PATIENT AND SERVICE USER EXPERIENCE STRATEGY APRIL 2017 TO MARCH 2020 Date 24 March 2017 Version Final Version Previously considered by The Patient Experience Group version 0.1 draft The Executive Management Team version 0.1 - draft Document Author Tracey McErlain-Burns, Interim Chief Nurse Page 1 of 11
Foreword At The Tameside and Glossop Integrated Care NHS Foundation Trust we are passionate about delivering services and care of a high standard and quality. As we become one of the first Integrated Care Organisations in England we aspire to delivering services that are rated outstanding by our patients, service users and our regulators. As we explore new service configurations and develop our multi-disciplinary neighbourhood approach to person centred care this strategy aims to develop and support a culture that places the quality of patient and service user experience at the heart of decision making and the transformation of our services. Everyone in Tameside and Glossop matters and as we embark on the next phase of our integration plans we will use a range of tools described in this strategy to capture the experience of patients and service users, to inform our plans and guide us on our journey. Everyone has a responsibility for patient and service user experience and whilst the Trust Board is responsible for setting direction, everyone working within the Tameside and Glossop Integrated Care NHS Foundation Trust has a part to play in achieving the aims of this strategy. Karen James Chief Executive Page 2 of 11
Introduction As an Integrated Care NHS Foundation Trust our aim is to deliver, with our partners, safe, effective and personal care which you can trust. Working together with colleagues across the Trust we have developed a set of values and behaviours that underpin our interactions with patients, service users, partners, service commissioners, external stakeholders, and each other. Each year we refresh our strategic objectives and for the duration of this strategy these include our commitment to improve patient and service user experience through a personalised, integrated, responsive, compassionate and caring approach to the delivery of care. Ultimately as an Integrated Care Organisation we want, and need, to prevent ill health and enable people to live healthy, independent lives where possible. We want to help people to manage their health conditions in their own homes and communities and to get access to the best joined-up services, in the most appropriate location, at the right time to maximise health benefit and their experience of care and services. This strategy sits alongside the Patient and Service User Safety Programme and the Quality Strategy and is embedded in our assurance framework. The Patient and Service User Experience Group led by the Chief Nurse is responsible for the design and delivery of the key work-streams underpinning this strategy to achieve our three patient and service user experience objectives to Listen, Learn and Act to Improve. Each year the Patient and Service User Experience Group will recommend a set of annual improvement measures based on the themes that have emerged from the listening and learning activities in the previous 12 months (or more). Those recommendations will be presented to the Service Quality and Operational Governance Group and ultimately endorsed by the Non-Executive Director led Quality and Governance Committee. Our measures for 2017/18 can be found at appendix 1. Page 3 of 11
Objective 1 We will LISTEN to our patients and service users and collect data / information in a range of different ways that will help us to understand their experience. As an Integrated Care Organisation we are committed to understanding the needs of our patients and service users and as our organisation changes so too must the ways in which we engage with and listen to the people we serve. We must engage in ways that are both generic and specific in order to be assured that we are listening to all of our communities. To achieve this we will work with partners and key stakeholders for example, voluntary and third sector service providers, Healthwatch Tameside and the Tameside Young Inspectors. To do this we will: Ensure that all patients and service users have the opportunity to participate in the NHS Friends and Family Test. Promote the use of the NHS Choices website and Patient Opinion. Participate in the national NHS Patient Survey Programme. Utilise our First Friday Initiative as a means of clinical and managerial leaders engaging with patients and service users to hear about their experience first-hand. Promote the responsible use of social media by working with our communications team. Develop the role of Patient and Service User Listening Ambassadors working with our own volunteers. Promote engagement with our chaplains Promote the use of the Patient Advice and Liaison Service. Develop and use local and service specific surveys which might include repeating some surveys over time to understand the experience of some patients and service users with ongoing or long-term conditions. Explore systems of real-time patient feedback for patients with cognitive and / or communication impairment. Work with our Governors to host community and hospital based engagement stalls at least twice a year. Engage with Experts by Experience Groups. Telephone ten patients / service users on an active pathway each month to discuss their experience. Recognise the role of Carers and develop a Carers Strategy which will incorporate John s Campaign. Page 4 of 11
To measure and drive improvement we will: Design a single experience dashboard that brings together all the data and information relating to objective 1 to provide assurance that care is personalised, integrated, responsive, compassionate and caring Consider whether we need to refresh the tools we use annually. Agree and routinely report on annual improvement metrics to our Trust Board and publish these in our Quality Account and on our public facing website. Identify the skills and competencies that all front line colleagues need to demonstrate effective listening to patient and service user experience, and build those into our workforce development and skills programmes. Objective 2 We will LEARN from the reported patient and service user experience and continually strive for improvement. Our assurance framework already demonstrates that we have systems and processes in place to learn from incidents and events that occur and in February 2017 the Care Quality Commission rated the Tameside and Glossop Integrated Care NHS Foundation Trust as Good in the Well-Led domain, and Good overall. We must continue to use our assurance frameworks to test out the extent to which we have taken actions in response to the feedback we have received, to build upon services already providing a good experience and assist them to design improvements and respond to negative feedback or that which highlights a poor experience. To do this we will: Develop and implement a mystery shopper programme. Capture Patient and Service User Stories. Undertake audits. Further develop existing Matron Safety, Experience and Quality Rounds. Develop by my side programmes of escorts with community practitioners. Undertake departmental inspections in partnership with colleagues working in those departments. Engage patient and service user representatives in improvement programmes. Visit other organisations to enrich our understanding, share ideas and benchmark our services. Develop a list of always events specific to Tameside and Glossop integrated care services and present them using I statements. Page 5 of 11
Have the courage to pilot new ideas and ways of working and build patient and service user feedback into each and every evaluation. To measure and drive improvement we will: Provide you said we did story boards at the entrance to each of our main public buildings and refresh these each quarter. Identify the skills and competencies that team leaders and service managers need to understand and use the assurance framework, and build those into our workforce development and leadership programmes. Objective 3 We will ACT to IMPROVE our reported patient and service user experience by analysing data; addressing key themes and causes of dissatisfaction and embed good practice. The information that we collect and analyse over the lifespan of this three year strategy will change in line with the development of the Integrated Care Organisation. In year-one the focus will be on triangulating existing recent data relating to community and hospital services to identify the themes and priorities for action. By the very nature of having annual milestones (appendix 1) there will be a phased approach to this strategy. In years two and three there will be a bigger focus on community settings and integrated pathways of experience for the person as a whole. To do this we will: Work with divisions to carry out an audit of current systems to collect information on patient and service user experience and collate a directory of sources. Develop and agree an annual work plan for the Patient and Service User Experience Group to deliver. When transferring services into the Integrated Care Organisation the due diligence processes will explore existing systems and processes for capturing the experience of patients and service users, the position at that point in time and any improvement plans. Include our improvement metrics in the Integrated Quality Report and annual Quality Account. Develop an integrated ward / service dashboard of which patient and service user experience is one element and make this visible on entering the ward /service. Agree thresholds for supportive intervention which can be used when a range of measures, when brought together, are suggestive of decline. Page 6 of 11
Disseminate good practice and stories of improvement through Open Forums, Team Brief, Catch up with Karen and other opportunities. Explore all opportunities to publish the improvement journey in professional journals and through conference presentations. Specify the measures of service user experience and standards expected when commissioning services, and monitor those through contracting processes. To measure and drive improvement we will: Empower our colleagues and volunteers to act 1 on patient and service user feedback and provide them with the necessary training and support required to help them to collate and use information. 1 Not all improvements we wish to make require financial support for example the way we communicate and interact with patients and service users can positively improve experience. Where financial support is required we will explain how decisions are taken. Page 7 of 11
Appendix 1 LISTENING, LEARNING AND IMPROVING IN 2017/18 LISTENING MILESTONES 2017/18 Friends and All in-patient areas to achieve a 30% response rate. Family Test Maternity to achieve a 30% response rate. ED to sustain the 25% response rate. Adult community services to achieve a 95% positive response rate. Children s community services to achieve a 95% positive response rate. Out-patients to achieve a 20% response rate All areas to achieve 95% positive response rating. NHS Choices and All postings receive a response within 72 hours of the Trust being Patient Opinion notified of the posting. NHS Surveys Participate in the mandatory National Survey programme. First Friday Social Media Local surveys 2 Cognitive and communication impairment Patient and Service User Listening Ambassadors Engagement stalls 10 patient pathways Dashboard Annual improvement metrics Carers Strategy Minimum of 20 First Friday visits per month. Collective summary report to each P&SUEG. All positive feedback is retweeted from @tandgicft with thanks. Advertise @tandgicft on all patient information leaflets when they are revised. Survey of involvement in decision making to be undertaken (feedback from NHS Survey). Appropriate tools identified. Role descriptor developed. At least one person recruited / identified for each service area. Quarterly development sessions programmed and at least one session delivered. Agreement reached with Governors and first stalls have happened. A minimum of 70 patients / service users on active pathways / active care packages have been spoken to and their feedback is being presented to the P&SUEG. A single experience dashboard has been developed bringing together all the data sources, aligned to the three objectives in this strategy. Measurement is taking place against the 2017/18 metrics and metrics are agreed for 18/19. Carers Strategy published and John s Campaign embedded. 2 Collect information in accordance with the Equality and Diversity Plan and where possible collect evidence of reasonable adjustments being made to enhance patient and service user experience. Page 8 of 11
LEARNING MILESTONES 2017/18 Mystery Shopper Framework developed and agreed. Two mystery shopper experiences completed and reported to P&SUEG. Patient and Patient stories presented to each meeting of the Trust Board. Service User Agreement reached that patient stories will be presented to each Stories divisional governance meeting. Audits Audits of noise in the in-patient environment will be undertaken (feedback from NHS survey). Audits of support at mealtimes will have be undertaken (feedback Safety, Experience and Quality Rounds By my side Departmental inspections Service representatives Visits to other organisations Always events Pilots from NHS survey). Matron rounds to include the capture and reporting of experience. Programme of escorts with community practitioners developed to capture real time experience in the community setting. At least one departmental inspection to take place informed by the single experience dashboard. The current levels of service and user involvement in improvement groups will be identified. At least one external visit will have taken place. Develop a list of always events (actions or interactions that should always happen) and engage with patients and service users to agree a series of I statements. The P&SUEG will be involved in evaluating at least one service pilot in year. IMPROVING MILESTONES 2017/18 Audit of current At least 30% of services within divisions will be audited. systems in divisions Annual work plan The annual P&SUEG workplan will be agreed by March each year having completed governance approvals. The workplan will routinely include engagement with the annual PLACE audit. Integrated quality Improvement metrics are in the integrated quality report to Board report and the annual Quality Account Integrated ward Dashboard developed by year-end 17/18. dashboard Thresholds for Thresholds agreed by year-end. supportive intervention Sharing good The Patient Experience Report will capture good practice and at least practice one piece will feature in corporate communications each month. Professional Subject matter identified for publication in 18/19. journals Page 9 of 11
ANNUAL IMPROVEMENT MEASURES 2017/18 Friends and All in-patient areas to achieve a 30% response rate. Family Test Maternity to achieve a 30% response rate. ED to sustain the 25% response rate. Adult community services to achieve a 95% positive response rate. Children s community services to achieve a 95% positive response rate. Out-patients to achieve a 20% response rate All areas to achieve 95% positive response rating. NHS Survey Reduction in disturbance from noise in the in-patient environment. Improved levels of support at mealtime. Improved involvement in decision making. 10 Patient Pathways A minimum of 70 patients / service users on active pathways have been spoken to and their feedback is being presented to the P&SUEG. Page 10 of 11
Patient & Service User Experience Strategy 2017-2020 Measure and Drive Improvement Supporting feedback and improvement in Tameside & Glossop LISTENING: Design a single experience dashboard that brings together data and information relating to objective 1 to provide assurance that care is personalised, integrated, responsive, compassionate and caring Consider a refresh of the tools we use annually. Agree and routinely report on annual improvement metrics to Trust Board and publish results in our Quality Account and on our public facing website. Identify skills and competencies that all front line colleagues need to demonstrate effective listening to patient/ service user experience, and build those into our workforce development and skills programmes. LEARNING: Provide you said we did story boards at the entrance to each of our main public buildings and refresh these each quarter. Identify the skills and competencies that team leaders and service managers need to understand and use the assurance framework, and build those into our workforce development and leadership programmes. ACTING to IMPROVE: Empower our colleagues and volunteers to act on patient and service user feedback and provide them with the necessary training and support required to help them to collate and use information. Objective 1: LISTEN Ensure all patients/ service users have opportunity to participate in the NHS Friends and Family Test. Promote the use of the NHS Choices website and Care Opinion. Participate in the national NHS Patient Survey Programme. Use of First Friday as a means of clinical and managerial leader engagement with patients/ service users to hear about their experience first-hand. Promote the responsible use of social media by working with our Communications Team. Develop the role of Patient and Service User Listening Ambassadors working with Trust volunteer staff. Promote engagement with our Chaplains Promote the use of PALS. Develop and use local and service-specific surveys to understand the experience of patients/ service users with ongoing or longterm conditions. Explore systems of real-time patient feedback for patients with cognitive and / or communication impairment. Work with our Governors to host community and hospital based engagement stalls at least twice a year. Engage with Experts by Experience Groups. Telephone ten patients / service users on an active pathway each month to discuss their experience. Publish a Carers Strategy Page 11 of 11 Objective 2: LEARN Develop and implement a mystery shopper programme. Capture Patient and Service User Stories. Undertake audits. Further develop existing Matron Safety, Experience and Quality Rounds. Develop by my side programmes of escorts with community practitioners. Undertake departmental inspections in partnership with colleagues working in those departments. Engage patient and service user representatives in improvement programmes. Visit other organisations to enrich our understanding, share ideas and benchmark our services. Develop a list of always events specific to Tameside and Glossop Integrated care services and present them using I statements. Have the courage to pilot new ideas and ways of working and build patient and service user feedback into each and every evaluation. Objective 3: ACT to IMPROVE Work with divisions to audit current systems to collect information on patient and service user experience and collate a directory of sources. Develop and agree an annual work plan for the Patient Experience Group. Use of due diligence processes to explore existing systems/ processes for capturing patients and service user experience and plan improvements, with particular regard to the Integrated Care agenda Include improvement metrics in the Integrated Quality Report and annual Quality Account. Develop an integrated ward / service dashboard to include patient and service user experience for display at entrance to wards /services. Agree thresholds for supportive interventions where a range of measures are suggestive of decline in care/ quality. Disseminate good practice/ improvement stories through a wide variety of sources - Open House Forum/ Team Brief/ meetings. Explore opportunities to publish the improvement journey in professional journals and through conference presentations. Identify measures of service user experience/ expected standards when commissioning services, and monitor via contracting processes.