ST HELENS CQUINs March 2017

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1 ST HELENS CQUINs March 2017 All CQUINs on track and green except uptake of flu vaccine CQUIN as red. Borough St Helens National CQUIN1a Introduction of health and wellbeing initiatives Option A Achieving a 5 percentage point improvement in each of the 3 staff survey questions on health and wellbeing, MSK and stress. Providers will be expected to achieve an improvement of 5% compared to 2015 staff survey results for each of the three questions in the NHS Annual Staff survey outlined below. Paula Woods Question 9a there was a 6% improvement Question 9b there was an 8% improvement Question 9c there was a 6% improvement 1. Question 9a: Does your organisation take positive action on health and wellbeing? Yes, definitely/ Yes, to some extent/ No response.

2 2. Question 9b: In the last 12 months have you experienced musculoskeletal problems (MSK) as a result of work activities? Yes/No response. Question 9c: During the last 12 months have you felt unwell as a result of work related stress? Yes/No response St Helens National CQUIN 1b Healthy food for NHS staff, visitors and patients N/A N/A St Helens National CQUIN 1c Improving the uptake of flu vaccinations for front line staff within Providers Improving the uptake of flu vaccinations for frontline clinical staff Achieving an uptake of flu vaccinations by frontline clinical staff of 75% Number of front line healthcare workers (permanent staff and those on fixed contracts) who have received their flu vaccination by December Peter Morgan Bridgewater wide scheme Vaccine available from October 2016, vaccination continued throughout the flu season. Achievement of the CQUIN to be based on percentage achieved by the end of December Target of 75% was not met. Target achieved was 43.25% which was an improvement on of 38%

3 St Helens Shared decision making in wheelchair service The wheelchair service will develop a format based around the 3 questions to enable the shared decision making process to be captured on the electronic records. This will enable the service to collate the number of users / carers involved in shared decision making. The service will pilot the process initially to ensure the information can be captured on the electronic records and can be collated. Questions to be asked: What are my options? What are the possible benefits and risks of those options? How likely are the benefits and risks to occur? The cohort of patients who would benefit from this CQUIN will be Wheelchair clients (adults and children) requiring postural support. The outcomes to be realised from this CQUIN would provide evidence of clients and carers involvement in deciding what equipment is right Lynne Peters The service has completed 5 workshops with AQuA during the implementation. The team with support from AQuA developed a Driver diagram and identified areas for action. All actions have been completed or have plans in place. Staff have completed pre and post implementation questionnaires which show the team perception has changed to emphasize the involvement of both staff and patients, and supporting patients along the care pathway. AQuA will continue to work with the team to complete case studies. CollaboRATE patient questionnaires were issued to all clients or carers and results have been collated by AQuA. Results show patients do feel included in decision making but there is still room for improvement which is expected as part of the programme. Service in conjunction with AQuA have been accepted to present at Posture and Mobility Group (PMG) national conference in July in Cardiff. Benefits realised for patients / service include: Telephone triage completed so patients are placed in the right clinic and informed if don t meet criteria sooner

4 St Helens Reporting Outcomes of Care for families accessing Children s Speech and Language Therapy services for them and the opportunity to discuss the risks and benefits of each option. For 2016/17 a CQUIN to support the implementation of this questionnaire in St Helens SALT Children s Services There will be two parts to this CQUIN. 1. The team will use the feedback from the Outcomes of Care questionnaire to inform service provision, eg contacting sample families Gail Mann Improved management of DNA s by service Patients choice of appointment for standard clinics to reduce cancellations for service Service can inform a patient who is involved in their case and where it is up to. Patient / carer involvement in appointment letter design and content Improved contact with service for patients and referrers Improved access for patients and referrers to service information Quicker provision for standard wheelchairs. This CQUIN has been successfully completed, with the final reports due to arrive with teams at the beginning of May 2017; reflecting Quarter 4 data. This CQUIN was designed to support the implementation of the Outcomes of Care questionnaire and a new Team reporting and action planning process. The Outcomes of Care questionnaire was previously codesigned with parents, through the use of in depth interviews, highlighting what was

5 to get more in depth feedback, discussion in team meetings, brief case studies for continuous improvement 2. reports will be made available to teams on a quarterly basis so they can review the data from parent responses important to and for them when accessing services. Each quarter, each clinical team receives a report identifying their scores for the quarter as well as narrative feedback from parents. Each team takes ownership of their own feedback and are encouraged to use it to inform service provision, e.g. contacting sample families to get more in depth feedback, discussion of themes in team meetings, brief case studies for continuous improvement. An additional survey was completed with both team leaders and team members, so that they could comment on the questionnaire, its implementation, and the reporting process. This provided useful feedback and will support us in our development of the tool and reporting process, ensuring that it works effectively for our practitioners, and provides them with the feedback which will help them to develop services.

6 The feedback from families has been largely positive, but we have also found that the tool is sensitive enough to pick up concerns, which enables teams to respond. It has also been helpful to have comparative data from the same clinical service in a different localities, and different clinical services in the same locality, to help understand what the data is telling us. This CQUIN has been successful and discussions are progressing about the viability of implementing the questionnaire and process on a longer term basis. St Helens Delirium Following implementation of guidelines and processes for assessment and treatment of delirium for patients within Newton Inpatients the unit will aim to improve this process by educating health care assistant staff to recognise, escalate and support the treatment of patients experiencing the signs and symptoms of delirium. Maxine Dickinson 100% of HCA s (numbers) now trained and have successfully completed training and competencies. Training extended to therapy staff on Ward and Maple Unit nursing staff.