Experience Strategy. The document provides a summary of the proposed approaches and models under each of the key sections of the strategy. Comments and feedback is being sought through consultation with wide range of staff, patient and service user and other stakeholder groups. The Trust Management board are asked to consider and approve the approach set out below. 2. Introduction The strategy sets out the Trust s approach to improving the patient and service user experience. This revised strategy has been developed following a review of the patient experience strategy and builds on the progress that has been made in delivering sustainable change and improvements at all levels of care. The term Patients is used throughout the strategy to cover all patients, service users, their families and carers that come into contact with the Trust. 3. Purpose At the start of 2014 the Trust launched a new organizational strategy, Achieving Together, which sets out the mission of the Trust and our long term priorities for the period up to The mission of the Trust is to provide Safe, compassionate, effective care provided to our communities with a transparent, open approach. Listening to and learning from patients experience of their care is central to the Trust meeting this mission and ensuring that every patient receives the best care possible. Achieving Together has three overarching priorities to support delivery of the mission; these are Quality, Integration and Growth. Each of the priorities is further broken down into 3 aims and a positive patient experience is one of the Quality aims. The Trust s patient experience aim is to: Ensure all patients have an excellent experience of our services through providing person-centred care that takes into account each patients or service user s needs concerns and preferences. Two success measures are stated within the strategy for the patient experience aim and these are To achieve and maintain a position in the top 20% of Trusts for patient and staff experience surveys 90% of staff to be assessed, within their appraisal, as consistently meeting the Trusts values. 1

12 The purpose of this strategy is to describe the approach that will be taken to ensure the Trust s patient experience aim is achieved by To this end the strategy has 4 objectives which are: 1. To ensure all interactions with patients and their families are underpinned by the Trust s values. 2. To deliver sustained improvement in our priority areas of a. Discharge b. Care and caring c. Trust and confidence in nursing d. Trust and confidence in doctors e. Food and nutrition 3. To develop and implement an integrated patient experience feedback system that operates across both acute and community services and acts as a driver for improving patient experience. 4. To provide all patients with the information they need to make choices, and feel fully involved in the planning, delivery and self-management of their care. 5. For the Trust to meet its regulatory and statutory requirements in relation to patient and public involvement. 4. Delivering the Strategy The NHS Patient Experience Framework (2011) sets out a working definition of a positive patient experience. This strategy is built around the eight elements of the definition and uses the elements as a framework for improvement and measurement of patient experience. The eight elements of the definition are set out below. 1. Respect including: cultural issues; the dignity, privacy and independence of patients and service users; an awareness of quality-of-life issues; and shared decision making 2. Coordination and integration across the health and social care system 3. Information, communication, and education on clinical status, progress, prognosis, and processes of care in order to facilitate autonomy, self-care and health promotion 4. Physical comfort including pain management, help with activities of daily living, and clean and comfortable surroundings 5. Emotional support and alleviation of fear and anxiety about such issues as clinical status, prognosis, and the impact of illness on patients, their families and their finances 6. Involvement of family and friends on whom patients and service users rely, in decision-making and demonstrating awareness and accommodation of their needs as care-givers 7. Transition and continuity as regards information that will help patients care for themselves away from a clinical setting, and coordination, planning, support and empowerment to ease transitions 2

13 8. Access to care with attention for example, to time spent waiting for admission or time between admission and placement an in-patient setting, and waiting time for an appointment or visit in the out-patient, primary care or social care setting. Emotional and Transactional Aspects of Care Care is not only about meeting patients physical needs but is also about meeting their emotional needs. The emotional aspects of care, such as dignity, empathy, emotional support, caring and feeling safe are as important for the overall patient experience as the transactional aspects, such as access, waiting times, food, noise and the environment. A high quality patient experience requires that both the transactional and emotional needs of patients are met across all 8 elements of the patient experience. The table below provides a diagrammatic representation of how both the transactional and emotional elements of patient experience combine to determine the overall experience. H L Transactional Efficient and impersonal Chaotic, rude and indifferent Efficient and personal Chaotic and personal L Emotional H By aligning the 8 elements of patient experience with the transactional and emotional dimensions of care it is possible to build a simple, but holistic patient experience framework. Patient Experience Element Transactional Emotional Respect for values, preferences, and expressed needs Coordination and integration of care Information, communication, and education Physical comfort Emotional support Welcoming the involvement of family and friends Transition and continuity Access The above framework will provide the structure for ensuring both our improvement plans and systems for monitoring feedback cover all the elements required for ensuring we deliver a 3

14 consistently high quality experience to patients across the entire pathway. 5. Measuring and Monitoring Patient Feedback and Experience Understanding and monitoring of patient experience should be in place at every level from ward to board. Ward to board reporting puts patient experience at the heart of the Trust by supporting staff across the organisation to understand their level of responsibility and how they contribute to the outcome measures for patient experience. An effective ward to board reporting system will need to track progress against both the objectives set out within the strategy and the associated improvement plans that are developed as a response to the feedback we receive. In addition, the system will need to be able to provide real time feedback to services that can be used as both an alert system and a means of driving service improvement at a local level. It is important to remember that collecting data in itself has no value; it is how the information is used to drive improvement that is important. In order to support the objectives of the strategy and the approach outlined above the patient experience measuring and monitoring system will need to: Be built around an integrated governance model that monitors a range of quantitative and qualitative metrics. Produce easily accessible and understandable reports that can be aggregated from the service or ward level upwards. It will also be necessary for the reporting to align to the 10 point framework and feed directly into performance dashboards from ward to board level. Cover both acute and community services and effectively measure the patient experience at all points along the patient pathway. Drive improvement through tracking progress against the strategic objectives and any improvement plans. Feedback Collection Methods When measuring patient experience it is important to use a range of feedback collection methods in order to provide the maximum opportunity for patients to share their views and ensure feedback is both quantitative and qualitative. In addition, it is important to remember that the way that feedback is collected can influence the response and therefore using a wide range of collection methods will reduce any potential bias.the methods we will use for measuring patient feedback will include: Qualitative surveys based on a sample of patients. This will include o mandatory national surveys such as the inpatient survey, outpatient survey, cancer survey etc. o Internal local surveys and audits Point of care surveys which are offered to all patients and typically include a small number of questions. This will include o The Trust s real time patient feedback solution o The friends and family test o You said we did cards 4

15 Patient initiated feedback. This will include o Complaints and PALS enquiries o Feedback left on social media and websites Patient and public focus groups and forums. This will include o Trust User Engagement Group o Members meetings o CCG PPI forum Service level patient and user groups 6. Patient Experience Improvement Cycle The diagram below sets out the key steps that need to be followed to drive the cycle of improving the patient experience. The process of improvement starts at the top of the cycle with agreeing the priorities and success measures. Continuous improvement is driven by moving round the cycle and ensuring each step is completed before the process moves on. Report Points 1 and 4 in the improvement cycle are addressed in sections 2 and 5 above, respectively. Our approach to identifying and planning improvements will take into account both the extent of the improvement required and the opportunity for impact, with the focus being on areas that 5

16 require the greatest improvement and also have a high potential for impact. In Figure 1 below actions that fall into the top right hand quadrant will be the highest priority. H L Problem score High priority/ low potential for impact Low priority/ Low potential for impact High priority/ High potential for impact Low priority / High potential for impact L Potential for improvement H 7. Addressing the Emotional Dimension of Care. Delivering on the aims and objectives of this strategy will require the emotional aspects of care to be attended to in all patient interactions. The model below sets out the elements that need to be in place for developing an organisational culture that consistently meets patients emotional as well their physical needs. All elements in the model need to be in place for the delivery of truly personalised care. Excellent Patient Experience Staff Skilled, competent and working to the values Leadership behaviour committed to quality and role model to others Local services adopting values and setting the culture Organisational Values Safe, Personal, Effective and Responsibility The table below sets out the key staff and organisational development interventions planned for the first few years of the strategy to support the delivery of the emotional dimensions of care model. Emotional Dimension Organisational Values Intervention Living Our Values booklet distributed to all staff All key policies and process to be aligned to the values On-going programme of communications and awareness raising initiatives 6

17 Local services values and culture Leadership behaviour Staff behaviours Values based recruitment introduced Service culture and values toolkit introduced Quarterly survey of staff to measure to measure and track organisational culture. Re-launch of Trust leadership development programmes Appraisal and coaching training rolled out to all line managers Values and behaviour incorporated into appraisal system Emotional awareness and engagement training programme Staff experience improvement plan Patient Experience Strategy timeline for consultation 19 March Strategy consultation introduced to Patient Experience and Engagement Forum (PEEF) Consultation Groups 31 March Heads of Nursing 1 April Circulate to Healthwatch 9 April Nursing, Midwifery and Health Visiting Board 10 April Sisters/Charge Nurse/ Community Leads meeting 11 April Trust Management Board 23 April Board of Directors 24 April CCG PPI 15 May Medical Council 19 May User Engagement Committee 23 May Nurses/ Midwives Day 29 May End of Consultation 18 June Launch Patient Experience and Engagement Strategy at PEEF 7

18 AGENDA PATIENT EXPERIENCE & ENGAGEMENT FORUM ( PEEF ) To be held on Wednesday 18 th June in Classrooms 4 and 5, Education Centre, Homerton Hospital ITEM PAPER Welcome and Apologies: 1 Minutes and Action points from meeting held on 19 March Homerton Patient Experience and Engagement Strategy A B Sheila Adam, Chief Nurse and Director of Governance Sheila Adam, Chief Nurse and Director of Governance Daniel Waldron, Director of Organisation Transformation 3 Homerton Patient Experience action plan C Sheila Adam/Margaret Howat 4 PE work streams to feedback on progress Trust and confidence 5 AOB PLACE Discharge management group verbal Margaret Howat, Karen Gordon, Chipo Takavarasha, Louise Egan, Marcia Smikle, Sarah Webb Adrian Laugee Osian Powell Date of next meeting : 1200 and 1300 on 17 th September 2014 in Conference Room 1, Education Centre Please send any apologies or queries to Lesley Haines, Patient Experience Support Officer lesley.haines@homerton.nhs.uk

19 MEMBERSHIP Chief Nurse (Joint Chair) Director of Transformation (Joint Chair) Patient member(s) CCG PPI representative Healthwatch representative Governors Chief Operating Officer Head of Healthcare Compliance Ward Sisters/Charge Nurses/ representatives Community Lead representatives Department Senior Nurses Head of Outpatients Head of Adult Safeguarding Head of Patient Experience Human Resources representative Divisional Representatives Service Manager Quality and Risk Representative Estates and Facilities lead Therapies Representative Central Bookings Service Manager Reception staff leads (acute & community) Chaplaincy Team Leader Communications Lead Patient Experience & Engagement Coordinator - patient information and PALS Patient Experience Support Officer (notes)

20 Mapping of patient feedback to cross match themes from patient feedback National Inpatient Survey Themes for improvement ranked by level of problem score Discharge process information, delay, communication, warning signs and who to contact Care and Caring Pain management, emotional support, involvement in decisions about care, responding to call buzzers Improving Trust and Confidence in Nurses Not enough on duty and clear answers, confidence and trust Healthwatch Hackney Insight Event held December 2013 Discharge process communication, information, planning, no support, coordination between services Care and Caring Attitude, pain and medication, waiting for care, quality, lack of training, older people, medication issues Improving Trust and Confidence in Nurses Not enough, no coordination FFT comments from Q Discharge process medication, delays Care and Caring Medication, pain, told different things, poor attitude, staff did not listen, waiting times for care Improving Trust and Confidence in Nurses Communication not enough nurses Frequent Feedback Q Care and Caring Lack of sympathy, carers not asked for information which would help with caring, waiting for assistance Carers not given information Improving Trust and Confidence in Nurses Communication, told different things. Day Case 2013 Discharge process written/ printed information medicines/ delays; not kept informed Care and Caring Could not always find staff member to discuss concerns with Young Inpatients Survey 2012 Discharge process waiting for medicines or to see a doctor Care and Caring Not fully involved in decisions, lack of privacy Improving Trust and Confidence in Nurses Lack of confidence and trust Cancer Survey 2013 Care and Caring Pain, told different things, not given choice, not treated with dignity or privacy Improving Trust and Confidence in Nurses Communication, information not listened to Maternity Survey 2103 Care and Caring Did not get enough help and advice Improving Trust and Confidence in Midwives care at home Lack oftrust and confidence

21 National Inpatient Survey Themes for improvement ranked by level of problem score Nutrition and Hydration quality of food and help with meals Improving Trust and Confidence in Doctors Healthwatch Hackney Insight Event held December 2013 Nutrition and Hydration poor quality, not satisfied with choice, food available to visitors/carers Improving Trust and Confidence in Doctors FFT comments from Q Nutrition and Hydration not offered choice, food not good Improving Trust and Confidence in Doctors Frequent Feedback Q Nutrition and Hydration Day Case 2013 Young Inpatients Survey 2012 Nutrition and Hydration family lack of access to hot food Cancer Survey 2013 Improving Trust and Confidence in Doctors Maternity Survey 2103 Doctors not giving clear answers Ungrouped comments Noise at night from other patients, A&E not enough/too much information about condition, Doctors attitude, waiting times Ungrouped comments Links with local community, safety (patients wandering), quality of care for older people, PALS and complaints, environment, accessibility, waiting times Doctors attitude/communi cation Ungrouped comments Environment of ward, noise at night A&E - Waiting times No comments on privacy or dignity Positive comments on information Ungrouped comments Noise at night A&E noise, waiting for assistance Ungrouped comments Not being given a choice Doctors talked in front of patients Ungrouped comments Communication written information side effects/ financial support.

22 National Inpatient Survey Themes for improvement ranked by level of problem score Healthwatch Hackney Insight Event held December 2013 A&E waiting, information and communication FFT comments from Q Frequent Feedback Q Day Case 2013 Young Inpatients Survey 2012 Cancer Survey 2013 Maternity Survey 2103