HALTON CQUINs March 2017

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1 HALTON CQUINs March 2017 All CQUINs on track and green except flu which is red. The uptake of flu vaccine CQUIN target of 75%was not met. Borough Halton National CQUIN1a Introduction of health and wellbeing initiatives Option A Achieving a 5 percentage point improvement in each of the 3 staff survey questions on health and wellbeing, MSK and stress. Providers will be expected to achieve an improvement of 5% compared to 2015 staff survey results for each of the three questions in the NHS Annual Staff survey outlined below. 1. Question 9a: Does your organisation take positive action on health and well-being? Yes, definitely/ Yes, to some extent/ No response. Paula Woods Question 9a there was a 6% improvement Question 9b there was an 8% improvement Question 9c there was a 6% improvement

2 2. Question 9b: In the last 12 months have you experienced musculoskeletal problems (MSK) as a result of work activities? Yes/No response. Question 9c: During the last 12 months have you felt unwell as a result of work related stress? Yes/No response Halton National CQUIN 1b Healthy food for NHS staff, visitors and patients N/A N/A Halton National CQUIN 1c Improving the uptake of flu vaccinations for front line staff within Providers Improving the uptake of flu vaccinations for frontline clinical staff Achieving an uptake of flu vaccinations by frontline clinical staff of 75% Number of front line healthcare workers (permanent staff and those on fixed contracts) who have received their flu vaccination by December Peter Morgan Bridgewater wide scheme Vaccine available from October 2016, vaccination continued throughout the flu season. Achievement of the CQUIN to be based on percentage achieved by the end of December Target of 75% was not met. Target achieved was 45.67% which was an improvement on of 41%

3 Halton Frail and Elderly Delivery of high quality care for the frail and elderly population which places the individual and their family at the centre of care. Will build on the frailty CQUIN from and participation in an Older peoples pathway, utilise none health related support services including social prescribing, Pilot social value training, participate in the Warrington and Halton Integrated Steering Group, scope Frailty Index for year 3 and develop the rollout of Mental Health Crisis training. Halton Shared decision making in wheelchair service The wheelchair service will develop a format based around the 3 questions to enable the shared decision making process to be captured on the electronic records. This will enable the service to collate the number of users / carers involved in shared decision making. The service will pilot the process initially to ensure the information can be captured Jacqui Tudor Lynne Peters Bridgewater continuing to lead on the following at the Warrington Integrated Steering Group: Looking at potential joint working with LA to develop joint NWAS Community Care Plans. Reviewing referrals across Bridgewater and Halton Authorises to avoid duplication. Supporting and sharing information with Transformation Delivery manager- Frailty Lead with pathways and implementation of the Edmonton tool. Developing Care Home Joint Assessments this has been paused until EMIS Rollout to avoid duplication. The service has completed 5 workshops with AQuA during the implementation. The team with support from AQuA developed a Driver diagram and identified areas for action. All actions have been completed or have plans in place. Staff have completed pre and post implementation questionnaires which show the team perception has changed to emphasize the involvement of both staff and patients, and supporting patients along the care pathway. AQuA will continue to work with the team to complete case studies.

4 Halton Reporting Outcomes of Care for families on the electronic records and can be collated. Questions to be asked: o What are my options? o What are the possible benefits and risks of those options? o How likely are the benefits and risks to occur? The cohort of patients who would benefit from this CQUIN will be Wheelchair clients (adults and children) requiring postural support. The outcomes to be realised from this CQUIN would provide evidence of clients and carers involvement in deciding what equipment is right for them and the opportunity to discuss the risks and benefits of each option. For 2016/17 a CQUIN to support the implementation Gail Mann CollaboRATE patient questionnaires were issued to all clients or carers and results have been collated by AQuA. Results show patients do feel included in decision making but there is still room for improvement which is expected as part of the programme. Service in conjunction with AQuA have been accepted to present at Posture and Mobility Group (PMG) national conference in July in Cardiff. Benefits realised for patients / service include: Telephone triage completed so patients are placed in the right clinic and informed if don t meet criteria sooner Improved management of DNA s by service Patients choice of appointment for standard clinics to reduce cancellations for service Service can inform a patient who is involved in their case and where it is up to. Patient / carer involvement in appointment letter design and content Improved contact with service for patients and referrers Improved access for patients and referrers to service information Quicker provision for standard wheelchairs. This CQUIN has been successfully completed, with the final reports due to arrive with teams

5 accessing Children s Specialist Services of this questionnaire in Halton Children s Specialist Services There will be two parts to this CQUIN. 1. The team will use the feedback from the Outcomes of Care questionnaire to inform service provision, e.g. contacting sample families to get more in depth feedback, discussion in team meetings, brief case studies for continuous improvement 2. reports will be made available to teams on a quarterly basis so they can review the data from parent responses. The CDC services that will be involved in delivering the CQUIN are Therapies, LD Nursing, and Community Paediatrics at the beginning of May 2017; reflecting Quarter 4 data. This CQUIN was designed to support the implementation of the Outcomes of Care questionnaire and a new Team reporting and action planning process. The Outcomes of Care questionnaire was previously co-designed with parents, through the use of in depth interviews, highlighting what was important to and for them when accessing services. Each quarter, each clinical team receives a report identifying their scores for the quarter as well as narrative feedback from parents. Each team takes ownership of their own feedback and are encouraged to use it to inform service provision, e.g. contacting sample families to get more in depth feedback, discussion of themes in team meetings, brief case studies for continuous improvement. An additional survey was completed with both team leaders and team members, so that they could comment on the questionnaire, its implementation, and the reporting process. This provided useful feedback and will support us in our development of the tool and reporting

6 process, ensuring that it works effectively for our practitioners, and provides them with the feedback which will help them to develop services. The feedback from families has been largely positive, but we have also found that the tool is sensitive enough to pick up concerns, which enables teams to respond. It has also been helpful to have comparative data from the same clinical service in a different localities, and different clinical services in the same locality, to help understand what the data is telling us. This CQUIN has been successful and discussions are progressing about the viability of implementing the questionnaire and process on a longer term basis.

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