Patient Experience Annual Report 2016/17

Transcription

1 Patient Experience Annual Report /17 Patient Experience Annual Report /17 The /17 patient experience annual report describes the progress we have made to ensure that patient feedback is used to improve services and the patient s experience of using our services. CONTENTS Page 1. Overview and Strategy Capturing the patient experience Analysing the patient experience feedback Using the patient experience feedback Communicating the actions we ve taken Governance Next Year (/18) Appendices Page 1 of 39

2 Patient Experience Annual Report /17 1. Overview and Strategy By collecting and responding to patient feedback, Northern Devon Healthcare NHS Trust (the Trust) aims to embed a culture of continuous improvement within the organisation which will benefit patients, reward staff and enhance our reputation with commissioners and stakeholders. At Board-level, the Trust s director of nursing, quality and workforce has responsibility for patient experience which includes: Delivery of our patient experience strategy and annual work programme Compliance with the national Friends and Family Test (FFT) Reporting and demonstrating that we have used patient experience feedback to improve the experience of care Patient experience features as the third element of the Trust s quality strategy, thereby placing it firmly at the heart of the Trust s continuous drive to improve the quality of the services we provide. We have developed a patient experience programme that covers the majority of services provided by the Trust: in hospital, clinic or in the patient s home. Patients provide their feedback in real-time through the inpatient surveys at North Devon District Hospital (NDDH), social media, NHS Choices, Care Opinion, postal surveys, national surveys, focus groups, face-to-face engagement, PALS/complaints and, of course, routinely throughout the Trust via the FFT. At the start of each board meeting, either a patient story is presented or a member of staff presents a piece of work which has been developed to improve the experience of patient care. Patient stories are obtained either through the complaints process, service transformation projects, letters to the chief executive or from patients who have approached the Trust. This sometimes involves the patient being present to give a more detailed account, which allows the board to see and hear first-hand the impact of the Trust s work. FFT results are routinely reported to the Trust Board and NEW Devon Clinical Commissioning Group. Patient experience data is shared and welcomed by clinical and operational teams. The patient experience team provides a report to the NDDH acute/maternity ward within 2-3 hours of the feedback being collected by a patient experience surveyor (see page 5). Reports to services are provided on a monthly or bimonthly basis. In addition, it is shared with the Quality Improvement team in recognition of the importance of patient experience in assessing the quality of NHS services alongside effectiveness and safety. Via the Learning from Patient Experience Group (LPEG), the patient experience feedback is routinely compared alongside staff experience and operational data in recognition of the close links between staff experience, operational pressures and patient experience. Page 2 of 39

3 Patient Experience Annual Report /17 Using the structure of the patient experience strategy this report outlines our progress against our local priority areas for the patient experience programme as well as the nationally-mandated Friends and Family Test programme, which includes the following services: North Devon District Hospital Acute inpatient wards Emergency department Maternity services Outpatients Daycases Community Community hospital inpatient wards Community hospital outpatients Community hospital daycases Community children s nursing Minor injury units Walk-in centres Pathfinder urgent care Pathfinder complex discharge Home-facing services Community therapy Community nursing Rapid Response Service Specialist community services: Sexual health Podiatry Bladder and bowel Dental Chronic fatigue syndrome/me (to ) Review of patient experience strategy During -17, the Trust began a fundamental review and updating of its patient experience strategy, working with patients, carers and other stakeholders to ensure that it, and the associated workplan, reflects even better the priorities expressed by patients. At the beginning of, three focus groups were carried out with patients in conjunction with Healthwatch. 37 people attended. We also carried out a survey with a youth club, parents group and rugby club. 53 people took part (33 children and young people (aged years) and 20 adults). One of the next steps in our strategy development is to explore how we can extend this exercise to reach the large cohort of house-bound patients. During the research, we explored five key themes based on a combination of the Trust s own patient experience data and findings of the King s Fund as follows: Page 3 of 39

4 Patient Experience Annual Report /17 Communication Availability of staff Co-ordination of care Self-care Encouraging patient feedback The feedback from patients and the public was presented to staff in two meetings in which the themes which had emerged were discussed. The output of this work was a thematic summary triangulating the feedback from patients received during the Healthwatch focus groups and the responses from staff. During this stage of the project, staff identified several specific areas of improvement which sought to address the feedback received from patients. These were discussed by a sub-group of LPEG and priorities established which were mapped to current projects, identifying any gaps. During -18, to the strategy will be finalised and the projects will be agreed, with each project being allocated an owner. A communications campaign will be carried out across the Trust to raise awareness of the new strategy and the importance of listening to patients and improving based on their feedback. The existing patient experience strategy can be accessed here: Patient Experience Strategy Publication of FFT scores and patient comments Trust-wide FFT scores and patient comments together with the acute inpatient survey results are published on the Trust website here: Friends and Family Test NDDH An example of a Trust website report is attached as Appendix A. On most weekdays, we use social media such as Twitter and Facebook to publish patient comments collected by our team of volunteer patient experience surveyors on our acute wards at North Devon District Hospital (see page 5). The Trust s patient experience strategy uses the following model and this report uses the same structure to articulate achievements: Capture the experience using all available and appropriate tools to capture the experience of patients, carers and staff. Understand the experience by identifying the touch-points of a service and gaining knowledge on what people feel when experiencing our services and when they feel it. Improve the experience by ensuring the feedback is heard and understood by the relevant clinical and managerial teams. Receiving, analysing and presenting feedback and then involving users and staff in developing the solution completes the you said, we did governance cycle. Disseminate and measure the improvement by you said, we did. Page 4 of 39

5 Patient Experience Annual Report /17 2. Capturing the patient experience The Friends and Family Test (FFT) gives patients who have received care throughout the Trust the opportunity to provide immediate feedback about their experience via the question: How likely are you to recommend our ward / hospital / department / service to friends and family if they needed similar care or treatment? The Trust s Friends and Family Test results for the year are attached as Appendix B. During -17 the average number of FFT responses received from around the Trust was over 1,000 per month 1. This was in addition to items of patient experience feedback received from other sources. Trust staff routinely offer patients the opportunity to provide feedback using all available and appropriate methods. Volunteers Our patient experience programme at North Devon District Hospital (NDDH) would not be possible without the support and assistance of our volunteer patient experience team. It is an essential element in the patient experience survey programme operating across the Trust. Team members routinely visit all inpatient wards at NDDH to collect real-time patient feedback at the bedside. On a one-to-one basis, patients are invited to respond to a series of questions about their experience on the ward. A volunteer patient experience surveyor goes through the realtime patient experience survey with a patient in a surgical ward at North Devon District Hospital. The aim is to visit inpatient wards several times a month. A report is issued to the ward within 2-3 hours of every visit. This allows the Trust to respond immediately to any feedback as well as staff receiving a morale boost from the many positive comments we receive. Other team members engage patients in the outpatient waiting areas at NDDH, explaining to them the value to the Trust of providing feedback through the completion of a Friends and Family Test card and inviting them to contribute before they leave. Personable, approachable and always willing to go the extra mile, the members of the patient experience team consistently demonstrate outstanding dedication and commitment. The quality of the feedback obtained by the team is invaluable to the Trust in 1 Oct-16 to Mar-17 following the transfer of some of the eastern services with effect from Oct-16 Page 5 of 39

6 Patient Experience Annual Report /17 monitoring patient satisfaction. It is detailed, clear, concise and, most importantly, reflects the views of patients in their own words. In /17 we were helped by Chantal, John, Khaliq, Michael, Pauline, Roger and Suzanne. The work of this team made an invaluable contribution to the Trust s routine and systematic monitoring of the patient experience, feeding into the continuous improvement of the experience of patients in the Trust s care. Improving FFT response rates The Trust has set targets for both the response rates for the FFT (20% for acute, A&E, and community hospitals) and also the would recommend score (75%). Whilst the Trust consistently exceeds the target would recommend score, some areas experience lower response rates and action plans to boost response rates have been implemented during the year. In /17 we saw a significant improvement in the response rates in our paediatric inpatient ward due to an increased focus amongst staff and additional use of volunteers. With a view to increasing the Trust s FFT response rate in our emergency department, a bespoke patient feedback centre was developed during the year and went live shortly after the yearend. The new wall-mounted installation offers patients different patient feedback options in one place. Patients are invited either to complete the FFT online via a touchscreen TV, by completion of an FFT feedback card or by texting the word SURVEY to The new patient experience feedback centre in our emergency department at North Devon District Hospital The following actions implemented during -17 helped to increase the number of FFT responses: Recruitment of volunteers to engage patients in our acute outpatient waiting areas at NDDH, explaining to them the value to the Trust of providing feedback through the completion of a Friends and Family Test card and inviting them to contribute before they leave Ongoing awareness-raising amongst the teams on the wards as to the importance of capturing patient feedback, including discharge co-ordinators on the medical wards More than just the Friends and Family Test In many services, more than the standard Friends and Family Test question is asked in order to gain a deeper understanding of the experience of care. The additional questions can be found in the table of methodology which is attached as Appendix C. These additional questions are the product of a dialogue with the relevant service which allows the team to consider other issues and the feedback methodology is formulated to best suit the service. Page 6 of 39

7 Patient Experience Annual Report /17 The Trust s data capture methodology is selected, piloted and continually refined according to the needs of the patient group concerned. Inclusivity In line with the principle of inclusivity, the Trust offers as standard the option of carer/parental support in completing the forms and alternative communication formats such as audio tape/computer disc, Braille, large font, high contrast, British Sign Language, easy read, as well as translated versions. We provide black typeface on yellow, large print cards for all ophthalmology clinics as well as care of the elderly due to the prevalence of patients with dementia. A children and young person s version of the Friends and Family Test card is available. The learning disability nursing team has developed tailored communication materials to support patients with a learning disability and are increasingly using apps on ipads to communicate with patients in the Trust s care. A Friends and Family Test card for patients with learning disabilities has been developed. National inpatient survey According to the latest national inpatient survey, patients who have received hospital-based care at the Trust rate their experiences highly and better than care delivered at other trusts across England in some areas. Over 600 people responded to the survey, which is published by the Care Quality Commission. Overall, more than 97% of patients felt that they were sometimes or always treated with respect and dignity. Over 98% of patients said that they were well looked after by hospital staff always or sometimes. Patients rated the Trust particularly highly in the following areas, resulting in scores of nine out of 10 or above: Cleanliness Transition between services the specialist they saw in hospital had been given all the necessary information about their condition or illness from the person who referred them Explanation from anaesthetists Privacy, both in the emergency department and when being examined Feeling well looked after Confidence and trust in nurses The Trust scored better than most other trusts surveyed in two particular areas: Patients felt that they knew which nurse was in charge of looking after them, which is particularly important following shift changes Page 7 of 39

8 Patient Experience Annual Report /17 Patients felt staff considered their family and home situation when planning their discharge According to the survey, some patients said they would like more help to eat meals. The Trust is recruiting mealtime companion volunteers to provide additional support at mealtimes to motivate patients to eat and drink, allowing staff to spend more time with patients who need more assistance. Although patients feel the noise at night on our wards has improved, this can still be an issue. We have an annual SHUSH campaign and the plan is to re-launch this and remind staff to have Soft silent shoes, a Heightened awareness of noise and Understanding that our patients need Sleep and rest for Healing. Communication has been raised as a concern although there is an improvement on the 2015 survey. This issue is raised with our staff during their training days. The senior nurses are working on raising the awareness around compassion and how we can improve communication further with our patients. National cancer patient experience survey The National Cancer Patient Experience Survey 2015 was the fifth iteration of the survey first undertaken in The survey is designed to monitor national progress on cancer care; to provide information to drive local quality improvements; to assist commissioners and providers of cancer care; and to inform the work of the various charities and stakeholder groups supporting cancer patients. Overall, the Trust is performing well, with an average rating of 8.9 which is above the national average and places the Trust as 4th in the South West. The data collated from the survey has identified the success of the many processes and teams involved in the provision of cancer services. In general the data highlights the high standard of care patients receive when referred into cancer services. On the whole, the Trust is improving year on year. Key findings: 79% - patients given a complete explanation of the test results in an understandable way 72% - patients completely understood the explanation of what was wrong 76% - patients given easy to understand written information 76% - treatment explained in an understandable way 55% - patients told about the long-term effects of treatment Page 8 of 39

9 Patient Experience Annual Report /17 57% - patients were given information on financial advice by hospital staff 82% - hospital staff told patients about free prescriptions 51% - patients felt able to discuss worries and fears with hospital staff 25% - felt unable to speak to healthcare professionals in Day Case/Outpatient appointments 33% - patients received a care plan As with any review, there are areas for enhancement and improvement to benefit those requiring cancer services. During the review of the survey results, a number of recommendations were drawn from the data published. These included: A review of patient written information and inclusion of care plans to enable independence and control over diagnosis The need for an Information and Support Centre to allow patients to discuss their worries and fears in a safe environment Further education and training across the inpatient area in order to raise awareness of cancer, its treatment and provide confidence to non-specialist staff to care for those patients admitted with cancer related issues An action plan has been drawn up to implement these recommendations. 3. Analysing the patient experience feedback The systematic analysis and triangulation of all forms of patient experience feedback, including complaints, results in the production of monthly detailed patient experience reports. Developing an understanding of the patient experience by identifying the touch-points of a service and gaining knowledge of what people feel when experiencing the Trust s services and when they feel it is crucial to the process of enabling the Trust to improve the experience of patients in its care. This allows the Trust to identify trends and themes, an example of which is attached as Appendix D. The process of analysis identifies where either action needs to be taken or a deep dive instigated to gain further understanding of the patient experience. An exciting new development in the effective analysis, accessibility and use of the large volume of data has been the investment in the Meridian database. During -17, Meridian was implemented Trust-wide. The full reporting potential of Meridian continues to be explored, but the new system already makes it easier to carry out functions such as Page 9 of 39

10 Patient Experience Annual Report /17 searching by keywords to analyse themes, generate reports and collate the monthly FFT data for the submissions that we make to NHS England. Following feedback from divisional teams, we have developed an online dashboard, which enables them to view data from a number of systems in one place. The aim is to provide an overview of FFT responses, complaints and Datix incidents which will enable managers to highlight areas of concern and triangulate data to make more informed decisions. 4. Using the patient experience feedback Receiving, analysing and presenting feedback and then involving users and staff in developing the solution completes the you said - we did governance cycle. This part of the process involves ensuring that the feedback is heard and understood by the relevant clinical and managerial teams and then disseminating and measuring the improvement either by subjective outcomes such as repeat surveys or objective outcomes e.g. less feedback volume on a particular topic. The overwhelming flavour of the feedback the Trust receives is positive. However, we look very closely at the free text feedback we get because this allows us to make the often small changes to improve the experience of care for future patients. You said, we did The table below highlights some of the you said - we did improvements to patient experience that were made in /17: You said 1 The car park at North Devon District Hospital is too expensive. 2 The starting point for serving ward meals at North Devon District Hospital should be alternated. 3 The delivery of some distressing news was given to a patient by a consultant in not a private or appropriate way on a ward at North Devon District Hospital. 4 In the acute inpatient survey, patients are asked if the side effects of their medication have been explained to We did The option to purchase more cost-effective 5 or 7 day passes has been made more visible following the installation of new car park pay machines. The options are now integrated in the payment process. Staff have been reminded of the procedure to rotate the starting point for the delivery of meals on a daily basis so that it is not always the same patient who is served last. This also helps with food temperature even though the meal trolley is maintained at the correct temperature. The lead consultant was contacted and asked to share the feedback with the teams. As result of enhanced communication of this aspect of care, in the year ending Mar- 17, the Trust achieved target in 11 out of Page 10 of 39

11 Patient Experience Annual Report /17 them. This question had been scoring lower than the other questions in the survey. 5 More simple food choices at North Devon District Hospital, particularly in respect of sandwiches i.e. the provision of plain sandwiches with condiments provided separately in sachets. 6 The physiotherapy outpatients department at North Devon District Hospital could be nicer and more private. 7 It would be better to be able to attend physiotherapy appointments before and after work. 8 Improve the level of avoidable missed doses of medication for inpatients at North Devon District Hospital. 9 Prevent avoidable inpatient readmissions by improving communication on discharge. 10 There is a delay in accessing medication from pharmacy. the 12 months. Simpler sandwich options were introduced with sachets of condiments provided separately for patients to add as required. The department has been refurbished and now has individual clinic rooms to improve privacy and dignity. The Trust s flexible working policy has been used to allow clinicians to alter their working hours to offer early and late appointments for patients. In respect of newly-admitted patients, pharmacy technician ward sweep has been introduced daily at 9am with the aim of getting any missed doses of medication back on the ward by 10am. Additionally, pharmacy communication books and dedicated pharmacy trays for drug charts with missed doses needed have been introduced onto each ward. A downward trend in missed doses of medication has resulted. A medicine support service has been established. Subject to patient consent, a copy of the patient s discharge summary is sent to the designated community chemist so that the next prescription received from the GP can be checked to ensure the changes made during admission are followed up in the community. The focus is currently on patients requiring blister pack medication. A sufficient number of bleeps has been purchased so that each ward has a dedicated pharmacist and ward-based technician to contact should they require a discharge prescription processing or an urgent/newly-prescribed medication supplied. Page 11 of 39

12 Patient Experience Annual Report /17 11 The facilities for parents on Caroline Thorpe Ward require improvement. 12 Mums who have had a difficult delivery are not always able to visit their babies on SCBU e.g. if they are in intensive care. 13 Families said that they are often unable to visit babies in the SCBU due to the visiting times. 14 Mums often have to wait for their baby s milk to be warmed. 15 Mums have had difficulty expressing their milk due to a lack of breast pumps. 16 Parents would like more involvement in their baby s care. They do not want to miss their baby s firsts. 17 Parents would like more information while they are on SCBU. The parents small kitchen area has been redecorated and enhanced, funded by the ward s charity Care for kids. Parents are able to make themselves beverages and heat snacks in an uplifting environment featuring a coastal theme. SCBU has purchased two dedicated ipads which link up mum to baby via Skype, enabling mum to see baby in real-time even when she cannot be present. Staff asked parents by questionnaire what they would like. As a consequence, SCBU has changed its visiting times in line with the feedback received. Visiting times are now more family-friendly. SCBU has introduced a second milk warmer so that babies can get their feeds without waiting. SCBU has now purchased enough breast pumps for there to be a dedicated pump per cot. In addition, the delivery suite will have one to enable mothers to express within two hours of delivery, according to best practice guidance. SCBU is working towards delivering Family Integrated Care. Parents will be encouraged to stay in and taught how to care for their baby. This will enhance parental bonding, satisfaction, breastfeeding and ownership. New documentation and booklets are being created. Parents will involve themselves collaboratively with staff in care planning and informed decision-making. The ward welcome leaflet has been updated to include the information that is required quickly. SCBU staff have made up baby friendly packs of parent information specific to the length of stay and gestation of the baby. All parents now receive an admission pack, a day 2 pack and a discharge pack tailored to the requirements of their baby. In addition they are given a special bag for their baby s cot in which to Page 12 of 39

13 Patient Experience Annual Report /17 18 Parents said that once their baby was discharged they felt abandoned with no one to turn to who had expertise in preterm infants. 19 Patients were concerned that on returning home they would have no ongoing point of contact. (Pathfinder Urgent Care) 20 There is insufficient patient parking at Barnstaple Health Centre. 21 Toys for younger children are needed in the waiting area at Litchdon House. 22 Conversations in the consulting rooms at Litchdon House can be overheard. 23 More patient-friendly chairs are required in the main waiting room at Litchdon House. 24 The waiting room at Bideford Minor Injury Unit is dull and needs repainting 25 Patient information leaflets are not easily accessible at Bideford Minor Injury Unit. 26 A patient received a waiting list letter with the wording if you improve and no longer need our intervention etc. when the patient was palliative. (Barnstaple Community Rehabilitation Team) store mementos to take home. SCBU saw the need for a community service as required for service standards. A neonatal outreach team has been created linked to the Children s Community Nursing Service. All babies who reach an agreed criteria are visited at home. This is enhancing parental satisfaction and confidence and babies can be discharged home earlier. A follow-up phone call to all patients discharged by the urgent care stream has been introduced. This has reassured patients that they will be supported when their care is transferred from the acute hospital to the community and has also led to reduced readmissions. Car parking machines have been installed and patrols introduced from Monday to Friday for 20 hours a week at peak times. A wooden toy table to entertain the children in the predominantly paediatric waiting area has been introduced. Music has been introduced so that conversations in consulting rooms cannot be overheard and to try to make the atmosphere in the waiting areas more relaxing/comfortable. New chairs which are firmer, higher and have arms for assistance have been introduced. The reception hatch area has been painted and a new sign clearly identifying where to go on arrival has been installed. Funded by the League of Friends, the patient information leaflets have been relocated from behind the nursing station to the main corridor. The wording on the letter was changed to reduce the risk of upsetting patients or their families. 27 The patient environment in the A temporarily-available area is being used Page 13 of 39

14 Patient Experience Annual Report /17 physiotherapy outpatient department at Ilfracombe Community Hospital is poor. on a trial basis to provide an improved patient environment. Work with the locality and senior management to improve privacy and dignity is continuing. Case Studies Here are two examples of the type of detailed work carried out by the Trust in response to patient feedback received: Case Study 1 Medication on inpatient discharge Issue: The improvement of turnaround times for the dispensing of tablets to take away on discharge from an inpatient ward at North Devon District Hospital. Ward-based discharges have been rolled out with pharmacists screening discharge medication at ward level and a dedicated ward pharmacy technician checking medication, also at ward level. The average time taken for medication to be processed with pharmacy has improved as follows: Year Medical Ward Surgical Ward Women and Children mins 96mins 80mins 36mins 71mins 58mins The roll-out was completed on surgical wards in January, and the average turnaround for surgical wards in stands at 54mins. A computer on wheels has been introduced and labelled medication packs for regular items required post-surgery. This enabled surgical discharge medication to be completely dispensed at ward level. Case Study 2 Young people with anorexia nervosa Issue: Young people admitted to Caroline Thorpe Ward with anorexia nervosa were experiencing variable levels of care. These young people were being admitted to hospital for lengths of stay ranging from 1-48 days. The care being delivered was inconsistent, staff morale was low and the challenging behaviours of these young people were being reinforced. The lack of knowledge and understanding from staff was leading to poorer outcomes for the young people. The need for change became particularly apparent not least because the mortality rate for anorexia nervosa is higher than childhood leukaemia. We implemented an inpatient plan based on the Junior MARSIPAN (Management of Really Sick Patients under 18 with Anorexia Nervosa) working group guidelines. A nurse-led team including a paediatric consultant, two paediatric consultant psychiatrist and the CAMHS eating disorder team developed a three week re-feeding programme. Support and training for the ward staff was provided to improve their knowledge and empathy. Page 14 of 39

15 Patient Experience Annual Report /17 The change in the care delivered has been outstanding. Prior to the plan, in the previous two years there were 14 patients admitted to Caroline Thorpe Ward with anorexia nervosa. Looking at the 5 patients immediately prior to the implementation of the plan, the length of stay varied from days and 3 of these were admitted to a specialist Tier 4 unit. Following the introduction of the plan, 20 young people were admitted to the ward for anorexia nervosa. 18 of these completed the 3-week plan and only 1 was admitted to a Tier 4 unit. Staff now actively engage with these young people and the level of treatment has been likened to a specialist unit. Exceptional standards of care are now being delivered in this area. Using patient experience data in the quality and safety programme Patient experience feedback forms part of the Trust s programme of Quality and Safety visits. These are pre-announced visits to clinical teams based in the acute and community services. The aim of the visits is to engage with staff and patients and celebrate the achievements of the teams and the services they provide. The visiting team, which consists of Board members and the Quality Improvement team, meet with staff and patients and, using the CQC five domains, provides a constructive feedback report. Prior to the visit, the Quality Improvement team triangulates all quality information about the service to be visited. The quality information includes patient experience data as well as patient safety and effectiveness data. During /17, patient experience feedback reports were produced to support the Quality and Safety visits in the following services: NDDH 1 Bassett Ward Community 1 2 Capener Ward 3 Day Surgery Unit 4 Fortescue Ward 5 Glossop Ward 6 King George V Ward 7 Lundy Ward 8 Medical Assessment Unit 9 Petter Day Treatment Unit 10 Radiology 11 Staples Ward 12 Vanguard Unit Barnstaple Community Nursing Team 2 Holsworthy Community Hospital Page 15 of 39

16 Patient Experience Annual Report /17 3 South Molton Community Hospital 2. Food at North Devon District Hospital Comments collected in relation to food by the Trust s team of volunteer patient experience surveyors on the acute wards at North Devon District Hospital (see page 5) are routinely reported to Sodexo via the Facilities Department. These comments are included in the wider analysis of the food survey which is conducted by Sodexo. The themes identified and addressed by Sodexo during the year -17 are detailed in the attached Sodexo report in Appendix D. 3. Provision of patient experience data to support/inform transformation programmes Patient experience data has been reported to the operational teams to support the ongoing work in Holsworthy, where inpatient beds have been temporarily closed since March, due to operational and safety issues. 5. Communicating the actions we ve taken When feedback results in an action being taken, it is vital that we communicate what we have done. Actions taken as a result of the patient experience feedback are communicated through various channels as follows: Direct feedback to the patient e.g. via meetings, complaint letters You said - we did noticeboards at ward/department level and on the Trust website Monthly integrated performance reports and the patient experience dashboard presented to Board Pulse - the Trust newsletter Reports to Healthwatch Devon Reports to Overview and Scrutiny Committees Outpatient TV screens at North Devon District Hospital Trust Annual Report Quality Account Press releases and case studies Trust website and intranet Social media, including Care Opinion Presentations at national/regional events and conferences Wider patient engagement and involvement Page 16 of 39

17 Patient Experience Annual Report /17 6. Governance Performance and progress against objectives are addressed at every monthly divisional review, bi-monthly at LPEG, Involving Patient Steering Group (IPSG), Quality Assurance Committee and at Trust Board. This ensures that staff, patients and the public are kept informed about progress and implementation of the patient experience strategy. IPSG and LPEG remain the primary assurance route for overseeing the patient experience programmes. Learning from Patient Experience Group (LPEG) Every two months the multi-disciplinary members of the Learning from Patient Experience Group (LPEG) meet to discuss and triangulate patient experience, staff experience, quality, safety, complaints, national surveys, PPI activities and audit feedback data to identify themes and areas of concern. This meeting is chaired by the director of nursing, quality and workforce. LPEG allows the data from all parties to be shared, producing a group discussion between members on what the data is telling us. The data sources and feedback are discussed and triangulated at the LPEG meeting and actions assigned to leads to address concerns, understand more or resolve the problem causing the feedback. This process enables the Trust to identify hotspots quickly using evidence. The outputs from LPEG are discussed at the Quality Assurance Committee, a sub-committee of the Board. Also feeding the work of LPEG are any care reviews or reports from Healthwatch Devon. Involving People Steering Group (IPSG) The purpose of the Involving People Steering Group is to advise the Trust on appropriate methods of involvement regarding the following: The planning or provision of healthcare services The development and consideration of proposals for changes in the way those services are provided Decisions to be made affecting the operation of those services To provide a forum for members to identify any specific areas where services could be improved in relation to the specific needs of their respective groups and the wider community This approach provides the Trust with an opportunity to work in true partnership with staff and people as well as ensuring that the Trust meets its responsibilities with regard to patient and public involvement in the most appropriate, effective and inclusive ways and that there is evidence that involvement and experience has influenced decision-making. Page 17 of 39

18 Patient Experience Annual Report /17 7. Next Year (/18) Next year we aim to focus on the following objectives/projects: - Implementation of the next steps in the revision and updating of the patient experience strategy, including the finalising of the projects to be worked on and assignment of individual project ownership - Establishment of a new Quality Improvement Board (QIB) with a view to re-focussing the patient experience programme around the concept of improvement. It is the intention that the QIB will replace a number of existing groups, including LPEG - Communicating the new patient experience strategy and FFT brand Trust-wide to make it more prominent and consistently recognisable at a glance throughout the Trust - Continue to refine the patient experience reporting and explore the full reporting potential of Meridian - Increasing the FFT response rates Page 18 of 39

19 Patient Experience Annual Report /17 Appendix A - Acute Wards - North Devon District Hospital An example of an acute inpatient survey ward report published on the Trust website here: Acute Inpatient Survey NDDH Page 19 of 39

20 Patient Experience Annual Report /17 Appendix B - Friends and Family Test (FFT) Scores Adult FFT card question How likely are you to recommend our ward / hospital / department / service to friends and family if they needed similar care or treatment? Response options: Extremely likely, Likely, Neither likely nor unlikely, Unlikely, Extremely unlikely, Don t know. Children and young person s FFT card question Would you tell your friends that this is a good ward / hospital / unit / service / department to come to? Response options: Yes, Maybe, No, Don t know. Quantitative Results The FFT score is calculated as outlined in the NHS England guidance. The calculation is as follows: Would recommend percentage is calculated as follows: Extremely likely + Likely (Yes) Extremely likely + Likely + Neither likely nor unlikely + Unlikely + Extremely unlikely + Don t know (Yes + Maybe + No + Don t know) X100 Would not recommend percentage is calculated as follows: Extremely unlikely + Unlikely (No) Extremely likely + Likely + Neither likely nor unlikely + Unlikely + Extremely unlikely + Don t know (Yes + Maybe + No + Don t know) X100 The Trust s target Would recommend score is 75% director of nursing, quality and workforce Page 20 of 39

21 Patient Experience Annual Report /17 Acute / A&E Ward/Unit / Department Target April May June July August September October November December January February March A&E only A&E (i.e. A&E / MAU combined) Acute Stroke Unit Fortescue Ward Capener Ward Caroline Thorpe Ward Lundy Ward Glossop Ward King George V Ward Medical Assessment Unit Staples Ward director of nursing, quality and workforce Page 21 of 39

22 Patient Experience Annual Report /17 Ward/Unit / Department Target April May June July August September October November December January February March Tarka Ward Victoria Ward Acute / A&E combined Maternity Services Touch point Target April May June July August September October November December January February March Maternity Services - Total Antenatal Service Labour Ward Postnatal Ward Postnatal Community Service director of nursing, quality and workforce Page 22 of 39

23 Patient Experience Annual Report /17 Community Hospitals Location Target April May June July August September October November December January February March North Community - Total Bideford- Elizabeth Holsworthy South Molton Community Nursing Teams Team Target April May June July August September October November December January February March Community Nursing Teams - Northern Barnstaple Bideford Holsworthy/Torrington director of nursing, quality and workforce Page 23 of 39

24 Patient Experience Annual Report /17 Team Target April May June July August September October November December January February March Ilfracombe Lynton/Lynmouth Out of Hours Northern South Molton Community Therapy Teams Team Target April May June July August September October November December January February March Community Therapy Teams - Northern Barnstaple Bideford Ilfracombe South Molton director of nursing, quality and workforce Page 24 of 39

25 Patient Experience Annual Report /17 Team Target April May June July August September October November December January February March Torrington/Holsworthy Outpatients and Daycases NDDH Service Target April May June July August September October November December January February March NDDH - Outpatients Service Target April May June July August September October November December January February March Value Value NDDH - Daycases Seamoor Unit Day Surgery Unit Endoscopy Suite director of nursing, quality and workforce Page 25 of 39

26 Patient Experience Annual Report /17 Service Target April May June July August September October November December January February March Value Value Petter Day Treatment Unit Radiology Urology Suite Vanguard Unit Community Healthcare Minor Target April May June July August September Injury Units October November December January February March Bideford Ilfracombe Lynton director of nursing, quality and workforce Page 26 of 39

27 Patient Experience Annual Report /17 Walk-in Centres Target April May June July August September October November December January February March Walk-in Centres - Total Walk-in Centres (RD&E) Walk-in Centres (Sidwell Street) DVT Service (RD&E)) Community Outpatients Target April May June July August September October November December January February March Barnstaple Health Centre Bideford Holsworthy Ilfracombe South Molton director of nursing, quality and workforce Page 27 of 39

28 Patient Experience Annual Report /17 Community Outpatients Target April May June July August September October November December January February March Stratton Torrington Litchdon House Specialist Services Target April May June July August September October November December January February March The Centre - Barnstaple The Centre - Exeter Podiatry Bladder and Bowel - Adult Dental The Centre - Exmouth The Centre Okehampton director of nursing, quality and workforce Page 28 of 39

29 Patient Experience Annual Report /17 Specialist Services Target April May June July August September October November December January February March The Centre - Tiverton Bladder and Bowel - Paediatric The Centre - Holsworthy director of nursing, quality and workforce Page 29 of 39

30 Patient Experience Annual Report /17 Appendix C - Methodology Service Questions Additional data collected Data collection method Frequency of data collection Dissemination of results 1 Acute Inpatients 1. We would like you to think about your experience on this ward. How likely are you to recommend our ward to friends and family if they needed similar care or treatment? 2. Have you been involved as much as you wanted to be in decisions about your care and treatment? 3. Have hospital staff been available to talk with you about your worries and fears? 4. Have you been given enough privacy when discussing your condition / treatment? 5. Have the doctors and nurses talked to you about medication side effects? 6. Overall, do you feel you have been treated with respect and dignity while you have been in hospital? 7. If you have concerns once you leave the hospital will you know how to get more information? 8. Have you any suggestions for ways we can improve the service or any other comments on the service you have received? Gender Age Volunteers using an electronic device Daily Volunteers visit the wards every day Each ward is usually visited several times per month Ward manager - within 2-3 hours FFT data - monthly UNIFY2 upload Performance - monthly BOB - monthly. LPEG - bimonthly 2 Community Hospital Inpatients 1. We would like you to think about your experience on this ward. How likely are you to recommend our ward to friends and family if they needed similar care or treatment? 2. Have you been involved as much as you wanted to be in decisions about your care and treatment? None Matron s Walkround Checklist Monthly Performance - monthly BOB - monthly director of nursing, quality and workforce Page 30 of 39

31 Patient Experience Annual Report /17 3. Have hospital staff been available to talk with you about your worries and fears? 4. Have you been given enough privacy when discussing your condition / treatment? 5. Have the doctors and nurses talked to you about medication side effects? 6. Overall, do you feel you have been treated with respect and dignity while you have been in hospital? 7. If you have concerns once you leave the hospital will you know how to get more information? LPEG - bimonthly 3 Community Nursing Teams director of nursing, quality and workforce 1. We would like you to think about your recent experiences of our service. How likely are you to recommend our service to friends and family if they needed similar care or treatment? 2. At what stage in your care are you completing this Patient Experience Survey? 3. Please can you tell us why you gave the response you did to question 2? 4. Were you offered a morning or afternoon appointment for us to visit you in your home? 5. Were you contacted in advance if we were unable to keep an appointment? 6. Were you involved as much as you wanted to be in decisions about your care and treatment? 7. Have your family and carers been involved in decisions about your care as much as you would like them to have been? 8. Before you received any treatments (e.g. an injection, dressing, physiotherapy) did a member of staff explain any risks and / or benefits in a way you could understand? Page 31 of 39 Gender Age Ethnicity The survey form is left with the patient at home Patients who decide to participate complete the form and return it on a reply-paid basis Daily FFT data - monthly UNIFY2 upload Service leads - monthly Performance - monthly BOB - monthly LPEG - bimonthly