Patient Experience Strategy

Transcription

1 Patient Experience Strategy

2 Contents Introduction... 3 Why do we need to know about patient s experience?... 5 What is meaningful feedback?... 7 How do we know what is important to the people who use our services? Prudent Healthcare and Co-Production Involving Service Users How will patient experience be reported? Conclusion Appendix Appendix

3 Introduction Powys Patient Experience Strategy is committed to continually developing and improving care provision for patients and their carers, ensuring all who access services, from primary care through to hospital-based services, have an experience that reaches societies widely held expectations that they will be cared for safely, by knowledgeable, skilled and compassionate staff. It is imperative that lessons are learnt from the negative patient stories which have been experienced by so many across the UK, that have been widely and publicly reported in the media. Patients and carers have a right to experience respectful and professional care, in a considerate and supportive environment, where their privacy is protected and dignity maintained. A high quality experience should be fundamental, underpinned by appropriate standards, whatever and wherever the setting of care and treatment. This strategy sets out how (PTHB) staff are expected to contribute to improving every patient and service users experience of health and in some cases social care provision, by actively seeking meaningful feed back. This includes; primary care, community, out patients, minor injury units and all wards, ensuring we share best practice and can address areas for improvement to service delivery based on the feedback we receive from those who use our services. PTHB recognises that much of the care and treatment Powys residents access are commissioned, by the health board, from neighbouring health boards and NHS Trusts in Wales and England. This is because there are no District General Hospitals in Powys and it is predominantly a community-based organisation. It is therefore important to monitor the patient experience of Powys residents wherever they receive their care. Through the new Commissioning Assurance Framework, patient experience will be reviewed using patient and carer feedback, along with any compliments, complaints or concerns raised with PTHB. This will help us to identify any deterioration in quality, as well as gathering evidence of excellence that should be adopted and shared both in and out of county. Current health board structures mean that there are separate Executive portfolio holders for Patient Experience, Communication and Consultation and Engagement. Participants in the recent Patient Experience Strategy workshop raised that this could present challenges to seamless communication. The health board is acutely aware of the need for close working and effective communication to ensure that any gaps or duplication in the work that is carried out under each portfolio are minimised. The approach to collecting patient and service user feedback must be robust, relevant, timely and reflect the principles of the Welsh Government Framework 3

4 for Assuring Service User Experience 1 and as subsequently updated in the 1,000 Lives White Paper Listening and learning to improve the experience of care 2. The health board also has its own values and aims as set out in the Annual Quality Statement 3 pivotal to which is the aim of ensuring we provide truly integrated care, centred on the individual, where seeing the person in the patient is the at the heart of all we do. Listening to the staff who provide health and social care will also be an important part of delivering against this strategy as these are the people who interact on a daily basis with patients and service users, with an ear to the ground on what is going well and what needs to improve. Staff are frequently service users too and as such will have their own views on what makes a good user experience. Encouraging a culture of openness and transparency, where blame is not the first or only response when things go wrong, will ensure staff feel able to safely speak out about care and the environment where it is viewed as less than optimal. In the Keith Evans Report 4 he advised that the overarching aim of every organisation should be that all staff, at every level, must be able to; humbly wear our customer s shoes placing ourselves in their position in order to better understand what is going right and wrong (Evans 2014 p3) This strategy has been developed by drawing on both local and national research evidence and has been benchmarked against other health boards in Wales. A consultation workshop was held in Powys in February 2016, which included staff from PTHB and Welsh Government, the Community Health Council and user and advocate participants from across a wide range of service areas. The strategy was warmly welcomed by those present and the comments and ideas gathered from the day, some of which are contained within this strategy, will be invaluable in developing the action plan to support the implementation of this strategy (see action plan template appendix 1). Further opportunities to consult on the action plan will be sought. An easy read version of this strategy will be published on the health board website, alongside the full strategy. Both the full strategy and the easy read versions will be available in Welsh or other languages on request. The three year action plan will set out how the health board aims to build upon the current methods of gathering feedback to ensure all patients and users, regardless of age, impairment or disability, and no matter how much or where they have, or will use our services should have equal opportunities to provide their views, have them listened to and most importantly acted upon. 1 Framework for Assuring Service User Experience Welsh Government April Listening and learning to improve the experience of care Lives Improvement June Annual Quality Statement 2014/15 Powys Teaching Health board A Review of Concerns (Complaints) Handling in wales. Using the gift of complaints Evans June

5 Why do we need to know about patient s experience? PTHB, in its Annual Quality Statement, 5 sets out its core values and aims which are: Improving health and wellbeing Ensuring the right access, to the right services, at the right time, in the right place Striving for excellence Respect Involving the people of Powys Fairness Making every pound count & Valuing, supporting and developing our staff Equality Application of these values and aims centres around the provision of truly integrated care based on the needs of the individual in order to support people, helping them to lead happy, healthy lives. Furthermore, all staff are expected to Kindness & Caring demonstrate these six behaviours that are fundamental to everything we do in relation to public and patient care. "Truly integrated care centred on the needs of the individual" Working Together Trust Integrity The Board is responsible for monitoring the services provided and for demonstrating that the core values, aims and behaviours are being consistently applied throughout the organisation and that standards set out in the Long Term Agreements (LTA) with commissioned services are complied with. This includes monitoring clinical and service delivery performance, planning for the future and spending wisely. It also includes consulting about the services we provide through partner organisations and, more directly, with the people of Powys who we are here to serve. Feedback from patients enables us to; Rectify - gives us an opportunity to put things right if the patient experience was not to the standard planned or expected The NHS in Wales already has in place a robust system for investigating and responding to complaints and concerns about serious reports on lapses in care1. More often it s the little things which adversely affect patients and these can be quickly remedied, but only if we know about them. This requires staff to be alert to what the patient is experiencing, open to their feedback and prepared to do something about it1. We also know from several major reports into serious health care failings that small lapses, if left uncorrected, can lead to a culture where patient care rapidly deteriorates and poor standards become the norm1. We will support staff in encouraging feedback, develop a means to build vital links between complaints, serious incidents and patient feedback, looking for trends to enable additional support in areas where concerns are more prevalent. 5 Annual Quality Statement 2014/15 Powys Teaching Health board

6 Compare - enables us to understand differences in patient experiences over time and between locations and specialties Excellence matters to us and one of our key aims is to strive for excellence in everything we do. Measuring variance in patient experiences tells us where we are succeeding as well as where we can do better. In order for this to be a meaningful process it requires standard measures to be used across all services and on a regular basis over time. The results from careful analysis of patient experience data is a starting point in seeking excellence, not a goal in itself. Therefore publishing the data collected and using it to identify variation is seen as a high priority. The health board expects patient experience to be discussed and acted upon by all staff as part of routine meetings where performance measures are reviewed. We will support a programme of systematic data collection and analysis to provide robust patient experience information. The Board will also receive, and take in to account, regular reports on patient experiences including patient stories to inform the decisions it makes about service delivery and improvement. Improve - enables us to make changes where needed and identify whether the changes made have actually improved care. Most improvements in service and patient experience come from change, but not every change is necessarily an improvement. It is therefore important that the impact of changes are measured to demonstrate that they have had the intended effect of making things better. Although the impact being sought by the change may be financial (savings) or clinical (patient outcomes) consideration must be given to the impact on patient experience. We will encourage and support data collection relevant to the patient experience throughout any change or improvement process. Demonstrate - health board services are regularly inspected by external bodies to check how well we provide care, feedback is one means of demonstrating patient outcomes. Like all public bodies we are held to account for our performance. The patient experience is a key part of how we are judged, particularly by the public. Our commitment to listening to and acting upon patient feedback, outlined above, forms a sound basis for reporting to other bodies. We will comply with all requirements for external reporting and support relevant, appropriate and proportionate data collation which supports our values 6

7 What is meaningful feedback? Feedback generally can be classified into three types Process data tells us about the way services are delivered Outcome data demonstrates what difference the service made to the patient Impact data relates more to the longer term effects once patients have left our care. There is a further distinction to be made between Clinical outcomes which is about how the treatment or care impacted on a person s physical or mental health and Patient outcomes are about people s experience and expectations, and the extent to which they were met or unmet. Whilst all these sources of feedback are important this strategy is specifically about feedback from patients and service users who access care and treatment in Powys or receive services we buy from other health boards or Trusts for Powys residents. Figure 2 gives some examples of the different types of measures and feedback. Figure 2 Clinical measures Patient measures Impact measures Process measures Blood test results, body temperature Satisfaction with services, take up of services offered Service demand Outcome measures Freedom from symptoms, mortality rates Improvement in quality of life, ability to manage their condition Population health, morbidity The Welsh Government published a Framework for Assuring Service User Experience 6 in April This was in support of the earlier Welsh Government Five Year Vision, Together for Health 7 which required all NHS services in Wales to publish specific information including the views of service users. The Vision also required Wales to agree a national way of measuring patient satisfaction, a requirement which is now met through the National Survey for Wales. The overarching aim of the framework is to ensure the service user voice is heard at all levels in NHS Wales. 6 Framework for Assuring Service User Experience Welsh Government April Together for Health A Five Year Vision for the NHS in Wales

8 The Framework defines the service user experience, and users are defined as someone who uses or has access to Health Services in any setting, including their families and unpaid carers as; What it feels like to be a service user of the NHS in Wales (WG p3 2013) In order to continually improve the service user experience, organisations must understand the key determinants of what makes a good experience. This includes the experience for all, and especially for those who are vulnerable and in hard to reach groups. There must also be a mechanism for using patient feedback to drive and influence change to service provision and delivery, along with a means of delivering and measuring such improvements. The Framework, using national and local published evidence, has identified three domains under which a good service user experience might be described. These domains were discussed in the recent PTHB Patient Experience Strategy workshop to test whether Powys service users and residents agreed that these were areas they considered relevant to them or if there were others that should be included. Feedback is presented under each domain as follows; First and lasting impressions; Receiving care in a Safe, Supportive, Healing Environment; Understanding and involvement in care. 8

9 Domain 1 - First and Lasting Impressions 9

10 Domain 2 - Receiving care in a Safe, Supportive, Healing Environment Receiving care in a safe and supportive healing environment is not just about a ward, this domain must consider how staff deliver this in community, OPD and in every other area in and out of Powys Need to support initiatives where patients design care processes The framework standards of care in a clean, clutter free environment with rigorous infection control practice in place and receiving good, nutritious food are really the minimum to be expected Recognising emotional and spiritual needs and listening to the patient, service users - this is really about a person centred approach Familiar environment e.g. use of local art. The environment needs to be appropriate for people with dementia and mental health needs Need to support initiatives for patients to design the environment Partnership working and co-production, together with communication, are really important 10

11 Domain 3 - Understanding and Involvement in Care Ask the patient about how much information they want/need, too much can cause anxiety, too little means they can also have anxiety, don t underplay the situation, and understand the patient Appropriate Staff training on how to deal with patient experience: good and bad Empowerment, Patients making choices Take away the jargon, use information which is clear and simplified although be aware that some patients will understand more complicated information e.g. retired nurse. Don t just assume it all has to be simple. Transparency of complaints processes. Communicate lessons learnt and be proactive about an issue that is raised. Discuss alternative intervention or approaches for individuals A need to understand the differences between the term patient centred or patient led Partnership - Dr/Nurse are the clinical experts, me, I am the patient expert, I know me. Maintain two-way dialogue always Good experience is about being empowered, enabled, expected to have an active role. Being co-authors in care plans and choice. 11

12 How do we know what is important to the people who use our services? There have been many reports and papers published in recent years, some of which have previously been referred to in this strategy. These reports aimed to provide direction to the NHS about the need to use a balanced approach, from a number of data sources, in order to fully understand, at an individual and organisational level, the patient experience. The Keith Evans Report 8 set out very clearly the need to include complaints and compliments as important sources of information regarding patient s experiences of care in saying: It is recommended, beyond complaints, that Health Boards and Trusts expand their range of activities and contacts to draw in direct and personal experience of services. (Evans p84) The revised Welsh Government Framework published in the White Paper, Listening and learning to improve the experience of care, 9 was updated to take account of this guidance. The revised Framework strongly recommends that a mixture of methods is used wherever possible, to gather views in each of the three key domains referred to above, in order to obtain a balanced understanding of what it feels like to be a service user. Patient feedback should also be considered with other sources, including complaints and compliments, which can also be classified using the key domains. This process of triangulation of evidence is the most likely way of identifying areas for improvement and will support lesson learning from areas that are performing well. Figure 3 sets out the range of methods for consideration in order to provide a balanced view of patient experience, as purported by the Welsh Government Service User Experience Framework. PTHB will embrace the approaches espoused within the quadrant, to ensure patient experience feedback is consistently elicited using multiple methodologies. 8 A Review of Concerns (Complaints) Handling in wales. Using the gift of complaints Evans June Listening and learning to improve the experience of care Lives Improvement June

13 Figure 3: Gathering balanced feedback Real Time Short surveys used to obtain views on key patient experience indicators whilst patients, carers and service users are in our care (such as in hospital) or very shortly afterwards (such as on discharge or immediately after an out-patient appointment). Limitations May be subject to bias, not related to longer term outcomes Proactive/Reactive Provide opportunities for all service users/families/carers to provide feedback. Includes feedback cards, permanent and temporary online surveys and emerging methods such as text, QR codes and social media. Limitations Results may not be generalisable to all areas, may be expensive to set up Retrospective Surveys post discharge or any clinical encounter in any setting to gain in depth feedback of service user experience. They can also incorporate quality of life measures and Patient Reported Outcome/Experience Measures (PROM/PREM) Limitations Low response rates, reflect average experience not the highs and lows Balancing Concerns and complaints Compliments Clinical incidents Patient stories Patient groups Third party surveys such as Community Health Councils, Healthcare Inspectorate Wales and voluntary organisations Limitations Small numbers, potential respondent bias The appropriate methods for gathering balanced feedback from Powys service users were also tested as part of the consultation process in the PTHB strategy workshop. The information gathered has been added at appendix 2 and will be used to inform the development of the strategic action plan. PTHB is committed to using a mixed methods approach which does not rely on one source or type of data. We are also committed to the choice of methods being informed by those who work directly with patients, their families and their carers and will ensure there are means to communicate with us through the medium of Welsh and other languages as appropriate. Equally we will gather views of staff, seeking to understand what it is like to work for PTHB, as it is important, as a responsible employer, to know 13

14 what helps our staff to be content within the workplace as this ultimately affects the care that they provide to patients and the public. Staff are also well placed to visit, listen to, and gather patient stories, as well as to carry out peer reviews in care settings other than their own workplace. This will inform their opinions on how best to adapt standard survey/feedback tools for local use and learn lessons from best practice or areas for improvement. The health board acknowledges that staff need to be trained in the purpose and methods of collecting and analysing patient feedback and it is committed to providing adequate training and resources to enable this to happen. Prudent Healthcare and Co-Production Involving Service Users Co-production, as described in the 1000 Lives improvement tool 10, is an approach to delivering public services which requires providers to involve citizens, communities and the professionals who support them. The pooling of joint expertise across health, social care and the third sector will enable the delivery of more effective and sustainable outcomes and an improved experience for all involved. Developing the theme of co-production further, the paper, Achieving prudent healthcare in NHS Wales, 11 suggests that the introduction of prudent healthcare now requires a new partnership between clinicians and the people they care for to deliver the best, most appropriate healthcare in the safest, most effective way. Prudent and co-produced healthcare can therefore be best defined as; A means of providing services that are safe, effective, accessible, affordable and sustainable - reducing harm, variation and waste. It means delivering person centred care for all patients and re-designing and delivering services to achieve this aim. (Co-producing service, Co-creating health p6) PTHB has embraced the principles of co-production and prudent healthcare; where new services are to be introduced, or existing services need to be reconfigured or changed, patient, user and public views will be gathered and taken into account. In addition, when new services have been developed it will be usual practice for relevant staff to systematically monitor the experience of patients who are using new or changed services 10 Co-producing Service Co-creating health Live Tools for Improvement Achieving prudent healthcare in NHS Wales Public Health Wales June

15 to demonstrate that the revised service provided continues to meet their needs. How will patient experience be reported? It is imperative that as an organisation we are not just interested in collecting patient experience data but importantly we use it to improve service delivery throughout the organisation. To ensure this happens, we will communicate the results of our data collection and analysis publicly and as widely as possible. We will also ensure there are effective mechanisms in place to enable closer working between the Patient Experience, Communication and the Consultation and Engagement work streams to minimise gaps or duplication in important information. This strategy is not a stand-alone document and complements the health board s External Stakeholder Engagement Strategy and Communication Strategy both of which detail the importance of working in close partnership with Powys service users and other key stakeholders such as Powys County Council and the third sector, ensuring there is effective two-way communication at all times. The Board Ultimately the responsibility for the health board s performance lies with the Board so members require access to the information they need to direct the activities of the organisation. The Welsh Audit Office has recently published a very helpful leaflet with questions for NHS Board members to consider when seeking assurance that their organisation is doing enough to learn from patients and are using the learning to improve their services. The leaflet in English and Welsh can be found at the following link: or It is our intention to use these questions to inform regular audit of the action plan. The Board receives a report on patient experience at each of its formal meetings as well as listening to a patient story relevant to one of the agenda items. Whilst this is the case, further work is required to ensure there are robust mechanisms for a continuous two way flow of information between the Board and the services it oversees and directs. 15

16 Staff For most patients, staff are the patient experience so it is important that they are the first to know about both positive feedback from patients and where there are concerns. Concerns should always be treated as an opportunity for improvement and that means reporting reliable facts. Staff involvement in local feedback helps this process. Each ward or department will produce quarterly reports, or more frequently if required, identifying best practice and any areas for development. They will also receive a quarterly report from the patient experience team measuring their ward or department s progress against the health board as a whole. This will ensure appropriate action to address shortcomings can be implemented as soon as is practical, after it becomes known, and there is opportunity for health board wide learning from events and concerns. Partners Increasingly we deliver services in partnership with others such as Powys County Council, and third sector organisations and we need to share patient feedback with them to inform our partnership working. This Patient Experience strategy will take account of feedback PTHB receives from users in relation to their experiences from services we commission on their behalf as well as those we provide in county. Regular commissioner/provider meetings will facilitate two way communication with those we commission services from and contracts will make clear the expectations in regard to reporting patient experience. Furthermore external organisations such as Healthcare Inspectorate Wales or the Community Health Council in Wales and the Clinical Quality Commission and Health Watch in England, carry out unannounced inspections and then provide the health board with feedback on their findings. This enables PTHB to benefit from a fresh eyes review of the services provided and commissioned. It is also an opportunity for us to receive compliments on good practice but also to address less optimal provision that we may not have been aware of otherwise. The public Public reporting is already in place through the use of a dedicated area on both the Internet and the Intranet which makes information accessible to all. It is acknowledged that work is required to further enhance and maximise this. The website contains information on how a member of the public can raise a concern (complaint) with the appropriate form to do so, as well as the form to provide us with a compliment in both Welsh and English. It is our intention to develop further the section on You said We did which is where we can tell you what action we have taken as a result 16

17 of feedback we received. We also have a Facebook page, Twitter account and can be found on YouTube. Success could be described as achieved when everyone in the health board: Sees excellent patient experience as their business; Can quantify their contribution to its overall success; Feels proud to be part of that success. Conclusion This Patient Experience Strategy affirms that patients and carers have a right to experience respectful and professional care, in a considerate and supportive environment, where their privacy is protected and dignity maintained. A high quality experience should be fundamental, underpinned by appropriate standards, whatever and wherever the setting of care and treatment and we are committed to listening to, and acting upon, all patient, user and public feedback. We recognise the challenges faced by the NHS in the current economic climate and how important it is we make best use of public money in delivering healthcare that is high quality, safe, effective, relevant, timely and as near to home as possible. Action cannot be in isolation and we are committed to working in partnership with those we are here to serve, which includes all Powys residents who have either used, may use, or have a friend or relative who may use our healthcare services, or use those purchased by PTHB from other NHS bodies. We recognise that although we will continually try to walk in patients shoes, to better understand what it is like to be a patient or service user in Powys, we may not always get it right and that is because the same size shoe does not fit all people. However, with the ongoing input of those who the services are developed for, we will continue to strive for the best fit at all times. Finally, we know we are only at the beginning of our journey to ensure the patient experience, in all its many forms, is firmly embedded in everything we do. There are many examples of good practice but it is currently not consistent. The Patient Experience Strategy provides clarity and proposes an approach to enable information gathering, in many ways, to improve practice at the frontline and provide assurance to that continuous improvement to patient experience and outcomes is being achieved. 17

18 The Strategy spans a three year timeframe for us to secure improvements and develop a consistent and meaningful approach. This strategy is an example of co-production, which PTHB staff and Powys residents are jointly signed up to deliver on. Only through developing strong partnerships, where views of service users and staff are of significant value, will we achieve our ultimate aim of putting individuals at the centre of all we do and ensuring positive patient experience. 18

19 Appendix 1 Implement mechanisms for capturing patient experience feedback systematically across all health board services Implement mechanisms for capturing patient experience feedback systematically across all health board commissioned services Implement mechanisms for capturing staff feedback systematically across the health board Action Plan Year /17 Year /18 Year /19 Explore mechanisms for capturing patient experience feedback systematically in care home settings Explore mechanisms for capturing patient experience feedback systematically in primary care settings e.g. dental, pharmacist, opticians

20 Strategic Aims Four Quadrant Framework Year /17 Year /18 Year /19 Real Time Retrospective Proactive/Reactive Balancing 20

21 Appendix 2 The following comments and ideas were provided by participants at the Powys Patient Experience Strategy workshop and have been grouped together under common themes in the methods of gathering balance feedback. Real time Any format that the patient wishes, not to be restrictive Surveys are a bit restricted, need more comments boxes Visitor feedback Professional feedback e.g. chaplains, capture info during discussions/ chats to patients Short Surveys Someone to talk to then and then There needs to be a range of approaches both high tec and low tec Stamped addressed postcard, short and simple Do an activity with a patient and talk to them at the same time, informal moments, these need to be recognised as important e.g. when undertaking person hygiene the patient may comment on something Choice of postcard or A4 sheet with everyone logo on Choice of methods Short survey capture information better collected by an independent person Surveys should be completed at different points in the patients care When sending out an appointment, send out to inform the patient that they will be asked about their experience or just after ask the patient would they be happy to participate Top 5 or top 10 important things to patient Online Twitter Downside is that we could be selective about what we publish Negatives should be published Welcome opportunity for public engagement on annual, regular basis Press releases, although this would only be a one off and the press would most likely pick up on the negative Press release specific on the learning, what have we learnt you said we did Press release Breaking the culture that patients fear of making comments Be clear around indicators vs outcomes Trained patient s panel members to speak to patients PALs type people, just having someone available A volunteer to go and talk to people A peer to peer support questionnaire approach Through voluntary organisation Engagement with charitable organisation e.g. diabetic UK 21

22 Retrospective, after leaving our care Asking the patient when they would like to be asked, e.g. 1 week after, 2, weeks after etc. At the point of leaving, ask the patient would they be happy to participate can you help us to improve, are you happy to help us Some questionnaires poor, asked 2 questions in 1 question, properly designed questionnaire Face to face Surveys, can be variable Use of transfer of care co-ordinators with some admin support to undertake surveys in the DGH Feedback post DGH experience, how we capture issues at home e.g. SALTs Inform staff to help inform community/ inpatients at large Need to be asking patients how / what they need or want to feedback Integration agenda is key that the survey feedback needs to be combined Health and Social Care Integrated Agenda, survey to cover the whole journey Ensure transparency and independent scrutiny of reports before board level Board papers in the public domain should be easy read Need to raise awareness of Q&S and how to encourage two way communication Clarify what are the lines of communications from patient/focus groups to Q&S/Board Specific pages on the Website for specialist groups Updated by patient reference groups Patient focused groups, run by CHC before Need to identify specialist patient groups, who, where, when 22

23 Proactive/ Reactive With what ever method, the ability to remain anonymous Co-ordination of survey activity to avoid overload Keep it simple Suggested surveys with multiple choice questions e.g. pre paid envelopes, colour coded for different hospital sites etc. Patient feedback cards used widely Local council meetings, health issues heard, channelled to medical practitioners etc. Capturing patient experience where joint input and care e.g. leg clubs, lymphedema clinic Use of independent bodies in gathering information or others e.g. ex nurses, volunteers Citizen Advice council, test out surveys etc. Face to face Suggestion box Real time feedback to ward level/team level Online availability Could there be a page on the website, where a complaint is shown and what was done about it, how the organisation responded Quarterly newsletter published Annual patient experience report Patient want to know a concern has been actioned Inability to audit Facebook not sure how genuine Need an informal system, Facebook not doing the job Contact number etc. should be added to PTHB for people to contact as opposed to using Facebook Need to think about work associated with analysis of feedback and putting improvements in place Feedback must be clear, concise and open The organisation need to understand how the organisation learns and feedbacks One fit doesn t suit all 23

24 Balancing Closer relationships with GP s in terms of better engagement with HB staff Training for chaplains and others who listen to patient with Alzheimers / dementia and knowing what to feedback and how Patient stories If by video or edited, need to go back to the patient to check that it hasn t been edited too much and the message lost Patients to write it down independently Someone to talk to their and then The purpose of the patient story needs to be clear Clarity on who to give the story too, then how we feedback to patient groups, patient story authors etc. Need to include staff stories as well as patient stories Where are the reference groups, these need to be representative of patient needs - Yes would be interested in attending patient groups, but need to be on a district, county basis, local travel with more local people attending There needs to be a structured area for patient s feedback e.g. it s an agenda item on a patient experience group PTHB could be asking for this information in a structured way Develop lunch and team meetings to workshop the problems The mechanism of feedback from third sector e.g. monitoring reports, patient experience, patient stories Gaps between consultation/engagement (DoP) vs patient experience (DoN) There needs to be resources for undertaking the correct analysis of the feedback Are we clear on the quality of the reports and outputs Should there be a rolling program to seek out patient experience and feedback 24