We value each other / We are empowered / We keep things simple / We are connected. Title: Patient Experience Strategy Progress Update April 2017

Transcription

1 Report To: Board of Directors (Public) Paper Number: 2.3 Report For: Information Date: 27 April 2017 Report Author: Karen Reynolds Head of Governance and Quality Assurance Report of: Caroline Harris-Birtles Director of Nursing FoI Status: Strategic Priorities Report can be made public Early and effective intervention Supported: Cultural Pillar Supported: We value each other / We are empowered / We keep things simple / We are connected Title: Patient Experience Strategy Progress Update April 2017 Executive Summary The Patient Experience Strategy was launched in April There are five key work streams with milestones, underpinning the strategy.the work streams are: always listening; understanding the things we are told; sharing, collaboration and coproduction; responsibility and making changes; and getting the basics right. The report contains a summary of progress with milestones and shows there has been a lack of progress in some areas. A refresh and reinvigoration of the approach is needed to meet the 2017 milestones. This lack of progress can be attributed to several factors: The absence of a Patient Experience Lead for a large part of 2016/17. This role was expected to co-ordinate the strategy and its implementation. Action: Fill Patient Experience role The Experience group not meeting to provide oversight of the strategy Action: Reconvene Patient Experience group to meet in May The Quality Assurance Framework and review is key to measuring and reporting Patient Experience, however no recent Quality Assurance Reviews have been undertaken Page 1

2 Action: Review the Quality Assurance Framework process and report approach to next Quality Committee May 2017 (link to CQC yearly self-assessment process) Lack of consistent and specific local improvement and assurance plans for services that incorporate patient experience outcomes. Action: Develop local Improvement and Assurance plans for divisions and services including Patient experience. Report these plans into the Trust Quality Governance meeting in July 2017 To get back on track and meet our ambition to embed patient experience in all our services we need to take the steps outlined in the report and reinvigorate the implementation of the strategy. Recommendation to the Board of Directors As part of our commitment to improving the experiences of our service users, families and carers, note the actions to bring the Strategy back on track. Risk Implications Damage to reputation with service users Failure achieve well led CQC standards Finance Implications No new financial implications Equality and Diversity Impact / Single Equalities Impact Assessment No impact Page 2

3 Patient Experience Strategy Progress Update April 2017 Overview The Patient Experience Strategy was launched in April 2016 with the aim to: ensure that we have effective systems for understanding and capturing people's experiences, that we act on this information consistently, and that we commit to collaboration and innovation to continually develop best practice The strategy is attached in appendix 1. How patients experience our services is a key component of quality. Feedback from patients is important to us. This is why a patient experience strategy is in place, to ensure we develop our systems and people to incorporate the service user voice into everything we do. Patient feedback also lets the Trust understand where improvements need to be made and where services are working well. Our ambition is to embed patient experience in all our services. Summary of progress with milestones This is a 4 year strategy and as can be seen in the in the summary of progress with milestones below there has been a lack of progress in some areas. To get back on track and meet our ambition to embed patient experience in all our services we need to take the steps outlined here and reinvigorate the work on patient experience. There are five key work streams with milestones, underpinning the strategy. The work streams are: always listening; understanding the things we are told; sharing, collaboration and coproduction; responsibility and making changes; and getting the basics right. This lack of progress can be attributed to several factors: The absence of a Patient Experience Lead for a large part of 2016/17. This role was expected to co-ordinate the strategy and its implementation. Action: Fill Patient Experience role The Experience group not meeting to provide oversight of the strategy Action: Reconvene Patient Experience group to meet in May The Quality Assurance Framework and review is key to measuring and reporting Patient Experience, however no recent Quality Assurance Reviews have been undertaken Action: Review the Quality Assurance Framework process and report approach to next Quality Committee May 2017 (link to CQC yearly self-assessment process) Lack of consistent and specific local improvement and assurance plans for services that incorporate patient experience outcomes. Action: Develop local Improvement and Assurance plans for divisions and services including Patient experience. Report these plans into the Trust Quality Governance meeting in July 2017 Page 3

4 In addition to these actions, next steps have been identified for each of the work streams and milestones to bring the strategy back on track in the next 6 months. Always listening 1 Service users from all C&I services are represented in centrally gathered feedback Status: Achieved 100% of eligible teams represented in FFT feedback Next steps Developing improvement plans based on feedback. 2 At least 10% of those in contact with C&I use patient feedback tools in , with improvement year on year Some services are using Meridian for locally developed surveys Some services have patient experience groups in place Low response rates to the national surveys How does this link to the Service User Involvement Strategy? Next Steps Status: Not achieved Establish what other Patient Experience tools will be used in addition to FFT Understanding the things we are told 3 Biannual formal qualitative analysis report (Apr 2016) Status: Partly achieved Regular reports on patient experience are produced for several committees. However, the Patient Experience group has not met recently and the reports are not shared with the services or via the Trust Website Next steps Convene the Patient Experience group. Establish the communication and reporting framework for the Patient Experience Reports. Page 4

5 4 Patient experience section of every quality assurance review Status: Not achieved No Quality Assurance Reviews undertaken in 2016/17. Next steps: Review approach to Quality Assurance and incorporate into CQC inspection preparation and yearly CQC compliance self-assessment. Sharing, collaboration and co-production 5 Summary of patient experience feedback on Trust website four times per year (Feb 2016) See Step 3 Status: Not achieved Next steps Create Patient Experience Feedback page on the Trust Website 6 Implementation of Quality Boards on all inpatient wards Status: Partly Achieved Quality Boards have been introduced in inpatient areas but the content and currency of the information needs reinvigorating (link to CQC inspection prep) Next Steps There is a drive to reinvigorate the use of Quality Boards during May Display of patient experience information in all services On display in all inpatient areas and some outpatient services Status: Partly achieved Next steps: Assess as part of 15 steps Link to drive to reinvigorate the use of Quality Boards during May 2017 Responsibility and making changes Page 5

6 8 Implementation of divisional patient experience plans Status: Partly achieved Some services have a clear approach to patient experience but services do not tend to have explicit patient experience plans in place Next steps: Services are carrying out local projects that need to be formally reported, so that learning can be collated and shared. Develop local Improvement and Assurance plans for divisions and services. Patient experience plans will be defined alongside the annual clinical audit plan coordinated by Clinical Audit and Service Improvement Facilitators. 9 Delivery of divisional patient experience plans (by Apr 2017) As above. 10 Inclusion of You said, we did In Quality Boards and other displays across divisions Boards are in place but the currency of the information needs checking. Status: Partly achieved Next steps Check that Boards are still being updated on a regular basis Update Quality Boards to encourage teams to share things they are proud of, via section called Our team are great at to share positive stories and to help staff feel proud. Recommendations To get back on track and meet our ambition to embed patient experience in all our services we need to take the steps outlined above and reinvigorate the implementation of the strategy. As part of our commitment to improving the experiences of our service users, families and carers, note the actions to bring the Strategy back on track. Page 6

7 PATIENT EXPERIENCE STRATEGY HEAD OF PATIENT EXPERIENCE APRIL 2016

8 PATIENT EXPERIENCE STRATEGY Introduction Patient experience sits alongside patient safety and clinical effectiveness as a key component of quality in healthcare services. This paper provides a briefing for the Quality Committee on the Trust's first patient experience strategy, setting out key priorities and next steps. The patient experience strategy is developed with reference to the NICE quality standard for service user experience in adult mental health, the quality priorities set out in the Quality Accounts, learning from serious incident investigations, feedback from CQC inspection reports and learning from serious failings in other Trusts, such as those described in the Francis Report. Patient experience makes up a theme of the action plan developed in response to the CQC comprehensive inspection. In January 2015, the National Quality Board published its shared understanding and ambition for improving people's experiences of care. The group, which includes Department of Health, NHS England, and the CQC, explain that a person's experience may include: What people experience when they receive care or treatment, including both interactions with the Trust, and the processes they are involved in (e.g. admissions processes, arranging appointments) How the 'what' makes them feel (e.g. respected, valued). In order for us to ensure the highest standards of patient experience at C&I, we must ensure that we have effective systems for understanding and capturing people's experiences, that we act on this information consistently, and that we commit to collaboration and innovation to continually develop best practice. 1.1 Aims of the patient experience strategy The C&I patient experience aims to: Provide a framework for a continuing cycle of assessing, improving and evaluating patient experience across the Trust; Ensure the impact of changes on patient experience (positive and negative) of projects, changes and service developments, is routinely assessed and considered; Establish a system for measuring patient experience that allows services, divisions, the Trust Board, service users and the wider community to remain informed about progress; Ensure actions taken to improve patient experience are communicated to key stakeholders, ensuring that stakeholders are assured that their feedback is both valued and influential; Support the role of the internal Quality Assurance Framework by providing intelligence, oversight and standards for patient experience;

9 PATIENT EXPERIENCE STRATEGY Define key priority areas for patient experience and deliver improvements where needed; To develop service-user led measures of outcomes for each division, which will be incorporated into the Trust s performance framework. 2. Development of the patient experience strategy 2.1 Approach to patient experience at C&I As part of the development of the Patient Experience Strategy for C&I, strategies for a range of other mental health and acute trusts have been reviewed. As a developing area, patient experience has been interpreted in a range of different ways by different providers. For some, patient experience encompasses patient feedback, including complaints. For others, patient experience is considered jointly with service user involvement with minimal distinction between the two. At C&I, it is recognised that patient experience forms one of the three key elements of quality, alongside patient safety and clinical effectiveness. Therefore, patient experience moves beyond collection of patient feedback and also onto how this is used and responded to, and how this data informs and influences quality assurance processes throughout the trust. Whilst developing and implementing ways of monitoring patient experience will necessarily involve service users, the patient experience strategy is distinct from the service user involvement strategy. 2.2 Staff Consultation Both formal and informal consultation has taken place with C&I staff. In June 2015, staff were invited by to complete a survey giving their ideas for the strategy (Appendix 1). Visits to divisional quality forums and individual team meetings also took place to gather feedback and ideas from a wider range of staff. Thirty five staff submitted written responses to the consultation, with all divisions represented in the feedback. The consultation survey asked for ideas, and also asked whether staff members teams routinely collected feedback, had made changes in response to feedback in the past year, or had made changes to improve patient experience in the past year. A sample of feedback from this is given in Section 0 (Appendix 2). Service users have been central to the development of the patient experience strategy, both by formal consultation and through the inclusion of over 500 examples of service user and carer feedback in setting the strategic priorities. 2.3 Existing strengths and challenges In the staff consultation survey, 74% of respondents said that patient feedback was routinely collected within their team, but only 42% that they had made changes in response to this over the past twelve months. Sixty eight percent said that they had made positive changes to patient experience in the last year. This evidences the challenge of ensuring that the feedback loop of making changes is addressed. Therefore, monitoring and sharing information about changes will be a key focus of the strategy. Lack of changes in response to feedback, and lack of information about changes can be demoralising and reduce service user and staff engagement with providing this information. Discussion of these issues with

10 PATIENT EXPERIENCE STRATEGY more senior managers showed that some ideas are acted on, but that this information might not reach frontline staff and service users, and so communication of progress is also an area for development. Visits to teams and divisional quality forums highlighted that staff are passionate about patient experience, and have a range of ideas. However, they have sometimes found it difficult to implement ideas about gathering information about and improving patient experience. There has not previously been a central point where teams can find resources to capture patient experience, or access support with designing and implementing patient experience initiatives. Therefore, projects have often relied on specific staff members with interest/expertise in this area being available to take this work forward. The impact of this is a somewhat inconsistent approach where some teams have been able to implement this work much more comprehensively than others. Further, whilst many teams have implemented paper-based feedback measures, they have found it difficult to find administration time to complete data entry and analysis, and have therefore been limited in taking the work forward. These challenges are common across the organisation, but are not insurmountable. The patient experience strategy will address each of these, and therefore will facilitate substantial improvements in the coverage and coordination of this process. 3. Content of the patient experience strategy The developing patient experience strategy takes into account learning from consultation with staff and service users, consideration of strategies adopted by other providers, and the learning from reviewing existing work in place at C&I. It is summarised in table form in Section 0 (Appendix 3). There are five key work streams, each of which is briefly summarised here, with key aspects of each work stream and milestones to be achieved. The work streams are: always listening; understanding the things we are told; sharing, collaboration and coproduction; responsibility and making changes; and getting the basics right. 3.1 Always listening C&I will actively seek and listen to our service users and carers experiences. We will ensure that all aspects of our community are able to share their views. Continued roll out of the Friends and Family Test. At Month 10 of the financial year, over 90% of teams have submitted Friends and Family Test data, with a target of all teams doing so by the end of March 2016; Development of bespoke patient experience measures for specific teams, measured in a way that works for their team and service users; Facilitating feedback from all members of our community, ensuring that adaptations are made to make this accessible to those who might be underrepresented, including those with disabilities and those speaking English as a second language, for example; Engaging with technology. C&I will continue to use the Meridian system to facilitate data analysis and collection, and will consider other technological

11 PATIENT EXPERIENCE STRATEGY Milestones solutions, including text-message based feedback to increase coverage and accessibility. 1. Service users from all C&I services are represented in centrally gathered feedback (Apr 2016). 2. At least 10% of those in contact with C&I use patient feedback tools in , with improvement year on year. 3.2 Understanding the things we are told Information and data about patient experience will be integrated with other quality intelligence to ensure C&I has a good understanding of people's experiences and reliable information on which to make changes. Analysis of the information will be robust, systematic and effective. Formal analysis will be undertaken on the increasing quantity of qualitative feedback. This will ensure a robust understanding of themes emerging, allowing C&I to act on these effectively; Triangulation of patient experience feedback with other quality intelligence. As patient experience is a key aspect of quality, patient experience data is routinely considered as part of the intelligent monitoring approach to quality assurance. In practice, this means that information on patient experience is considered alongside performance information, incidents information, complaints and other quality intelligence to support the trust in understanding the quality performance at team, divisional and trust-wide levels; As patient experience feedback is incorporated in quality intelligence in this way, it is influential in the quality assurance programme. Where challenges are identified, actions are taken to address these under the Quality Assurance Framework. Milestones 3. Biannual formal qualitative analysis report (Apr 2016). 4. Patient experience section of every quality assurance review (Oct 2016). 3.3 Sharing, collaboration and co-production C&I is committed to the transparent and open sharing of information about patient experience, quality and performance. We will ensure this information is available, accessible and accurate. We welcome discussion, information and challenge from our stakeholders, and will respond to their thoughts and ideas to coproduce our strategy with them.

12 PATIENT EXPERIENCE STRATEGY Coproduction of patient experience measures will continue and be encouraged across teams; Accessible information on patient experience will be made available via public displays, and on the C&I website; Quality information will be displayed prominently in all clinical services, via Quality Boards (example in Section 0, Appendix 4); Detailed information on patient experience and patient feedback will be regularly shared with service leads to allow them to take action; All stakeholders are invited to contribute to the patient experience programme, and will be regularly re-invited to do so. Milestones 5. Summary of patient experience feedback on Trust website four times per year (Feb 2016). 6. Implementation of Quality Boards on all inpatient wards (Oct 2015). 7. Display of patient experience information in all services (Oct 2016). 3.4 Responsibility and making changes C&I will respond to information about patient experience, and will use this information to make tangible changes. Delivery of actions will be routinely monitored and managed to ensure excellence. Every division will have a patient experience plan from Apr 2016, monitored and presented alongside annual clinical audit plans; Every service will display You said, we did to demonstrate changes made in response to patient feedback; Any patient experience concerns raised will be monitored and followed up under the Quality Assurance Framework, including implementation of improvement plans where required; Clear processes for collating information have been introduced so that nothing falls through the gaps. Milestones 8. Implementation of divisional patient experience plans (Apr 2016 and ongoing) 9. Delivery of divisional patient experience plans (by Apr 2017) 10. Inclusion of You said, we did In Quality Boards and other displays across divisions (Feb 2016)

13 PATIENT EXPERIENCE STRATEGY Getting the basics right This area reflects the elements of patient experience that link and cross-over with other core functions, and distinguishes areas which the strategy delivers from those delivered through other processes that only link with patient experience. A number of functions that are essential to delivering the highest standards of patient experience are delivered via other strategies. These include: Complaints Service user involvement Clinical effectiveness and clinical audit Patient safety Learning from serious incidents Duty of Candour Chaplaincy Clinical strategy Quality Assurance Framework Milestones These are delivered via processes in place across the Trust, rather than directly via this strategy.

14 4. Updates on milestones (February 2016) Work stream Milestone Update Status Always listening 1 Service users from all C&I services are represented in centrally gathered feedback (Apr 2016) 93% of eligible teams represented in 2015/16 FFT feedback (February 2016). On track Understanding the things we are told Sharing, collaboration and coproduction 2 At least 10% of those in contact with C&I use patient feedback tools in , with improvement year on year 3 Biannual formal qualitative analysis report (Apr 2016) 4 Patient experience section of every quality assurance review (Oct 2016) 5 Summary of patient experience feedback on Trust website four times per year (Feb 2016) 6 Implementation of Quality Boards on all inpatient wards (Oct 2015) 2015/16 focus has been on Milestone 1, to prepare for meeting this milestone in 2016/17 Text methodology being investigated to increase FFT feedback Identified qualitative methodology suitable for review. Framework Analysis training sessions scheduled for Clinical Audit Facilitators. On track On track Separate report of compliments for teams shared across the Trust 236 compliments received in Q All 28 recent QA Reviews include clear evidence of patient experience as On track a key aspect of Quality Assurance Framework Next steps: Reporting templates for QA Reviews to be adapted to make this more explicit Develop expert by experience aspect of Quality Assurance Framework Delayed until April 2016 to coincide with Milestone 3 Delayed until April 2016 Achieved. Achieved Responsibility and making changes 7 Display of patient experience information in all services (Oct 2016) 8 Implementation of divisional patient experience plans (Apr 2016 and ongoing) On track. On display in all inpatient areas and some inpatient services as of February Patient experience plans will be defined alongside the annual clinical audit plan development, coordinated by Clinical Audit and Service Improvement Facilitators. On track

15 PATIENT EXPERIENCE STRATEGY Projects within each division continue to make good progress: R&R A pilot of a combined audit / patient experience approach using the most important event framework with occupational therapists in R&R has been successful, with OTs finding this has helped track activity provision and feedback. This pilot is now being developed into a longer term project. SMS the SMS annual survey is about to launch, this year incorporating both FFT and validated measures of therapeutic alliance alongside other questions. Acute presented their service-user led patient experience project, including findings and changes made as a result, to colleagues from both Camden and Islington CCGs at the Clinical Quality Review Group. CMH Assessment and Advice Team consistently top team for collecting FFT responses. Both ADHD and ASD services have also developed patient experience measures specific to these services and have successfully launched these. SAMH with support of newly appointed psychologist, Stacey Street Team are developing approaches to understanding patient experience in people with dementia. COG working group Have designed and launched a patient experience programme to understand how service users rate the importance of multiple aspects of care planning, as well as how well C&I performs on these. Initial feedback was presented to the working group in December Areas for further development: Inclusion of learning disabilities services in plans Approach professional leads to consider any profession-specific projects Developing feedback loops to ensure changes are implemented and communicated

16 PATIENT EXPERIENCE STRATEGY Delivery of divisional patient experience plans (by Apr 2017) 10 Inclusion of You said, we did In Quality Boards and other displays across divisions (Feb 2016) Share learning from projects across divisions of the organisation. As above. This milestone will also be developed to include delivery of any patient experience actions identified from the February 2016 CQC inspection. These have been included. Examples of recent changes include: Working with transport companies to improve patient transport (Netherwood and Raglan Day Centre) Implemented breakfast club on inpatient wards Enabled self-referral to occupational therapy on Sapphire Ward Offered more independence at breakfast time (Dunkley Ward) Reduced gaps between events / sessions (Community Recovery Service for Older People) Increased access to computers (Laffan Ward) Updated Quality Boards to encourage teams to share things they are proud of, via section called Our team are great at to share positive stories and to help staff feel proud.

17 5. Appendices Appendix 1 PE strategy consultation

18 Appendix 2: Sample feedback from staff consultation survey Division My team routinely collect information about patient experience (e.g. surveys, feedback boxes, informal comments). I/my team/my service have made changes in response to patient feedback over the last year. I/my team/my service have made changes to improve patient experience in the past year. The most important thing we could do to improve patient experience is: Acute from the patient surveys and informal comments Community Mental Health Community Mental Health Community Mental Health Although we have the facility to do this, it is not routinely performed and there is considerable resistance among staff to obtaining patient feedback. No By discussing it during business and making suggestion on how to improve on the services provided. Patient feedback is not responded to; no one has responsibility for collating it and responding to it. No Discussing it with other teams and share what has been successful on each ward. Provide better pathways to collect and respond to patient feedback including setting up a patient reference group Don't know Don't know Don't know listen to clients and how they feel we should improve a team member telephones past clients and asks them to complete a short survey and asks for feedback about our service. Don't know our team is flexible in our support approach for each client depending on their diagnosis and their support goals Community Mental Health Community Mental Health Community Mental Health PEQ feedback questionnaire at assessment and end of treatment. feedback boxes. asking clients directly in sessions. regular meetings of patient advisory group clients comments used to inform website, questionnaire measures, leaflets etc. No Thought has been given to patient waiting area Questionnaire at end of assessment and treatment. Box for clients to leave comments on feedback slips. Advertised address for feedback to service (this isn't used much). Regular advisory groups, use of ad hoc surveys. Opportunity for service users to record their patient experience with a member of staff (audio / video / Made changes to staffing of reception, use of name tags in groups, changes to handouts used in groups, redesign of patient information leaflets, changes in handouts used in therapy groups. See above, development of information on website, use of exservice user to help develop better workshops and groups for clients. Consultation to clients about how to make improvements to reduce waiting times. Ask clients to be involved in service development via patient advisory groups. Training reception staff in customer service and telephone skills. More privacy at reception area. Consult to service users on all decisions, for service users to be embedded in the management of the organisation (in a meaningful rather than tokenistic way) To keep the position of the service user at the forefront of all decisions making... ask self - what is the impact of this for our service users, how will they experience it.

19 PATIENT EXPERIENCE STRATEGY written) Community Mental Health Community Mental Health patient experience questionnaire at start and end of treatment, opportunity for all clients to join service user group After each patient completes an episode of treatment they are provided with a PEQ. R&R forms and questionnaires to staff at hostels for homeless. The questionnaire has been reviewed and developed. We test out materials (e.g. new leaflets, screening scripts etc) with SUs at the service user forum for feedback and make relevant adaptations. Don't know deployment of the Bloomsbury cultural formulation interview that works for all ethnic groups, but often in view of time, cannot be done for all. the routine user experience surveys do not capture the nuanced depth of experiences that would allow for better clinical intervention as they are too superficial to make access across to patient feedback forums different groups (BME/ LGBT etc) as easy as possible. offer service user forums in different locations across C&I Having a larger number of community hubs that pts are seen in - not simply health centres. more time with patients, focus on patients explanation using a structured interview that can take up to 30 minutes but gathers excellent information of use to clinicians. see video of how this works at and scroll down to click on the longer video interview on left called bcfi or shorter version called cultural formulation interview for dsm 5 field trials on the right side of the web page.

20 PATIENT EXPERIENCE STRATEGY Services for Aging and Mental Health feedback boxes and informal comments Don't know Not to separate it from the experience of ourselves as professionals as whole human beings. For example actively support professionals in single and group Mindfulness practices by giving space and time for this. This in turn helps us to become more receptive, open and nonjudgmental to the experiences of our own inner lives and that of others. It widens and deepens our perceptual abilities which in turn make us more effective and efficient in our work with patients as well as more compassionate in our behaviour. Services for Aging and Mental Health Substance Misuse Services SAMH CMHTs - Advisory Group for Older People (AGOP) service user forum. Client satisfaction questionnaires (CSQ). SAMH Memory Services - Meeting with patients and carers to interview them on their experience of using the service. CSQs. Feedback box, PET, feedback forms for groups Some examples: Feedback from memory service patients led to the development of a new intervention (memory strategies group) which meets the needs of higher functioning people who are not well served by current interventions, i.e. CST, which we are about to pilot. AGOP working on developing a maintaining wellbeing summary sheet for use on discharge from the CMHTs. AGOP have provided feedback on a number of questionnaires used by the service to ensure they are accessible and useful. Changing name of one of the groups, started a clothing donations box More focus on non-medical therapies - complementary therapies, EFT, healing, relaxation etc.

21 Appendix 3: Patient experience strategy summary table Principle Always listening Understanding the things we are told Purpose C&I will actively seek and listen Information and data about patient to our service users and carers experience will be integrated with experiences. We will ensure other quality intelligence to ensure that all aspects of our C&I have a good understanding of community are able to share people's experiences and reliable their views. information on which to make changes. Analysis of the information will be robust, systematic and effective. Key aspects Continued roll out of FFT Development of bespoke patient experience measures Facilitating feedback from all members of our community Engage with technology Milestones 1. Service users from all C&I services are represented in centrally gathered feedback (Apr 2016) 2. At least 10% of those in contact with C&I use patient feedback tools in , with improvement year on year Understanding themes from patient experience feedback Triangulation of patient experience feedback with other quality intelligence Impact of patient experience feedback on quality assurance and quality improvement across C&I 3. Biannual formal qualitative analysis report (Apr 2016) 4. Patient experience section of every quality assurance review (Oct 2016) Sharing, collaboration and coproduction C&I is committed to the transparent and open sharing of information about patient experience, quality and performance. We will ensure this information is available, accessible and accurate. We welcome discussion, information and challenge from our stakeholders, and will respond to their thoughts and ideas to coproduce our strategy with them. Coproduction of patient experience measures Accessible sharing of patient experience information Display of in-service quality information Sharing of detailed internal data with operational leads Invitation to all stakeholders to support development of patient experience methodologies based on experience and expertise Continued engagement with stakeholders including collaboration via CQUIN framework, Council of Governors working groups, and other approaches 5. Summary of patient experience feedback on Trust website four times per year (Feb 2016) 6. Implementation of Quality Boards on all inpatient wards (Oct 2015) 7. Display of patient experience information in all services (Oct 2016) Responsibility and making changes C&I will respond to information about patient experience, and will use this information to make tangible changes. Delivery of actions will be routinely monitored and managed to ensure excellence. Every division has a patient experience plan from Apr 2016, monitored alongside clinical audit plans Display of You said, we did to demonstrate changes Escalation of patient experience concerns under the Quality Assurance Framework, including implementation of improvement plans where required Clear processes for collating information so that nothing falls through the gaps 8. Implementation of divisional patient experience plans (Apr 2016 and ongoing) 9. Delivery of divisional patient experience plans (by Apr 2017) 10. Inclusion of You said, we did In Quality Boards and other displays across divisions (Feb 2016) Getting the basics right Patient experience does not stand alone and is impacted by many of the Trust s essential functions covered by other related strategies and policies. Delivery of other key functions affecting patient experience, including: o Complaints o Service user involvement o Clinical effectiveness and clinical audit o Patient safety o Learning from serious incidents o Duty of Candour o Chaplaincy o o Clinical strategy Quality Assurance Framework Delivered via processes in place across the Trust, rather than directly via this strategy

22 Appendix 4: Example Quality Board

23 Appendix 5: Example service-user designed patient experience measure

24 PATIENT EXPERIENCE STRATEGY Appendix 6: Map of feedback sources

25