Patient Experience & Patient Information Amy Sherman, Macmillan Project Manager, LCA
Patient Experience Why? Who? Why? Link between patient experience & health outcomes Link between patient experience & cost of care Link between patient experience & staff wellbeing Reputation of organisation (media coverage, my cancer treatment website) Who? Organisations: culture, values, behaviours MDTs: every aspect of work should consider patient experience/benefit to patients Individuals: change the way we think, manage, act
Back to basics The NHS Constitution Principles High-quality care that is safe, effective, and focused on patient experience Patients, with their families and carers, will be involved in and consulted on all decisions about their care Patient Rights Right to being given information to assist in making decisions Staff Rights Right to have access to tools, training, and support to deliver care NHS Values
Policy & Guidelines Patient Experience & Patient Information The NHS Operating Framework 2012/13 NHS should collect and use patient experience information in real time and use it for service improvements The NHS Outcomes Framework Ensuring that people have a positive experience of care Quality Standards NHS Constitution NICE Quality Standards CQUIN payment framework, local quality improvement goals Quality accounts London: Model of Care Written information MDT working Staff knowledge, values, skills Workforce issues
Feedback Tools which include Patient Experience General Inpatient survey Staff survey PROMs Friends & family test Cancer specific national Cancer Patient Experience Survey Radiotherapy survey Chemotherapy survey Local Real time feedback Surveys face to face, postal, telephone, online Complaints, PALs feedback, Compliments, Comment cards Walking the floor, Public meetings, Mystery shoppers
Cancer Patient Experience Survey (CPES) Audits of 2000, 2004 CPES 2010, 2011/12 - national service improvement tool Themes Communications CNS role MDT working Strategic accountability and straight forward action plans London trusts poorest performers (LCA - 4 of bottom 10) London trusts have patchy performance some trusts significant percentile improvements London most diverse patient population (younger, over 75, ethnic minorities, non heterosexual, rarer cancer type, less likely to give positive answers) London performs well - access to clinical trials LCA patients rated care as very good or excellent, 68% - 92%
CPES - London worst performing region on Q11 11 / patient questions told (s)he could bring a friend (LCA 56%-81%) (based on competitive RAG rating) Q21 / easy to contact CNS (LCA 62%- 80%) Q40 / ward nurses provided understandable answers to important questions (LCA 50% - 85%) Q41 / confidence and trust in all ward nurses (LCA 41% 77%) Q46 / asked what name they preferred to be called (LCA 31% - 71%) Q49 / able to discuss worries and fears with staff (LCA 40% - 76%) Q55 / post discharge, given enough help from health and social services (LCA 32% 69%) Q59 / given enough emotional support by outpatient and day case staff (LCA 57% 83%) Q61 / outpatient appt waiting time within 30 minutes (LCA 53% - 80%) Q65 / GP staff fully supportive during treatment (LCA 49% - 79%) Q66 / GP staff worked well together (LCA 47% 68%)
*Internal Presentation for planning purposes CPES - London worst performing region on 5 questions (based on percentile scoring) Q25 / hospital staff gave information on financial help (LCA 38% - 63%) Q27 / taking part in cancer research (LCA 20% - 62%) Q29 / patient would have liked to be asked about taking part in cancer research (LCA 39% - 66%) Q54 / family given all information needed to help care at home (LCA 48% - 68%) Q68 / patient offered written assessment and care plan (LCA 18% - 34%)
CPES context and limitations Provides context good service improvement tool that provides national benchmarking Identifies several patient experience issues Provides a starting point for further understanding Limitations Inpatient survey Low sample size at some trusts Competitive RAG rating Overall scores don t necessarily appear to be representative of patient comments Doesn t identify the why behind the low scoring questions Timeframe of results and start of next survey
Transition focus from research to quality improvement Quality Improvement Understand the patient experience Identify opportunities for improvement Design services, set standards Measurements that lead to positive change Resources to collect, analyse, interpret, and report Collect in a variety of ways, triangulate data Real time feedback Patient & staff involvement Patient Centred Care Good communications, clear information, clear expectations, patient preference is priority Staff are available, competent, treat patient as an individual Good relationships within and between organisations
LCA Patient Experience & Patient Information Project LCA: improve working relationships between trusts; share best practice; ensure changes on the ground Data analysis Lead Cancer Nurses Group CNS Role Trust produced written information CPES quick wins Clinical Board level work Strengthening critical pathway points, primary/acute, acute/tertiary Pan London work group Thematic analysis of CPES patient comments Real time feedback methods
LCA Patient Experience & Patient Information Project Pathway Groups Consider patient experience and patient information within every part of your work plan, strong leadership, focused deliverables What are the patient experience & information issues specific to your patients? (based on your knowledge & experience as professionals and all patient feedback surveys/tools) What can your group influence, change? How can your group improve services?
Summary of survey and analysis Background of survey The overall England report can be found at the following link:- http://www.quality-health.co.uk/surveys/2011-12-cancer-survey.html The Trust level reports can be found at the following link:- http://www.quality-health.co.uk/surveys/2011-2012-cancer-survey-trust-level-reports.html Key points to consider in analysis LCA mean is calculated using the mean of the percentages of the trusts who had a figures reported for (i.e where more than 20 responses provided) Response only recorded if more than 20 responses at that trust for that tumour group This analysis only includes inpatients from October November 2011 I.e. patients who only attend outpatients aren t included in the analysis. 13
Questions prioritised by user group Q21 - Patient finds it easy to contact their CNS Q68 Communication all way through pathway to ensure that I and relevant other understood correctly a) test results, b) diagnosis & prognosis c) treatment options including referral elsewhere eg for second opinion on pathology/reconstruction etc if I felt necessary This would provide trust & confidence in professionals treating me. Patient offered written assessment and care plan Q29 - Patient would like to have been asked about taking part in cancer research - Access to trials suitable for me. Q49 - Patient was able to discuss worries or fears with staff during visit Q61 - Waited no longer than 30 minutes for OPD appointment to start Q31 No change of date for surgery accept slight risk of this Q64 Good collaboration with Primary Care Team and clear discharge information
The London Cancer Alliance West and South
The London Cancer Alliance West and South
The London Cancer Alliance West and South
The London Cancer Alliance West and South
The London Cancer Alliance West and South