PATIENT EXPERIENCE REPORT

Improving Patient Experience PATIENT EXPERIENCE REPORT 1st July 2012 30th September 2012

Patient Experience Report - Page 2 Introduction The Patient Experience Report aims to present a rounded picture of patient experience and as such, provides information on all aspects of experience, good and less positive. Where poor experience is reported, actions are then taken to ensure improvements are made and these are then featured in future reports. The reports present a wide range of information from different sources. Including the following: - National Surveys - Frequent Feedback - Website Feedback - Comments Cards - Complaints - Clinical Assurance Toolkit (CAT) - Service Improvement Projects - Governor and LINk Visits It is understood that each method of feedback has its strengths and weaknesses. Using all methods of information available enables the Trust to better understand the patient s experience of the services offered and delivered, and is beneficial to help prioritise where to focus efforts on action planning.

Patient Experience Report - Page 3 LIVE PATIENT EXPERIENCE NEWS HEADLINES Staff Attitude was the area that received the highest amount of feedback from website, comments cards and complaints in the past year. The number of comments cards received this quarter has increased greatly since the introduction of using volunteers to approach patients. The Friends and Family Test will be introduced by 1st April 2013. The Trust s performance for replying to complaints within 25 working days is 87% against a target of 85%. The Frequent Feedback Inpatient Survey has highlighted areas of high performance including confidence in doctors; along with areas for improvement including patients being given conflicting information by staff and being disturbed by staff while resting or sleeping. The Patient Partnership Department has been awarded charitable funding towards the implementation of a patient information system. National Cancer Survey results show the Trust has achieved significantly improved scores than in the 2010 survey on 9 questions and performed worse than in 2010 on 3 questions. The National A&E survey has highlighted that since 2008, Trust performance has improved on information on waiting times and information given to family and friends, but has deteriorated on patients not being told who to contact if they are worried. BREAKING NEWS PATIENT EXPERIENCE REPORT JULY TO SEPTEMBER 2012

Patient Experience Report - Page 4 Executive Summary Key highlights from the Patient Experience Report are as follows: Feedback Overview shows the top 5 themes raised in unsolicited feedback where patients and families are able to freely comment on any aspect of services. The top 5 positive and negative themes show similar results to the previous quarters. Emergency Care and Head and Neck continue to be the care groups that received the most feedback during this quarter, significantly more than other care groups. The Trust has received 290 new complaints between July and September 2012, which is a decrease from 327 in the previous quarter; this is still consistent with the average numbers received over the past year. The Trust s performance for replying to complaints within 25 working days was 87% this quarter against a target of 85%. There has been a large increase in the number of comments received from Tell Us What You Think comments cards following the introduction of a new approach involving volunteers inviting patients to complete a card. By proactively approaching patients to ask for comments, there has been an impact on the range of ratings that patients are giving their experience. Previously, the majority of patients/visitors would rate their experience as excellent or poor, this reflects that individuals generally felt motivated to give feedback when their experience was either very good, or very poor. Since the introduction of using volunteers, a wider range of ratings are being selected, as detailed on page 10. From the 1st April 2013 the Friends and Family Test will be introduced across the Trust which will be based on a simple question: How likely are you to recommend our ward / A&E department to friends and family if they needed similar care or treatment? The Trust is expected to offer all patients who are discharged following either inpatient care or after attending A&E, the opportunity to answer the FFT question about how likely they would be to recommend the service to their family or friends. Care Group and Directorate Breakdown tables aim to show performance in relation to key indicators by care group and, where information is available, by directorate. Results in this report show findings from the Inpatients Frequent Feedback survey. The Inpatient survey captures feedback from every inpatient ward across the Trust on a range of topics. A minimum of 20 surveys are carried out for each ward, with the aim of completing these within one week. Results suggest excellent performance for patients having confidence in doctors treating them; confidence in nurses treating them; pain management; and treating patients with respect and dignity. The report also indicates that improvements are needed in a number of areas including: doctors talking in front of patients as if they aren t there; being disturbed by noise from staff while resting / sleeping and patients being confused by staff giving different information or advice.

Patient Experience Report - Page 5 Following good progress made over the last year to reduce the number of patient information leaflets which are beyond their review dates, performance at directorate level is presented in this quarter s report. The Patient Partnership Department has recently been awarded charitable funding towards the implementation of a new patient information system. The new Interlagos system will improve the production, quality and access to patient information resources, as well as ensuring patient information is accurate, up to date, and consistent. National Surveys Results from the National Cancer Survey were published during this quarter. The Trust achieved significantly improved scores from the 2010 survey on 9 questions. These improvements include providing information to patients on tests, what to expect during tests, side effects and privacy when discussing treatment. In addition to this patients also reported that they were receiving better guidance on financial help, free prescriptions and other information. The Trust s performance was not as good as in the previous survey on 3 questions. These included the patient s family definitely having the opportunity to talk to a doctor, there always being enough nurses on duty, and patients always being treated with respect and dignity by staff. Actions plans are being developed by the relevant Cancer Action Teams to identify ways to address areas for improvement. Focus on A&E A programme to capture patient experience in A&E has been running since April 2011. This work is part of the national A&E quality indicators framework to capture the views of patients, using a different feedback method each quarter. The quarter 1 results in 2012/13 are based on the 2012 National A&E survey. Compared to 2008, when the last National A&E survey took place, the Trust has performed significantly better on 3 questions, and significantly worse on 1 question. Areas where we performed better include information on waiting times, information given to family and friends, and family or home situation being taken into account upon leaving hospital. The area where the Trust did not do as well relates to patients not being told who to contact if they are worried once they had left the department. Visits LINk and Governor visits appear as a regular feature in reports as and when they are carried out. The Governor visit which was carried out at the Beech Hill Intermediate Care and Rehabilitation Unit during September 2012 features in this quarter s report. Patient Experience Reporting across the Trust Individual Quarterly Patient Experience Reports are now being produced for all Care Groups. These reports capture and provide further detail on all aspects of feedback that is specifically relevant to each Directorate and Care Group. The reports aim to bring patient experience intelligence together to enable managers and staff to assimilate the feedback relevant to their individual areas, cascade the key patient experience messages to staff teams and identify priorities for action as required.

Patient Experience Report - Page 6 Contents Click on an item to navigate to that section: 1. Feedback Overview 7 2. Care Group and Directorate Breakdown 15 4. National Surveys 20 5. Focus on A&E 21 6. Visits 24 a) Website Feedback and Comment Cards 7 b) Word Clouds 12 c) Complaints 13 a) Complaints by Outcome 15 b) Inpatient Survey 16 c) Patient Information Status 19 a) National Cancer Survey 20 a) Accident and Emergency Quality Indicators 21 a) Governor Visit - Beech Hill 24 Did you know Clicking on the page number at the top of each page will bring you back to this contents page.

Feedback Overview Patient Experience Report - Page 7 Website Feedback and Comment Cards The graphs and tables on the following pages show all feedback received through website feedback and comments cards. Each comment received can cover a range of themes and the analysis below is based on the themes covered in the individual comments. During the period July to September 2012, 728 individual comments were received through website feedback and comment cards. Top 5 Positive Themes Jul- Sep 2012 Apr- Jun 2012 Jan- Mar 2012 Oct- Dec 2011 The meals are good, staff are cheerful and helpful The waiting time for my appointment is too long 1 Staff Attitude 31% 29% 35% 37% 2 Nursing Care General nursing care 19% 18% 14% 10% 3 4 5 Medical Care Competence of Staff Communication Environment - Cleanliness 8% 7% 7% 15% 14% 5% 9% 12% 10% 11% 15% 11% I was put in a queue and was left behind a pillar, no one seemed to know I was there My Consultant was warm and friendly and will try and answer any queries Attentive staff, always friendly and wanting to help There were long delays for blood tests, often resulting in seeing the consultant first Top 5 Negative Themes Jul- Sep 2012 Apr- Jun 2012 Jan- Mar 2012 Oct- Dec 2011 1 Waiting Times 17% 13% 14% 12% Embarrassingly bad communication breakdowns between staff I am always kept well informed 2 3 4 Staff Attitude Nutrition Quality of Food Communication 12% 11% 9% 11% 9% 20% 15% 5% 9% 14% - 8% 5 General Nursing Care 6% 7% 3% 2%

Feedback Overview Patient Experience Report - Page 8 Website Feedback and Comment Cards - 12 month analysis of themes The tables below give a breakdown of themes raised through website feedback and comment cards between 1 st October 2011 and 30 th September 2012. Top 5 Positive Themes Top 5 Negative Themes 1 Staff Attitude 36% 1 Waiting Times 14% 2 Nursing Care - General Nursing Care 19% 2 Staff Attitude 13% 3 Communication 11% 3 Communication 10% 4 Medical Care - Competence of staff 10% 4 Nutrition - Quality of Food 7% 5 Environment - Cleanliness 9% 5 Environment - Facilities 6% 1 2 3 4 5 Staff Attitude Most Frequently Raised Themes (positive and negative feedback combined) Nursing Care - General Nursing Care Communication Medical Care - Competence of staff Environment - Cleanliness Regular analysis of unsolicited feedback also showed both attitude and communications to consistently be in the top 5 negative and top 5 positive themes, highlighting that these two themes are issues of great importance to the overall experience of care. In addition, the Trust s Annual Complaints Report for 2011-12 highlighted the themes of attitude and communication as issues that lead to a high number of complaints. The tables above show that over the past quarter, staff attitude and communication continue to be subjects that visitors to the Trust comment on most, accounting for 42% of all subjects raised. A number of current work streams aiming to make improvements in relation to attitude and communication performance are in place. These include the introduction of the PROUD values and behaviours to recruitment and appraisal processes, the staff well being work stream, and targeted customer care training for some staff groups. 31% 16% 11% 9% 8%

Feedback Overview Patient Experience Report - Page 9 Website Feedback and Comment Cards 350 Website and Patient Comment Card Responses 1st October 2011 to 30th September 2012 Total Responses Positve Comments Negative Comments 300 No. of comments received 250 200 150 100 50 Comments Card Ratings 662 completed comments cards were received between July and September 2012. Of these, 655 gave their experience a rating. Between October 2011 and September 2012, 1037 ratings have been received. The % split of these ratings is displayed below. 0 Critical Care and Anaesthetics Diagnostics and Therapeutics Emergency Care Head and Neck Obs and Gynae Spec Med & Rehab Surgical Services South Yorkshire Regional Specialities General Not stated 700 600 673 Comments Cards - Breakdown of experience rating October 2011 - September 2012 Ratings in order of % 1. Excellent 61% 2. Very Good 26% 500 3. Poor 6% 400 4. Good 6% 5. Fair 2% 300 200 219 100 0 85 41 19 Excellent Very Good Good Fair Poor

Feedback Overview Patient Experience Report - Page 10 Tell Us What You Think comment cards As highlighted in the previous report, the Trust has set a target this year to increase the amount of feedback received through Tell us what you think comment cards by 50% to 861 for 2012/13. Since 1st July, all volunteers conducting patient interviews for the frequent feedback programme have been issuing comments cards to other patients. As a result of this, up to the end of September 2012, 752 comments cards have been received. As the graph opposite illustrates, the increase in performance has been immediate. However, the new approach has had an impact on the range of ratings that people are choosing to give their experience. In the past, the majority of completed comment cards would rate the experience as excellent, with the next most selected rating being poor. This suggested that individuals generally felt motivated to complete a comment card when their experience was either very good, or very poor. Since the introduction of using volunteers to approach patients, a wider range of ratings are being selected. There has been a large increase in those selecting very good, a slight increase in those selecting average and a considerable decrease in those who rated their experience as poor. This could be because volunteers are handing comments cards to patients personally and sometimes completing them on behalf of the patients, therefore the patients may be more reluctant to rate their experience as poor. The Friends and Family Test should overcome this as patients will be asked to post their comments into a ward post box on or following discharge. No. comment cards completed 300 250 200 150 100 50 0 14 Jan-11 50 24 Feb-11 Mar-11 64 Tell Us What You Think Comment Cards Total comment cards completed Positive responses Negative responses 31 34 30 35 Apr-11 May-11 Jun-11 Jul-11 Aug-11 65 59 52 40 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Month 15 18 132 27 36 21 Feb-12 Mar-12 Apr-12 May-12 Jun-12 147 237 284 Jul-12 Aug-12 Sep-12 In addition to this, the detail included in patients comments has changed in that fewer patients have provided detailed or specific comments, and many don t have a comment to make. The comments below were received in September 2012: This is something that needs to be monitored as the change in process has clearly had an impact on the types of responses patients are giving. There s very little to complain about Nothing in particular Quick. Efficient. The following page features the new Friends and Family Test providing an overview of future developments which will change the way we collect this type of feedback. Comments, such as in the examples above, are as a result of patients being approached to give their feedback rather than them feeling motivated to do so themselves.

Feedback Overview Patient Experience Report - Page 11 Friends and Family Test In January 2012, the Prime Minister announced the plan to establish the Friends and Family Test (FFT) which will be based on a simple question about how likely patients would be to recommend the ward (or A&E department) in which they had just been cared for and treated to their friends or family if they needed similar care or treatment. A standard FFT will be introduced by 1 April 2013. In the first instance all inpatients and those attending A&E should have the opportunity to respond to the FFT question at the point of, or within 48 hours of discharge. Results will be reported nationally each month and published to enable benchmarking of both response rates and FFT scores between Trusts. Trusts are also expected to produce internal FFT score reports at ward or department level. All hospitals are expected to obtain responses from at least 15% of eligible patients. At STHFT this means capturing responses from around 40,000 patients in 2013/14. The number will increase as FFT is extended to include patients accessing maternity and outpatient services in due course. How likely are you to recommend our ward / A&E department to friends and family if they needed similar care or treatment? Extremely Likely Likely Neither likely nor unlikely Unlikely Extremely unlikely Don t know The Trust is in the process of agreeing how the FFT will be operated. This is a major undertaking and is likely to involve a range of methods for capturing patient responses including paper based comments cards and on line feedback options. We need to ensure all patients have an opportunity to respond and that responses are captured from a representative group of patients as efficiently as possible. As well as the FFT question, patients will have the opportunity to provide supplementary free text comments. Every effort will be made to ensure the impact of FFT on staff at ward and department level in terms of gathering FFT responses is minimised. The FFT will eliminate the need to proactively encourage patients to complete comment cards, although the Trust comments cards will continue to be available for patients to help provide feedback as and when they want to. As well as setting up FFT, careful consideration is being given to reporting arrangements to ensure data, including scores and any supplementary comments, can be fed back to staff teams in a timely and helpful way.

Feedback Overview Patient Experience Report - Page 12 Website Feedback and Comment Cards Word Clouds The word clouds below present the qualitative data collected from website feedback and comments cards between July and September 2012. The clouds give greater prominence to words from the feedback received this quarter that appear more frequently. For example, the words staff and helpful appeared most frequently in positive comments and waiting and staff appeared more than other words in the negative feedback. Positive Feedback Negative Feedback

Feedback Overview Patient Experience Report - Page 13 Complaints Complaints activity July 2012 to September 2012 Complaints received by activity Oct 2011 to Sept 2012 The number of new complaints received has decreased slightly in Quarter 2 with 290 new complaints being received compared to 327 in the previous quarter. New Complaints Received Between July and September 2012, inpatient areas that received a higher number of complaints when linked to bednight activity are: Huntsman 3 and Huntsman 6 which both received 6 complaints each. Upon investigation, there were no specific themes in these complaints. Between July and September 2012 the two departments which received the most complaints were Gynaecology Outpatients and Cardiology. In Gynaecology Outpatients the highest number of complaints recorded relate to medical care, i.e. appropriateness of care and competence. In Cardiology the number of complaints received remains consistent for this directorate compared to the past 12 months; there are no specific trends or themes to report for this quarter. Any areas with higher number of complaints will continue to be monitored to identify any themes or trends. Up to the end of September 2012, the Trust s performance for replying to complaints within 25 working days was 87% against a target of 85%, for the year to date. Complaints received for the year are reported against the overall activity for that directorate for comparison and, where indicated further investigations can be undertaken, as illustrated in the graph opposite. Whilst remaining high compared to other clinical directorates, the number of complaints received overall by General Surgery has reduced in quarter 2 compared to previous quarters. Complaints A National Perspective The Parliamentary and Health Service Ombudsman (PHSO) has released her report on NHS Complaints Handling in 2011/12. Nationally complaints have increased by 1.3 % however at STHFT the numbers received in 11/12 remained the same as in 10/11. In addition, the PHSO reported that significantly more patients are referring their concerns on to the PHSO as they are not satisfied with the outcome of the local complaints procedure at their hospital. It is pleasing to report that the numbers of complainants who remained unsatisfied and went to the PHSO from STHFT in 2011/12 did not increase. In total the PHSO received 65 complaints about STHFT in 2011/12 of which 2 were accepted for investigation and one was upheld by the PHSO. The PHSO report highlights the importance of good communication, sensitivity, explaining decisions properly, acknowledging mistakes and making changes when things go wrong. The results from 2011/12 demonstrate the strengths of the Trust s complaints handling service and reflect the hard work and efforts that go into ensuring that complaints are handled well by staff across the Trust. The Trust will continue to ensure that we keep a careful focus on the systems and processes we have for ensuring complaints continue to be well managed, closely monitored at senior levels throughout the Trust and that complainants continue to be heard.

Feedback Overview Patient Experience Report - Page 14 Complaints The diagram below shows the top 5 sub-subjects raised in complaints between July and September 2012. The number of people represent the number of times a sub-subject has been recorded and the different colours indicate which care group the complaint was regarding. ATTITUDE APPROPRIATENESS OF MEDICAL TREATMENT GENERAL NURSING CARE COMMUNICATION WITH PATIENT The issues most frequently raised by complainants across all Care Groups relate to staff attitudes and communication. This finding is echoed in patient experience information gathered through unsolicited general feedback. The fact that issues of attitude and communications are frequently commented on by patients and their families, highlights their importance in the overall experience. A number of current work streams aim to make improvements in relation to attitudes and communications and performance will continue to be monitored through the Trust s ongoing programmes of patient feedback. In particular, questions relating specifically to staff attitude have now been incorporated into the Frequent Feedback survey programme which will enable more detailed collection of data at ward level. COMPETENCE OF MEDICAL STAFF KEY Corporate Departments Diagnostics & Therapeutics Emergency Care Head & Neck Obs, Gynae & Neonatology Op Services, Crit Care & Anaesthetics Community Care Spec Cancer, Medicine & Rehab Surgical Services South Yorkshire Regional Services

Care Group and Directorate Breakdown Patient Experience Report - Page 15 Care Group and Directorate Breakdown The Care Group and Directorate Breakdown aims to compare key indicators by care group and, where information is available, by directorate. Complaints by outcome, findings from the Frequent Feedback inpatients survey and patient information status results are presented. Complaints by Outcome Trust Total Crit Care, Anaethetics & Operating Services Critical Care Anaesthetics and Operating Services Diagnostic & Therapuetic Services Pharmacy Medical Imaging & Physics Laboratory Medicine Professional Services Emergency Care Diabetes & Endocrinology Gastroenterology Geriatric & Stroke Medicine Emergency Medicine Respiratory Medicine Head & Neck Services Neuro-Sciences ENT / Ophthalmology / Oromaxiofacial Obs, Gynae, Neonatology Obs / Gynae / Neonatal Assisted Conception South Yorkshire Regional Services Renal Cardiac Vascular Specialised Cancer, Med & Rehab Specialised Medicine Specialised Rehab Specialised Cancer Communicable Diseases Surgical Services General Surgery Orthopaedics / Plastics Urology Community Services Care Closer to Home Health and Well Being Interface Services Rehabilitation Services Upheld Complaints (%) 21% 33% 33% 33% 40% 50% 25% 50% 50% 28% 33% 20% 25% 28% 33% 11% 9% 14% 9% 9% - 16% 40% 13% 0% 23% 44% 0% 17% 0% 30% 13% 32% 50% 18% 25% 50% 0% 0% Complaints Partially Upheld Complaints (%) 45% 50% 33% 67% 40% 50% 50% 0% 50% 28% 0% 20% 38% 33% 17% 52% 45% 59% 45% 45% - 48% 20% 53% 60% 45% 33% 80% 50% 0% 52% 50% 54% 50% 36% 25% 0% 50% 100% Not Upheld Complaints (%) 34% 17% 33% 0% 20% 0% 25% 50% 0% 45% 67% 60% 38% 39% 50% 36% 45% 27% 45% 45% - 36% 40% 33% 40% 32% 22% 20% 33% 100% 18% 38% 14% 0% 45% 50% 50% 50% 0% TOTAL COMPLAINTS (QTY) 247 6 3 3 10 2 4 2 2 40 3 5 8 18 6 44 22 22 33 33 0 25 5 15 5 22 9 5 6 2 56 16 28 12 11 4 2 4 1 Since April 2010 all complaints on completion have been assessed and reported as Well Founded, Partially Founded or Unfounded to help categorise the outcome. In October 2012, the definitions were amended to upheld, partially upheld and not upheld to be consistent with those used by the Healthcare Ombudsman (PHSO). This outcome assessment is made by the Patient Partnership Co-ordinator and, as such, is subjective. An independent audit is to be undertaken by members of the Patient Experience Committee, including governors, to check the consistency of a sample of these assessments. Although the outcome assessment is subjective, the Trust is in line with other trusts in relation to the proportion of complaints that are upheld either partly or in full. Complaints Outcome Definitions Upheld Partially Upheld Not upheld Complaints in which the concerns were found to be correct on investigation. Complaints in which, on investigation, the main concerns were not found to be correct, however some of the concerns or issues raised by the complainant were found to be correct. Complaints in which the concerns were not found to be correct on investigation.

Care Group and Directorate Breakdown Patient Experience Report - Page 16 Frequent Feedback Inpatient Survey The Inpatient survey is designed to capture patient feedback from across the Trust on a range of topics. The Trust has previously completed 2 waves of the inpatient survey, the first from June 2009 to May 2010; this was then updated in June 2011 when the second wave ran until June 2012. The survey has recently been revised to include questions on issues which are of importance to patients as demonstrated in Picker research and based on the Trust s scores in the National Inpatient survey 2011. In addition, questions on mixed sex accommodation and five Commissioning for Quality and Innovation (CQUIN) questions continue to feature in the survey. The new survey is also now used to form the patient survey element of the Clinical Assurance Toolkit (CAT) Patient Questionnaire. The questionnaire covers topics such as: communication from doctors and nurses, getting help when needed and provision of information. A new feature has been introduced on the electronic survey devices so we are now able to capture free text comments. A selection of these is featured on page 17. Scoring On the following page, each score from the survey is colour coded to give a guide to highlight those areas performing well and those performing not so well. The colour coding is as follows: 85% or above is excellent 75%- 84% is good 65% -74% is average 64% or below is poor As highlighted earlier in this report, attitude is an issue that leads to a high number of complaints. Regular analysis of unsolicited feedback also shows attitude to consistently be in the top 5 negative and top 5 positive themes, highlighting that this is of great importance to the overall experience of care. To enable the Trust to closely monitor patient s perception of staff attitude, questions relating specifically to staff attitude have been incorporated into the Frequent Feedback survey programme. The questions are listed below and results will feature in future Patient Experience Reports. Overall, how would you rate the attitude of the staff on this ward? Thinking about the staff you have seen on this ward, have any of them demonstrated an excellent attitude? Thinking about the staff you have seen on this ward, have any of them demonstrated a poor attitude? The aim in 2012/13 is to increase the number of patients asked to give us their views through frequent feedback by 20% on last year and to provide survey reports targeted specifically to the areas from which the feedback was gathered quickly. Results for the directorates that have been surveyed so far are presented on the following page. Directorates where there are no results have been excluded and will be reported on in future reports.

Care Group and Directorate Breakdown Patient Experience Report - Page 17 Frequent Feedback Inpatient Survey Scores Percentages show the results for all positive responses to the areas surveyed to date. Questions asked Thinking just about your stay on THIS WARD, have you shared a sleeping area, for example a room or bay, with patients of the opposite sex? Has someone explained to you the reason why you shared a sleeping area, for example a room or bay, with patients of the opposite sex? During your stay on THIS WARD, have you used the same bathroom or shower area as patients of the opposite sex? Trust Wide Emergency Medicine Neuro-Sciences ENT / Ophthalmology / Oromaxiofacial Obs / Gynae / Neonatal Renal Cardiac Vascular 99% 99% 98% 100% 100% 100% 95% 97% 99% 100% 99% 99% 100% 99% 99% Specialised Medicine 32% 20% 33% 38% 100% 100% 33% 89% 90% 91% 85% 97% 94% 71% 97% 81% 73% 93% 88% 87% 94% 96% Whilst on this ward, have you been disturbed by noise from staff whilst resting / sleeping? 79% 79% 82% 76% 65% 75% 80% 89% 79% 78% 70% 89% 80% 76% 78% In your opinion, how clean is the hospital room or ward that you are in? 87% 90% 80% 72% 65% 91% 89% 89% 88% 91% 82% 86% 87% 83% 78% When you have important questions to ask the staff treating you, are you able to understand the answers you are given? 97% 95% 97% 96% 85% 98% 97% 100% 95% 99% 100% 98% 100% 95% 99% Do you have confidence and trust in the DOCTORS treating you? 90% 90% 88% 91% 81% 89% 94% 94% 95% 90% 97% 92% 88% 89% 89% Do DOCTORS talk in front of you as if you aren't there? 83% 81% 77% 89% 94% 87% 81% 72% 85% 89% 91% 87% 86% 89% 79% If you ever need to talk to a DOCTOR, do you get the opportunity to do so? 96% 96% 95% 100% 96% 98% 94% 98% 97% 95% 97% 98% 94% 96% 91% Do you have confidence and trust in the NURSES treating you? 93% 91% 93% 89% 94% 97% 97% 96% 95% 90% 95% 96% 94% 92% 92% Specialised Rehab Specialised Cancer Communicable Diseases General Surgery Orthopaedics / Plastics Urology Inpatient Survey Do NURSES talk in front of you as if you aren't there? 89% 87% 85% 94% 94% 93% 92% 93% 83% 91% 87% 96% 94% 88% 87% Whilst on this ward, have you been confused by staff giving different information or advice? 83% 83% 86% 100% 70% 93% 86% 92% 66% 71% 89% 75% 83% 85% 72% Do the staff treating you introduce themselves? 96% 96% 98% 92% 100% 95% 100% 100% 98% 94% 96% 95% 94% 92% 97% If you need help to eat or drink are you given the help you need? 99% 100% 100% 90% 100% 100% 97% 92% 100% 98% 81% 89% 96% 96% 88% If you need help to wash or dress are you given the help you need? 97% 98% 93% 100% 100% 100% 99% 100% 100% 100% 90% 97% 96% 98% 94% If you need help from staff getting to the bathroom or toilet, do you get it in time? 96% 97% 97% 100% 96% 94% 99% 97% 98% 97% 89% 94% 96% 96% 94% Do you think the hospital staff do everything they can to help control your pain? 98% 98% 99% 100% 93% 100% 100% 99% 100% 94% 100% 97% 98% 98% 100% When you use the call button do you get the help you need within an acceptable time? 98% 98% 98% 95% 94% 100% 100% 100% 100% 93% 96% 100% 99% 94% 94% Are you involved as much as you want to be in decisions about your care and treatment? 95% 94% 93% 100% 100% 92% 94% 91% 100% 95% 98% 98% 94% 95% 95% Are you given enough privacy when discussing your condition or treatment? 94% 93% 92% 96% 100% 93% 98% 96% 100% 94% 100% 100% 94% 94% 88% Have you or your family been involved in planning what will happen when you leave hospital? 64% 63% 66% 69% 83% 47% 71% 62% 91% 47% 79% 75% 51% 70% 61% Overall, do you feel you have been treated with respect and dignity during your stay in hospital? 99% 99% 99% 100% 97% 100% 100% 99% 100% 98% 100% 100% 99% 98% 100% Overall, how would you rate the care you have received? 98% 98% 99% 100% 97% 100% 98% 100% 99% 99% 100% 98% 98% 98% 98% During your hospital stay, have you been asked to give your views on the quality of your care? 17% 16% 21% 40% 35% 5% 14% 13% 47% 23% 22% 33% 13% 13% 9% Would you recommend this hospital to your family and friends? 97% 96% 98% 100% 94% 100% 98% 97% 99% 98% 100% 99% 94% 95% 96%

Care Group and Directorate Breakdown Patient Experience Report - Page 18 Frequent Feedback Inpatient Survey Patient Comments Along with the recent changes to the inpatient survey, a new feature has been introduced on the electronic survey devices so we are now able to capture free text comments as part of the Inpatient Survey. A sample of comments received this quarter are presented below to illustrate the range of comments made. Full comments for each ward will be circulated quarterly in the Care Group Patient Experience Reports as part of the Trust s Reporting Framework. Royal Hallamshire Hospital E1 Can hear other diagnosis of patients in room. E2 Dr didn t tell patient what he had arranged next G2 Every body lovely. Very good hospital. H2 All staff excellent couldn t wish for better. I1 Food is excellent. L2 Staff have all been very nice and respectful. M2 Too much noise from patients at night. N2 Perfect P1 Staff run off their feet. P2 Fantastic service. P3 Staff's care extended to support of my partner...some1 noticed her anxiety and took her somewhere private to talk with her. Northern General Hospital Brearley 3 Time lapse when call button is used. Brearley 4 MAU WARD ABIT NOISY Burns Unit Very friendly staff. Chesterman 2 Very satisfied with care. Can t fault it. Chesterman 4 Food isn t very tempting. Firth 2 Food is dreadful...not good. However I think I have received the best medical care. Firth 4 Pressed call button during the night and nobody arrived after a long wait; had to turn it off and wait for a nurse to walk past Firth 6 / MAU 3 Never had such good treatment. Firth 7 Enjoy being on this ward very much. Firth 9 I was just impressed by the medical care I have received. Huntsman 6 Comfortable as you can be under circumstances. Robert Hadfield 1 Well I have been treated with dignity and courtesy. Vickers 4 Staff are very courteous ~ nothing is too much for them. Weston Park Hospital Ward 3 Was supposed to go to chemotherapy at 9; but doctor hasn t turned up; not yet had treatment. Grateful for everything. Ward 4 Everyone does their best; thanks. Friendly staff.

Care Group and Directorate Breakdown Patient Experience Report - Page 19 Patient Information Status To meet Trust standards all leaflets need to be reviewed on a 2 yearly basis. Since January 2012 any un-reviewed leaflets reaching 3 years old are now automatically archived. The status of leaflets is monitored on a monthly basis by the Patient Information Manager. Crit Care, Anaethetics & Operating Services Critical Care Anaesthetics and Operating Services Diagnostic & Therapuetic Services Pharmacy Medical Imaging & Physics Laboratory Medicine Professional Services Emergency Care Diabetes & Endocrinology Gastroenterology Geriatric & Stroke Medicine Emergency Medicine Respiratory Medicine Head & Neck Services Neuro-Sciences ENT / Ophthalmology / Oromaxiofacial Obs, Gynae, Neonatology Obs / Gynae / Neonatal Assisted Conception South Yorkshire Regional Services Renal Cardiac Vascular Specialised Cancer, Med & Rehab Specialised Medicine Specialised Rehab Specialised Cancer Communicable Diseases Surgical Services General Surgery Orthopaedics / Plastics Urology Community Services Care Closer to Home Health and Well Being Interface Services Rehabilitation Services Total Information Resources 49 47 2 97 19 27 10 41 300 204 12 2 77 5 204 87 117 87 86 1 101 22 47 32 255 71 74 94 16 80 46 30 4 51 Information Status Information Leaflets within review date Information Leaflets less than 12 months beyond review date Information Leaflets more than 12 months beyond review date 65% 64% 100% 91% 100% 81% 100% 97% 90% 89% 100% 100% 90% 100% 97% 97% 97% 94% 94% 100% 82% 73% 91% 75% 92% 82% 98% 94% 94% 93% 91% 93% 100% 78% 35% 36% 0% 8% 0% 15% 0% 11% 10% 11% 0% 0% 10% 0% 3% 3% 3% 6% 6% 0% 17% 27% 9% 22% 5% 14% 1% 2% 6% 6% 7% 7% 0% 22% 0% 0% 0% 1% 0% 4% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 3% 3% 4% 1% 4% 0% 1% 2% 0% 0% 0% Click here to access live data Total number of resources 1200 1000 800 600 400 200 0 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Patient Information - Monthly Progress (Status by Total Resources) Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 The Patient Partnership Department have been successful in securing funding from Sheffield Hospitals Charity towards the implementation of a new patient information system. Interlagos Advanced Publishing System will improve the production, quality and access of patient information resources. It will allow staff to easily update the content of their patient information leaflets via a secure internet site to predefined templates set up by the Trust, ensuring accurate, up to date, and consistent information. As well as the new patient information system, other aspects of information provision are to be improved. These initiatives will be detailed in a future report but will include: Supporting information provision across community services Encouraging the uptake of Information Prescriptions for patients with a long term condition Improving the information used as part of the consent process Improving access to patient information via the internet Improving access to information for patients with specific needs The first stage of implementation for the Interlagos system will be completed by the end of January 2013.

National Surveys Patient Experience Report - Page 20 Introduction and Background National Cancer Survey The National Cancer Survey 2012 survey included all adult patients (aged 16 and over) with a primary diagnosis of cancer who had been admitted to an NHS hospital as an inpatient or as a day case patient, and had been discharged between 1st September 2011 and 30th November 2011. 160 NHS trusts providing cancer services participated in the survey. The Trust received a response rate of 70% (1241 questionnaires), compared to the national response rate of 68%. Overall, the results of the National Cancer Survey 2012 show the Trust performance is similar to the results achieved in the 2010 survey. 40 35 30 25 20 15 10 5 Count of questions where performance more than 5% worse than national average Count of questions where performance more than 5% better than national average Cancer Patient Experience Results 2012 Results Summary 0 The Trust achieved significantly improved scores from the 2010 survey for 9 questions. Improvements include providing information to patients on tests, what to expect during tests, side effects and privacy when discussing treatment. It is also pleasing to note more patients reporting that they were receiving better guidance on financial help, free prescriptions and other information. Breast Colorectal Lung Prostate Brain / CNS Gynaecological Haematological Head & Neck Sarcoma Skin Upper Gastro Urological The Trust has three areas where further improvement is required: - Patients family definitely had opportunity to talk to doctor (72% in 2010, 66% in 2012) - Always / nearly always enough nurses on duty (67% in 2010, 60% in 2012) - Always treated with respect and dignity by staff (87% in 2010, 83% in 2012) The Trust also: Scored in the top 20% of trusts for 18 questions (out of 70 questions) Scored in the lowest 20% of Trusts for 2 questions Action plans are being developed to identify ways to address areas for improvement. These will be developed by the relevant Cancer Teams.

Focus on A&E Patient Experience Report - Page 21 Accident & Emergency Clinical Quality Indicators Quality Indicators 2012/2013 A&E Quality Indicator performance initiatives have been agreed for 2012/13. Each quarter there will be a specific initiative to collect feedback relating to patient experience. This will vary each quarter in line with the recommended approach to experiment with various means of obtaining feedback, perhaps including focus groups, discovery interviews, web based feedback or written questionnaires. The schedule for each initiative will be: Quarter 1, April - Jun: National A&E Survey (results summary on next page) Quarter 2, Jul- Sept: Staff Survey. Semi structured staff interviews will take place to obtain views on patient experience. A range of staff groups will be interviewed including, nursing, medical, admin and portering staff. Interviews will be carried out by trained volunteers and Trust governors. Quarter 3, Oct Dec: Patient Survey. A paper based survey using snap survey software will be designed and analysed by the patient partnership department. Interviews to be carried out by trained volunteers and Trust governors. Quarter 4, Jan- Mar: Experience Based Design (EBD) Project. Staff and patients completing the surveys in quarters 2 and 3 will be invited to take part in this project to triangulate feedback and identify improvement areas. By using different methodologies, the initiatives above aim to capture a broad range of data. The project in quarter 4 will involve working together with staff and patients to pull together the results from the previous quarters, identifying areas for improvement and agreeing actions. In addition to the quarterly initiatives, other regular feedback that is available for A&E will be monitored and reported on a quarterly basis in order to provide a consistent measure across time to enable us to monitor any changes in performance. These include: Comments card feedback Complaints Website Feedback

Focus on A&E Patient Experience Report - Page 22 National A&E Survey Results Introduction and Background The survey was undertaken by a postal questionnaire based on a random sample of patients who attended the Trust in January, February and March 2012. The purpose of the survey is to understand what patients think of A&E department services provided by the Trust and was developed through consultation with patients, clinicians and trusts. A total of 818 eligible patients were sent the survey, of which 276 returned a completed questionnaire, giving a response rate of 34%. The response rate for the A&E Department Survey in 2008 was 37%. Results Summary A total of 42 questions were used in both the 2008 and 2012 surveys. Compared to the 2008 survey, the Trust performed: Significantly BETTER on 3 questions Significantly WORSE on 1 question The scores show no significant difference on 38 questions Compared to other Trusts who contracted with Picker, the survey showed that our performance was: Significantly BETTER than average on 3 questions Significantly WORSE than average on 1 question The scores were average on 56 questions Trust performance compared to the previous A&E survey Note that lower scores indicate better performance The Trust has improved significantly on the following questions: Question 2008 2012 Waiting: not told how long would have to wait to be examined 66% 55% Care: not enough information given to family/friends 20% 12% Leaving: family or home situation not taken into account 72% 51% The Trust has worsened significantly on the following questions: Question 2008 2012 Leaving: not told who to contact if worried 22% 33% Latest results compared to other A&E departments Results were significantly better than the 'Picker average' for the following questions: Question Trust Average Ambulance: waited more than 30 minutes for care to be handed over to A&E staff 4% 9% Waiting: should have been examined sooner 33% 39% Hospital: unable to get suitable refreshments 22% 30% Results were significantly worse than the 'Picker average' for the following questions: Question Trust Average Care: not enough privacy when discussing condition or treatment 33% 26% The Picker Average compares the performance of the Trust to that of the other 65 trusts who used Picker to administer their survey.

Focus on A&E Patient Experience Report - Page 23 A&E Patient Feedback Activity April to June 2012 A&E Subjects raised in Complaints Received There were 20 complaints received regarding A&E between April June 2012. As the graph below demonstrates, Lack of Care Medicine received the highest number of complaints, however the overall number of complaints received has continued to fall. 14 13 Complaints received regarding A&E April - June 2012 A&E Website Feedback and Comment Cards The receptionist was in no way sympathetic or acted liked she cared about what she was doing Absolutely everyone I had contact with was very professional, extremely helpful and a credit to the NHS The doctor I saw in A&E was patronising and didn't let me explain the pain I was in 12 10 8 6 The staff were very kind and welcoming and did not make me feel troublesome They do not tell you how long you need to wait!!! It is really annoying All the staff were wonderful to my Mum 4 4 2 1 1 1 0 Lack of care - Medicine Bedside Manner Delay Environment Discharge A&E Complaints Received Sept 2010 to Sept 2012 This graph shows complaints are within a consistent range for the level of clinical care delivered and indicates that the number of complaints have been reducing:

Visits Patient Experience Report - Page 24 Governor Visits This page provides an overview and recommendations from the Governor visit to the Beech Hill Intermediate Care and Rehabilitation Unit on the 10 th September 2012. All recommendations for new Governor visits are sent to the Trust Executive Group (TEG) for comment. Observations / Recommendations Governors comments Governor Visit Beech Hill Intermediate Care and Rehabilitation Unit Department Response Key Points Governors who visited were impressed with what they saw and learned from patients and staff The Unit accommodates 31 patients in their own en-suite room At the time of the visit Sheffield had 93 intermediate care beds, Beech Hill and five independent providers this has now been increased to 124 The highest proportion of Beech Hill patients are aged 90+ and many have no family support 80% of patients are discharged to their own homes The multidisciplinary team working ethos seems strong A mental health team is employed in partnership with the Health and Social Care Trust, more than 40% of intermediate care patients have mental health problems TEG Response Is it possible to secure the mental health resource in the longer term? Beech Hill aside, is STH confident that the market will provide sufficient, quality intermediate care and rehabilitation units to meet demand for the next few years? Is the number of Beech Hill patients being readmitted to hospital as expected? Under the tariff does STH incur a financial penalty for each hospital readmission? A review of intermediate care provision is currently being undertaken by Commissioners (NHS Sheffield). As part of this we have proposed a model of service delivery, including maintaining the current mental health provision. STH is extending the transfer of care/ discharge work programme of Deloittes to undertake a capacity and demand review to inform the debate on bed demand. We will also work closely with Independent Homes to ensure continuous improvements on quality, both through intermediate care staff and our Care Home Support Team. Risks regarding funding for homes from Local Authority are a concern in the future. The patients admitted to Beech Hill have become progressively more complex with higher needs and multiple co morbidities. They are also transferred from hospital at an earlier stage. Although patients have to be confirmed as medically fit for transfer the frailer older person is obviously at risk of deterioration while they are still in a recovery phase. The service is not aware of any benchmarking of re admissions from community IC rehabilitation units for comparison. We are not aware of any financial penalty for the hospital at present but do know re-admissions will be included in future contracts. TEG supports the Care Group s approach to this issue. This also part of ongoing discussions with commissioners. TEG supports this piece of work and has good links with the local authority to address possible pressures from funding challenges. This issue will continue to be monitored. The issue of readmissions is closely monitored as part of the contract with our local commissioners There are financial penalties in some circumstances