Agenda item 7(v) THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST COUNCIL OF GOVERNORS NATIONAL CANCER PATIENT EXPERIENCE SURVEY 2014 1. INTRODUCTION AND OVERVIEW The Cancer Patient Experience Survey 2014 (CPES) follows the successful implementation of the first CPES in 2010, designed to monitor national progress of cancer care. The 2014 survey is congruent with the National Operating Framework (NOF) for the NHS 2014, which defines quality as those indicators of safety, effectiveness and patient experience that indicate that standards are being maintained or improved. The CPES provides information that can be used to drive local quality improvements, both by Trusts and Commissioners, and is consistent with the objectives of NHS Policy. Adult patients with a primary diagnosis of cancer who had been admitted to a NHS hospital as an in-patient or as a day case and had been discharged between 1st September 2013 and 30th November 2013 were selected to take part in the survey. 1877 eligible patients from this Trust were sent a survey, and 1158 completed questionnaires were returned. This represents a response rate of 66%, once deceased patients and questionnaires returned undelivered had been accounted for, against a national response rate of 64%. 93% of patients rated the care they received in the Trust as excellent/very good, which shows a 1% increase on 2012/13 results. The Trust was ranked in the highest 20% of Trusts for this question. Following the publication of these results the Corporate Cancer Team will be working with Directorates and Multi-Disciplinary Teams to develop a Trust wide action plan against which progress will be monitored. To support the quantitative data, the survey has also produced a report which only shows the patient comments. These have been reviewed and the key points have been highlighted below. Some of the comments/areas for improvement evident throughout the patient comments refer to the waiting times for chemotherapy. This survey was conducted between September and November 2013 and since this time a considerable amount of work has been done to improve the overall experience of patients undergoing chemotherapy in the Northern Centre for Cancer Care (NCCC). This includes the launch of the Chemotherapy in the Community service; delivering care closer to home, recruitment of nurses into vacancies and improvement of the overall environment in which patients receive their treatment. Local patient satisfaction surveys carried out within NCCC illustrate improvement in chemotherapy patient experience. As all the comments are anonymous and being a Tertiary referral centre we are unable to ascertain that the patients treatment was solely carried out within the 1
Trust as many of our patients begin their journey in the surrounding District General Hospitals. Some comments could be referring to surrounding Trusts. 2. PATIENT COMMENTS Comments from the specific tumour site groups are illustrated in the following section: Brain/Central Nervous System The comments received from this group of patients were generally all very good. Patients refer to their care as outstanding, efficient and first class treatment. Themes are visible around patients feeling they have very supportive Medical and Nursing staff. One patient felt that they were perhaps discharged too quickly following surgery. Breast A number of comments were received from patients highlighting that they had received fantastic care from the point of diagnosis through to treatment finishing. Comments were made in relation to the efficiency and speed at which treatment was started. Patients indicated that they are pleased to live in Newcastle and are well supported by very caring staff. This group of patients found valuable support in the Maggie s Centre on the Freeman site. Waits for chemotherapy appeared to be evident for this group of patients. Patients did not feel supported by the GPs whilst undergoing treatment. Patients made reference to quality of food whilst an inpatient. Colorectal/Lower Gastrointestinal The comments received from this group of patients are generally very positive. Patients feel well supported by their Consultant and Nurse Specialists. Notes made with regards to how caring and professional all staff groups were. A number of patients refer to their care as excellent. Areas for improvement include communication between chemotherapy and radiotherapy for patients. Some patients did experience long delays from having x-rays/scans to being told results. Work to be undertaken with ward level nurses with regards to communication skills when dealing with cancer patients. Patients feel unsupported once treatment has ended and they have been discharged back into the community. Gynaecological There were a small number of responses from this tumour group. Comments include excellent level of care at the Freeman and excellent ward nurses. Patients felt that the Consultants listened to them and cared. 2
Concerns were around nurse staffing levels on inpatient wards at night and the attitude of chemotherapy nurses. Patients do not feel that we provide adequate parking facilities near to NCCC and why is parking not free like surrounding District General Hospitals. Haematological Comments from this group of patients are very positive. Patients feel the Doctors and Nurses are exceptional, they receive very special care from Nurses at all times and excellent coordination of care. Being able to access Nurse Specialists and ward staff after routine working hours was invaluable to patients. Concerns were in regard to support from GP and time taken for GP to recognise possible cancer symptoms. Some patients referred to food quality. Lack of benefits advice was a problem to a small number of patients. Waiting times for chemotherapy and supportive therapies was highlighted as a concern from a number of patients. Head & Neck Patients were very impressed with the quality of care and dedication of all who looked after them. Staff were referred to as caring, professional and compassionate. Comments made with regards to Consultant and Nurse Specialists treating patients as individuals not just as a patient. Some patients felt that they had to wait too long in between scans and results, and commented on chemotherapy appointments being cancelled due to shortage of beds. Lung Patients were impressed with the speed that cancer was dealt with and the persistence of the doctors in the diagnosis. Care at both the RVI and Freeman is described as exceptional. Patients feel that the nurses cannot do enough for them and their care was excellent. Very few areas for improvement noted with this group of patients responses. Concerns noted in relation to nurse staffing levels at weekends and that hospital transport could be improved. Prostate Feedback was very positive with regard to the robotic surgery. Patients note that their care from start to finish was outstanding. The professionalism of the Consultants and Nurses was referred to in a number of questions and the overall experience was first class. Work needed to be undertaken with regard to discharge information for this group of patients. Concerns from some patients with regard to the time taken for the GP to refer to the hospital, even when blood test levels were high. Lack of wheelchairs to access Sir Bobby Robson Unit was raised as a concern. 3
Sarcoma Good feedback with regard to NCCC. Patients feel that the team at the Freeman are exceptional in their care and treatment. Good availability of Nurse Specialists and Consultant on the telephone. Post-operative discharge information needs to be addressed and improvements made. Skin Very positive experience illustrated from this group of patients, feel able to contact Nurse Specialist at all times and overall care is excellent. Speed of treatment noted as a very positive experience. Concerns raised about administrative processes between Newcastle and Carlisle and levels of nursing staff on chemotherapy day unit. Patients feel that consideration needs to be given to parking and parking concession. Upper Gastrointestinal Very positive comments with regards to Medical and Nursing Care. Reference made to the excellent support from the District Nurses and Palliative Care Team. Patients feel well supported by the Maggie s Centre. Comments include best in the country and a first class service. Patient s raised concerns with regards to support that they received whilst undergoing their chemotherapy treatment and long waits for scan results. Some patients feel that they should have been referred into the service sooner by their own GP. Reference made to the number of nurses on the wards at weekends and improvement needed with food quality. Urology The comments received from this group of patients were very positive. Staff found to be very sympathetic and helpful. Patients found having treatment at home to be a very positive experience. Doctor and Nurses found to be professional, caring and brilliant. One patient referred to being treated like a VIP. Speed of treatment after seeing GP was excellent. Concerns expressed with regard to food quality, time taken for discharge medications to arrive from pharmacy and the administrative process for outpatient letters, one patient referred to letters arriving the day after appointment should have been. Attitude and number of night nursing staff on inpatient wards was raised as an area for improvement. Some patient comments include: I was treated with care and kindness by everyone involved in my treatment and 4
it does make a difference Fantastic care from start! Doctors, nurses, everyone absolutely lovely. Cannot fault a single thing The Freeman Hospital and the Royal Victoria have lived up to their reputation as first class units I could not praise the treatment I have received highly enough, it has been excellent I had a long distance to travel to hospital and the staff were excellent in accommodating visitors outside of normal hours and overnight stays for my husband. The care I have had has been superb! Inconsistent food options and quality There could be more staff on the chemotherapy day unit at the Freeman. This would reduce delays in waiting for treatment on the day of attendance and staff being less overworked and dealing with lots of patients simultaneously. Staff turnover may be improved. Delays in treatment are the norm Parking why can t we have free parking like in other local hospitals? 3. SUMMARY The results of the National Patient Survey would suggest that the majority of cancer patients who access the Trust respond positively with regard to the care they have received. We cannot however be complacent and must endeavour to address those areas identified as requiring improvement within the Survey and this includes the sharing of the Survey results with Key members of each of the cancer site teams (Clinical Director, Site Specific Clinical Lead, Directorate Manager, Clinical Nurse Specialists, Matrons and Ward Sisters). These individuals will be required to identify action points for development/improvements and feed this back to the Corporate Cancer Team, supporting attainment within the Cancer Peer Review process. 5 Christine Eddy Head of Patient Services Jane Beveridge Macmillan Lead Cancer Nurse / Nurse Consultant Cancer Services 3 rd November 2014