PATIENT FEEDBACK MAKING A DIFFERENCE

Transcription

1 PATIENT FEEDBACK MAKING A DIFFERENCE QUARTERLY PATIENT EXPERIENCE REPORT QUARTER 3 (October-December) 2016/7 SOLENT NHS TRUST VALUES Page 1 of 23

2 CONTENTS 1. INTRODUCTION 2. PATIENT FEEDBACK MAKES A DIFFERENCE 3. QUARTER 3 PATIENT FEEDBACK 4. CONCERNS AND COMPLAINTS 5. PLAUDITS 6. COMMUNICATING TO OUR PATIENTS THE ACTIONS TAKEN BASED ON THEIR FEEDBACK 7. CARERS 8. ACCESSIBLE INFORMATION AND VOLUNTEERS 9. RECOVERY AND PEER WORKERS 10. PATIENT STORIES 11. CLAIMS 12. SUMMARY AND RECOMMENDATIONS Page 2 of 23

3 1. INTRODUCTION This is the quarter three (Q3) patient experience report for Solent NHS Trust for the period 1 October 2016 to 31 December Patient experience is one of the 3 domains of quality together with patient safety and clinical effectiveness. The aim of this quarterly report is to bring together a range of ways in which we receive feedback from our patients and their families and to review this feedback to give us insight into patient experience. This insight helps us to know what we are doing well and where we may need to make improvements. Solent NHS Trust has a quality goal for to: Focus on what matters to service users and carers Information is gathered from a range of methods of feedback, including patient experience activity and complaints. Each source of data provides rich information and is viewed comparatively in this report to determine if there are patterns emerging, enabling the Trust to identify challenges and concerns that need addressing. Where the report highlights areas for improvement the service concerned develops an action plan in order for issues to be addressed effectively and efficiently to ensure the Trust is continually improving. The Patient Experience report can be viewed on our public website. It is also discussed at the Patient Experience Forum and Board meetings to ensure patient experience is reported and reviewed at the highest level. At Board level, the Chief Nurse has responsibility for patient experience which includes delivery of the organisation s patient experience strategy for and demonstrating that we have used patient experience feedback to improve the experience of care. For the purpose of this report, the term patient will be used to encompass the alternative terms of client or service user. 2. PATIENT FEEDBACK MAKES A DIFFERENCE Patient experience is the responsibility of every member of staff. Solent s Patient Experience Strategy sets out a commitment to improve experience by putting people at the centre, listening to people s views, gathering information about their perceptions and personal experience and using that information to further improve care. Solent NHS Trust receives feedback via a number of different methods and although the majority of this feedback is complimentary, we recognise that we do not always get it right and that every comment, concern or complaint that we receive is an opportunity to learn and make improvements. Similarly, compliments and positive free text comments provide the opportunity for us to know what matters to our patients and share with staff to ensure we keep doing what we do well and recognise and acknowledge our staff for the care they provide. 3. QUARTER 3 PATIENT FEEDBACK 3.1 FRIENDS AND FAMILY TEST (FFT) - The FFT gives patients the opportunity to submit feedback to providers of NHS funded care or treatment, using a simple question which asks how likely, on a scale ranging from extremely likely to extremely unlikely; they are to recommend the service to their friends and family if they needed similar care or treatment. The FFT is intended as a service improvement tool, measuring performance continually and enabling increased responsiveness to Page 3 of 23

4 near real time feedback. It is also a mechanism to encourage and motivate staff and reinforce good practice. Bar Chart 1: Trust Overall Percentage of Patients who would and would not recommend Solent services (October-December responses) The FFT results show an encouraging and consistently high level of satisfaction throughout the quarter for the organisation overall. In Q1, Q2 and Q3 the proportion of patients who have responded that they would recommend Solent services has been maintained at the Trust internal target of 95% and above. In Q3 Solent received a total of 3719 responses to the FFT across the organisation. This is an increase in comparison to Q2 when 3231 responses were received. During Q3, 3565 people responded they would be extremely likely or likely to recommend Solent services, 58 responded they would not recommend Solent services and 96 responded either they did not know or would be neither likely nor unlikely to recommend. Solent results in comparison to national FFT results: At the time of writing this report national FFT results for October 2016 are the most recent national results available to compare with Solent s Q3 results. National results are presented for community services and mental health services separately. Info graphic data for National FFT Results for Community and Mental Health Services for October 2016 N.B Mental Health data results include Child and Mental Health Services (CAMHS). Page 4 of 23

5 Bar Chart 2: Solent Community Results for Q3 Comparing the national results to Solent s Q3 community results (Bar chart 2) shows that Solent s community services overall exceed the national results on the measure for those who would recommend community services. Bar Chart 3: Solent Mental Health Results for Q3 The mental health services results, which include CAMHS and older person mental health services, for Q3 show that Solent mental health services overall have consistently exceeded the national October results on the measure for those who would recommend Solent s mental health services and that there has been consistency between Q2 and Q3 results. However, in October there was an increase in the proportion who would not recommend Solent Mental Health service. The free text comments included a number of comments about staffing levels in October: more staff are needed as they are not miracle workers Service Line Level Results for Q3 The FFT feedback is reviewed at service level to provide more detailed understanding of patient experience and the results are accessible to services direct from the technology platform used. In addition, on a monthly basis the Patient Experience team extract the results and the free text comments and distribute to the services enabling as near real time feedback as possible, action planning and learning. Table1: FFT Results by Service Line for Quarter 3 (aggregated October-December results) Page 5 of 23

6 Comparing Q2 and Q3 results, there has been an increase in responses within Adults Southampton and the Sexual Health Service. During November the Sexual Health Service launched a 3 month pilot to use as the method of gaining FFT feedback as responses in the service had been low. Within the first month of the pilot the completion rate improved, and continues to do so. Although the pilot is not yet complete, it is likely the service will continue with this and other service lines are considering implementing this method of gaining FFT. The free text comments provide the detail from which to gain insight into patients experience and this is discussed at a later section of this report. The Monkey survey, introduced by Children s services in Q2, is an inclusive version of FFT which empowers very young people to be able to give their own feedback, rather than solely relying on the feedback of parents or guardians. In this format the FFT question is adapted and free text comments are gathered from the young person in a drawn picture format, in place of writing, enabling the sentiment of their experience to be interpreted. An example of feedback received from a young person in Q3: 3.2 TRUST SURVEY The core questions in this survey are those that the research evidence has shown matters most to people who use our services, based on the findings of the Warwick Patient Experience Framework, (2014), and agreed locally with Solent s Patient Experience Forum. This survey includes the FFT as the initial question and is followed by 5 I statements which ask for a response of either strongly agree, agree, don t know, strongly disagree or disagree. The number of Page 6 of 23

7 responses and percentage results for each question are detailed in table 2. There is variance in returns across the service lines as the method of survey feedback varies and in some clinical settings the FFT postcard which asks the FFT question alone is used. The decision on the most suitable survey is made by the clinical service. In Q3 there has been an increase in the number of teams offering patients the opportunity to provide feedback via these questions (62 teams in Q3 compared to 25 teams in Q2). Of these 62 teams the response rates to the survey ranged from 1 to 159. Table 2: Core Question survey results for Q3 The responses to these questions from the patients in the AMH service who completed this survey are below the Trusts standard 90% target on all questions. Although there were relatively small numbers of returns of this survey over the quarter, this is disappointing and was also the position in Q2. The results from all other service lines show an overall high level of satisfaction in relation to these key questions, meeting or exceeding the trust target of 90% on most questions. However, these are aggregated results of all teams in each service line which can mask variances at team level. For example, in response to each I statement 12 team s scores were below the trust target on the statement regarding knowing who to contact. Therefore, deeper analysis at service and team level is necessary to gain detailed insight alongside review of the free text comments received. Services are sent monthly reports and an extraction of the free text comments received to enable learning and plan improvements from this form of patient feedback. The Chief Nurse also reviews this detailed information THEMES FROM FREE TEXT COMMENTS AND IMPROVEMENT PLANS Although the quantitative FFT and survey results are encouraging, and the overwhelming flavour of the feedback the trust receives is positive, it is the free text comments from patients that provide the richest source of information. All free text comments are examined as, even when quantitative results are positive and complimentary, the comments may include suggestions of small changes that can be implemented to improve the experience of our patients. Examples of complimentary free text comments and comments are: Page 7 of 23

8 3.4. Examples of Complimentary comments received in Q3 by each service line: Practioner was a lovely kind and gentle person. Interventions put in place have had a hugely positive effect. Adults Southampton It gives a good grounding for parents to go away and practice with their child at home. Comments & Compliments This display contains positive comments received from service users during Q3 Oct - Dec Children and Families Caring staff members always positive, helped me reduce my anxiety. Thank you all. Specialist Dental Services Without the care, patience and kindness of the staff and patients, I would not have recovered from my breakdown. Adult Mental Health When using the online service, I found it excellent, quick and discrete Sexual Health It was lovely to have somebody so caring and thoughtful to attend me. Primary Care Happy girls who made it enjoyable to exercise. They are encouraging and fun. Thank you for your patience and professionalism. Adults Portsmouth Page 8 of 23

9 3.5 Examples of YOU SAID - WE DID learning/ actions from FFT for quarter 3 You said, we did You said: more staff are needed as they are not miracle workers We did: We had a number of vacancies in the crisis resolution and home treatment team which have now been recruited to and staff sickness levels have reduced. This display shows improvements that have been in response to patient feedback received during Q3 Oct - Dec You said: you are unhappy with the timeliness of advising people that they can t be seen. We did: We are about to launch a 3 month pilot as a quality improvement project which is aimed at improving patient access and overall experience in accessing the service and are planning a change in delivery of the way the service is managed You said: Dinner plates are not hot enough. We did: Housekeepers now place the dinner plates in the serving trolley to warm You Said: Broken toilets We did: The two broken toilets have now been repaired. Page 9 of 23

10 3.6 Working Together- Example of a Partnership Approach During Q3, Solent s and Southern Health Foundation Trust s services for people with multiple sclerosis (MS) provided an information day for people with recently diagnosed MS. The day was attended by 14 patients and 6 of their supporters and provides an example of how Solent works collaboratively with patients and partner organisations. The information day included a session provided by a patient titled MS What it has meant to me Patient Perspective. Examples of comments received from this session are: Down to earth and useful What a super inspiration Positive knowing everything The feedback from patients and their supporters will be used for planning future information days. 4. CONCERNS AND COMPLAINTS Everyone counts. We take all negative feedback very seriously. Our Chief Executive is notified of all complaints when they arrive in the Trust and reads all responses personally before they are issued. Complaints handling and any trends or themes identified from them are shared and discussed regularly by the Executive Team and the Board. Concerns and complaints are also reviewed within each of the service lines at their monthly governance meetings. Between October and the end of December 2016 the Patient Advice and Liaison Service (PALS) and complaints Team received a total of 56 new complaints (including one professional feedback and one MP query) and 55 service concerns. This compares to 69 new complaints and 55 service concerns in Quarter 2 (July September 2016). The figures show a slight decrease in the number of complaints being raised in Q3. However, it is important to recognise that any reduction in the number of complaints and service concerns is not, as a single factor, an indicator of improved satisfaction. It is also essential to ensure our complaints process is accessible to all our patients. Services should inform the PALs and complaints team of all concerns they receive and the outcomes so that they are recorded centrally in order to provide an overall understanding of what is important to our patients. Although some service concerns are later escalated to formal complaints, either because the person who raised the concern is not satisfied with the response provided at the local level or because the service are unable to adhere to the time limit that applies, only one concern escalated to a complaint in Q3. Page 10 of 23

11 Bar chart 4: Number of complaints received by Service Line in Quarter 3 (2016/7) The position in Q3 is similar to that of Q2. Primary Care received the highest number of complaints but in relation to the number of patient interactions this service line provides by the musculoskeletal and podiatry services in Southampton, Portsmouth and parts of Hampshire, as well as three GP surgeries in Southampton, this is not a proportional variance. The number of complaints related to the AMH service is the same in Q3 as in Q2 (13). However, during Q3 responsibility for Older Persons Mental Health (OPMH) was transferred to AMH from Adults Portsmouth and three of the complaints received by AMH would previously have been considered by Adults Portsmouth. The themes of complaints from this service generally concern issues related to discharge from an in-patient ward or from the Access to Intervention (A2I) team, and issues related to clinical treatment. Complaints received by the AMH service are often made by family members on behalf of patients. Although these complaints are investigated, issuing a response to the person who has made the complaint may be delayed or not possible if the patient has not given their informed consent for this to happen. The pattern of complaints received in Q3 for Adults Portsmouth has not changed since Q2 in relation to the number of complaints received and themes of complaints (sporadic visits, issues relating to clinical care and communication). Children s Services received fewer complaints in Q3 compared to Q2 (10 to 6 respectively) but the complaints received by Childrens services are often complex and involve more than one service provider. Page 11 of 23

12 Bar Chart 5: showing Complaints by Theme and Service Line for Q3 Bar chart 2 illustrates the break down in categories across complaints and provides an indicator of emerging themes. The themes arising from complaints in Q3 reflect a similar pattern to Q1 and Q2 and involve clinical issues (e.g. dissatisfied with medication or diagnosis); appointments (availability of); communication (e.g. lack of guidance, failure to inform about cancelled appointments and failure to follow up); and attitude of staff (e.g. they are perceived as being rude or disinterested in the patient s condition). Some complaints include more than one theme, for example a complaint may be about a patient s discharge from the service and the way this was communicated. It is for this reason that in Q3, although 56 complaints are recorded, there are 86 categories. Complaints are recorded and categorised to help the Trust identify themes and trends and identify improvement and actions in response to the findings. A monthly complaints report and tracker is produced to enable the services and Trust overall to monitor the categories of complaints and concerns so that issues can be addressed at both Trust wide level and service level in a timely way. 4.1 LOCAL RESOLUTION MEETINGS (LRM) As part of the complaints process a local resolution meeting (LRM) is offered to people who have reason to complain. This will either form part of the initial complaints process to enable additional information to be obtained from the complainant in relation to what they would like investigating or, alternatively, it may form part of the final resolution process when the complainant wants to discuss the formal response they have received. Solent NHS Trust values the opportunity to meet with people at a LRM so that they can discuss their concerns direct with the service and wherever possible receive an early answer to the issues of concern rather than waiting for a formal response. However, this is the choice of the individual and we recognise that in some circumstances people prefer to pursue the formal complaints process and receive a response from our Chief Executive. In Q3 the PALs and Complaints Team attended four LRMs as part of the resolution process. Examples of outcomes and actions following LRMs: Page 12 of 23

13 Safeguarding - A meeting was held to explain and clarify the reasons behind the rapid response process and why information was shared in the meeting. The family felt that they were now better informed about the purpose and reasons for the process and the meetings. Sexual Health Service - a second LRM was held as a patient continued to have concerns about the treatment provided for their condition. The service was able to demonstrate that they had learnt from the patient s experience and changes to clinical procedures have been introduced. 4.2 PROFESSIONAL FEEDBACK It is important for other clinicians and agencies to be able to provide professional feedback in relation to Solent NHS Trust Services. They, or one of their patients, may have had an unsatisfactory interaction with a service or they may be unfamiliar with processes and require clarification about a particular service. Professional feedback is also an important way for receiving suggestions on how services can improve. In Q3 in response to professional feedback from GPs in a previous quarter, Adults Services Portsmouth have put a system in place for the community nurse localities to be linked to specific GP practices so that the GPs have a direct contact if they need to escalate any concerns over patient care. This is enabling concerns to be addressed at service level and is preventing the need for a formal escalation via the professional feedback mechanism. 4.3 PERFORMANCE TARGETS The only nationally prescribed target applies to formal complaints which should be acknowledged within three working days. Although this does not include service concerns, MP queries or professional feedback, the PALs and complaints team aim to meet this target across all concerns raised.. At the time of writing this report, the Trust has achieved 100% compliance for this target in Q3. Responses There is no nationally set time frame for responding to a complaint. Solent NHS Trust has set itself a deadline of 30 working days to investigate and respond to the complaints. It is not possible to provide the full figures for Q3 in this report as some complaints submitted in that period are still within the 30 working day deadline. However, for July and August this target was achieved for 78% of complaints compared to the annual figure of 40% for 2015/6. This reflects the work being carried out by, the PALs and complaints team as well as the services, to ensure that complaints are responded to in a timely manner. When the target is not met the PALs and complaints team are responsible for ensuring communication with complainants to keep them fully informed that the response will breach the deadline. Breaches occur for a number of reasons including that the complaint is in depth and requires a more detailed investigation, the complaint due to its severity may be subject to the serious investigation (SI) process, there may be delays in accessing all the information required for the investigation of the complaint or delays related to staffing issues. In addition complaints may involve more than one organisation which makes achieving the response target more complex and each provider may have differing response targets. Solent NHS Trust is part of the NHS England Page 13 of 23

14 Wessex Area Complaints Manager Forum and the protocol for managing joint responses is currently under review. 4.4 COMPLAINTS REFERRED TO THE PARLIAMENTARY HEALTH SERVICE OMBUDSMAN (PHSO) The PHSO is the second and final stage in the complaints process. In 2013/4 the PHSO released a 5 year plan with a focus in 2014/5 on increasing the number of complaints investigated. In view of this we recognise that our contact with the PHSO may increase, although in Q3 there were no approaches from the PHSO. The PHSO did conclude one investigation in Q3 relating to the care provided to a patient on one of our Older Persons Mental Health (OPMH) wards. The PHSO did not uphold this complaint and found that the clinical treatment provided was appropriate. 4.5 LEARNING FROM COMPLAINTS The Trust recognises the opportunity complaints bring to learn and share learning across the organisation to effect improvement for the benefit of our service users and staff. During 2015/6 we have introduced a new complaints tracker to ensure monitoring and completion of actions agreed as a consequence of learning from complaints. This tracker is shared on a weekly basis with the Chief Executive Officer, the Chief Operating Officers, the Medical Director, Chief Nurse, the Clinical and Operational Directors of each service line and Clinical Governance Leads. In addition, the tracker is reviewed on a monthly basis at the Quality Improvement and Risk Group and at monthly service line governance groups. We strive to demonstrate the changes that have been made as a result of the learning from complaints and to sustain the changes for long term improvement. The table below provides examples of themes that have arisen in complaints and the action and learning that has taken place as a consequence: Table 3: Examples of Complaint themes and actions /learning in Q3 Complaint theme Clinical delay in communication to patient regarding test results Communication/ staff attitude Missed home appointments Appointment wait times Onward referral process Actions taken As a result of this complaint the service has made changes to the way results of specimens (blood, urine, stools) are reported. The results are now reported to the GP or Consultant for actioning. This was a powerful complaint that led to positive changes in practice. The team apologised that incorrect information had been provided regarding the provider of advocacy. Clinical teams have now been made aware of the new provider. A recruitment drive is in progress and a review of the visit triage system is underway to ensure improved prioritisation. The service has reviewed processes for managing waiting times and implemented improved signage at the bespoke clinics. The process has been discussed with the clinician concerned to ensure that they action referrals in a timely manner to prevent delay and distress to patients. Page 14 of 23

15 Information governance breach The service has made changes to the printing of letters following clinical appointments as a patient received his letter together with information relating to another patient. Since the new process has been in place there have been no further breaches. This complaint was escalated to a high risk incident and investigated independently of the service. The patient has received an apology. 4.6 COMPLAINTS REVIEW PANEL The complaints review panel met for its second meeting in December This panel is chaired by one of our Non-Executive Directors together with our Chief Nurse. Membership includes a Healthwatch colleague and senior clinical representatives from each of our service lines. The purposes of the panel are to drive quality improvement in relation to managing complaints and to provide a mechanism for cross organisational learning from complaints. The outcomes and learning from four complaints were discussed and reviewed at the meeting in December. The agenda also included discussion regarding managing persistent or unreasonable complaints and complaint response times. The learning that was shared included: Patient expectations concerning the level of service available needs to be managed as early as possible. Early attempts at resolution may result in a de-escalation of a complaint A policy to manage the process when community patients transfer to our care has been introduced The decision concerning whether a patient is considered housebound should be considered holistically The panel agreed that the current Managing Concerns and Complaints policy requires amendment and strengthening in regards to the management of persistent and unreasonable complaints. It was also agreed that the target for responding to complex complaints will be reviewed by the Head of Patient Experience in consultation with the Chief Nurse, commissioners and the complaints panel members. 4.7 COMPLAINANT SATISFACTION SURVEY The statements of expectations outlined in the user-led vision for raising concerns and complaints in health and social care developed by the PHSO, Healthwatch England and the Local Government Ombudsman provide the framework for our complainant satisfaction survey: Page 15 of 23

16 Diagram 1: A user-led vision for raising concerns and complaints in health and social care My expectations for raising concerns and complaints PHSO, NHS England, LGO (2014) All complainants are offered the complainant satisfaction survey at closure of their complaint. Both historically and nationally there tends to be a low response to complainant satisfaction surveys. In Q1 the organisation received only 2 responses with a slight increase in Q2 when 7 surveys were returned. However, the response rate has dropped again in Q3 with only 4 surveys received. The overall proportion of satisfaction across all the questions asked in the survey is 82.5%. All respondents confirmed that they : Knew they had a right to complain Felt their complaint had been handled fairly Felt the outcome they received directly addressed their complaint Felt the response was personal to them and the specific nature of their complaint. However, two of the respondents felt that they did not always know what was happening with their complaint. This is an area where we need to improve as this is a theme that has recurred from Q2. In the free text comments one commented that they did not feel that their complaint had been answered. However, in contrast, another respondent confirmed that they were. very pleased and grateful with the outcome. We thank you so much keeping us updated with each step of the way. 5. PLAUDITS Plaudits may be received from patients, their family, or members of public, expressing their thanks and appreciation for the care provided. During Q3, 326 plaudits were received, an increase since Q2, and these were spread across all service lines. Examples of plaudits received in quarter 3: Children s Services: I really appreciate all the attention that you've given to **** over the last 2 years, and I understand now why the decision has been reached to close ***** case. Thank you, as always, for all the work you've done with **** over the last 2 years. It's always been much appreciated. Page 16 of 23

17 Adults Portsmouth: Thank you for all of your help with management of COPD to give people the motivation and get up and have a go with your cheerful and bouncy natures. You are a credit to your profession, you are doing a great job'. Adults Southampton: It is very easy to take the NHS Service for granted, but we would like to put on record how well the service is running and how reassuring all the points of contact were at a worrying time. The calm efficiency of the Nurses who came out to my **** and the nurse who volunteered help and delivered antibiotic tablets to our home late evening were so helpful. With our grateful thanks to all who helped us at a difficult time, we say a big thank you. Specialist Dental Services My son was so nervous on his first visit but was helped to relax accept that there may be some pain but assured that it would be better after the treatment. All in all a first class surgery that deserves recognition for their hard work and caring nature. Sexual Health Service: * was very friendly and made me feel at ease during the session remaining very professional throughout, 10/10 would let him screen me again. Adult Mental Health: To all the staff, Doctors/Nurses at * ward, I am so thankful for all you have done for me, I've never had someone to care for me like you all did, I will miss you all loads, you all are wonderful people, all the best for the future to you all, I am so grateful and appreciated all that you did for me, thank you so much. Take care. Primary Care Thank you so very much for all the care, treatment and advice you have given me over the past very important weeks to aid my recovery. A huge enormous thank you! Both * and myself will always be grateful for the support you gave us. 6. COMMUNICATING TO OUR PATIENTS THE ACTIONS TAKEN BASED ON THEIR FEEDBACK Actions taken as a result of patient feedback are communicated to both staff and patients by a variety of channels: Direct to the patient, e.g. via complaints letters You said, we did noticeboards at ward and outpatient clinic waiting areas Newsletters to staff Quarterly reports including this report Trust website and intranet At the patient experience forum 7. CARERS A carer is someone who provides support to family or friends who could not manage without this help. This may be caring for a relative, partner or friend who is ill, frail, disabled or has mental health or substance misuse problems. All the care they give is unpaid. National Carers Rights Day took place on Friday 25 th November and was entitled: Missing out? Know your Rights as a Carer. Page 17 of 23

18 Solent used this national day of focus on carers to launch our Staff Carers Pledge Permit. This is a communication tool intended to help capture information about how an individual member of staff s carer responsibilities may impact on their work. It also provides a framework to help staff open up a conversation with their manager and develop a proactive plan to help maintain their wellbeing and performance in work alongside their personal carer responsibilities. Angela, a Solent member of staff, shares her story of working alongside her caring responsibilities: My father was diagnosed with Oesophageal Cancer at the beginning of January Up until this point my Father was very capable and able to drive and maintain his own independence and also care for my Mother. However, during this period of time he found it difficult to absorb the amount of information he was given and along with the numerous appointments he needed to attend. Leading up to his treatment, it became very stressful with appointments not being made and needing to be chased many times over. Treatment started in the February 2016; five weeks of Chemo therapy (once week) and Radiotherapy (5 days per week) began. I was extremely lucky to have the most amazing support from my Managers and colleagues. My managers were absolutely amazing allowing me to swop my working days, take annual leave, use my lunch periods in order for me to support my Father through this process. They consistently asked how I was and ensured that I could juggle my hours in order for me to still have some annual leave for myself. They took time to talk to me and I truly felt incredibly supported throughout this whole period. Thinking that once the five weeks were over all would be well, however, Dad was admitted three times after treatment and not once did I feel that I was a burden to the team, instead that genuine support continued throughout this very difficult and emotional period. I cannot express enough how the support from the Managers and my lovely colleagues helped to get me through this tough time and I regard myself as incredibly lucky to be part of such an amazing team. The flexibility shown enabled me to maintain my mental health, continue working and still have some annual leave which I so very much needed at the end of his treatment. In Q3, Adults Services Portsmouth has commenced joint working with Portsmouth Carers Centre to support building effective communication with carers. This joint initiative will form part of a quality improvement programme over the next 12 months. It will aim to ensure carers are identified, Page 18 of 23

19 involved, provided with accessible information about services to manage expectations and signposted to support. During Q3, 87 carers gave feedback via the FFT. The proportion who would recommend Solent services in this quarter is 98.85% (86 respondents) and those who would not are 1.15% (1 respondent). The feedback reflects a similar level of positive sentiment to that of the patient FFT and is overall an encouraging finding. 8. ACCESSIBLE INFORMATION (AI) AND VOLUNTEERS Accessible Information or AI is the name given to the process of making information easier for people with communication and/or information needs. Across Solent NHS Trust it is estimated that 10,000 people struggle to access standard spoken and written information, which in turn impacts on all aspects of their healthcare. From June 2016, all health and social care services must comply with the NHS England Accessible Information Standard. Building Networked Power Building on the success of the accessible information training in the summer, in Q3, the newly trained champions have formed the Solent Accessible Information Network. This network is aimed at supporting collective intelligence and social learning (peer-to-peer) to improve accessible information practice across the Trust. Monthly meetings take place chaired by the clinical lead and the champions are actively engaging in the rolling agenda items (illustrated right). An impressive amount of quality improvement work is evidenced in this meeting and it appears to be an effective way of supporting Trust wide developments at both scale and speed. Solent s AI Portfolio Supporting Information for All, led by Dr Clare Mander, has been selected as a finalist in the national Patient Experience network (PEN) Awards for Winners will be selected at a celebration event on 21 March Page 19 of 23

20 To support the work of the AI network, two types of volunteering roles have been developed Accessible Information Patient Volunteers and Accessible Information Support Volunteer. Our patient volunteers will be people who have communication and/or information needs. Through our collaborative work during the training project, we have identified a patient pioneer Keith who is working with us to develop the inclusivity of the volunteering policy. To date, Keith has supported the design of an Easy Read leaflet (left) that explains volunteering and has piloted Talking Mat resources that explore the types of activities our volunteers can support. It is recognised that some of the patient volunteers may require support to fully engage in activities; therefore support volunteers are also being recruited. To date, we have two volunteers from a local university who are studying a BSc in Human Communication and have previously helped on the training project in a work experience capacity. During Q3 the Specialist Dental Service has been focussing on improving patient experience by developing their accessible information resources for patients attending the General Anaesthetics (GA) clinics concentrating on the Poswillo Centre in Portsmouth and the service based at University Hospital in Southampton. With support from the service a parent of a young person who has autism has developed a story board to help prepare her son before going for the GA. This improved the young person s experience as he was well prepared for his visit to the dental service and his procedure. Both his mother and his school had talked through the story board with him in the 2 weeks prior to his appointment. Examples of AI resources for GA clinics In Q4 the service will be asking patients for feedback on the AI resources they have developed. 9. RECOVERY PEER WORKERS In April 2016 a Trust Lead for Recovery & Peer Workers was introduced. This role is designed to explore how the Recovery Approach can improve outcomes for Recovery is: Living a life worth patients, carers and services. We have learnt that a key element living with or without on-going in this is to harness the expertise of people who have symptoms themselves used the service or had similar health conditions. Page 20 of 23

21 Drawing on national and local evidence we find that greatest improvements are made when we move beyond listening to people, to using coproduction. This approach means working equally with people who use a service to consider problems, develop and deliver solutions together. Working in this way has been shown to develop more innovative and sustainable results with improved wellbeing for those participating. This can happen in different ways in different services. Early developments and examples where this work is taking place include: - A benchmarking exercise is being undertaken to identify where this work is taking place, to gather best practice examples and identify any training needs of staff. - The Trust s Volunteer Policy now has specific guidance for Peer Volunteers people undertaking voluntary roles in which they will use their personal experience to support another (for example someone who used to attend an outpatient service now helping to deliver a group for people who still attend that service). - Service users in Adult Mental Health have co-developed and co-delivered a training package for staff about how to improve the experience of having their risk of suicide assessed. - A project to use a Patient Reported Outcome Measure in Adult Mental Health used the coproduction approach from the beginning including a staff training and consultation process led by service users. - A work stream to engage adults with Learning Disabilities in the recruitment of staff; service audits and evaluation has been established. - Project underway to recruit peer volunteers who live well with diabetes to work with people accessing the diabetic foot clinic. The aim is to improve wellbeing through improved selfmanagement. - Work underway with a Community Nursing team to enhance methods of gaining patient experience feedback from a vulnerable and disparate client group through projects to tackle social isolation and improve wellbeing. - Solent Recovery College based in Portsmouth is an exemplar of the benefits of coproduction. In partnership with Solent Mind and Highbury Further Education College, we provide education courses about mental health for people who use mental health services and carers & staff. All courses are developed and delivered by adult mental health staff and peer trainers (people who have / have had mental health issues). We continue to host national and international visitors wishing to learn from our model. Our student outcomes are consistently positive and the power of being taught by someone who has been there is consistently identified as a source of inspiration and motivation to make change. We are now working to expand this model for people with other long term conditions. 10. PATIENT STORIES Patient stories are an extremely powerful way to find out how we make a difference to our patients. The blend of emotion, insight and candour captured from a story is used to facilitate learning and improvements. Page 21 of 23

22 Patient stories are heard at our Board meetings, either by patients attending to tell their story direct, by the story being presented by the member of staff or by a video recording. In Q3, Solent hosted its first Allied Health Professions (AHP) conference which was chaired by NHS England s Chief AHP Officer. The conference opened with stories from patients who are receiving care from each of Solent s AHPs (art therapy, physiotherapy, clinical psychology, occupational therapy, podiatry, social work, and speech and language therapy). Patients talked about their personal experience and the difference that the interventions from each allied health profession had made to them. 11. CLAIMS During Q3, two personal injury claims were received by the trust, one in relation to a member of staff who was involved in an electrical incident at another organisations premise, the other concerns a member of staff who was injured during an incident with an agitated and distressed patient. A procurement claim was received against Solent NHS Trust, South of England Procurement Group and ten other NHS Trusts collectively in relation to a tender for feeding tubes. Four clinical negligence claims were received by way of letters of claim and two records requests have been received under the pre-action protocol of the Civil Procedure Rules indicating that a claim is to follow. 12. SUMMARY AND RECOMMENDATIONS The patient experience report aims to bring together a range of sources of feedback to give us insight to better understand what matters to our patients, what we do well and where service improvements are needed. The report evidences how we use the many rich sources of information gathered from patients, how we value patient views, how we listen, how we learn and how we act on feedback to improve the experiences of people who use our services. Overall patients are reporting a positive experience of care. However, it must be acknowledged that this high level of reporting masks variances and a deeper, granular level of analysis at team level is necessary to fully identify the specific areas where improvements are needed based on our patient s feedback. This level of analysis takes place by the services and is beyond the scope of this report. This report has identified specific actions where we need to strive to make improvements in Q4: Ensure people who have made a complaint are kept informed on the progress of the investigation of their complaint Review of the response time frames for complex complaints A focus on increasing feedback from carers Continued roll out of phase 3 of the AI project Service and team level insight of what matters to their patients and evidence of improvements made that are communicated to patients Roll out of new methods for gaining FFT including trial of and text messaging Page 22 of 23

23 Measures to increase feedback on the complaints handling process Continued roll out of training to staff on managing concerns and complaints This report has aimed to give as comprehensive a view as possible on what our patients have told us in Q3 and our actions as a consequence. However, inevitably a report cannot capture, nor do justice to, all the ways in which staff strive, on a daily basis, to provide great care. Ann Rice Head of Patient Experience and Allied Health Professions 16/02/2017 Page 23 of 23