Influence, inspire, empower

Transcription

1 Influence, inspire, empower Impact Report Picker Impact Report

2 The Principles of Patient Centred Care Our work reflects and builds upon the Picker principles of patient centred care that derive from empirical research originally conducted by the Picker Institute in the USA. Contents 4 Building on solid cornerstones Chairman s review 6 Focused growth foreword from the CEO 8 A person centred landscape 10 Influencing service through policy and research 12 Bringing national data collection to life in the NHS Fast access to reliable health advice Effective treatment delivered by trusted professionals Continuity of care and smooth transitions Involvement and support for family and carers 16 Taking healthcare co-design from aspiration to reality 20 Licensing a flexible approach to quality measurement 22 Creating a space for children to be seen and heard 26 International footprint driving the patient centred care agenda 28 Growth from change Clear, comprehensible information and support for self-care Involvement in decisions and respect for preferences Emotional support, empathy and respect Attention to physical and environmental needs 30 Accounts 31 Board of Trustees Our mission We are here to: Influence policy and practice so that health and social care systems are always centred on people s needs and preferences Inspire the delivery of the highest quality healthcare, developing tools and services which enable all patients experiences to be better understood Empower staff working in health and social care to improve patient experience by effectively measuring, and acting upon people s feedback Our vision The highest quality health and social care for all, always. Picker Impact Report

3 Picker would not be Picker without its people. Committed, talented and dedicated, they continue to deliver work of the highest quality... As ever, our promise to support those commissioning and delivering care services to improve quality still holds; and we continue to do this in partnership with professionals, service users and families. While interest and momentum for person centred care continues to grow, we are still not at a point where people s experiences are used systematically and routinely to measure and improve quality in health care systems across the world. Where there is systematic and routine collection of people s experiences, there is still significant variation in the quality of the care delivered, and in the ability of systems, organisations and pathways to deliver the excellence in the relational aspects of care that are known to matter most to service users and families. To this end, we have furthered our reach with new quality improvement programmes, research and evaluations in the UK, Ireland, Germany, Spain and through the commencement of a World Health Organisation (WHO) Europe evaluation into mental health services across all 53 WHO Europe member states. Alongside this we have driven developments in the Middle East, Asia, Australia and New Zealand. This is a significant agenda for a small-sized charity that would not be possible without our ongoing collaborations with like-minded organisations including the Beryl Institute, Planetree (US and Netherlands), the Institute for Healthcare Improvement (US), University of Oxford, The King's Fund and The Health Foundation. However, it is not only our partners and collaborators that are worthy of note. Picker would not be Picker without its people. Committed, talented and dedicated, they deliver work of the highest quality that not only underpins our global reputation for excellence in our field, but supports the delivery of person centred care at all levels. My personal thanks and gratitude also goes out to our trustees. As our most senior volunteers their continued support and input is vital to our ongoing success. They bring a wealth of experience and insight from a range of sectors and industries. This has been invaluable in helping us drive towards our vision and mission. Building on solid cornerstones Since its foundation in 2000, Picker has built a strong reputation for excellence in the field of person centred care. Over the past year we have continued to develop the depth of our research, tools and insights, as well as increase our reach as a charity. Stuart Bell CBE, Chairman 04 Picker Impact Report Picker Impact Report

4 Focused growth Although the year has not been without its challenges, Picker has enjoyed a number of notable successes as we continue our journey to use people s experiences to influence, inspire and empower positive change. In England, the Care Quality Commission (CQC) has again chosen Picker to be the national coordination centre for patient experience in the NHS and has extended our role to include social care for the first time. This allows for a range of developments, including research into social care facilities and recommendations for positive change in the quality of residents' experiences of care homes. From this position we can innovate and encourage improvement through integrated research. The charity will also continue to deliver the national coordination centre for the NHS staff survey, one of the largest staff experience evaluations in the world. At a local level we have supported over 200 NHS organisations to evaluate the experiences of both their service users and/or their staff. Our Always Events programme in collaboration with the Institute for Healthcare Improvement (IHI) continues to thrive, with 10 trusts now using the programme and two designations awarded. This initiative continues to grow and has increased our impact as a charity. It is a shining example of how to facilitate service improvement through collaborative change. This year also saw Picker successfully transition our operating model in Germany, with our evaluation and improvement services now delivered under licence by our business partner BQS/AnaQuestra across Germany, Austria, Switzerland and Luxembourg. Moving forward this change will allow Picker to retain its focus on insight, policy and development work across Europe and further afield in pursuit of our mission. Members of the Picker team are frequently invited to present our research and concepts on the global stage such as at The King s Fund and Health Foundation conferences, government and opposition party consultations, and international thought-leadership events including ISQUA and the Beryl Institute International conference. This awareness has grown year on year, increasing our profile and underlining the impact of our case for change among key stakeholders. I hope that you find this year's Impact Report a true reflection of why we do what we do and the importance of the charity's work. As we look to the opportunities and, no doubt, the challenges ahead, we must also remember to reflect on that which has been achieved so far. A chance to not only celebrate the hard work and commitment shown, but also to refuel the fires of innovation, dedication and inspiration that will ensure future successes in the Picker story. Internationally we are partnering with WHO Europe to survey the extent and nature of mental health services in all 53 member states of the European region. This will involve us contacting leads in mental health and disability offices in all participating countries. The second phase requires online training of national leads to help them undertake quality audits of mental institutions using a model developed in Turkey. This programme will be an important lever in improving the quality of mental healthcare in Europe. Dr Andrew McCulloch, CEO 06 Picker Impact Report Picker Impact Report

5 A person centred landscape As a charity, one of Picker's core objectives is to inspire and influence health and social care improvement through our work. Our charitable profile plays an integral role in achieving this aim. Supported over 250 organisations to understand, measure and improve people s experience all over the world; surveyed over 500,000 patients in England on their healthcare experiences Presented at 36 conferences nationally and internationally and took part in 8 formal national policy consultations Hosted: 6 national staff and patient workshops 2 national maternity workshops 38 improvement workshops to help service providers better understand national survey data and thus drive quality improvement Secured over 112 mentions in the media, including the Health Service Journal, Nursing Times, British Medical Journal, The Guardian and BBC News Collaborated with leading patient and quality improvement agencies, research and academic bodies including: Published 5 peerreviewed articles and 19 non peerreviewed articles Partnered with key charities including Macmillan Cancer Support, Motor Neurone Disease Association and Barnado's to develop insights around excluded groups The Beryl Institute, Held the Visitors to our Planetree Held 3 webinars Picker Institut website grew by Worked Institute for Healthcare Improvement with NHS England and Deutschland Annual 32% in the UK and with partners to Royal College of Paediatrics & Child Health the Patient Experience Forum attended by by 457% across the share positive practice The King's Fund, Network on children and over 100 healthcare rest of the world including judging and The Health Foundation young people s needs providers to share sponsoring the Positive Oxford University and excellence in best practice in patient Practice in Mental Health CLAHRC patient experience experience Awards and the Patient Experience Network National Awards 08 Picker Impact Report Picker Impact Report

6 Influencing service through policy and research Providers spoke of the challenges that they face in using patient feedback in a systematic and sustained way citing issues around leadership, culture, engagement, resources, and understanding. Continuing to shape the thinking and delivery of person centered care in the NHS Picker has successfully embedded the concept of person centred care and the process of national evaluation of people s experiences of care into NHS England's best practice over the last 15 years. Going forward we are focusing on shaping the thinking and policy that leads to substantive improvements in people s experiences of care at a local level. 2015/2016 was equally productive with a number of new releases including our internationally recognised policy briefings, large scale research projects and the continued development of NHS national surveys. Working with NHS England and the Care Quality Commission, our teams have continued to support the coordination and publication of surveys of NHS staff; hospital inpatient; community mental health service users and mothers experiences of maternity care, surveys and policy recommendations. With the national patient survey progammes now well established and regularly conducted, we have gone on to investigate to what extent people s experience of care has changed over the last decade. In a significant new study completed jointly with colleagues at The King s Fund, we set out to establish whether the quality of person centred care has improved in line with the growing policy focus on patient experience. To do this, we looked at trends in trust-level results for the NHS inpatient survey over a nine-year period. Although national trends are well known, this was the first time such an investigation had been completed at trust level. Our landmark study showed there has generally been only modest improvement in people s experience of care over the last decade. The greatest improvements have been in areas of policy focus for example around hospital cleanliness but there have been relatively limited changes in many of the areas that are most important to patients and their families. Interviews with NHS providers, completed as part of the study, highlight the work still to be done to make patientled improvement an everyday reality in the NHS. Providers spoke of the challenges that they face in using patient feedback in a systematic and sustained way citing issues around leadership, culture, engagement, resources, and understanding. This new study shows the appetite and potential to deliver greater levels of improvement. However the NHS and its constituent organisations are still struggling to overcome the hurdles many systems and organisations face when trying to implement evidence-based initiatives that move beyond the transactional aspects of process improvements and result in a sustained change in everyday behaviours. To help trusts overcome these challenges we have commenced a major new study with the University of Oxford and other colleagues to look at how NHS staff receive and apply patient experience information to improve services. The study, referred to as US-PEx, will involve an ethnographic review of six case study sites as they attempt to apply patient feedback to drive improvement. Ultimately the findings will allow us to develop a toolkit for the NHS to help providers make more effective use of the information and insight they receive. Successfully deployed, this will help organisations take the next crucial step beyond measurement to deliver meaningful and sustained improvement in the quality of care that so many NHS staff are striving to achieve. 010 Picker Impact Report Picker Impact Report

7 Bringing national data collection to life in the NHS Spotlight on the National Inpatient workshops Working together to deliver positive experiences and outcomes The NHS regulator, the CQC, runs a series of annual patient and staff evaluation programmes developed by Picker, but there is work to be done translating the insight into quality improvement. Despite being able to access more data on people's experiences than ever before, there is still a need for deeper understanding of how to translate this data into measurable quality improvements that can be sustained over time. As a charity we have committed a significant amount of our resource to this end, supporting: Organisations to focus their improvement activity and efforts on the areas that matter most to those using and providing care services; Organisations and individuals to better access, understand and act upon the data they receive. Over the years, Picker has created a series of national and local workshops to facilitate these goals. The workshops are unique to Picker and enable trusts to review and discuss the current issues and challenges highlighted by their experience data; share their learnings as well as develop practical ideas for improvement. Whereas national surveys provide an accurate data source for government, regulators, organisations, professionals and the public the workshops add an important level of support, and encourage the development of a culture of caring that improves quality of service for both staff and patients. The national workshops are part of a comprehensive service we provide to trusts while conducting the National Inpatient Survey on their behalf. To ensure full understanding we offer extra data analysis, bespoke presentations and individual trust workshops, plus delegate places at the national workshops. This year, frontline staff from a range of trusts got together to learn about key survey findings and draw comparison with the previous year. Throughout the day interactive sessions focused on case studies, good practice, key challenges and ideas for improvement. The day closed with trend analysis from 10 years of inpatient surveys and an outline of the 2016 Picker Outpatient Survey. Discharge Improvement local workshop Wrightington, Wigan and Leigh NHS Foundation Trust Approach Picker facilitated an independent workshop attended by patients who had been discharged within a threemonth period, staff, CCG, Healthwatch support groups, local authority, governors and the CQC. Areas focused on: How does the trust get it right for patient discharge? Where are the top areas for improvement? The top three priorities based on long, medium and short-term goals. Outcomes and improvements included: Comprehensive report on 32 goals for long, medium and short term improvements Action plans developed and presented to the Discharge Committee New patient discharge process flow chart developed Patients' discharge plans and wallet New volunteer caller and driver service offered Relocation of the discharge lounge. 012 Picker Impact Report Picker Impact Report

8 Spotlight on the National Staff workshops Informed by previous patient workshops that led to key implementations and enhanced patient experience, we first ran follow-up workshops for NHS staff in 2009/10. By demonstrating the importance of evidence, we ensured high participation, engaged staff and enthusiasm for change. Picker s 2016 workshops welcomed staff involved in acute, mental health, community and ambulance services to share workplace issues. Attendees were drawn from staff able to take actions as a result of the findings, including HR Directors, OD Leads and staff engagement specialists. Divided into three sections, the workshops started with presentations from Picker to encourage involvement, understanding of the process and application of the recommendations. Dr Kay Stewart, formerly of The King's Fund, shared insights on how to create a culture of staff engagement and six trusts presented case studies to illustrate the improvements made as a result of applying insight from previous surveys. I thoroughly enjoyed the workshop. I found it particularly useful knowing other trusts are having the same experiences. I also found the advice on how to interpret/present the data particularly useful. Great opportunity to network and the guest speaker was very informative and engaging Staff workshop attendee Creating a safety culture Liverpool Heart and Chest Hospital NHS Foundation Trust (LHCH) 2015 As the largest single site specialist heart and chest hospital in the UK, serving a catchment area of 2.8 million, LHCH has a clear vision to be the best cardiothoracic integrated healthcare organisation. Patient and staff safety is critical. Following on from 2014 NSS survey results, LHCH introduced a series of initiatives designed to create a safety culture for patients, families, carers and staff. Approach Daily safety huddle every day at 9.30 in the office of the CEO. All staff welcome to attend. Actions identified are progressed through a number of different work streams including: Sign up to Safety an NHS initiative with the aim to halve avoidable harm in the NHS over the next four years and save 6,000 lives as a result. By signing up, LHCH committed to listening to patients, carers and staff, learning from what they say when things go wrong and taking action to improve patients' safety to ensure patients get harm free care Speak out Safely introduced by the Nursing Times, the campaign aims to make it safe for staff to raise concerns about patient care and safety. LHCH joined the programme and extended it to all staff Human Factors LCHC believes that understanding human factors is important in improving safety. Twenty employees nominated themselves to be Human Factors champions Listening in Action a new way of working that mobilises staff around better patient care, gives permission to act and simple processes to effect change Outcome The 2015 survey results saw a 4% improvement in raising concerns about unsafe clinical practice, a reduction in errors/near misses/incidents that could hurt staff and a reduction in errors/near misses/incidents that could harm patients. Presented at the National Staff workshop, Manchester 2016 To find out more about our national or bespoke trust workshops please contact us at staff.feedback.team@pickereurope.ac.uk 014 Picker Impact Report Picker Impact Report

9 Taking healthcare co-design from aspiration to reality When the Always Events programme launched in England in 2014, it set out to prove that using evidence-based co-design could be an answer to driving care quality improvement through inspiring and supporting cultural change. An Always Event is a clear, action-oriented practice or set of behaviours that provides: A foundation for partnering with patients and their families; Actions that will ensure optimal patient experience and improved outcomes; A unifying force for all, that demonstrates an ongoing commitment to person and family centred care. The Always Events co-production concept enables healthcare providers to work with service users at all times. Once embedded into the fabric of care delivery, the framework ensures that the voices of those who know their conditions best, stay at the core of everything providers do, from communication to clinical delivery. Launched by Picker and the Institute for Healthcare Improvement (IHI) in partnership with NHS England, a handful of trusts were invited to pilot the concept and see if the programme could support them to make the changes required to improve the quality of care they delivered. Always Events are aspects of the patient experience that are so important to patients and families, that health care providers must perform them consistently for every patient, every time. Two years later this approach is rooted in evidence and the programme has grown into a collective movement, influencing service provision, policy and practice. Over 30 NHS trusts now use or are signed up to use the methodology saw the launch of a best practice toolkit and annual quality improvement summit, giving this positive approach to improving care a significant platform. To date, the methodology has been successfully implemented by a number of the organisations that took part in the original pilot. Some have gone a step further, building on their original events selection, rolling them out across services and adding new interactions as they go. One of the biggest insights identified by service users and families was that sometimes it is just small changes (that are simple and cost neutral for staff to deliver) that can result in significant improvement in the quality of care delivered. 016 Picker Impact Report Picker Impact Report

10 Lancashire Care NHS Trust Disability Unit The first trust to pilot an Always Event Goals Implement Always Events to put the patients and their families first and inform two service touchpoints : Supporting people moving from one area of care to another; Helping staff to communicate more effectively with learning disabled people. Spotlight event Pop in and chat: Following service user comments about the quality of care management and post discharge support, the service was introduced for patients to keep in touch with care teams and meet others in similar circumstances. When patient feedback showed the venue for the sessions as unfamiliar to service users and a barrier to entry, it was quickly changed to be in the Learning Disability Unit. Sessions are now used as an ongoing forum to discuss quality improvements, specifically developing the easy read Friends and Family Test, and to engage with and build relationships with patients. Over the last two years the Always Events programme has given us a framework to improve care across services. We have seen how co-design between staff at the point of care, patients, families and carers, supports us to make effective quality improvements, that make a real difference. The approach has had a measurable impact on staff engagement and morale. Instead of a target driven, top down approach to improvement, codesign gives reassurance that teams are responding to people s needs. The general co-design principle is now embedded into our organisational quality plan. Frontline staff and lead commissioners see it as key to closing the learning loop and supporting people to stay at the heart of everything we do. Helen Lee, Head of Quality Improvement and Experience University Hospital of Morecombe Bay NHS Foundations Trust Furness General Hospital Maternity Unit Goals Support pregnant women, their families and carers and staff in identifying an area of improvement that really matters to them. Spotlight event Allowing loved ones to stay overnight Feedback from both the women using our services and Maternity Matters engagement events revealed a desire for partners and families to be able to stay overnight during the labour and after birth. It would help both parties to bond with, and take care of their baby rather than all the responsibility being on a new mum. We look forward to offering this option to women and their families over the coming months, and will continue to work with Always Events to see if there is anything more that we could change, to make the experience even better. Sacha Wells, Director of midwifery, gynaecology and obstetrics (UHMBT) 018 Picker Impact Report Picker Impact Report

11 Licensing a flexible approach to quality measurement The programme works on two levels: Providing appropriate feedback that can be used to identify service improvements and support the delivery of quality care lies at the heart of Picker's mission. For healthcare improvements to be achieved, we must be able to trust and act upon data that is high quality and that focuses on those areas that matter most to service users and healthcare staff. However, as a small organisation it is not possible for Picker to conduct all of this work alone. We will continue to rely on our partners to support this work and have also looked to introduce other models that: Allow us to ensure the data collected regarding people s experiences of care is of the highest quality Ensures quality can be maintained whatever country you are in Picker s licensing programme supports the charity by providing a framework for the collection of high quality experience data that can be used by stakeholders from countries across the world. Geographical partnerships Where we can identify suitable and credible partners we will enable and empower them though our licensing programme to conduct service user and staff evaluations in a given geography or set of geographies on behalf of the charity using both the Picker name and evaluation tools. Picker s German office in Hamburg was set up to support the achievement of our charitable aims in mainland Europe. Picker continues to retain a presence in in Hamburg with colleagues developing the evidence to influence both thinking and policy in the region. In early 2016, to better support the impact of this work, Picker reached a new licensing agreement with The Board of Quality Service (BQS)/ AnaQuestra. Working alongside our Picker team BQS will take on the delivery of our evaluation work in the region using Picker tools to assess quality from the healthcare user/staff perspective. This partnership will cover Germany, Austria, Switzerland and Luxembourg and is a key part of Picker s expansion plans over the coming year. Organisations and or individuals We remain committed to giving organisations and individuals access to the highest quality tools and as such are broadening our licensing programme to be able accept requests for licences from specific healthcare organisations and individuals. During the charity will be working towards an integrated licensing platform available through its website. If you are interested in the Picker tools available and or potential partnership please visit for more details or a member of the team for more details info@pickereurope.ac.uk Increasing our reach and charitable income in this way also supports Picker to invest in supporting the experiences of care users from lesser heard and or more vulnerable groups. We are developing insight and tools to raise both understanding and profile to a level where we can collaboratively support services to better meet their needs. 020 Picker Impact Report Picker Impact Report

12 Creating a space for children to be seen and heard With early life events forming such a key part of our development into adulthood, we must ensure that children and young people s experiences of health and social care are as positive as possible. Negative experiences of health and social care at a young age can have a profound effect on attitude towards care and a direct impact on healthcare outcomes in later life. Systematically capturing, analysing and acting upon young people s feedback can prevent this negative attitude. While progress has been made in this area, there is still some way to go. Picker s leadership in progressing the Children and Young People s experience of care agenda nationally is valued in the highest regard. Their expertise in seeking out the views directly from children and young people has shown the system that they can offer meaningful insights into their care that can and do drive improvement. Kath Evans, Experience of Care Lead Maternity, Infants, Children and Young People, Nursing Directorate, NHS England At Picker we work with leading NHS children s hospitals, NHS England and the Care Quality Commission (CQC), national and international special interests groups, patient associations, children s charities and organisations such as the Royal College of Paediatrics and Child Health. This ensures the best possible understanding of children s and young people s healthcare experiences. This enables us to: Develop and share insight into what matters most to children and young people Build and disseminate evaluation and measurement tools for service providers Work with key influencers and stakeholders to influence change nationally and internationally 022 Picker Impact Report Picker Impact Report

13 Gathering the views of children and young people (CYP) can be a daunting prospect. It requires an approach that is specific to the needs and abilities of all ages, yet is consistent to ensure high quality and comparable findings. The experience of parents and carers should also be collected, but whilst these experiences are valuable, they don't compensate for understanding how children themselves feel about care. All Picker CYP tools are developed and tested with children to capture what is most important to them, including their opinions on everything from overall look and feel, to their interpretation of specific questions. In addition, our range of survey tools support experience-led improvements across the NHS CYP services and our work on paediatric care improvements is used across the world. To find out more about our children and young people tools please go to Insight into what matters most to children and young people* Children Pain control; having their worries discussed/ addressed; communication they can understand; feeling listened to; friendly staff; feeling safe Parents Children being looked after; being respected; being listened to; friendly staff; their children feeling safe; staff working well together *Source: 2014 NHS National Children's Inpatient and Day Case Survey Evaluation and measurement tools for service providers Acute hospital care: paediatric inpatient, outpatient and emergency department, neonatal Community services: speech and language therapy, occupational therapy Children s Family and Friends Test Transition to Adult Services Health Visiting Service User Experiences Influencing change nationally and internationally First survey of children, adults, parents and carers living with sickle cell disease* The NHS National Children's Inpatient and Day Case Survey** Children's Urgent and Emergency Survey and Neonatal Survey now licenced to healthcare providers in New Zealand. Speaking engagements at the Europaediatrics Congress in Italy and the International Society for Quality in Healthcare 32nd International Conference, Doha, Qatar *In collaboration with the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care, Northwest London and the Sickle Cell Society. **Developed with the Care Quality Commission and now part of the NHS national patient survey programme. Next survey to take place in early Picker Impact Report Picker Impact Report

14 International footprint driving the person centred care agenda Research, analytics and evaluation programmes; consulting, collaboration, licencing and policy presentations throughout the world New quality improvement programmes, research and evaluation initiatives Picker events and conferences to share best practice, staff and patient tools, new initiatives Ongoing collaboration with leading patient centred organisations and academic partners Licencing and consultation in new jurisdictions World Health Organisation Europe research into mental health services across 53 member states 026 Picker Impact Report Map for illustrative purpose only for main activities Research and policy presentations at leading international conferences Picker Impact Report

15 We see a shift away from simply collecting greater volumes of evaluation data towards focused collection and use of highly representative data sets. These deliver the insights that create tangible opportunities for collaborative quality improvement initiatives. Growth from change It is clear the coming year will not be without its challenges. Increased pressure on public sector budgets and increasing demand for services will naturally cause conflict in the pursuit of high quality service delivery. We see a shift away from simply collecting greater volumes of evaluation data towards focused collection and use of highly representative data sets. These deliver the insights that create tangible opportunities for collaborative quality improvement initiatives. We will: Continue to drive the research agenda in the field of person centered care, producing new insight into the use and importance of experience data. Develop new understanding as to the care experiences of people living with specific health conditions. Develop our international reach, identifying relevant stakeholders and supporting them to embed person centered practice in their health system. Through partnership with providers, we will support their use of experience data to drive measurable improvement in care by: Delivering our improvement workshops to front line staff to help them to plan and embed local improvement initiatives in partnerships with patients and families. Growing our Always Events co-design programme in partnership with the Institute for Healthcare Improvement, while bringing staff, service users and families together to improve the quality of service delivery. Celebrating and sharing excellence in the delivery of person centred care, and supporting the dissemination and recognition of those initiatives that have positively transformed the experiences of care users and staff. Work with national regulators, accreditors and policy makers to ensure that experience based evaluation programmes always return high quality actionable data and drive the reach of those programmes to ensure they cover all experiences of care, no matter the setting or delivery model. 028 Picker Impact Report Picker Impact Report

16 Group accounts For the year ended 31 March 2016 Board of Trustees During all or part of the period April 2015 and up to September All Funds All Funds '000 '000 Income resources Incoming resources from generated funds Investment income 4 - Incoming resources from charitable activities Surveys and survey development 3,935 4,576 Research Quality improvement Total incoming resources 4,933 4,962 Resources expended Patron Sir Donald Irvine Former president of the General Medical Council, UK Chairman Stuart Bell Chief Executive of Oxford Health NHS Foundation Trust Treasurer Chris Gale Former Chief Financial Officer of Allocate Software Members of the Board Dr Ann Abraham Chair, Dorset Healthcare Professor Ben Bridgewater Consultant cardiac surgeon, University Hospital of South Manchester Elizabeth Hampson Senior Manager (Healthcare Strategy) at Deloitte Consulting Professor Tracey Howe Professor, Rehabilitation Sciences, Glasgow Caledonian University Charitable activities Surveys and survey development 4,089 4,407 Research Quality improvement Policy Governance costs Total resources expended 5,184 5,009 Professor Gillian Hundt Professor of Social Sciences in Health, University of Warwick Professor Mike Pringle President of the Royal College of Practitioners Madeleine Wang Patient Advocate Net outgoing resources (251) (47) Translation costs 15 (18) Professor Edmund Neugebauer Professor and Chairman, Witten/Herdecke University Net movement in funds (236) (65) Total funds brought forward 1 April ,522 2,587 Ronny Obegbami Clinical Research Consultant at Roche Total funds carried forward 31 March ,286 2, Picker Impact Report Picker Impact Report

17 Picker Institute Europe Buxton Court 3 West Way Oxford, OX2 0JB Tel: +44 (0) Fax: +44 (0) Info@Picker.org Website: Registered Charity in England and Wales: Registered Charity in Scotland: SC Registered Picker Company Impact Limited Report by Guarantee: