PATIENT EXPERIENCE AND INVOLVEMENT STRATEGY

Affiliated Teaching Hospital PATIENT EXPERIENCE AND INVOLVEMENT STRATEGY 2015 2018 Building on our We Will Together and I Will campaigns

FOREWORD Patient Experience is the responsibility of everyone at Kettering General Hospital NHS Trust, from our clinical staff who are supported by administrators, housekeeping and estates staff, together with volunteers and our Governors. Every action we take, in some way impacts on the patient s experience. Our dedicated staff work to provide high quality care at all times to our patients. We are proud of their dedication and of the high quality of care and service they provide every day to our patients, their families, carers and visitors. We aim to involve patients and those who care for them at all stages of their care. We will make every effort to reflect the needs and experiences of all our patients when planning and developing our services. We want to see consistent improvements in patient care and treatment, which will result in patients being the focus of all that we do and work to achieve. Patient experience and involvement is a vital part of our 2014-16 Quality & Safety Strategy and this means that every member of staff, at every level, must work, with support from Governors and members, to make a real difference, so that patients feel valued and their needs are understood. We want our patients and local community to have the very best experience when in our care. We are fortunate to have Patients and their Volunteer Representatives who are passionate about our service and who are willing to give up their time to help develop our services. We want to ensure that that patient involvement is consistently integrated into all that we do. Our Aims: Ensuring a systematic approach to capture feedback: Devise an effective and reliable way of capturing patient feedback so that patients, their families or carers can respond in a way that enables them to tell us what they really want us to know. Action for improvement: Use that information, alongside other data, to make concrete improvements to care and communications and to continue to monitor the improvements we make as a result. Building meaningful and positive engagement and involvement: Where there is good practice, listen to patients/families/carers to sustain improvement and quality of care and supporting development across the Trust. It is vital that we mean what we say and take realistic and positive steps to be good listeners and respond in meaningful ways. Every patient should feel respected as an individual. By working together, we can achieve this. Graham Foster Chairman David Sissling Chief Executive 2

INTRODUCTION We are an Acute Hospital NHS Foundation Trust providing high quality healthcare services for approximately 295,000 people within North Northamptonshire, Rutland and parts of Leicestershire. We exist to champion and deliver the best care, service and wellbeing outcomes possible for each individual in the communities we serve. Each year we look after over 40,000 inpatients, 38,000 day-case patients, we have 235,000 outpatients contacts, 83,000 visitors to our Emergency Department, and over 3,600 women who choose to give birth within our Rockingham Wing. Our most valuable resource is our staff and together with key partners, have developed this strategy to set out our commitment to the people we serve and provide clear direction for all of us who work together to provide the best experience possible for our patients. WHAT WE MEAN BY PATIENT EXPERIENCE AND INVOLVEMENT Patient Experience Patient experience is what the process of receiving care feels like for the patient, their family and carers. It is a key element of quality, alongside providing clinical excellence and safer care. Quality of care including quality of caring. This means how personal care is the compassion, dignity and respect with which patients are treated. One of the ways the quality of caring can be improved is by analysing and understanding patient satisfaction and experience and responding to this. A definition of good patient experience was developed by the Department of Health (DoH) after extensive research involving patients, the public and NHS staff. They found that patients want: An NHS that meets not only our physical needs, but our emotional ones too Positive feedback example: Quality of care first class. Over several visits treated with the upmost respect, courtesy and care and I just wanted to thank KGH. NHS Choices Website, 2015 3

Positive feedback with a prompt for us to explore standards on other wards: I received a call from the daughter of a patient currently in hospital. She wanted to say thank you to the ward caring for her mum and pass on her positive comments. She said the ward staff are fantastic, it s the only ward they have felt comfortable on, the staff don t mind them being on the ward at any time of the day as this helps to settle dad, the staff are not only really kind to mum but also the whole family, communication with the family has been brilliant and all staff are supportive and listen. Telephone call taken by a member of staff, 2015 Patient Involvement Public involvement is at the core of the NHS Constitution. Patients have the right to be involved in discussions and decisions about their healthcare and to be given information to enable them to do this. Patients have the right to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services. Our commitment is not just to involve patients, but to also work in partnership with families, carers and representatives. Short narrative here about a recent piece of involvement work with a positive outcome BUILDING ON OUR 2014-16 QUALITY AND SAFETY STRATEGY Our strategic Quality Objectives and Key Goals are: Reduce Mortality Reduce Harm Quality Patient Experience Develop a culture of safety and continuous improvement Our Patient Safety Campaign is underpinned by I will keep you safe by. This covers focus areas where safety improvements are continuous and monitored for effectiveness through our Quality Dashboard. Our I will campaign is widely recognised, and put simply, clearly states our commitments to safe, high quality care. It incorporates the 6Cs as purported by the Chief Nursing Officer Compassion, Caring, Courage, 4

Commitment, Communication and Competence; and forms the foundation of the Trust s Core Values and Behaviours. The I WILL campaign supports a growing body of evidence that shows patient experience is not only an important outcome in its own right, but that it also influences patient safety and clinical effectiveness, for example: Good communication and compassionate care results in reduced anxiety, improved compliance and more active self-management of long-term chronic conditions. 1, 2 Compassion and empathy makes patients more forthcoming about their symptoms and concerns, enabling more accurate diagnosis, better care and faster recovery. 3 The patient experience and involvement commitments with our 2014-16 Quality and Safety Strategy are summarised: Patients are Treated as individuals Treated with respect and dignity Involved in shared decision making Provided with information to make shared decisions Listened to and we act on their feedback THE I WILL APPROACH TO IMPROVE EXPERIENCE AND INVOLVEMENT Treating our staff as we expect them to treat patients is a core value and communicating a clear vision for ownership of improving experiences and involvement is essential for the success of this Strategy. We will continuously raise staff awareness of their responsibility for ensuring that delivering a good experience is everyone s business and contributes to a quality staff experience at the same time. The benefits we will seek to achieve through improving patient experience and involvement are: Patients with more control over their care and the ability to make informed choices about their treatment; 1 Redelmeier DA et al, (1995) A randomised trial of compassionate care for the homeless in an emergency department, The Lancet, 1131-1134. 2 Yoon et al (1993) Controlled trial evaluation of an asthma education programme for adults Thorax 48, no. 11; 1110-1116. 3 Halpern J (2001, 2011); From Detached Concern to Empathy@ Humanizing Medical Practice; Oxford University Press; Oxford 5

Patients who have a better experience of care generally will have better health outcomes; Patients who have better experiences and better health outcomes may require shorter stays in hospital and less treatments, reducing healthcare costs; Patients who have better experiences impact positively on staff experience and the culture of the organisation; Patients who have better experiences enhance the reputation of the organisation. We believe that the perfect patient experience is possible. STRATEGY ELEMENTS Experience We will focus on the areas below that will collectively impact on the patient experience to make improvements: Feedback systems, including concerns, complaints, NHS Choices, Patient Opinion and local surveys (Friends and Family etc), PLACE audits; Use of listening booths (pop up stands manned by staff in areas such as outpatients, main reception and rest areas) to promote engagement and feedback from all; Patient stories to the Board and other local level meetings; Communication; Equality First impressions including our local work with the 15 Steps Challenge undertaken by Health Watch; Our programme of internal inspections known as Walk-abouts ; Cleanliness and the environment; Food; Patient information; Support for families and carers; Infection prevention and control; End of life care; Patient perceptions of safety and quality of care; Bereavement care; Involvement During the period of this Strategy, we will aim to build on established patient and carer user groups, local patient focused organisations, and national organisations such as Healthwatch with regional teams. Involvement will also include working with our local health and social care partners, including commissioners. The NHS Health Research Authority plan to undertake a study titled A stronger voice? The role of patient and public involvement in health and social care commissioning and provision in the East Midlands. We will work with the Authority undertaking this study with links to the University of Leicester. The aim of the study will be to assess the degree to which patients and public have a say in health and social care services. 6

Kettering General Hospital s Council of Governors and our established relationship with Healthwatch Northamptonshire provides two further key avenues for patient experience and involvement. Healthwatch representatives and governors are members of our governance structure committees such as the Patient Experience Steering Group. Similarly, governors and representatives from Healthwatch are involved in formally assessing our patient environments. Non-executive Directors and Governors assist the quality governance team and Executive Directors in safety walk about visits. In terms of equality, we will ensure this is a core component of all involvement initiatives and that focus groups help us to improve our services. During the period covered by the Strategy we will implement an involvement plan to track the continued development of working in partnership with our patients and other key stakeholders. PLANNING IMPLEMENTATION In order to achieve our goals, a Patient Experience and Involvement Implementation Plan will be developed and approved by the Patient Experience Steering Group in March each year as part of the annual planning round. This process will review progress in the prior year, confirm priorities and measures of success as well as the necessary resources. It will also pay particular attention to ensuring mechanisms are in place to systematically implement things that will bring improvement to the patient experience. The framework of the implementation plan is at Appendix 1 and will be monitored by the Patient Experience Steering Group, which we plan to rename the Patient Experience and Involvement Steering Group. This group reports to the Trust s Integrated Governance Committee. The revised Terms of Reference for the newly named Group are attached at Appendix 2. ROLES AND RESPONSIBILITIES Involving patients and the public and improving the patient experience is not just the role of a central team. It is something that needs to take an organisation approach and have commitment at every level. Empowering and encouraging staff to obtain their patients feedback can have a positive impact on both themselves and their patients and lead to improved working practices, better information and communication and ultimately and improved patient experience. To support delivery of this Strategy: There is a named Executive (Director of Nursing and Quality) on the Trust Board with explicit responsibility for Patient Experience and Involvement across the organisation; The Patient Experience and Involvement Steering Group will drive forward and monitoring the Patient Experience and Involvement Implementation Plan; The Learning and Development Team will incorporate patient experience and involvement within current leadership and change management programmes for staff and within the wider organisational development; 7

Service development and service pathway design will have patient experience and involvement embedded; Our organisational development strategy will be informed on utilisation of patient experiences and using involvement to inform strategy delivery; At Clinical Business Unit level, there will be named representatives and nominated deputies to be members of the Patient Experience and Involvement Steering Group; We will continuously remind, support and train staff, Governors and volunteers to understand their role in listening and responding to the patient s experience; We will ensure that all relevant staff and volunteers can enable patients to tell their story of care by having access to the methods and skills in order to capture those stories; Seek to capture, report, include and act on real time data; We will continue to research and explore new methodologies, including social media and new technology for capturing feedback and clearly articulate the business case for investment in measuring and improving patient experience; We will develop service user groups and link across to other work streams and committees such as Equality and Diversity to evaluate the experience of those under protected characteristic; We will continue to promote an open culture where staff can raise concerns about the quality of care that is provided. RESOURCING Making the most of our resources to ensure we deliver the aims of this strategy is critical to its success. Patient experience and involvement is integral to everything we do and in this respect additional resources are not required. The roles and resource within the Quality Governance Team will be redesigned to support a strengthened system. This will enhance the measurement and reporting of patient experience and facilitate involvement. Our implementation plan will include consideration of resources within the Quality Governance Team and consider the need for a dedicated Patient Experience Lead/Team. ENSURING OUR STRATEGY IS DELIVERED Progress will be reported to the Patient Experience and Involvement Steering Group and Integrated Governance Committee on a quarterly basis. Exception reports and assurances will be detailed in our Quality Dashboard that will be revised to include the key metrics identified in our implementation plan and with the intention of continuing to support our I WILL patient safety campaign. The patient experience report will be submitted to the public section of the Board of Director meetings on a six monthly basis. Clinical Business Unit monthly performance reviews lead by Executive Directors and Quality Panel Reviews held monthly and jointly chaired by the Director of Nursing and Quality and Medical Director will see assurance from staff that they are implementing the requirements of this strategy. The ethos of You Said, We Did will be publicised in our annual reports and quality accounts, together with assurance on the progress of delivering this strategy. We will continuously seek feedback from our staff and patients on the effectiveness of this strategy in the spirit of listening to experiences and involvement. 8

STRATEGY REVIEW Our shared purpose, vision, values, standards and expectations are not expected to change, but will be reviewed no later than March 2017 and will be updated if necessary in line with any changes in national policy or local circumstances in the meantime. The implementation plan underpinning this strategy will be subject to quarterly reviews and monthly exception reporting. 9

Appendix 1 Patient Experience and Involvement Implementation Plan 2016/17 We will focus on experiences and involvement feedback from the following areas during 2016/17; We will report progress to each Patient Experience and Involvement Steering Group meeting throughout the year; Where new actions are identified to improve patient experience and involvement, this will be included in an update to this pl an so that prompt action can be taken.. Our Patient Experience and Involvement Steering Group will als o identify further priorities. Inpatient Surveys Priorities set by our Steering Group GP feedback mechanisms Council of Governors and Foundation Trust Membership Patient Advice and Liaison Service (PALS) Cancer Services Survey 2015 Our Patients Our Listening Booth as it travels across the Trust NHS Choices, Patient Opinion and Friends and Family Surveys Complaints Health Watch Internal and external inspections Patient Stories Duty of Candour experiences Hospital environment survey

Appendix 1 cont. John s Campaign/ Dementia Care Transformation Team Progress End of Life Care Patient Information Freedom to Speak Up Our Patients Preventing Avoidable Deterioration (Sepsis and Acute Kidney Injury Care) Inclusion and Diversity Preventing Pressure Tissue Damage Preventing Falls

Affiliated Teaching Hospital 1. PURPOSE Appendix 2 TERMS OF REFERENCE PATIENT EXPERIENCE AND INVOLVEMENT STEERING GROUP 1.1 The Patient Experience and Involvement Steering Group (PESG) provides assurance to the Trust Integrated Governance Committee that effective systems and structures are in place to hear and respond to the voice of the patient and public. This will inform the work of PESG in implementing national and local agendas to improve patient experience at the Trust 2. MEMBERSHIP AND ATTENDANCE AT MEETINGS 2.1 Chief Executive Officer (Chair) Director of Nursing and Quality (Vice Chair) Associate Director Quality Governance Head of Patient Experience (Quality Governance Department) Patient Advice and Liaison Service (PALS) Co-ordinator (Quality Governance Department) Strategic Liaison Nurse for Learning Disabilities Medical representative Representative Medicine CBU Representative Surgery CBU Representative Clinical Services Representative Women and Child Health Discharge team representative Trust Equality & Diversity lead also representing Human Resources Faculty member Representative of Estates and Facilities General Practice representative Corby and Nene Commissioning Group representative Two Northants Volunteer and Community Service representatives Two Healthwatch representatives Two Patient and public representatives Two representatives from patient/user groups reporting to PESG 2.2 Quoracy Chair or vice chair plus one representative from the Quality Governance department, one representative from at least two CBUs and two patient or public representative or Healthwatch member 3. FREQUENCY OF MEETINGS 3.1 Monthly. Chairman: Graham Foster Chief Executive: David Sissling

Affiliated Teaching Hospital 4. AUTHORITY 4.1 PESG is a sub-committee of the Trust s Integrated Governance Committee. 5. DUTIES AND RESPONSIBILITIES 5.1 The duties and responsibilities of PESG are as follows: To develop and agree a patient experience strategy that is underpinned by a coherent work programme that is consistent with national and local improvement requirements. To implement and monitor the work programme both at organisational level and also across each of the CBUs To review progress against the Patient Experience and Involvement priorities included within the Trust s Annual Quality Account and Patient Experience and Involvement Strategy To raise the profile and awareness of the Trust s commitment to improving patient experience across the Trust. To receive and review a collated report from all sources of patient feedback gained through complaints, national surveys, Net Promoter Scores, NHS Choices, Patient Opinion, PALS, peer review, patient/public representative information, Healthwatch and that provided to us by Commissioners and GPs; using this intelligence to identify themes to be addressed to provide a coordinated response To learn from patient experience by way of a patient story being heard as a standing agenda item and to incorporate any relevant learning or actions into the work programme. To act as the overarching Steering Group for Patient Experience, into which all other Trust patient and user groups will report To review national initiatives regarding patient experience such as the Patient Revolution, Dying Matters and Dignity Day to inform improvement programmes and staff engagement To advise the Integrated Governance Committee of key themes, actions and priorities associated with improving patient experience; providing assurance that this is taken seriously. To receive information regarding complaints performance and themes for the Trust to determine appropriate actions. Chairman: Graham Foster Chief Executive: David Sissling

Affiliated Teaching Hospital To review quarterly Patient Experience reports detailing key metrics such as complaints and patient survey results and also progress against the Patient Experience work programme To review the findings of the annual staff survey to understand staff views about the organisation and the potential impact that this may have upon patient experience. Work with Trust partners in determining priorities for improvements to the environment or to obtain equipment required to improve patient experience that informs application for funding. To determine a process through which all patient and user led groups in place across the Trust will report to the Patient Experience Steering Group though a reporting schedule. 6. REPORTING AND ACCOUNTABILITY 6.1 Minutes of PESG will go to the Integrated Governance Committee and the vice chair of PESG will attend the Integrated Governance Committee to present the minutes. 6.2 An Annual Patient Experience report will go to the Integrated Governance Committee and the Trust Board 6.3 All patient experience sub groups will report to PESG. Current working groups include: Learning Disabilities group End of Life Care Older Adults Dementia group Patient Information group 7. REVIEW 7.1 The Terms of Reference of PESG will be reviewed on an annual basis. 7.2 Next Review Date: July 2017 8. SECRETARIAL SUPPORT PA to the CEO or Deputy Director of Nursing and Quality Reviewed July 2016 Chairman: Graham Foster Chief Executive: David Sissling