Patient and Carer Experience Strategy Evaluation

Transcription

1 Patient and Carer Experience Strategy Evaluation

2 Contents Page No. 1 Contents 2 Executive summary 3 Introduction Progress towards the Ambitions: Improve patient experience from start to finish of their journey Improve patient experience of accessing hospital services Improve communication with patients Meet the patient s physical comfort needs Provide patients with the emotional support they need whilst using Trust services Respect the needs of patients and recognise their individuality 19 7 Improve involvement of patients and carers 20 Priorities for Conclusion Appendix 1: Facts and Figures Appendix 2: Trust Patient Experience Action Plan Appendix 3: Kissing it Better & ENHT Annual Report August 2014 Patient and Carer Experience Strategy Evaluation Page 1

3 Executive Summary The Trust s Patient and Carer Experience Strategy was launched in July The Evaluation report summarising achievements towards the Strategy in was submitted to the Board in July This report summarises actions taken and achievements in towards delivering the seven ambitions within this three-year Strategy. I would like to acknowledge the significant achievements staff have made to maintaining excellent patient and carer experience throughout the year, particularly in light of the Our Changing Hospitals programme. We are grateful to all our patients and carers for their commitment to engaging and sharing their experiences with the Trust. In :- 320 patients responded to the CQC national inpatient survey 2,717 patients responded to our quarterly inpatient postal surveys 16,754 patients completed one of our Meridian electronic patient experience surveys 15,397 patients answered the Friends and Family Test question (6,183 Inpatients, 6,802 A&E and 2,412 Maternity) 2,289 patients responded to our post-discharge telephone call survey 616 patients responded to the national cancer survey 169 patients responded to the CQC national maternity survey Over 500 patients, carers and public members participated in engagement events Over 800 hours of interaction with patients from 112 further education college students during 105 visits organised by Kissing it Better Appendix 1 shows the full breakdown of patient experience survey responses during This wealth of feedback has helped the Trust prioritise areas for improvement and influenced the actions included in this report. In addition, the Trust participates in the national mandatory patient experience surveys co-ordinated by the Care Quality Commission and Department of Health. This feedback is valuable as it enables the Trust to compare performance with other Trusts throughout the country. Last year the Trust received feedback from the national inpatient, cancer and maternity surveys. A summary of results from the annual inpatient survey 2013 is shown on page 21. This highlighted key areas where improvements are needed:- Reducing noise at night from other patients Improving information provided about patient s condition and treatment Ensuring privacy during examination and treatment For surgical patients, ensuring that staff explain what will be done during the operation/procedure, that patients are told how they can expect to feel after the operation/procedure and that staff explain how the operation/procedure has gone Ensuring that patients have enough information about when they will be discharged from hospital Ensuring that copies of letters sent from the hospital to GPs are written in a way that patients can understand The strategic patient experience action plan (Appendix 2) details the actions that will be undertaken to improve performance in these key areas. This report provides many examples to demonstrate progress towards delivery of the Strategy in while acknowledging that there are further improvements to be made which will be taken forward in the final year of the current strategy. The strategy will be reviewed in 2015 following consolidation of the Our Changing Hospitals programme. Angela Thompson Director of Nursing and Patient Experience Patient and Carer Experience Strategy Evaluation Page 2

4 Introduction East and North Hertfordshire NHS Trust (ENHT) has as its vision to be amongst the best performing NHS Trusts in the country, with high quality care and excellent patient experience very much incorporated within the Trust values that underpin the vision: Our Changing Hospitals is a major programme of change to services at the Lister and QEII hospitals. The design teams have worked closely with clinicians and the public to ensure the facilities maximise safety and patient experience whilst meeting the needs of our population for the foreseeable future. The first three phases and the majority of the phase four projects have been completed with final completion scheduled for October To achieve our goal to be amongst the best we need our staff to be fully engaged, highly motivated and patient focussed. The ARC programme is a programme of education and support for all Trust managers aimed at building a culture of excellence. Providing a clear vision and direction which is shared amongst teams ensures that our staff understand their role and the contribution they make towards making the Trust a better place to work and a better place to receive care and treatment. Every member of staff is required to attend the delivering excellent customer care programme which uses role play to demonstrate how every member of staff is important in delivering excellent care and patient experience. The objectives of the three year Patient and Carer Experience Strategy are:- 1. To provide patients and carers with excellent experiences when they use East and North Hertfordshire NHS Trust services. 2. To actively seek the engagement of patients and carers in service development and patient experience work streams, ensuring vulnerable groups, children and young people are included. 3. To achieve performance in patient experiences which matches the top 20% of NHS Trusts. 4. To achieve top quartile performance in Net Promoter Scores when benchmarked against other Trusts. The Strategy sets out the Trust s seven key ambitions for improving patient experience: Ambition 1 Improve patient experience from start to finish of their journey Ambition 2 Improve patient experience of accessing hospital services Ambition 3 Improve communication with patients Ambition 4 Meet the patient s physical comfort needs Ambition 5 Provide patients with the emotional support they need whilst using Trust services Ambition 6 Respect the needs of patients and recognise their individuality Ambition 7 Improve involvement of patients and carers The following pages summaries progress towards the ambitions set for Patient and Carer Experience Strategy Evaluation Page 3

5 Ambition 1 Improve patient experience from start to finish of their journey 2013/14 Key Milestones Redesigned patient pathways implemented and embedded. Patients receive information about care pathways. All patients are given information about admission and discharge. All patients are given copies of discharge and clinic letters. Nursing transfer documents used with all patients. Redesigned patient pathways implemented and embedded. Patients receive information about care pathways The Trust s web-site includes details of all services and a link to the Trust s patient information leaflets which provide detailed information on specific services, care and treatment. All elective surgery patients receive either a telephone or face to face consultation regarding their admission to hospital. Information leaflets are provided to patients explaining the type of procedure, reasons for the procedure, possible complications, what to avoid before the procedure and what happens afterwards, along with contact details for patients to obtain further advice. Developments in the enhanced recovery pathway for colorectal, urology and trauma and orthopaedics patients continue. Posters are displayed in public areas and on the ward as a prompt to encourage patients to ask questions about their care and treatment during the ward rounds. The Trust s Meridian inpatient survey asks patients if they have felt involved in decisions about their care and treatment and the overall Trust score increased from 84 ( ) to 85 ( ). All patients are given information about admission and discharge Each patient s expected date of discharge is set and communicated to patients and their families along with their discharge plans. Elective surgical patients receive a letter regarding their pre-operative assessment appointment which includes information about their expected date of discharge. A discharge booklet has been introduced (an easy read version is also available) and a copy is included in patients admission pack. Discharge posters are displayed on wards reminding patients what they need to do in preparation for their discharge from hospital. Patient and Carer Experience Strategy Evaluation Page 4

6 Welcome cards have been introduced for all patients on arrival on a ward these are completed with information about what is happening next, who the patient should contact if they have any questions about their care, and the expected date of discharge from hospital. During post-discharge telephone calls were undertaken with 2,289 patients who had an unplanned admission to hospital. A member of the Patient Experience Team talked to patients about their hospital experience and provided advice on who to contact if patients had any questions about their care or treatment (see Appendix 1). The number of formal complaints relating to discharge fell from 39 ( ) to 35 ( ). The number of formal complaints relating to delayed discharge increased from 3 ( ) to 5 ( ). During the focus will be on reducing the number of delayed discharges. All patients are given copies of discharge and clinic letters All patients should receive a copy of their discharge letter and be sent a copy of any correspondence with their GP. The CQC national Inpatient survey 2013 shows the Trust as scoring 8.3/10 for this question (an improvement on the 2012 score of 7.9/10). Nursing transfer documents used with all patients A Hospital Discharge and Transfer Policy has been developed and compliance with the policy is monitored at ward level. Princes Wing have developed a transfer document specifically for trauma and orthopaedic patients. Patient and Carer Experience Strategy Evaluation Page 5

7 Ambition 2 Improve patient experience of accessing hospital services Improvements in appointment system noted 2013/14 Key Milestones Continue to maintain improvements (outpatient survey action plan) Evidence of number of hits on Trust website for information about services Increase in number of patients, carers or Trust members involved in service reviews or development projects Continue to work with partner agencies on improving access to health services Minimise waiting times along the patient journey Review outcomes of the Learning Disability Improvement plan Monitor the implementation and delivery of the Older Person s Strategy Improvements in appointment system noted Patients are able to directly book appointments via Choose and Book for GP referrals, this includes named referrals, advice and guidance. Follow-up appointments are now booked with patients prior to them leaving the clinic wherever capacity allows. The booking of these appointments is closely monitored to ensure that any clinical needs identified by the clinician are met, for example, if a review is required within a specified period of time. A direct dial appointments line has been set up to support patients with outpatient appointment queries. An online appointment cancellation service is available for patients via the Trust s web-site. Continue to maintain improvements (outpatient survey action plan) The TOMP programme of work is focussing on transforming the outpatients service including: Reduce waiting time for patients when phoning the appointments line Reduce hospital cancellations/rearrangement of outpatient appointments Pilot of patient led recording of consultations to better inform patients of their care plan Electronic communication of clinic outcome letter with GPs to ensure that information is available in a timely way Improving customer service Staff introduced an intentional rounding tool to assist in monitoring the clinic environment; this includes an assessment of patient comfort and safety issues. Some of the clinic areas at the Lister Hospital site are being upgraded and a review of the seating areas has been included in this. Two new clinic rooms with their own waiting area were opened in May Patient and Carer Experience Strategy Evaluation Page 6

8 The length of time patients wait for their clinic appointment continues to be monitored. The goal is that, wherever possible, patients have a maximum wait of 30 minutes from their scheduled appointment time. Recent patient experience survey results show that this target is met 80% of the time. This will continue to be monitored and clinics that regularly exceed this target will be subject to improvement measures. Evidence of number of hits on Trust website for information about services The number of Our Services pages viewed via the Trust s web-site increased from 167,098 ( ) to 254,395 ( ). Increase in number of patients, carers or Trust members involved in service reviews or development projects Following the Picker Institute Maternity survey carried out in 2013 a focus group was held in March 2014 with women to gain their feedback on how the service runs. Key themes and actions have been shared with all the women and partners who attended and feedback is being used to improve services. For example, women told us that they would like their partners to be able to stay with them overnight in the maternity unit. Recliner chairs have now been purchased for partners and a code of conduct developed for partners to stay on the ward overnight. We have had had very positive feedback from women about this facility: Twitter Feedback: The Trust was part of the carer friendly hospital project and a Carers Lead was appointed to lead on the development of a Carers Policy, increasing carer awareness and providing support to individual carers. The Trust holds a carers focus group each quarter and welcomes all carers to attend. Topics discussed during the year include:- management of medication whilst in hospital, management of children in A&E, manual handling for carers, discharge planning, our changing hospitals update as well as updates from other organisations, for example Herts Action on Disability. There are now six patient/public representatives on the Trust s Patient Experience Committee. Patients, carers and Trust members are involved in service reviews and development projects throughout the Trust co-ordinated by the Engagement Team. For example, there is patient/user involvement in the Trust s Research for Patient Benefit noise at night project group. Patient and Carer Experience Strategy Evaluation Page 7

9 Continue to work with partner agencies on improving access to health services Ward staff and the PALS office are able to provide information and contact details for other healthcare services that are available for patients and their carers. The Trust regularly refers carers to the services of Carers in Hertfordshire. 618 new carers were identified by Carers in Hertfordshire in Stevenage between April 2013 and January 2014, in comparison to 116 carers identified in Stevenage during the whole year Minimise waiting times along the patient journey Patient feedback is continually reviewed to highlight any concerns about waiting times along the patient journey. The number of complaints relating to delays reduced from 295 ( ) to 246 ( ). Within surgery the Division closely monitor the time to treatment throughout the 18 week pathway. Within Paediatrics a text message service has been implemented for parents acknowledging receipt of referral to the Child Development Service. Review outcomes of the Learning Disability Improvement plan Key actions to progress compliance with the Trust s Acute Learning Disability Improvement Plan include: Updating the Trust s information system so that patients with a learning disability can be identified on their admission to hospital and referred to the Learning Disability Nurses. Provided additional support to carers of people with a learning disability by the Carers Lead through the Carer Friendly Hospital project. Developed care pathways to supplement the Learning Disability Policy. Developed a Welcome pack for patients with a learning disability which explains the role of the Learning Disability Nurses and includes additional information about staying in hospital in an easy read format. Queen s wing day surgery unit have trialled the implementation of Hertfordshire equality standard mark within clinical areas. Introduced an easy read version of the Trust s patient experience postal survey. Introduced a post-discharge patient experience evaluation within the Health Liaison Team. Increased the number of learning disability champions across the Trust. There are now 30 Learning Disability Champions who range from clinical front line staff to Senior Managers and Executive Directors. A role description for the champions has been developed in conjunction with the Learning Disability nurses. Monitor the implementation and delivery of the Older Person s Strategy The Trust s strategy for care of people with Dementia continues to be progressed and a Lead Clinician for Care of people with Dementia and a Dementia Nurse are in post. 396 members of staff are clinically trained in dementia awareness through both the University of Hertfordshire and in-house training supported by the RAID (Rapid, Assessment, Interface, Discharge) team. This is Me booklet introduced, relatives or carers accompanying a patient who has memory problems or a diagnosis of dementia will be asked to complete this short booklet which will help staff have a better understanding of the patient. The forget-me-not symbol and yellow wristband have been introduced to identify patients with dementia to hospital staff in a discreet manner. Reminiscence activities, including music and crafts, are held weekly on the elderly care wards. Patient and Carer Experience Strategy Evaluation Page 8

10 Ambition 3 Improve communication with patients 2013/14 Key Milestones Produce new patient information where gaps exist Increased range of information available in different formats All patient information is available through the Trust website All staff are given customer care training PLACE (previously PEAT) assessment maintains excellent standard Significant improvement in patient experience surveys about medication side effects Continue to deal with complaints in the moment and reduce complaints Significant improvement in patient experience feedback about communication Produce new patient information where gaps exist There are currently 301 patient information leaflets available on the Trust s website Divisional patient information leads continue to review and produce new information for patients. Increased range of information available in different formats Information is offered to patients and carers to meet their individual needs including verbal, written and a wide variety of information is available via the Trust s website. All patient information leaflets state you can request this information in a different format or another language. When new patient information is developed authors are asked to consider the need for developing an easy read version. Translations of small documents can be arranged via Languageline. For larger documents the department would consider using the services of a translation company. The Trust uses the British Sign Language Interpreting Agency to provide language service professionals to facilitate effective communication with patients who are deaf, deaf-blind or hard of hearing. All patient information is available through the Trust website As new patient information leaflets are developed they are added to the Trust s website. Each Division has an identified patient information lead who is responsible for reviewing the patient information within their Division. Patient and Carer Experience Strategy Evaluation Page 9

11 All staff are given customer care training The Trust s organisational development strategy is supported by a programme called ARC. ARC is a Trust-wide programme of activities to aid us in delivering the highest quality of healthcare to our patients whilst recognising that an engaged and effective workforce is essential in achieving this aim. The customer care training programme was launched to the Trust s leaders and line managers at the September 2012 ARC sessions. It was rolled out to all staff in February 2013 and concluded in June By the end of the programme a total of 4880 training places will have been offered 640 places at the September 2012 ARC sessions and 4240 places on the Trust-wide programme. PLACE (previously PEAT) assessment maintains excellent standard PLACE is an annual assessment of non-clinical aspects of patient care including the environment, food, privacy and dignity. A key change from the former PEAT process is the increased involvement of patient assessors, all assessing teams include at least two patient assessors. The assessment process focuses on the environment in which care is provided with particular emphasis on cleanliness, general condition, appearance and maintenance, privacy and dignity and the provision of food and drinks. The Trust s PLACE scores for 2013 were: Cleanliness Food Privacy, Dignity and Wellbeing Facilities 97.26% 76.20% 87.86% 87.16% Significant improvement in patient experience surveys about medication side effects The Trust s quarterly inpatient postal survey asks patients if staff explained any medication side effects. The score remained consistent at 45 in the January 2013 and January 2014 survey. The Pharmacy Team have established a patient experience group to discuss feedback from patients around medication issues. The Pharmacy Department has reviewed the To Take Out Medication and Your Hospital Stay and Your Medicines patient information leaflets. These encourage patients to write down any questions they have about their medication and/or side effects which can be answered by a member of staff on the ward or the ward pharmacist. Patient and Carer Experience Strategy Evaluation Page 10

12 Continue to deal with complaints in the moment and reduce complaints Patients and their relatives/carers are encouraged to talk to the ward staff or Matron if they have any concerns or worries. The Complaints and Patient Advice and Liaison Service office (PALS) Team have been reorganised and now provide a centralised service. The PALS team are available to help address any concerns. We welcome comments from patients and their carers about our hospital. Comment cards are available on the wards and in the PALS office. New posters have been designed to encourage patients to provide feedback about their hospital experience, these include details of how feedback can be provided by completing one of our surveys, using social media, NHS Choices or Patient Opinion websites or by leaving on-line feedback as a secret shopper. Significant improvement in patient experience feedback about communication The number of complaints throughout the Trust regarding communication increased slightly from 148 ( ) to 150 ( ). The customer care training programme has focussed on improving communication between staff and patients using role play. The national CQC inpatient survey asks patients if staff contradict each other, if patients have been involved as much as they wanted to be in decisions and about the information given on their condition or treatment. The scores on all three questions was lower in the 2013 inpatient survey compared to the previous year. Improving communication has been identified as a key priority for in order to improve patient experience. Patient and Carer Experience Strategy Evaluation Page 11

13 Ambition 4 Meet the patient s physical comfort needs 2013/14 Key Milestones Maintain improvements in patient safety measures Maintain improvement in patient s experience of pain control Continue improvements to achieve best performing in cleanliness of hospitals Trust meets the DDA standards Maintain compliance with standards for eliminating mixed sex accommodation Adequate seating is available in patient waiting areas Maintain improvements in patient safety measures Safety walkabouts are undertaken by the quality and compliance teams. These are based upon the assessment format of the Care Quality Commission. There are four elements to the walkabouts including discussions with staff and patients; and a review of documentation and the environment. The vast majority of patients are highly complimentary about their care and about the staff. Observations demonstrate that dignity and respect is of an excellent standard and that people are involved in their care where possible. The standard of documentation is not always 100% and where there are matters that could be improved these are fed back to staff together with a summary of the entire findings. All wards have introduced the intentional rounding tool which is a regular check (hourly during the day-time and two-hourly at night-time) on patients to ask about their levels of pain, personal needs, comfort and whether the patients has any other needs. Using the intentional rounding tool is a proactive approach to asking patients about their needs and decreases the need for patients to use their call bell. During the 12 months to the end of March 2014, the Trust recorded just two hospital-acquired blood infections (bacteraemias) caused by Methicillin-resistant Staphylococcus aureus (MRSA) bacteria strains, along with 14 cases of infections due to the bacteria Clostridium difficile. The targets for these two important causes of hospital-acquired infections were none and 14 cases respectively. The Trust s performance on preventing infections caused by C. difficile over the last 12 months places it as the fifth best in the country and when compared to large acute NHS trusts, the performance was the best in the English health service. When in hospital, patients can trip and fall. Often little or no injury results, but occasionally the consequences can be more serious and in some cases even life-threatening. The Trust has worked to continually reduce the number of patient fall incidents and since March 2011 has reduced the number of patient falls by 52% (from 2058 in compared to 988 in ). The number of serious harm caused by falls for was 16 three of which resulted in death. This is an area of patient safety that remains a continued focus for the Trust. Patient and Carer Experience Strategy Evaluation Page 12

14 By the end of March 2014, 40 hospital acquired pressure ulcers were recorded in the Trust s hospitals. This demonstrates a year-on-year improvement, as it is a further 64% reduction on the previous year s figure of 112 (254 in ). In addition to this on-going reduction in the number of hospital-acquired pressure ulcers, the Trust has not recorded an unavoidable grade four the very worst pressure ulcer since October The NHS Safety Thermometer is a national audit designed to measure a snapshot once a month of patient harms from pressure ulcers, falls, urinary infection in patients with catheters and treatment for VTE. The audit does not take account of where the harm occurred, for example a patient arriving in hospital with an old pressure ulcer is counted as a patient harm. The percentage of patients with harm fell from 6.4% ( ) to 5.2% ( ). Maintain improvement in patient s experience of pain control The Trust s Meridian inpatient survey asks patients about their pain control and the overall Trust score improved from 93 ( ) to 94.5 ( ). Continue improvements to achieve best performing in cleanliness of hospitals For details of the PLACE (Patient-Led Assessments of the Care Environment) programme see page 10. The Trust s Meridian inpatient survey asks patients about the cleanliness of the ward and the overall Trust score improved slightly from 94.2 ( ) to 94.6 ( ). Trust meets the DDA standards The Trust Access Policy outlines the process for managing patients who are not classified as emergencies. This policy reflects national guidance and equality impact assessments. It aims to ensure that patients receive treatment according to their clinical priority, with routine patients and those with the same clinical priority treated in chronological order, thereby minimising the waiting times and improving the quality of the patient experience. Equality Impact Assessments are required on all service changes/policies and reconfiguration programmes. Patient and Carer Experience Strategy Evaluation Page 13

15 We have improved the Trust systems for identification of patients with a learning disability using hospital services so that reasonable adjustments can be made. Maintain compliance with standards for eliminating mixed sex accommodation The Trusts Eliminating Mixed Sex Accommodation Policy is continually monitored. There were no Same Sex Accommodation (SSA) breaches in The bedside locker folder includes details of the SSA standard, SSA patient information leaflets are available in hospital and via the Trust s web-site. Adequate seating is available in patient waiting areas The amount of seating has been increased within the Accident and Emergency Department and will be further increased with completion of the new build. Some of the clinic areas at the Lister site are being upgraded and a review of the seating areas has been included in this. There will are now two new clinic rooms with their own waiting area and seating. Staff introduced an intentional rounding tool to assist staff in monitoring the clinic environment; this includes patient comfort and safety issues. Ensuring that patients have enough seating is included and can be addressed at the time if more seating needed. Patient and Carer Experience Strategy Evaluation Page 14

16 Ambition 5 Provide patients with the emotional support they need whilst using Trust services 2013/14 Key Milestones All wards and departments to display and provide information about how to access spiritual and pastoral support Patient experience feedback shows significant improvement in questions related to personal needs, care and treatment Improvement in feedback from carers about their experiences of end of life care Show improvement in feedback from carers about their experiences All wards and departments to display and provide information about how to access spiritual and pastoral support There are posters in wards and public areas of the Trust promoting the Chaplaincy Team. The Trust s new chapel, chaplains office and prayer room is now well established at the Lister Hospital. These facilities are available for patients, relatives, carers and staff whatever their belief. Patient experience feedback shows significant improvement in questions related to personal needs, care and treatment The Trust s quarterly inpatient postal survey shows a slight improvement in patients being treated with respect and dignity from 90 (January 2013) to 91 (January 2014). In the CQC Inpatient survey the score for this question remained consistent at 8.7/10 in both the 2012 and 2013 surveys. The number of complaints received relating to treatment received reduced significantly from 317 ( ) to 187 ( ). Improvement in feedback from carers about their experiences of end of life care There were 12 complaints received during where end of life issues were raised. An adult end of life focus group was held in May 2013, attended by 67 patient and staff members. Important issues including where patients choose to die, the amount of information provided to patients and their families at the end of life and the support provided by the hospital were discussed. Once again, social workers, rehab, and hospital staff were excellent, promises were kept. [AAU] It really is good news that carers will be able to support patients during their hospital stay, especially with the young, elderly and disabled. In our situation because we care for our mother we are fully aware and understand her personal, physical and individual need, and history invaluable to nurses and doctors. Being able to be of support, to attend to the many needs, demands, to comfort, reassure and explain all attributes to lower stress levels, anxiety and improve the general well being of patients andrecovery. [7BN] Patient and Carer Experience Strategy Evaluation Page 15

17 Show improvement in feedback from carers about their experiences The Trust regularly asks carers to feedback about their hospital experience. A carers survey was developed in July 2012 with carers and other organisations eg Carers in Herts and a summary of the overall feedback is shown below: The Trust s carers survey was reviewed in February 2014 in conjunction with the Carer Friendly Hospital Working Group and Carers in Herts. The survey was shortened to concentrate on how supported carers felt and compliance with elements of the Trust s Carers Policy, eg carers agreement. Examples of feedback from carers include: I had to ask staff for information and the difficulty is knowing what questions to ask! I have no medical knowledge and would have appreciated more and focused help. [5A] The understanding and patients of all staff was outstanding. [Queens Wing Day Surgery] On ward 8BS there was a general acceptance and from some staff a welcome of our involvement. On 7BN we encountered resistance to our presence. However staff more understanding towards end. I read constantly about NHS being in crisis, low morale etc. That may be true in some places but not at Lister in AAU or Pirton. Very engaged staff, working constantly and with great skill; a credit to the country. Patient and Carer Experience Strategy Evaluation Page 16

18 Ambition 6 Respect the needs of patients and recognise their individuality 2013/14 Key Milestones Patient experience shows significant improvement (privacy and dignity) Learning Disability Champions in all clinical services Dementia Champions in all adult wards/clinical areas Protected groups do not report poorer outcomes in the Trust national surveys Evidence supports implementation of reasonable adjustments for eligible patients Patient experience shows significant improvement (privacy and dignity) The Trust s Meridian inpatient survey asks patients if they have been treated with respect and dignity and the overall Trust score increased from 97 ( ) to 98 ( ). The survey also asks if patients have had privacy for discussions and the overall Trust score remained consistent at 88 ( & ). Our carers survey asks whether the carer considers if the person they care for has been treated with respect and courtesy by staff and also whether the carer has been treated with respect and courtesy by staff. These were amongst the highest scoring questions in the carers survey, scoring over 90/100. Learning Disability Champions in all clinical services There are 30 Learning Disability Champions across the Trust. Dementia Champions in all adult wards/clinical areas 396 members of staff are clinically trained in dementia awareness through both the University of Hertfordshire and in-house training supported by the RAID (Rapid, Assessment, Interface, Discharge) team. Protected groups do not report poorer outcomes in the Trust national surveys National patient experience survey results do not provide a breakdown of results by protected groups. There were no complaints made by patients or carers relating to discrimination in (1 in ). Evidence supports implementation of reasonable adjustments for eligible patients Examples of reasonable adjustments made for patients include: Multi-disciplinary team discharge planning meetings with care workers, family carers, Learning Disability Nurses, carer s lead, social care, community services and continuing health services to manage the safe discharge of a patient with complex needs after a prolonged inpatient admission. Patient and Carer Experience Strategy Evaluation Page 17

19 Training provision to family carers and care workers to support discharge plans. Carer support, including sleeping and respite arrangements, and involvement of the carers lead, to enable the parents of a severely disabled patient to stay in hospital so that there was always someone around who was familiar to the patient. Transfer planning with a specialist hospital to ensure they could meet the needs of the patient and the patient s carers when care was transferred for specialist treatment. Detailed admission planning to the day surgery unit for a patient who had severe hospital phobia, in order to facilitate dental treatment for dental abscesses in their best interest. The patient did not have the capacity to understand the consequences of their decisions and was in a lot of pain but did not want to go to hospital. This included working with an anaesthetist, the community dentist, home carers and community learning disability team to plan the day surgery admission so that there was minimal upset to the patient and that their time in hospital was made as pleasant as it was possible, which included organising post-operative recovery in a ward with a more homely environment. Notification to bed managers and admission teams of pending admissions to enable direct admission to the post-operative ward to minimise disruption to the patient. Adjustments made to hospital appointments or attendance times to accommodate the needs of patients who have complex needs. Pre-operative arrangements made with a person s care home and carers to enable preoperative medication and preparation to be given at home to minimise the amount of time the person needed to stay in hospital. Learning Disability Nurses working with patients and their care teams to prepare patients for hospital admissions or clinic attendances which has worked particularly well for patients who have a fear of coming to hospital. Patient and Carer Experience Strategy Evaluation Page 18

20 Ambition 7 Improve engagement of patients and carers 2013/14 Key Milestones Maintain targets for patient experience feedback responses using Meridian Increase the number of engagement opportunities for service users and carers to contribute Ward and departments display monthly Meridian results and actions taken (you said we did) Maintain targets for patient experience feedback responses using Meridian The Meridian League Usage Report enables Matrons and Ward Sisters/Charge Nurses to monitor responses made to the Trust s patient experience surveys. A breakdown of the number of patient experience surveys completed during is included in Appendix 1. The response rate to the Friends and Family Test is closely monitored each month and the Trust achieved the national target response rates for the FFT in ,397 patients answered the FFT question - 6,183 Inpatients, 6,802 A&E and 2,412 Maternity. Increase the number of engagement opportunities for service users and carers to contribute The Trust s Engagement Strategy sets out how the diverse community of users of Trust services are involved in the review and development of Trust services. We actively encourage all patient and carer feedback and this is encouraged via the Patient Advise and Liaison Service, comment boxes, patient experience surveys, Friends and Family Test responses, social media (Twitter, Facebook), NHS Choices, Patient Opinion, patients telling their story, patients regularly attending Board meetings to talk about their experiences and regular focus groups. Appendix 1 includes details of the patient and public focus groups held in Ward and departments display monthly Meridian results and actions taken (you said we did) All wards have an A1 size laminated poster which is updated monthly with the best/worst performing areas in the patient experience surveys and the You Said We Did actions. The poster also includes the wards Friends and Family Test score which is calculated from responses to the Friends and Family Test question and includes the number of responses to the question for the month. Patient and Carer Experience Strategy Evaluation Page 19

21 Priorities for The Patient Experience Committee (PEC) has considered the Trust s priorities for improving patient experience and agreed that the main focus for the year should be to safely manage the final phase of Our Changing Hospitals programme and the Trust should focus on the following key themes which are problem scores on the inpatient survey and identified as being of high importance to patients:- improving communication and information pre- and post-operatively, actively promoting shared decision making no decision about me without me improving staff attitude enforcing current policies, eg silent night campaign, red tray and jug procedure and intentional rounding Discharge planning and information at discharge Treating patients with respect and dignity Improving access a TOMP workstream led by the Director of Operations Conclusion has been a year of tremendous change for the Trust and the final phase of Our Changing Hospitals will see all remaining inpatient and emergency services transferred from the QEII to The Lister. Having all acute services in one centre for specialist care will help ensure that we deliver the best possible care to our patients. In Spring 2015 the New QEII Hospital will open providing outpatient and diagnostic services to local people. We continue to strive to improve the care and treatment that we provide to our patients and look forward to the challenges ahead in Angela Thompson Director of Nursing and Patient Experience Philippa Davies Deputy Director of Nursing Jenny Pennell Project Manager Nursing and Patient Experience Patient and Carer Experience Strategy Evaluation Page 20

22 Facts and Figures Appendix 1 CQC National Inpatient Survey The annual survey of adult inpatients is undertaken in all NHS acute hospitals and results published by the Care Quality Commission. The inpatients were asked what they thought about different aspects of the care and treatment they received. Survey month Report received Response rate No. % July 2011 April July 2012 April July 2013 April The survey is divided into10 sections and a score out of 10 allocated for each question and section. Each trust is assigned a category showing whether their score is better, about the same or worse than most other trusts. In 2011 ENHT was worse in 3 sections and about the same in 7 sections. In 2012 and 2013 ENHT was worse in one section and about the same in 9 sections. Section Emergency department Worse Same Same 2 Waiting list and planned admissions Same Same Same 3 Waiting to get a bed on a ward Same Same Same 4 The hospital and ward Worse Worse Same 5 Doctors Worse Same Same 6 Nurses Same Same Same 7 Care and treatment Same Same Same 8 Operations and procedures Same Same Worse 9 Leaving hospital Same Same Same 10 Overall views and experiences Same Same Same Quarterly Inpatient Postal Survey The Trust surveys inpatients following their discharge home using questions from the national inpatient survey. The quarterly survey is undertaken for one month each quarter. During ,353 patients were sent the inpatient survey with an overall response rate of 32.5%. Survey Month No. of patients No. of surveys Response rate survey sent to returned April , % July , % October , % January , % TOTAL 8, % Patient and Carer Experience Strategy Evaluation Page 21

23 Meridian Surveys The Trust continually monitors feedback from patients and uses this feedback to make changes and improvements to the services it provides. An electronic patient survey system is in place called Meridian which enables patients to complete relevant surveys by the use of a simple electronic device (i-pad) whilst they are in the hospital; these surveys can also be accessed via the Trust s web-site for completion by patients at home. During ,754 patients completed one of our electronic surveys. Meridian Surveys No. completed Inpatient 6,112 Maternity 1,922 Outpatients 4,156 Accident and Emergency 434 Discharge 2,082 Neonatal Unit 136 Renal Dialysis Unit 1,397 Critical Care 118 Young Outpatients 312 Carers 85 TOTAL 16,754 A comparison of the inpatient survey results between shows that patient experience has improved in all elements except the rating of hospital food. Comparison of Meridian inpatient survey results Food and Cleanliness questions introduced in Patient and Carer Experience Strategy Evaluation Page 22

24 Friends and Family Test The Friends and Family Test question was launched nationally in April 2013 for all adult inpatient and A&E patients and from October 2013 in maternity. Patients are asked how likely are you to recommend the ward/department/service to friends and family if they needed similar care or treatment. The question must be asked at or within 48 hours of the patients discharge from hospital. Summary of Trust FFT score and response rate compared to national ( ): Inpatients Accident and Emergency Maternity - Summary of FFT score and response rate for ENHT and national ( ) The maternity FFT was implemented nationally from October Each woman is asked the FFT question at four stages: Antenatal service (at 36 week antenatal appointment) Ward/birthing unit/homebirth Postnatal ward Postnatal community service (at discharge from care of community midwifery team) Summary of Trust FFT score and response rate compared to national ( ): Antenatal Birth Patient and Carer Experience Strategy Evaluation Page 23

25 Postnatal Community Midwifery Post-discharge telephone calls Between July 2013-March 2014 staff carried out follow up telephone calls to 2,289 patients who had an unplanned hospital admission. Patients were asked:- On the day you left hospital was your discharge delayed for any reason? Did a member of staff tell you about any danger signals to watch out for when you went home? Did hospital staff tell you who to contact if you were worried about your condition or treatment after you left hospital? Did the doctors or nurses give your family or someone close to you all the information they needed to help care for you? Did you find someone on the hospital staff to talk to about your worries and fears? Did someone go through your tablets/medications with you? Responses to post-discharge calls between September 2013 March 2014: Patient and Carer Experience Strategy Evaluation Page 24

26 Focus Groups patient/public involvement Date Topic No. of members of the public/patients attended May 2013 Sustainability workshops 5 May 2013 End of life care for adults 30 June 2013 Francis report 22 October 2013 AGM 300+ November 2013 Complaints process 17 Quarterly Carers focus groups 44 Throughout the year Patient Led Assessments of the Care Environment (PLACE) Throughout the year Our Changing Hospitals tour 49 In addition to these focus groups there is patient/user involvement in a number of condition specific groups held within the Trust. 48 Patient Experience Committee The Patient Experience Committee is chaired by a non-executive Director of the Trust and includes representation from the Medicine, Surgery, Cancer, Women s and Children and Clinical Support Service Divisions, Director of Nursing and Patient Experience, Patient Experience Project Manager, Facilities Manager, Chaplain, Head of Engagement, Patient Safety/Complaints Manager, Health Liaison team and six patient representatives. The committee met seven times during and received regular updates on the Trust s patient experience survey results and updates on the Divisional patient experience action plans. In January 2014 the terms of reference for the committee were reviewed and monthly meetings arranged. Complaints The total number of complaints received in the Trust continues to fall: Patient and Carer Experience Strategy Evaluation Page 25

27 Complaint Response Handling Times The Trust s Management of Complaints and Concerns Policy sets out the process by which complaints and concerns are handled within the Trust. The Trust aims to respond to most complaints within 25 working days, though for the year we will be assessing response times against the period that has been agreed with the complainant. Service improvements take time to work their way through into complaints as people tend to complain historically: Division No. % Replied to in 25 working days No. % Replied to in 25 working days Cancer Services 38 74% 47 74% Clinical Support % % Medicine % % Surgery % % Women & Children s % 94 51% Others Trust Wide % % Breakdown of complaints by primary subject: Treatment received Delays Communication Attitude of staff Discharge Nursing Care Transport issues Confidentiality Catering/Facilities Medical records issues Policy and procedures Medical Care Patient's property Delayed discharge Consent Issues Infection Control Medication error Staffing issues Choose & Book Discrimination allegations Essence of Care Information Transfer arrangements LCP concerns/issues Pain control issues Cancellation of appointment/service 18 Information 3 new categories Equipment failure 2 Miscellaneous 5 TOTAL Patient and Carer Experience Strategy Evaluation Page 26

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29 PATIENT EXPERIENCE - TRUST STRATEGIC ACTION PLAN Date reviewed: August 2014 APPENDIX 2 The Patient Experience Committee (PEC) has considered the Trust s priorities for improving patient experience and agreed that the main focus for the year should be to safely manage the final phase of Our Changing Hospitals programme and the Trust should focus on the following key themes which are problem scores on the inpatient survey and identified as being of high importance to patients:- improving communication and information pre- and post-operatively, actively promoting shared decision making no decision about me without me ; improving staff attitude; enforcing current policies, eg silent night campaign, red tray and jug procedure and intentional rounding; Discharge planning and information at discharge; Treating patients with respect and dignity; Improving access a TOMP workstream led by the Director of Operations IDENTIFIED FROM: [1] CQC Inpatient/quarterly survey [2] KEY ISSUE: Meridian patient experience survey [3] FFT KEY ACTIONS: PROGRESS: LEAD TIMESCALE responses [4] Complaints/ Incidents [5] Other, e.g. national/ Picker RAG Red, Amber, Green Current Year End Ambition 1: Improve the patient experience from the start to the finish of their journey. Trust policies and procedures [2] Meridian patient experience survey, [3] FFT responses, [4] Complaints/ incidents Monitor compliance with key policies, eg nutrition and hydration, red tray and jug procedure and intentional rounding. DoN, DDoN, NSMs, Matrons review compliance during spot check ward visits. All wards review nursing documentation audit results and produce action plans to address issues identified. DoN, DDoN, NSMs, Matrons, Ward Sister/Charge Nurse Ongoing Discharge from hospital [1] CQC Inpatient Survey Monitor percentage of TTOs written up on the day before discharge and the number of patients transferred to the discharge lounge. Any delay with discharge escalated to the Ward Sister or Matron. Doctors write TTO's the day before discharge and before 3pm. All suitable patients transferred to the discharge lounge. Ward scorecard developed to measure percentage of TTO's written the day before discharge and the number of patients transferred to the discharge lounge. Wards have target for discharge lounge which is monitored weekly. All wards complete the BFT and update daily. Ward Sister/ Matron notified of any delay discharges. Medical Director, Divisional Directors, NSMs, Matrons, Ward Sister/Charge Nurse Ongoing Liaise with GPs regarding discharge of vulnerable elderly patients. Notify GPs 24 hours in advance of vulnerable elderly patients being discharged from hospital. Definition of vulnerable is those relying on primary or community health services for a safe discharge. L Welch Ongoing Trust performance in national patient experience surveys (Inpatients, Maternity, A&E, Cancer etc) [1] CQC/Picker/Quality Health - inpatient/maternity, A&E, cancer surveys, [5] Patient and Carer Experience Strategy Divisions to review results of national surveys and update Divisional patient experience action plans. Divisional patient experience action plans reviewed by PEC (each Division to present twice per annum). Patient Experience Manager, NSMs, Divisional Directors Ongoing

30 Friends and Family Test [5] Other NHS England Guidance and national CQUIN Implement FFT inpatients & A&E from Apr-13. Implement FFT Maternity from Oct-13. Implement FFT in Outpatients and Day Surgery from Oct-14. Monitor FFT CQUIN compliance monthly. FFT implemented in accordance with NHS England/DH guidance and reporting of results via UNIFY2 for inpatients, A&E and maternity. Monitor FFT score and response rate by ward and Division & report to Board. Wards and department teams review free text comments made by patients and share feedback with staff. Patient experience notice board on all wards displaying FFT score and You Said We Did actions. Patient Experience Manager, Divisional Directors, NSMs, Matrons, Ward Sisters/Charge Nurses April 2013/ October 2013/ October 2014 & Ongoing Improve Trust scoring in Trust Development Authority patient experience selfassessment [5] Other TDA patient experience self-assessment Monthly reports to Board on key patient experience measures Patient stories Board value and reward innovation by staff to improve the experience of patients Trust expresses commitment to patients through all communications Patient friendly complaint process Patient experience dashboard included in Board information pack monthly Board members received training in undertaking patient stories. Board members schedule time to listen to patient stories. Board focus on enforcing Trust policies to improve the patient experience Seek patient/carer involvement in proposed changes to Trust website and evaluate the resources provided to support Trust communications. Baseline aduit conducted against which improvements will be measured. Patient Experience Manager Jun-14 Executive and Non- Jul-14 & Executive ongoing Directors Executive and Non- Jul-14 & Executive ongoing Directors Director of Communications Head of Complaints/ PALS Jul-14 & ongoing Jan-15 Front line staff deal with issues raised by patients Patient feedback acted on by front line teams Patient feedack influences audits Proposals for service change review impact on patient experience Patients to share decision making about care and treatment Engage with patients Continue to encourage patients to raise issues with staff and for staff to deal with issues real-time Patient feedback reviewed on all wards and patient experience board updated with You Said - We Did Departments to notify Clinical Audit Team of audit needs identified from patient feedback Medical Director & DoN review all CIPs. Patient experience to be made more explicit within documentation No decision about me without me to be further embedded Patient engagement opportunities available. NSMs/ Matrons/ Ward Sister/ Charge Nurses Ward Sister/ Charge Nurses NSMs/ Matrons/ Ward Sister/ Charge Nurses Executive Directors MD/DoN Head of Engagement Jul-14 & ongoing Apr-14 & Ongoing Jul-14 & ongoing Jul-14 & ongoing Apr-14 & Ongoing Jul-14 & ongoing

31 IDENTIFIED FROM: [1] CQC Inpatient/quarterly survey [2] KEY ISSUE: Meridian patient experience survey [3] FFT KEY ACTIONS: PROGRESS: LEAD TIMESCALE responses [4] Complaints/ Incidents [5] Other, e.g. national/ Picker RAG Red, Amber, Green Current Year End Ambition 2: Improve patient s experience of accessing hospital services. Improve patient s access to Outpatient Services. TOMP workstream [5] Patient and Carer Experience Strategy A large programme of work focussing on transforming the outpatients service which includes many aspects of patient experience: Director of Operations Ongoing Review services to [5] Patient and Carer improve accessibility for Experience Strategy patients, e.g. digital technologies, digihealth. Reduce waiting time when patients phone our appointments line Reduce hospital cancellations/rearrangement of outpatient appointments Pilot of patient led recording of consultations to better inform our patients of their care plan Electronic communication of clinic outcome letter with GPs to ensure that the information is available in a timely way Improve customer service training in the outpatient clinics Establish Telehealth Steering Group. Telehealth Steering Group established. Director of Nursing Apr-14 Introduce Skype clinic pilot for Head and Neck cancer patients. Telehealth to support home dialysis patients. Forward plan to: develop Telehealth to support long term conditions including diabetes. Jackie Jones, CNS Cancer, successful in obtaining RCF funding to work up an RfPB bid to evaluate patients experience of Skype clinics to support cancer patients. Currently undertaking Skype clinic pilot for Head and Neck cancer patients. Presenting at planned programme board in August. CNS Head & Neck Cancer Suresh Mathavakkannan Peter Winocour Jun-14

32 IDENTIFIED FROM: [1] CQC Inpatient/quarterly survey [2] KEY ISSUE: Meridian patient experience survey [3] FFT KEY ACTIONS: PROGRESS: LEAD TIMESCALE responses [4] Complaints/ Incidents [5] Other, e.g. national/ Picker RAG Red, Amber, Green Current Year End Ambition 3: Improve communication with patients. Improve staff communication with patients 1] CQC inpatient/quarterly survey Csutomer care training for all staff and leading a customer care culture awareness training through ARC sessions. Customer care training in place for staff. Ward Sisters to monitor uptake and effectiveness. Interim evaluation report to PEC. Director of HR/ NSMs/ Matrons/ Ward Sisters/ Charge Nurses Improve patient s involvement in their care and treatment [1] CQC inpatient/quarterly survey Junior doctors induction programme to be reviewed to include ensuring that patients are given the opportunity to discuss their treatment at various stages along their pathway. Medical Director Ward managers to be present on ward rounds to encourage patient involvement. Ward managers present on ward rounds to encourage patient involvement. Ward Sisters/ Charge Nurses Apr-14 & Ongoing Any question' prompt sheets to be used as a prompt for patients to discuss any questions. Nursing staff encourage patients to complete 'any questions' prompt sheet. Discussed at ward team days. Nursing staff document evidence of patient comments when discussing decisions about care. Ward Sisters/ Charge Nurses Apr-14 & Ongoing Ensure that staff answer patients questions about the operation or procedure. [1] CQC inpatient/quarterly survey Ward managers review responses to this question within Meridian inpatient survey. All patients have a welcome card detailing what s happening next and expected date of discharge. Ensure patients receive information pre and post operatively. Ward sisters review responses on Meridian inpatient survey. Information leaflets provided with advice, contact details, procedure type, reasons for procedure, complications and information on what happens after the operation and how the patient can expect to feel. Ward Sisters/ Charge Nurses Ward Sisters/ Charge Nurses NSM Surgery/ Surgical Division Apr-14 & Ongoing Apr-14 & Ongoing Ongoing Patients encouraged to ask any questions during the ward round and any questions prompt sheet available to encourage patients to document any questions for staff. Posters displayed as a prompt to encourage patients to ask questions during the ward round. Welcome cards introduced explaining the next steps of care/treatment. Ward Sisters/ Charge Nurses Apr-14 & Ongoing

33 IDENTIFIED FROM: [1] CQC Inpatient/quarterly survey [2] KEY ISSUE: Meridian patient experience survey [3] FFT KEY ACTIONS: PROGRESS: LEAD TIMESCALE responses [4] Complaints/ Incidents [5] Other, e.g. national/ Picker RAG Red, Amber, Green Current Year End Ambition 4: Meet patient s physical comfort needs. Improve patient [1] CQC inpatient/quarterly Appoint Dementia Nurse Dementia Nurse in post NSM Medicine Jan-14 experience of being survey RAID Team to support staff in dealing RAID Team bothered by noise at with confused dementia patients. night from other patients. Monitor movement of patients at night. Reinforce the Silent Night campaign throughout the Trust. RAID Team available to provide support for ward staff. A&E Team meet monthly with AID Team. Night Manager has overview of hospital at night and monitors movement of patients at night. Ward managers and Matrons ask patients during walk round 'were you disturbed at night?' and feedback comments to ward staff. Silent night posters for staff and patients displayed on all inpatient wards. Matrons Patient Experience Manager, Matrons, Ward Sisters/ Charge Nurses Jan-14 & RAID Team Apr-14 & ongoing Sept-14 & Ongoing Improve patient [1] CQC inpatient/quarterly experience of being survey bothered by noise at night from hospital staff. Review and minimise the number of admissions during the hours of 22:00-08:00 and escalate any concerns. Matrons/ward managers to continually educate staff on need to reduce noise levels at night - 'silent night' campaign. RfPB project to introduce sound masking on wards. Reinforce the Silent Night campaign with staff throughout the Trust. Patient feedback monitored via real-time, quarterly post and national inpatient survey results. Matrons to undertake spot checks at night. Ward managers to ensure staff are reminded of need to talk quietly, wear quiet shoes, turn down call bells/ telephones at night. NSMs, Matrons, Ward Sisters/ Charge Nurses NSMs, Matrons Apr-14 & Ongoing Apr-14 & Ongoing Re-submission of RfPB application Julie Fillary Aug-14 Ward managers and Matrons ask patients during walk round 'were you disturbed at night?' and feedback comments to ward staff. Silent night posters for staff and patients displayed on all inpatient wards. Ward Sisters/ Charge Nurses, Patient Experience Manager Sept-14 & Ongoing

34 IDENTIFIED FROM: [1] CQC Inpatient/quarterly survey [2] KEY ISSUE: Meridian patient experience survey [3] FFT KEY ACTIONS: PROGRESS: responses [4] Complaints/ Incidents [5] Other, e.g. national/ Picker LEAD TIMESCALE RAG Red, Amber, Green Current Year End Ambition 5: Provide patients with the emotional support they need whilst using Trust services. Carer support [5] Patient and Carer Experience Strategy Engage with carers to make best use of their unique skills and knowledge. Monitor use of Carers Policy and carers agreement to enable carers to identify how involved they wish to be in the care of their relative/friend. Undertake monthly carers survey; review results by ward and address any issues identified. Carers focus groups held quarterly to discuss issues of importance to carers. Matrons, Ward Sisters/ Charge Nurses, Discharge Team, Demential Nurse, Patient Experience Manager Apr-14 & Ongoing

35 IDENTIFIED FROM: [1] CQC Inpatient/quarterly survey [2] KEY ISSUE: Meridian patient experience survey [3] FFT KEY ACTIONS: PROGRESS: responses [4] Complaints/ Incidents [5] Other, e.g. national/ Picker LEAD TIMESCALE RAG Red, Amber, Green Current Year End Ambition 6: Respect the needs of patients and recognise their individuality. Treating patients with respect and dignity [1] CQC Inpatient Survey ARC customer care training and Trust Values (PIVOT). NSMs to ensure ward staff are regularly reminded of the Trust's Values and these are incorporated and discussed within each members of staffs appraisal. Patient experience feedback (surveys, PALs comments and complaints) to be reviewed and any concerns discussed with staff NSMs, Matrons, Ward Sisters/ Charge Nurses Apr-14 & ongoing Customer care pledges. Customer care pledges clearly displayed in all wards/ departments. Adult Safeguarding Lead, Ward Sisters/ Charge Nurses Apr-13 Privacy for examination and treatment [1] CQC Inpatient Survey Ensure appropriate environment to examine/treat patients - retrain staff where necessary. All wards to offer private area for examination. Ward managers continue to promote staff awareness of the environment when examining or treating patients. Discussed at team meetings and re-training provided where indicated. Ward Sisters/ Charge Nurses Ongoing

36 IDENTIFIED FROM: [1] CQC Inpatient/quarterly survey [2] KEY ISSUE: Meridian patient experience survey [3] FFT KEY ACTIONS: PROGRESS: LEAD TIMESCALE responses [4] Complaints/ Incidents [5] Other, e.g. national/ Picker RAG Red, Amber, Green Current Year End Ambition 7: Improve engagement of patients and carers. Patient and carer feedback [5] Patient and Carer Experience Strategy Redesign the raising concerns posters throughout the Trust with Tell us what you think posters incorporating all methods of feedback eg surveys, social media, secret shopper link, PALS/complaints etc. Posters developed for Lister, QEII, HCH and MVCC and displayed in public areas. Patient Experience Manager Jul-14 Produce monthly summary of patient experience survey results including FFT for Board. Monthly patient experience dashboard produced with key patient experience survey results and response rates. Bimonthly patient experience update report for Risk and Quality Committee Patient Experience Manager Apr-14 & Ongoing Angela Thompson Jenny Pennell 7 August 2014 Director of Nursing & Patient Experience Project Manager - Nursing & Patient Experience Patient Experience Committee

37 in partnership with r R Liz Pryor Kissing it Better Hertfordshire July 2014

38 FOREWORD I am delighted that the Trust has been able to continue its partnership with Kissing it Better for a second very successful year, providing a variety of activities and services to improve the experiences of our patients at The Lister and Queen Elizabeth II Hospitals. Kissing it Better continues to engage with individuals, community groups, local schools and colleges to provide the little things that make the world of difference to our patients. We are truly grateful for the support and enthusiasm of all the Kissing it Better volunteers who should feel so proud of the work they do: Beauty therapy students provide wonderful relaxing hand and arm massages for patients in our elderly care wards and patients undergoing renal dialysis treatment. Hairdressing students wash and style patients hair, which really does make the world of difference. The regular visits from PAT dogs are a pleasure to see with many patients enjoying recounting stories of their own pets. We have also enjoyed visits from so many wonderful singers and choirs throughout the year. Volunteers provide afternoon tea and chat to patients who feel lonely and isolated. We are looking forward to welcoming more students from North Hertfordshire College and Oaklands College during the next academic year, working closely with our Dementia Lead Nurses and Kissing it Better to enhance the nursing care for those patients with dementia. I very much look forward to continuing to develop our links with Kissing it Better and the local community over the coming year. Philippa Davies Deputy Director of Nursing 1 P ag e

39 INTRODUCTION Kissing it Better has been working with East & North Hertfordshire NHS Trust for the past two years, engaging with groups in the community who give their time generously to come into hospital wards and lift patients spirits on a weekly basis. We are incredibly proud of our partnership. Working together, we do so much more than provide a little light relief for patients. We put the Trust firmly at the heart of the community. As our partnership grows, so does the sense that the community is looking after its own. We are addressing two very important needs in society: the need for the elderly and infirm to feel cherished and remembered, and the need for young people to learn vital life skills. Take the story of 76-year-old Margaret. She was a patient at The Lister s renal unit when the beauty therapy students from Oaklands College arrived to give hand and arm massages and manicures. As the girls pampered Margaret, she regaled them with wonderful stories of working in the local department store from the age of 14. The girls gained invaluable understanding and insight, but they also gained a friend Margaret keeps in contact, visits their college salon regularly, and champions their careers. Surely, this is wraparound community care in action. As the figures below demonstrate, the number of people in the community getting involved and making a difference continues to grow, year on year. We are enormously grateful to senior management at East & North Herts NHS Trust for their continued support and enthusiasm, and to all our wonderful students, community groups and volunteers, who give their time so generously to make a difference to patients and staff. Liz Pryor, Kissing it Better, Hertfordshire 2 P ag e

40 ACTIVITY SUMMARY North Hertfordshire College Beauty Department - visited The Lister twice a week, to offer free hand and arm massages and manicures to patients on Barley & Pirton Wards (both elderly care). Altogether, they provided 450 hours of treatments. Hair Department - provided free hairdressing treatments to patients on Barley & Pirton Wards, totalling 100 hours of care. 3 P ag e

41 Animal Care Department - visited Bluebell (children s) ward, and the Children s Emergency Department, providing 45 hours of fun and distraction. 4 P ag e

42 Oaklands College Beauty Department - visited The QEII and The Lister Hospital on a biweekly basis, offering hand and arm massages and manicures to patients on Princes Wing (QEII Orthopedics) and the Renal Dialysis Unit at The Lister. Altogether, they provided 180 hours of care. In Summary: Over 800 hours of TLC from 112 Further Education college students during 105 visits 5 P ag e

43 Music Events We have been very lucky to welcome to the Trust: Covenant Praise Community Gospel Choir Janice Cook, Jazz Singer Old Time Music Hall sing-along with Alive & Singing Choir members Jamie Serafi, Pianist Natalie Turner, singer Hitchin Boys School Senior Choir St Mary s Choir, Walkern Preston Village Choir Janice Cook, Jazz Singer Over 100 members of the local community bringing music to patients across the Trust. 6 P ag e

44 Pets as Therapy Our wonderful PAT volunteers, Adem and Anna, and their faithful friends, Yogi and Mr Jones, have visited patients 30 times over the past year, totalling an amazing 60 hours of time spent cheering up patients. The way that these volunteers engage with patients and chat to them about their lives and pets is an uplifting thing to see. Patients and relatives say they feel sparked up and remembered after a visit. One lady told me a story of how she coped when in hospital for two weeks. She said: I so enjoyed meeting Yogi and Adem, I was able to tell Adem all about the dogs I have had during my life, and he was interested and listened to what I was saying. I find sleeping difficult when I am in here, so every night, just before I go to sleep, I think about Yogi, wagging his tail by my bed, and the conversation I had with Adem, and I drift off with a smile on my face. I think that says it all. 7 P ag e

45 Tea for Two Kissing it Better volunteers have been running afternoon tea sessions on the elderly care wards, providing tea, cakes and chat to those who don t have many visitors. Our team of trusted tea ladies do a wonderful job, and have recently started working with the Dementia Lead Nurse to concentrate on spending time patients who are confused. Each visit they bring a different item to chat about - last week they took freshly picked herbs (rosemary, mint, sage and thyme) to give to patients to rub in their hands, and chatted about the aroma and memories that they evoked. The volunteers work closed with the Dementia Lead Nurse and Dementia Champions to make sure they visit patients who need company the most. Kissing it Better is looking forward to broadening this part of our work across the Trust next year. Tea for Two KIB volunteers, Nadia, Carole and Kate Strathmore Garden Our team of Kissing it Better garden volunteers have spent many an hour weeding and planting bulbs in the Strathmore Garden this year. The colourful garden provides a quiet space for patients to sit outside in the sunshine, and for members of staff to spend their lunch break away from the ward. From July 2014 the Strathmore garden will be looked after by members of Leydon House Day Centre in Stevenage. Kissing it Better is very excited about meeting the group, and we look forward to spending time in the garden and seeing it blossom and flower! 8 P ag e