SOMERSET PARTNERSHIP NHS FOUNDATION TRUST QUALITY ACCOUNT PRIORITIES 2016/17 Report to the Trust Board 22 March 2016 Sponsoring Director: Author: Purpose of the report: Key Issues and Recommendations: Director of Governance and Corporate Development. Director of Governance and Corporate Development. The report sets out the process for agreeing the quality account priorities for 2016/17 and the recommended areas for focus for the Trust in the coming year. The Quality Account is published annually by each NHS healthcare provider and made available to the public. Based on a range of criteria, the Executive Team has drawn up a long list of priorities for attention over the coming 12 months and we have consulted on these with staff, members, patient representative groups and Governors in deciding on a final priority list for 2016/17. The proposed areas for detailed focus and scrutiny in 2016/17 are: reducing avoidable pressure ulcers; improving understanding and recording of capacity and consent; improving personalised care planning; increasing carers involvement; investigating and learning from unexpected deaths; meeting needs for end of life care; improving the monitoring and detection of deteriorating patients. Actions required by the Board: The Board is requested to discuss the report and agree the proposed quality priorities for 2016/17. March 2016 Public Board - 1 -
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SOMERSET PARTNERSHIP NHS FOUNDATION TRUST QUALITY ACCOUNTS PRIORITIES 2016/17 1. INTRODUCTION 1.1 The Quality Account is published annually by each NHS healthcare provider and made available to the public. 1.2 The quality of the services provided is measured by looking at: patient safety; the effectiveness of treatments that patients receive; patient feedback about the care provided. 1.3 As always, while our aim remains to achieve continuous quality improvement in all our services, each year we focus on a number of particularly key issues where we think improved quality would make the most difference to our patients. 1.4 We then agree ways to measure how we have improved these aspects of our care delivery and report at the end of the year how they have made a difference both across the Trust and locally within teams. 2. CONSULTATION 2.1 For 2015/16, we identified the following priorities for our Quality Accounts: reducing pressure ulcers in hospital and community settings; reducing harm from falls in hospital; reducing medication administration errors; reducing the use of restraint in mental health wards; implementing screening tools to improve the coordination of care for frail elderly patients; implementing the Duty of Candour requirements. 2.2 Priorities for next year will be drawn from our own review of our quality performance and the identification of areas for improvement - whether March 2016 Public Board - 3 -
continuing existing areas or developing new themes from quality issues or feedback. 2.3 As in previous years, the Executive Team has undertaken an initial review of quality performance during 2015/16 to consider areas where we might wish to focus its priorities for quality improvement during 2016/17 and this has inevitably focused on issues identified before and during the Care Quality Commission (CQC) inspection in September 2015. 2.4 This initial review took into account: CQC Comprehensive Inspection reports; national patient safety and patient experience initiatives, such as the Sign Up to Safety campaign; patient, carer and public feedback on our services; learning from complaints, PALS, incidents and quality reviews; patient surveys and patient satisfaction questionnaires; feedback from Patient Safety Walkrounds and other staff listening events; feedback from other external reviews of our services (Healthwatch, external and internal audit); feedback on last year s Quality Account; our strategic objectives and service development plans. 2.5 At the Board and Governors Away Day in December 2015 we discussed priorities around the key strategic theme of Quality and Safety and in particular the further focus on harm free care and the response to the CQC report and findings. 2.6 We have committed to the national Sign Up to Safety campaign and developed our three year Quality Improvement Plan based on these commitments. We are therefore proposing to continue to align our Quality Account priorities to those we have identified for the campaign as well as key areas identified in the CQC report. 2.7 At its meeting in February 2016, the Council of Governors reviewed the long list of priorities and provided feedback on the areas they felt the Trust should particularly focus our attentions in 2016/17. March 2016 Public Board - 4 -
3. QUALITY ACCOUNT PRIORITIES 2016/17 3.1 General feedback from all sources has been supportive of the overarching approach and of the issues and priorities identified. On this basis we have developed the following shortlist of key priorities for the Quality Account 2016/17. The other areas on the original long list will continue to be addressed and monitored through the existing governance system: reducing avoidable pressure ulcers; improving understanding and recording of capacity and consent; improving personalised care planning; increasing carers involvement; investigating and learning from unexpected deaths; meeting needs for end of life care; improving the monitoring and detection of deteriorating patients. 3.2 We have developed key measures to make sure we are delivering the identified priorities and will develop further performance measures and monitoring arrangements as national and local CQUIN targets and other national performance indicators are agreed. 3.3 While all of these are important and we will make sure they are part of our quality improvement programme, we will focus on these key priorities in the next year to monitor more closely and make sure we are getting them right and we will report on these in more detail in our 2016/17 Quality Report. 4. RECOMMENDATION 4.1 The Board is asked to approve the quality priority areas for the 2016/17 Quality Account. DIRECTOR OF GOVERNANCE AND CORPORATE DEVELOPMENT March 2016 Public Board - 5 -
Links to Strategic Themes: Identify to which of the Somerset Partnership NHS Foundation Trust strategic themes this report relates by including a cross behind the relevant theme(s) Quality and Safety Innovation Viability and Growth Integration Service Delivery Culture and People Links to the Assurance Framework: Links to the NHS Constitution and Trust Values: Links to CQC Domains: Identify to which risks of the Assurance Framework this report relates The Trust fails to implement its Quality Improvement Plan and fails to achieve improvement in harm free care and patient and carer involvement leading to poorer patient experience and patient safety Risk rating: 4 x 3 = 12 Identify the Values to which the issues raised in this report relate by including a cross behind the relevant value(s) Working together for patients Respect and dignity Commitment to quality of care Compassion Improving lives Everyone counts Identify which of the CQC domains are covered by this report by including a cross behind the relevant domain(s) Is it safe? Is it caring? Is it well-led? Is it effective? Is it responsive to people s needs? Legal or statutory implications/ requirements: implementation of Health and Social Care Act 2012 in respect of commissioning structures and requirements for greater transparency in quality of services and improved patient and public involvement; the requirement for Foundation Trusts to produce a Quality Account and Report is set out in the Health and Social Care Act and guided by regulation. March 2016 Public Board - 6 -
Public/Staff Involvement History: The long list of priorities took into account sources of patient feedback, including complaints, Friends and Family Test, patient surveys and PLACE inspections. We have sought feedback on the priorities from Healthwatch Somerset, staff members, Trust members, other patient representatives and Governors. Previous Consideration: Reports on quality are presented to the Board on a monthly basis. The Quality Account priorities were considered by the Trust Board and Governors at the joint Away Day held in December 2015 March 2016 Public Board - 7 -