Quality Health Mental Health Inpatient Survey 2016 Management Report Avon and Wiltshire Mental Health Partnership NHS Produced 4 January 2017 by Quality Health
Avon and Wiltshire Mental Health Partnership NHS Table of Contents Background 3 Introduction 4 Observations and Recommendations 5 Reading the Report 11 A. Introduction to the Ward 13 B. About the Ward 16 C. Hospital Staff 27 D. Care and Treatment 35 E. Your Rights 45 F. Leaving Hospital 49 G. Overall 57 H. About You 60 Demographic Characteristics 62 Survey Results Manual 63 Page 2 of 81
Avon and Wiltshire Mental Health Partnership NHS Background The National Service User Survey (NPS) programme was introduced in 2001 by the Department of Health, and subsequently moved to the Healthcare Commission, and then to the Care Quality Commission in April 2009. There is a rolling programme of service user surveys, which includes acute and non-acute s. Some Mental Health s were first surveyed in 2003 (voluntarily); subsequently the survey (of community service users) has been mandatory. The first national survey of mental health inpatients was in 2009; this survey of inpatients in 2016 was undertaken voluntarily by 19 Mental Health s. The content of the 2016 Mental Health Inpatient Survey is identical to the national surveys run in 2009, 2010, 2011, 2012, 2013, 2014 and 2015. The question content of the National Service User Surveys is determined by the Care Quality Commission (CQC), as is the content of the covering letters that are sent to service users. A national MREC approval letter covers the ethical issues. Send out is normally undertaken on the s behalf by their approved contractor under an information governance agreement specified nationally and agreed between the parties. These arrangements were replicated for the 2016 voluntary survey of mental health in patients. The comparative data displayed in this report is from all the s with Mental Health functions surveyed by Quality Health this year (19 s decided to run the survey). Page 3 of 81
Avon and Wiltshire Mental Health Partnership NHS Introduction The Mental Health Inpatient Survey was undertaken for Avon and Wiltshire Mental Health Partnership NHS between August and November 2016. Questionnaires were sent to a consecutive sample of a maximum of 1,000 adults aged 16 to 64 (inclusive) who had a stay of at least 48 hours in an acute or psychiatric ward at the between 1st July and 31st December 2015. A census of all eligible service users was used if fewer than 1,000 adults aged 16-64 had an inpatient stay during this period. Response Rate 108 completed surveys were returned from the 's sample of 518. A group of 30 service users were excluded for the following reasons: Moved / not known at this address 30 Ineligible 0 Deceased 0 The response rate was 22% (108 usable responses from a usable sample of 488). Report Contents This report contains sections that describe the results from the survey, and sets out the full results in the same format as they appear in the questionnaire. It provides comparisons of the s results against those of other s undertaking the Survey in RAG charts and tables at the end of each section. Due to the nature of this survey, the number of respondents in some s fell below 50. In these cases the response data has to be treated as indicative only. For comparative purposes, the report contains a section comparing the national results from the Mental Health Inpatient Service User Survey to those of the general Inpatient Survey in NHS acute hospitals, where this is possible. This report also pulls together all the report s conclusions and action points into an Executive Summary. The questionnaire provided space for respondents to write their own comments about any aspect of their care. The comments received are set out in a separate supplement to this report. These comments have been anonymised as far as it is possible to do so by the removal of names or other identifying features where these have been included. Page 4 of 81
Avon and Wiltshire Mental Health Partnership NHS Observations and Recommendations Summary 108 service users of Avon and Wiltshire Mental Health Partnership NHS mental health inpatient services submitted completed surveys. Overall out of the 40 scored questions the was rated mainly within the middle 6 of all 19 s surveyed in 2016 by Quality Health. There were a few questions that scored in the upper and lower of s. The has the lowest score for service users feeling enough care was taken of their physical health problems and the highest score for service users being contacted within one week of discharge. Issues to consider include: welcome on arrival; time with psychiatrist; being involved in decisions about care and treatment; service users having their rights explained; and unfair treatment. The should consider examining the longitudinal charts to implement changes on areas where scores are declining, and identify and maintain the scores that have improved. Introduction to the ward 78.8% of service users said they were made to feel welcome on arrival. The highest rated scored 92.3%. Recommendation: Ensure that all service users are made to feel welcome on arrival. 26.7% of service users said that they felt that staff definitely knew about their previous care at the time of admission. The highest rated scored 46.2%. Recommendation: Ensure that, where possible, staff have knowledge of previous care given to service users, either in the community or as inpatients, at the time of admission. 34.6% of service users said they were told completely about the ward routine as soon as they arrived or soon afterwards. The highest rated scored 51%. Recommendation: Ensure that staff orientate service users to the ward effectively, taking into account service users' specific needs. Page 5 of 81
Avon and Wiltshire Mental Health Partnership NHS Observations and Recommendations (continued) About the ward 98.1% said that they did not have to share a sleeping area with service users of the opposite sex this is in the upper of s. 70.1% of service users were never bothered by noise from hospital staff at night. The highest rated scored 85.7%. Recommendation: Consider why some service users say there are high levels of noise from staff at night. If necessary, measure noise levels to ensure that staff are aware of actual levels and can take action where needed. 31.4% of service users said they always felt safe when in hospital. The highest rated scored 64.3%. Recommendation: Ensure that action is taken to increase the number of service users who say they feel safe while in hospital. Service users rating the food as very good / good was 63.5%, this compares to the highest score of 92.3%. Recommendation: Review food quality and the operation of the catering contract. 38.5% of service users said they always got the specific diet they needed when in hospital, the highest score was 10. Recommendation: Ensure that service users with specific dietary requirements get the food they require. 68.2% of service users rated the cleanliness of the ward or room they were in as very clean. 58.3% of service users rated the cleanliness of the toilets and bathrooms as very clean. Both these scores are within the middle 6 of s. Recommendation: Monitor the cleanliness of wards and bathrooms, consider a review of the cleaning contract in light of these scores. 52.1% of service users said they were definitely helped to keep in touch with family or friends, the highest rated scored 71.4%. Recommendation: Ensure that service users families and others close to them are as involved and kept in contact as much as the service user wants them to be. 43.5% of service users said they got all the help they needed from hospital staff with organising their home situation, this is in the middle 6 of s surveyed. Recommendation: Review procedures to ensure that service users receive the help they need with their home situation. Page 6 of 81
Avon and Wiltshire Mental Health Partnership NHS Observations and Recommendations (continued) Hospital Staff 52.4% of service users of Avon and Wiltshire Mental Health Partnership NHS mental health services say they feel that they were always listened to carefully and 39.6% of service users always had confidence and in their psychiatrist. Both these scores are within the middle 6 of 19 similar services surveyed. 40.6% of service users say that they were always given enough time to discuss their condition and treatment with psychiatrists, this is within the lower of s although it has improved slightly since 2015. Recommendation: Seek ways to improve communication between service users and psychiatrists, as a means of addressing issues of confidence and voiced by patients. Where possible ensure that service users have enough time with their psychiatrist(s) to discuss any questions they may have about their condition and treatment. 59.6% felt that they were always treated with respect and dignity by psychiatrists. This is within the middle 6 of s surveyed. This score has slightly declined since 2015 when the score was 62.3%. Recommendation: Look at ways of increasing service users' feeling that they are treated with respect and dignity by psychiatrists. 49.1% of service users of Avon and Wiltshire Mental Health Partnership NHS mental health services said they were always listened to carefully by nurses and 37.7% felt they were always given enough time to discuss their condition and treatment. Both these scores are within the middle 6 of s and have both improved since 2015. 41.1% of service users always had confidence and trust in the nurses, this is also in the middle 6 of s but has declined since 2015 when the score was 50.5% Recommendation: Seek ways to improve communication between service users and nurses, as a means of addressing issues of confidence and voiced by service users. Revisit recruitment, skill mix, and training issues for nurses in the light of the lower scores that mental health nurses receive than general nurses in acute hospitals. 56.1% of service users felt that they were always treated with respect and dignity by nurses. This is within the middle 6 of the 19 similar services surveyed by Quality Health. The score has slightly declined since 2015 when it was 57.4%. Recommendation: Look at ways of increasing service users' feeling that they are treated with respect and dignity by nurses. Page 7 of 81
Avon and Wiltshire Mental Health Partnership NHS Observations and Recommendations (continued) Care and Treatment 39.6% of service users of Avon and Wiltshire Mental Health Partnership NHS feel they were given a complete explanation about the purpose of their medication, and 24.7% were given a complete understandable explanation of possible side effects. These are both within the middle 6 of 19 similar services surveyed by Quality Health. Recommendation: Ensure that all service users are given information on the purposes of medications for their condition, and about any relevant and significant side effects they may encounter, as this issue is known to be one of the most important issues from the service users' perspective. 52.8% of service users said they were always given enough privacy when discussing their condition or treatment with hospital staff. The highest scoring was 85.7%. Recommendation: Look at ways of improving privacy for service users when discussing their condition or treatment with them. 25.7% of service users said they were definitely involved as much as they wanted in decisions about their care and treatment, this is within the lower of s surveyed. The score has declined from 2015 when it was 30.3%. Recommendation: Seek ways to improve participation of service users in decisions about their care and treatment. 32.1% said they had talking therapy during their stay in hospital, this has improved from 2015 when the score was 26.9%. 52.9% of those having talking therapy said they definitely found it helpful. Both these scores are within the middle 6 of s. Recommendation: Review provision of talking therapies, and continue improvement ensuring that those wanting talking therapy receive it. Service users were asked if they had enough activities during the week and at weekends. 24.3% said there were enough activities all the time during the day on weekdays and 11.2% said there were enough activities all the time in the evenings and/or weekends. Both these scores are within the middle 6 of s and both scores have declined since 2015. Recommendation: Look at ways of increasing the provision of activities for service users both on weekdays and, more importantly, during evenings and weekends. The score for service users definitely feeling enough care was taken of their physical health is 34.2%, this is the lowest score out of all the s surveyed and it has declined from 45% in 2015. Recommendation: Review how care, advice, information and access, for meeting service users physical health needs e.g. disability, long standing condition, injury is offered. Page 8 of 81
Avon and Wiltshire Mental Health Partnership NHS Observations and Recommendations (continued) Your rights Of those service users responding who said they were detained under the Mental Health Act, 27.6% said they had their rights explained to them completely. This is in the lower of s and has declined since 2015 when it was 5. Recommendation: Ensure that all service users detained under the Mental Health Act are given information on their rights under the Act at the time of being sectioned. 54% of service users said they were made aware of how they could make a complaint if they had one. The highest rated scored 77.3%. Recommendation: Ensure that all service users are given information about how to make a complaint if they were to have one. 55.6% of service users did not feel they were treated unfairly when in hospital. This is in the lower of s. Those that did feel they were unfairly treated gave a range of reasons including age, sex, ethnicity, religion, sexual orientation or disability. Recommendation: Investigate reasons for service users feeling unfairly treated while in hospital. Page 9 of 81
Avon and Wiltshire Mental Health Partnership NHS Observations and Recommendations (continued) Leaving Hospital 74% of service users felt they were given enough notice of their discharge and 77.4% of service users did not experience a delay with their discharge and 53.1% felt that staff took their family/home situation into account completely when planning their discharge. these scores are within the middle 6 of s who were surveyed. Recommendation: Ensure that service users are given enough notice of discharge from hospital. Recommendation: Look at ways of reducing delays in discharge, especially in relation to the speed with which medication prescriptions are available. Review the way in which discharge medication is ordered and delivered to the service user with a view to reducing delays or improving efficiency of the process. 73.3% had the number of someone they could contact out of hours. 76.3% of service users said they were given information about what to do regarding crisis support once they were discharged, both these score are in the middle 6 of s surveyed. Both scores show a slight decline since 2015. Recommendation: Ensure that all service users have an effective, local, out-of-hours phone number before they leave the ward. Recommendation: Ensure that all service users are given information about getting help in a crisis from local mental health services. Review arrangements for ensuring users know who to contact during out of office hours if they have a crisis. Consider ways of making this information more accessible and understandable. 92.3% of service users say they were contacted by a member of the mental health team since they had been discharged. The score for service users saying they were contacted within one week of discharge is 86.1 %, this is the highest scoring of the 19 surveyed. Overall 51.4% of service users rated their overall care during their stay as excellent / very good. The highest rated scored 92.9% and the lowest 36.6%. Recommendation: Examine the reasons for average scores on overall experience. Drill down into data to look for areas of care which are scored low and for any pockets of poor ratings from different groups or locations. Page 10 of 81
Avon and Wiltshire Mental Health Partnership NHS Reading the Report Important Note - Scored Questions For each scored question in the survey, the individual responses are converted into scores on a scale from to 10. A score of 10 represents the best possible response and a score of the worst. The higher the score for each question, the better the trust is performing. It is not appropriate to score all questions in the questionnaire as not all of the questions assess the trusts in any way, for example, they may be may be 'routing questions' designed to filter out respondents to whom following questions do not apply. An example of a routing question is Q23 (In the last 12 months, have you been receiving any medicines for your mental health needs? ). Benchmark Charts and Tables - Scored Questions Only The benchmark charts (example below) show results for scored questions only. <Example chart here> Each scored question has a bar that represents the range of results across all s that took part in the survey with Quality Health. The bar is divided into three segments as follows: A red section: the lowest-scoring of s An amber section: the intermediate 6 of s A green section: the highest-scoring of s The black circle represents the score for the. If the circle is in the green section of the bar, it means that the is among the top of s surveyed by Quality Health for that question. The line on either side of the circle shows the 95% confidence interval (the degree of uncertainty surrounding the 's score). For the majority of questions, a positive measure is taken. However, a small number of questions are scored negatively. These negative questions are highlighted with a red border and a shaded background. For example: "During your most recent stay, did you ever share a sleeping area, for example a room or bay, with patients of the opposite sex?" - For this question the 'No' response is scored. Page 11 of 81
Avon and Wiltshire Mental Health Partnership NHS Reading the Report (continued) Under each benchmark chart is a data table, detailing the following: The first column shows the question number and question text The second column shows the lowest score achieved across all s in the Quality Health database The third column shows the highest value in the lowest scoring of s (i.e. the threshold or end of the red segment of the chart); The fourth column shows the lowest value in the highest scoring of s (i.e. the threshold or start of the green segment on the chart); The fifth column displays the highest score achieved across all s in the Quality Health database The sixth column shows the base size or number of respondents for the question/ The seventh column shows the 's score for this year (as depicted by the black circle on the chart) The final column shows a RAG rating indicator. If a 's score falls within the lowest of scores for that question, a red dot will be displayed. If a 's score falls within the intermediate 6 of scores for that question, an amber dot will be displayed. If a 's score falls within the highest of scores for that question, a green dot will be displayed. If the 's score is supressed, no RAG rating is displayed. <Example data table here> Longitudinal Charts - Scored Questions Only Each scored question has a longitudinal chart showing the 2014, 2015 and 2016 scores for the plotted against the equivalent score for all s surveyed by Quality Health. Compositional Charts - Raw Data - Questions The compositional chart uses data as reported in the Survey Results Manual (frequency tables) at the end of this report. It shows the range of responses to the specified question for the organisation and for all similar organisations in the Quality Health database (survey average). The vertical scale is always 0-10. These charts exclude any non specific responses such as don t know / can t remember. Suppression scores within the benchmark charts and tables, and longitudinal charts pages are supressed if fewer than 11 respondents have answered an individual question. When scores are supressed, no RAG rating is assigned. Page 12 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS A. Introduction to the Ward - Benchmark Charts and Tables 1. Made to feel welcome on arrival by staff 2. Staff definitely knew about previous care received 3. Told completely about the ward routine on arrival 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 1. Made to feel welcome on arrival by staff 71.4% 79.1% 87.9% 92.3% 85 78.8% 2. Staff definitely knew about previous care received 12.7% 22.8% 31.6% 46.2% 90 26.7% 3. Told completely about the ward routine on arrival 25.8% 29.9% 44.1% 51. 107 34.6% Page 13 of 81
Avon and Wiltshire Mental Health Partnership NHS A. Introduction to the Ward - Longitudinal Charts 1. Made to feel welcome on arrival by staff 10 9 7 6 5 4 3 1 82.4% 84.5% 82.1% 84.7% 84.9% 78.8% 2014 2015 2016 2. Staff definitely knew about previous care received 10 9 7 6 5 4 3 1 24.3% 27.5% 26.2% 16. 28.7% 26.7% 2014 2015 2016 3. Told completely about the ward routine on arrival 10 9 7 6 5 4 3 1 35.2% 37.5% 36. 33. 33.9% 34.6% 2014 2015 2016 Page 14 of 81
Avon and Wiltshire Mental Health Partnership NHS A. Introduction to the Ward - Compositional Charts 1. When you arrived on the ward, did staff make you feel welcome? 10 9 7 6 5 4 3 1 79% 82% 21% 18% 21% 17% Yes No Can t remember 2. When you arrived on the ward, did you feel that the staff knew about you and any previous care you had received? 10 9 7 6 5 4 3 1 46% 43% 27% 26% 28% 31% 17% 14% Yes, definitely Yes, to some extent No Don t know / Can t remember 3. When you arrived on the ward, or soon afterwards, did a member of staff tell you about the daily routine of the ward, such as times of meals and visitors times? 10 9 7 6 5 4 3 1 35% 36% 32% 34% 34% Yes, completely Yes, to some extent No 3 Page 15 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Benchmark Charts and Tables 4. Did not share a sleeping area with opposite sex 5. Never bothered by noise at night from staff 6. Always felt safe in hospital 7. Hospital food very good / good 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 4. Did not share a sleeping area with opposite sex 83.7% 89. 97.1% 100. 108 98.1% 5. Never bothered by noise at night from staff 61.2% 70.1% 78.4% 85.7% 107 70.1% 6. Always felt safe in hospital 22.2% 31.1% 40.7% 64.3% 105 31.4% 7. Hospital food very good / good 40.4% 52.3% 70.8% 92.3% 104 63.5% Page 16 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Benchmark Charts and Tables (continued) 9. Always able to get specific dietary needs 10. Hospital ward or room very clean 11. Toilets and bathrooms very clean 12. Hospital definitely helped keep in touch with family 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 9. Always able to get specific dietary needs 12.5% 28.2% 60.3% 100. 26 38.5% 10. Hospital ward or room very clean 36.2% 50. 68.8% 92.9% 107 68.2% 11. Toilets and bathrooms very clean 25.3% 41.5% 61. 88.9% 108 58.3% 12. Hospital definitely helped keep in touch with family 29.4% 38.8% 52.8% 71.4% 96 52.1% Page 17 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Benchmark Charts and Tables (continued) 14. Received all the help needed from staff with home situation 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 14. Received all the help needed from staff with home situation 0. 22.5% 58.3% 70. 23 43.5% Page 18 of 81
Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Longitudinal Charts 4. Did not share a sleeping area with opposite sex 10 9 7 6 5 4 3 1 92.1% 91.1% 93.3% 93.2% 91. 98.1% 2014 2015 2016 5. Never bothered by noise at night from staff 10 9 7 6 5 4 3 1 74.9% 75.3% 72.1% 70.1% 66.7% 70.1% 2014 2015 2016 6. Always felt safe in hospital 10 9 7 6 5 4 3 1 40.2% 39.6% 36.8% 34.1% 40.5% 31.4% 2014 2015 2016 Page 19 of 81
Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Longitudinal Charts (continued) 7. Hospital food very good / good 10 9 7 6 5 4 3 1 59.9% 61.1% 60.3% 59.8% 61.8% 63.5% 2014 2015 2016 9. Always able to get specific dietary needs 10 9 7 6 5 4 3 1 38.7% 38.3% 42.2% 53.3% 31.8% 38.5% 2014 2015 2016 Page 20 of 81
Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Longitudinal Charts (continued) 10. In your opinion, how clean was the hospital room or ward that you were in? 10 9 7 6 5 4 3 1 56.9% 54.8% 58.2% 61.8% 54.6% 68.2% 2014 2015 2016 11. How clean were the toilets and bathrooms that you used in hospital? 10 9 7 6 5 4 3 1 47.4% 45.4% 47.7% 58. 56.9% 58.3% 2014 2015 2016 12. Do you feel the hospital helped you to keep in touch with family or friends? 10 9 7 6 5 4 3 1 45.6% 44.9% 45.1% 52.1% 38. 34.3% 2014 2015 2016 Page 21 of 81
Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Longitudinal Charts (continued) 14. Did you receive the help you needed from hospital staff with organising your home situation? 10 9 7 6 5 4 3 1 42.9% 45.2% 44. 54.8% 43.5% 29.4% 2014 2015 2016 Page 22 of 81
Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Compositional Charts 4. During your most recent stay, did you ever share a sleeping area, for example a room or bay, with patients of the opposite sex? 10 9 7 6 5 4 3 1 2% Yes 7% 98% No 93% 5. During your most recent stay, were you ever bothered by noise at night from hospital staff? 10 9 7 6 5 4 3 1 3 Yes 28% 7 No 72% 6. During your most recent stay, did you feel safe? 10 9 7 6 5 4 3 1 49% 44% 37% 31% 19% Yes, always Yes, sometimes No Page 23 of 81
Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Compositional Charts 7. How would you rate the hospital food? 10 9 7 6 5 4 3 1 24% 26% 39% 35% 24% 25% 13% 14% Very good Good Fair Poor I did not have any hospital food 3% 3% 8. Do you have a specific diet, for example because of your cultural or religious beliefs, because you have a particular health condition, or through personal choice? 10 9 7 6 5 4 3 1 23% Yes 77% No 9. Were you able to get the specific diet that you needed from the hospital? 10 9 7 6 5 4 3 1 42% 38% 38% 38% 23% 19% Yes, always Yes, sometimes No, never Page 24 of 81
Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Compositional Charts (continued) 10. In your opinion, how clean was the hospital room or ward that you were in? 10 9 7 6 5 4 3 1 68% 58% 35% 27% 4% 5% 1% 2% Very clean Fairly clean Not very clean Not at all clean 11. How clean were the toilets and bathrooms that you used in hospital? 10 9 7 6 5 4 3 1 58% 48% 33% 37% 11% 6% 3% 4% Very clean Fairly clean Not very clean Not at all clean I did not use a toilet or bathroom 12. Do you feel the hospital helped you to keep in touch with family or friends? 10 9 7 6 5 4 3 1 52% 45% 39% 34% 14% 16% 11% 13% Yes, definitely Yes, to some extent No, but I would have liked help No, and I did not need help Page 25 of 81
Avon and Wiltshire Mental Health Partnership NHS B. About the Ward - Compositional Charts (continued) 13. During your most recent stay, did you need any help from hospital staff with organising your home situation? 10 9 7 6 5 4 3 1 22% Yes 23% 78% No 77% 14. Did you receive the help you needed from hospital staff with organising your home situation? 10 9 7 6 5 4 3 1 43% 44% 43% 32% 24% 13% I received all the help I needed I received some of the help I needed I did not receive any help Page 26 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS C. Hospital Staff - Benchmark Charts and Tables 15. Psychiatrist always listened carefully 16. Always given enough time to discuss condition and treatment with psychiatrist 17. Always had confidence and trust in the psychiatrist 18. Always treated with respect and dignity by psychiatrist 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 15. Psychiatrist always listened carefully 38.9% 43.6% 58.6% 84.6% 103 52.4% 16. Always given enough time to discuss condition and treatment with psychiatrist 30.3% 40.6% 54.2% 69.2% 101 40.6% 17. Always had confidence and trust in the psychiatrist 31.9% 37.8% 51.2% 69.2% 101 39.6% 18. Always treated with respect and dignity by psychiatrist 52.1% 59.6% 74.1% 92.3% 104 59.6% Page 27 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS C. Hospital Staff - Benchmark Charts and Tables 19. Nurses always listened carefully 20. Always given enough time to discuss condition and treatment with nurses 21. Always had confidence and trust in the nurses 22. Always treated with respect and dignity by the nurses 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 19. Nurses always listened carefully 30. 40.8% 53.4% 85.7% 106 49.1% 20. Always given enough time to discuss condition and treatment with nurses 22.2% 33.3% 49.5% 71.4% 106 37.7% 21. Always had confidence and trust in the nurses 22.2% 37. 53.1% 71.4% 107 41.1% 22. Always treated with respect and dignity by the nurses 45.2% 51.3% 63.8% 84.6% 107 56.1% Page 28 of 81
Avon and Wiltshire Mental Health Partnership NHS C. Hospital Staff - Longitudinal Charts 15. Psychiatrist always listened carefully 10 9 7 6 5 4 3 1 50.2% 51.8% 51.6% 51.8% 52.4% 52.4% 2014 2015 2016 16. Always given enough time to discuss condition and treatment with psychiatrist 10 9 7 6 5 4 3 1 43.5% 46.7% 44.9% 41.2% 38.8% 40.6% 2014 2015 2016 17. Always had confidence and trust in the psychiatrist 10 9 7 6 5 4 3 1 42.2% 43.3% 42.8% 36.5% 42.3% 39.6% 2014 2015 2016 Page 29 of 81
Avon and Wiltshire Mental Health Partnership NHS C. Hospital Staff - Longitudinal Charts (continued) 18. Always treated with respect and dignity by psychiatrist 10 9 7 6 5 4 3 1 64.4% 65.6% 64.8% 61.6% 62.3% 59.6% 2014 2015 2016 19. Nurses always listened carefully 10 9 7 6 5 4 3 1 45.4% 48.4% 47.4% 38.6% 47.7% 49.1% 2014 2015 2016 20. Always given enough time to discuss condition and treatment with nurses 10 9 7 6 5 4 3 1 38.3% 39.2% 40.1% 37.1% 34.5% 37.7% 2014 2015 2016 Page 30 of 81
Avon and Wiltshire Mental Health Partnership NHS C. Hospital Staff - Longitudinal Charts (continued) 21. Always had confidence and trust in the nurses 10 9 7 6 5 4 3 1 43.1% 46.9% 43.8% 37.5% 50.5% 41.1% 2014 2015 2016 22. Always treated with respect and dignity by the nurses 10 9 7 6 5 4 3 1 58.1% 58.2% 56.2% 53.9% 57.4% 56.1% 2014 2015 2016 Page 31 of 81
Avon and Wiltshire Mental Health Partnership NHS C. Hospital Staff - Compositional Charts 15. Did the psychiatrist(s) listen carefully to you? 10 9 7 6 5 4 3 1 52% 52% 35% 31% 18% 13% 3% 3% Yes, always Yes, sometimes No Did not see a psychiatrist 16. Were you given enough time to discuss your condition and treatment with the psychiatrist(s)? 10 9 7 6 5 4 3 1 45% 41% 38% 32% 22% 24% Yes, always Yes, sometimes No 17. Did you have confidence and trust in the psychiatrist? 10 9 7 6 5 4 3 1 4 43% 32% 32% 29% 25% Yes, always Yes, sometimes No Page 32 of 81
Avon and Wiltshire Mental Health Partnership NHS C. Hospital Staff - Compositional Charts (continued) 18. Did the psychiatrist(s) treat you with respect and dignity? 10 9 7 6 5 4 3 1 65% 6 28% 24% 13% 11% Yes, always Yes, sometimes No 19. Did the nurses listen carefully to you? 10 9 7 6 5 4 3 1 49% 47% 42% 4 13% 8% Yes, always Yes, sometimes No 20. Were you given enough time to discuss your condition and treatment with the nurses? 10 9 7 6 5 4 3 1 44% 38% 4 37% 23% 18% Yes, always Yes, sometimes No Page 33 of 81
Avon and Wiltshire Mental Health Partnership NHS C. Hospital Staff - Compositional Charts (continued) 21. Did you have confidence and trust in the nurses? 10 9 7 6 5 4 3 1 41% 44% 4 39% 19% 17% Yes, always Yes, sometimes No 22. Did the nurses treat you with respect and dignity? 10 9 7 6 5 4 3 1 56% 56% 33% 34% 11% 1 Yes, always Yes, sometimes No Page 34 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Benchmark Charts and Tables 24. Purposes of medications explained completely 25. Told completely about the side effects of the medication 26. Always given enough privacy when discussing condition or treatment 27. Definitely involved as much as wanted in decisions about care and treatment 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 24. Purposes of medications explained completely 30.8% 36.1% 47.9% 58.3% 91 39.6% 25. Told completely about the side effects of the medication 8.7% 21.5% 32.9% 38.9% 89 24.7% 26. Always given enough privacy when discussing condition or treatment 29.6% 51. 65.9% 85.7% 106 52.8% 27. Definitely involved as much as wanted in decisions about care and treatment 14. 26.3% 39.2% 69.2% 105 25.7% Page 35 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Benchmark Charts and Tables (continued) 29. Had talking therapy if wanted 30. Definitely found talking therapy helpful 31. Enough activities available all of the time on weekdays 32. Enough activities available all of the time in evenings and on weekends 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 29. Had talking therapy if wanted 17.9% 21.9% 42. 50. 106 32.1% 30. Definitely found talking therapy helpful 33.3% 37. 65.1% 77.8% 34 52.9% 31. Enough activities available all of the time on weekdays 16.3% 19.7% 31.4% 39.3% 107 24.3% 32. Enough activities available all of the time in evenings and on weekends 0. 9. 20.6% 22.7% 107 11.2% Page 36 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Benchmark Charts and Tables (continued) 34. Definitely felt enough care taken of physical health 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 34. Definitely felt enough care taken of physical health 34.2% 41.8% 54.1% 72.7% 73 34.2% Page 37 of 81
Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Longitudinal Charts 24. Purposes of medications explained completely 10 9 7 6 5 4 3 1 42.9% 42.5% 42.3% 39.5% 42.9% 39.6% 2014 2015 2016 25. Told completely about the side effects of the medication 10 9 7 6 5 4 3 1 25.1% 25.7% 26.1% 22.4% 24.5% 24.7% 2014 2015 2016 26. Always given enough privacy when discussing condition or treatment 10 9 7 6 5 4 3 1 55.4% 57.3% 56.5% 56.2% 55.1% 52.8% 2014 2015 2016 Page 38 of 81
Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Longitudinal Charts (continued) 27. Definitely involved as much as wanted in decisions about care and treatment 10 9 7 6 5 4 3 1 32.9% 32.2% 32.5% 34.1% 30.3% 25.7% 2014 2015 2016 29. Had talking therapy if wanted 10 9 7 6 5 4 3 1 27. 28.2% 31.6% 25.6% 26.9% 32.1% 2014 2015 2016 30. Definitely found talking therapy helpful 10 9 7 6 5 4 3 1 49.7% 52.3% 49.5% 45.5% 55.2% 52.9% 2014 2015 2016 Page 39 of 81
Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Longitudinal Charts (continued) 31. Enough activities available all of the time on weekdays 10 9 7 6 5 4 3 1 25.7% 27.1% 25.8% 22.4% 26.2% 24.3% 2014 2015 2016 32. Enough activities available all of the time in evenings and on weekends 10 9 7 6 5 4 3 1 14.4% 16. 15.1% 8. 15.7% 11.2% 2014 2015 2016 34. Definitely felt enough care taken of physical health 10 9 7 6 5 4 3 1 42.7% 45.7% 47. 34.9% 45. 34.2% 2014 2015 2016 Page 40 of 81
Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Compositional Charts 23. During your most recent stay, were you given any medication (including tablets, medicines and injections) as part of the treatment for your mental health? 10 9 7 6 5 4 3 1 92% Yes 95% 8% No 5% 24. Did the hospital staff explain the purpose of this medication in a way you could understand? 10 9 7 6 5 4 3 1 4 42% 36% 33% 27% 22% 4% 7% Yes, completely Yes, to some extent No I did not need an explanation 25. Did the hospital staff explain the possible side effects of this medication in a way you could understand? 10 9 7 6 5 4 3 1 52% 46% 25% 26% 28% 24% 6% 8% Yes, completely Yes, to some extent No I did not need an explanation Page 41 of 81
Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Compositional Charts (continued) 26. Were you given enough privacy when discussing your condition or treatment with the hospital staff? 10 9 7 6 5 4 3 1 57% 53% 34% 3 13% 13% Yes, always Yes, sometimes No 27. Were you involved as much as you wanted to be in decisions about your care and treatment? 10 9 7 6 5 4 3 1 45% 42% 33% 3 26% 26% Yes, definitely Yes, to some extent No 28. During your stay in hospital, did you ever want talking therapy? 10 9 7 6 5 4 3 1 54% Yes 56% 46% No 44% Page 42 of 81
Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Compositional Charts (continued) 29. During your stay in hospital, did you have talking therapy? 10 9 7 6 5 4 3 1 32% Yes 32% 68% No 68% 30. If you had talking therapy during your stay in hospital, did you find it helpful? 10 9 7 6 5 4 3 1 53% 5 38% 39% 9% 11% Yes, definitely Yes, to some extent No 31. During your most recent stay, were there enough activities available for you to do during the day on weekdays (Monday to Friday)? 10 9 7 6 5 4 3 1 45% 41% 31% 33% 24% 26% Yes, all of the time Yes, some of the time No Page 43 of 81
Avon and Wiltshire Mental Health Partnership NHS D. Your Care and Treatment - Compositional Charts (continued) 32. During your most recent stay, were there enough activities available for you to do during evenings and/or weekends? 10 9 7 6 5 4 3 1 61% 49% 35% 28% 15% 11% Yes, all of the time Yes, some of the time No 33. During your most recent stay, did you have any medical tests about your physical health (e.g. having your blood pressure measures or having a blood or unine test)? 10 9 7 6 5 4 3 1 91% 9 9% 1 7% 5% Yes No Don't know 34. During your most recent stay, do you feel that enough care was taken of any physical health problems you had (e.g. diabetes, asthma, heart disease)? 10 9 7 6 5 4 3 1 34% 47% 4 31% 26% 3 22% 25% Yes, definitely Yes, to some extent No I did not have any physical health problems Page 44 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS E. Your Rights - Benchmark Charts and Tables 36. When sectioned, rights were explained completely 37. Made aware of how to make a complaint if had one 38. Did not feel unfairly treated for any of the reasons given 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 36. When sectioned, rights were explained completely 15.4% 32.6% 47.7% 70. 58 27.6% 37. Made aware of how to make a complaint if had one 37.3% 43.4% 59.1% 77.3% 87 54. 38. Did not feel unfairly treated for any of the reasons given 50. 55.8% 69.7% 85.7% 108 55.6% Page 45 of 81
Avon and Wiltshire Mental Health Partnership NHS E. Your Rights - Longitudinal Charts 36. When sectioned, rights were explained completely 10 9 7 6 5 4 3 1 39.7% 39.1% 39.3% 50. 35.3% 27.6% 2014 2015 2016 37. Made aware of how to make a complaint if had one 10 9 7 6 5 4 3 1 50.7% 53.2% 51.1% 43.7% 51.2% 54. 2014 2015 2016 38. Did not feel unfairly treated for any of the reasons given 10 9 7 6 5 4 3 1 56.4% 58.4% 60.9% 45.6% 53.6% 55.6% 2014 2015 2016 Page 46 of 81
Avon and Wiltshire Mental Health Partnership NHS E. Your Rights - Compositional Charts 35. At any time during your most recent admission were you detained (sectioned) under the Mental Health Act? 10 9 7 6 5 4 3 1 69% 55% 45% 31% 6% 6% Yes No Don't know 36. When you were detained (sectioned), or soon after, were your rights explained to you in a way that you could understand? 10 9 7 6 5 4 3 1 39% 4 35% 33% 28% 26% 17% 13% Yes, completely Yes, to some extent No Don t know / Can t remember 37. During your most recent stay, were you made aware of how you could make a complaint if you had one? 10 9 7 6 5 4 3 1 54% 51% 46% 49% 19% 18% Yes No Don t know / Can t remember Page 47 of 81
Avon and Wiltshire Mental Health Partnership NHS E. Your Rights - Compositional Charts (continued) 38. During your most recent stay, do you feel that you were treated unfairly because of any of the reasons below? 10 9 7 6 5 4 3 1 6% 5% 3% 3% 6% 5% 4% 3% 5% 3% Your age Your sex Your race / ethnic background Your religion Your sexual orientation 9% 7% 11% 11% A disability that you have Another reason 61% 56% None of these Page 48 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS F. Leaving Hospital - Benchmark Charts and Tables 39. Given enough notice of discharge from hospital 40. Discharge not delayed for any reason 42. Staff took home situation into account completely 43. Have out of hours phone number 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 39. Given enough notice of discharge from hospital 60.7% 64.6% 81.8% 85.7% 100 74. 40. Discharge not delayed for any reason 62.5% 71.4% 82.6% 88.9% 106 77.4% 42. Staff took home situation into account completely 27.8% 43.4% 54. 66.7% 96 53.1% 43. Have out of hours phone number 55.6% 63.1% 81.2% 88.3% 101 73.3% Page 49 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS F. Leaving Hospital - Benchmark Charts and Tables (continued) 44. Given information about getting help in crisis 45. Have been contacted by MH team since discharge 46. Contacted by MH team within one week of discharge 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 44. Given information about getting help in crisis 50. 73.7% 80. 86.7% 97 76.3% 45. Have been contacted by MH team since discharge 52.3% 77.9% 91.5% 95.9% 104 92.3% 46. Contacted by MH team within one week of discharge 40. 56.1% 80.5% 86.1% 79 86.1% Page 50 of 81
Avon and Wiltshire Mental Health Partnership NHS F. Leaving Hospital - Longitudinal Charts 39. Given enough notice of discharge from hospital 10 9 7 6 5 4 3 1 71.1% 75.4% 72.9% 71.3% 73. 74. 2014 2015 2016 40. Discharge not delayed for any reason 10 9 7 6 5 4 3 1 76.2% 78.7% 76.6% 74.7% 81.7% 77.4% 2014 2015 2016 42. Staff took home situation into account completely 10 9 7 6 5 4 3 1 46.1% 51.3% 48.1% 54.3% 57.9% 53.1% 2014 2015 2016 Page 51 of 81
Avon and Wiltshire Mental Health Partnership NHS F. Leaving Hospital - Longitudinal Charts (continued) 43. Have out of hours phone number 10 9 7 6 5 4 3 1 75.8% 72.7% 72.6% 76.3% 76.8% 73.3% 2014 2015 2016 44. Given information about getting help in crisis 10 9 7 6 5 4 3 1 73.4% 75.5% 74.7% 76.3% 81. 76.3% 2014 2015 2016 45. Have been contacted by MH team since discharge 10 9 7 6 5 4 3 1 85.1% 84.1% 82.1% 94. 88.9% 92.3% 2014 2015 2016 Page 52 of 81
Avon and Wiltshire Mental Health Partnership NHS F. Leaving Hospital - Longitudinal Charts (continued) 46. Contacted by MH team within one week of discharge 10 9 7 6 5 4 3 1 76.6% 76.3% 71.6% 80. 86.1% 71.6% 2014 2015 2016 Page 53 of 81
Avon and Wiltshire Mental Health Partnership NHS F. Leaving Hospital - Compositional Charts 39. Do you think you were you given enough notice of your discharge from hospital? 10 9 7 6 5 4 3 1 74% 73% 26% 27% 7% 7% Yes No Don't know 40. Once you were due to leave hospital, was your discharge delayed for any reason? 10 9 7 6 5 4 3 1 23% Yes 23% 77% No 77% 41. What was the MAIN reason for the delay? 10 9 7 6 5 4 3 1 32% 33% I had to wait to see a doctor or nurse in charge of the ward 5% 12% I had to wait for suitable accommodation I had to wait for financial help 9% 6% I had to wait for community services to become available? 55% 48% Something else Page 54 of 81
Avon and Wiltshire Mental Health Partnership NHS F. Leaving Hospital - Compositional Charts (continued) 42. As far as you know, did hospital staff take your family or home situation into account when planning your discharge from hospital? 10 9 7 6 5 4 3 1 53% 48% 32% 32% 15% 1 11% Yes, completely Yes, to some extent No Don t know / Can t remember 43. Do you have the number of someone from your local NHS mental health service that you can phone out of office hours? 10 9 7 6 5 4 3 1 73% 73% 27% 27% 9% 3% Yes No Don t know / Can t remember 44. Before you left hospital, were you given information about how to get help in a crisis, or when urgent help is needed? 10 9 7 6 5 4 3 1 76% 75% 24% 25% 9% 1 Yes No Don t know / Can t remember Page 55 of 81
Avon and Wiltshire Mental Health Partnership NHS F. Leaving Hospital - Compositional Charts (continued) 45. Have you been contacted by a member of the mental health team since you left hospital? 10 9 7 6 5 4 3 1 92% 82% 18% 8% 3% 4% Yes No Don t know / Can t remember 46. About how long after you left hospital were you contacted? 10 9 7 6 5 4 3 1 86% 72% 8% 17% 3% 3% 4% 9% 17% 15% One week or less Two weeks Three weeks Four weeks or longer Don t know / Can t remember Page 56 of 81
Number of Respondents Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS G. Overall - Benchmark Charts and Tables 47. Overall care during stay excellent / very good 1 3 4 5 6 7 9 10 Lower Higher This 2016 Lowest Scoring Lowest Threshold Highest Threshold Highest Scoring Score RAG Rating 47. Overall care during stay excellent / very good 36.6% 42.5% 56.6% 92.9% 105 51.4% Page 57 of 81
Avon and Wiltshire Mental Health Partnership NHS G. Overall - Longitudinal Charts 47. Overall care during stay excellent / very good 10 9 7 6 5 4 3 1 48.7% 50.2% 48.9% 45.2% 54.3% 51.4% 2014 2015 2016 Page 58 of 81
Avon and Wiltshire Mental Health Partnership NHS G. Overall - Compositional Charts 47. Overall, how would you rate the care you received during your recent stay in hospital? 10 9 7 6 5 4 3 1 34% 29% 22% 17% 22% 12% 15% 14% 14% Excellent Very good Good Fair Poor Page 59 of 81
Avon and Wiltshire Mental Health Partnership NHS H. About You - Compositional Charts 50. In general, how is your mental health right now? 10 9 7 6 5 4 3 1 22% 24% 27% 27% 14% 14% 16% 14% 17% 14% 4% 5% Excellent Very good Good Fair Poor Very poor 51. Other than your mental health condition, do you have any of the following longstanding conditions? 10 9 7 6 5 4 3 1 6% Deafness or severe hearing impairment 6% 2% 4% Blindness or partially sighted 28% 26% A long-standing physical condition 5% 8% A learning disability 15% 8% A long-standing illness 57% 52% No, I do not have a long-standing condition 52. Does your physical or mental health cause you difficulty with any of the following? 10 9 7 6 5 4 3 1 56% 49% Everyday activities that people your age can usually do 35% 36% At work, in education, or training 15% 14% Access to buildings, streets or vehicles 19% 18% 44% 38% Reading or writing People s attitudes to you because of your condition 6 54% Communicating, mixing with others, or socialising Page 60 of 81
Avon and Wiltshire Mental Health Partnership NHS H. About You - Compositional Charts (continued) 53. Are you currently in paid work? 10 9 7 6 5 4 3 1 22% 17% Yes 3% 3% Yes, but I am currently on sick leave 65% 6 5% 6% 8% 7% No No, I am retired No, but I work on a casual or voluntary basis 2% 2% No, but I am a fulltime student 54. Who was the main person or people that filled in this questionnaire? 10 9 7 6 5 4 3 1 81% 82% The service user/client (named on the front of the envelope) 4% A friend or relative of the service user/client 8% 9% 7% 7% 4% Both service user/client and friend/relative together The service user/client with the help of a health professional Page 61 of 81
Avon and Wiltshire Mental Health Partnership NHS Demographic Characteristics Gender Male Female 39% 46% 54% 61% 1 3 4 5 6 7 9 10 Age Group Aged 16-24 Aged 25-34 Aged 35-44 Aged 45-54 Aged 55-64 Aged 65-74 Aged 75-84 Aged 85+ 1% 1% 6% 7% 19% 16% 22% 23% 3 28% 22% 25% 1 3 4 5 6 7 9 10 Ethnic Group White 85% 89% Multiple ethnic group Asian or Asian British Black or Black British Arab or other ethnic group 6% 4% 2% 6% 4% 5% 1% 1 3 4 5 6 7 9 10 Page 62 of 81
Survey Results Manual This section of the report sets out the results from the 2016 Mental Health Acute Inpatient Service User Survey for Avon and Wiltshire Mental Health Partnership NHS, ordered in exactly the same way as the survey questionnaire sent to service users. the figures shown are derived from the raw, Reading the columns of figures The results are shown firstly in absolute numbers (#) then as percentage responses (%). The first two columns show the data for the last time your organisation participated in the survey, the next two columns show your organisation's data for the current survey and the final two columns show the data for the other Quality Health client organisations participating in the survey. The purpose of presenting the figures in this way is to give a direct, at-a-glance, comparison between the organisation's 2016 results and the overall results from the Quality Health client database for this survey. Conventions The percentages are calculated after excluding those respondents that did not answer that particular question. percentages are rounded to the nearest whole number. When added together, the percentages for all answers to a particular question may not total 10 because of this rounding. The Missing figures show the number of respondents who did not reply to that particular question. In some cases, the Missing figure is quite high because it includes respondents who did not answer that question or group of questions because it was not applicable to their circumstances (e.g. Q30). On some questions there are also some figures/responses which are italicised and marked with an asterisk. These figures have been recalculated to exclude responses where the question was not applicable to the respondent's circumstances, or they felt unable to give a definite answer. For example, on questions such as Q1 about whether staff made the patient feel welcome when they arrived on the ward, those not answering (Missing) and those saying "Can't remember" are excluded from the percentage calculated for the asterisked responses. Changes made to the data There are a number of questions which are routed (i.e. where respondents are directed to a subsequent question depending on their answer to the lead question). Sometimes there are conflicts in the answers that respondents give to these questions and the data is corrected to account for this. For example, if response 2 in question 8 is ticked and the respondent goes on to answer questions 9 onwards, then any data entered for question 9 will be deleted as the respondent should not have answered it. Mental Health Acute Inpatient Service User Survey 2016 Avon and Wiltshire Mental Health Partnership NHS Page 63 of 81 Survey Results Manual