Patient and Carer Experience Annual Report

Patient and Carer Experience Annual Report 2017-2018 Including Complaints and Patient Advice Liaison Service (PALS) 1

Contents 1. Introduction... 3 2. Achievements over the Past Year (2017/18)... 3 2.1 Goal 1: Innovating Quality and Patient Safety... 4 2.2 Goal 2: Enhancing Prevention, Wellbeing and Recovery... 12 2.3 Goal 3: Fostering Integration, Partnership and Alliances... 13 2.4 Goal 4: Developing an effective and Empowered Workforce... 14 2.5 Goal 5: Maximising an Efficient and Sustainable Organisation... 15 2.6 Goal 6: Promoting People, Communities and Social Values... 16 3. Complaints and Patient Advice Liaison Service (PALS)... 16 4. Reporting Arrangements... 21 5. Conclusion... 21 Appendix 1: Patient Experience Team Structure... 24 Appendix 2: Patient Story... 25 Appendix 3: The Patient, Carer and Staff Stories Pathway... 26 Appendix 4: Patient and Carer Experience Strategy 2018-2023 (Plan on a Page)... 27 Page 2 of 27

1. Introduction The Patient and Carer Experience Annual Report (2017/2018) including the Complaints and Patient Advice Liaison Service (PALS) provides an overview of the work carried out across the organisation over the past year to support the patient and carer experience and engagement agenda. Putting patients, service users and carers first is our priority at Humber Teaching NHS Foundation Trust (HTFT). Involving patients, service users their carers and our partners in all that we do has become an integral part of our culture and everyday thinking. In order to embrace a broad perspective, we actively listen to people from all parts of the community and equality and diversity is the golden thread woven throughout the patient and carer experience agenda. Due to the vast range of diverse services we provide, we believe that there is an immense wealth of knowledge that we can access from our patients, service users and carers to help us with our improvement journey and transformation plans. A new post Head of Patient and Carer Experience and Engagement commenced 1st June 2017 to strengthen the approach to capturing patient and carer experience to inform improvements in services (refer to appendix 1 which shows the structure of the Patient Experience Team). The best way to improve quality in an organisation is by finding out what our patients, service users and carers are saying through their lived experiences. We have introduced Patient and Carer Experience (PACE) forums where patients, service users and carers attend regular meetings to provide a voice of their lived experiences. Staff Champion of Patient Experience (SCoPE) forums have also been established where staff meet to share best practice and learning and provide a voice of experience on behalf of their clinical networks. We are continuing to build relationships with our partner organisations and meet every three months with our local Healthwatch colleagues so that everyone can understand what each other is doing and achieving. We will continue to embed a culture of genuine patient, carer and service user involvement and engagement within the organisation. This report provides an overview of the Complaints and Patient Advice and Liaison Service (PALS) activity for 2017-2018. Analysis of the themes from complaints and concerns is used to identify areas for learning to improve patient experience. In addition the information gathered is compared with other patient experience feedback. All feedback from complaints is shared with the relevant service area to enable teams to share positive feedback and consider suggestions for improvements made by patients, service users and carers. 2. Achievements over the Past Year (2017/18) This report includes achievements made across the organisation to support the patient and carer experience and engagement agenda over the past twelve months. The achievements have been aligned to the Trust s six strategic goals, which include: Page 3 of 27

2.1 Goal 1: Innovating Quality and Patient Safety By actively listening to patient, service user and carer views we can learn and act upon them to help improve the quality and safety of the services we provide. 2.1.1Patient Feedback Patients, service users and carers are providing valuable feedback across service areas through a variety of methods. During the summer of 2017 a scoping exercise was carried out to highlight the many different approaches used across our care groups to collect individual views to help inform future service delivery and to provide vital information to help inform learning. a) Developing Forums and Network We have created experience and engagement forums including: Patient and Carer Experience (PACE) forum provides a public voice by bringing lived experiences and individual perspectives. The first Hull and East Riding forum took place in January 2018 and meets every three months. Staff Champion of Patient Experience (SCoPE) forum shares best practice and provides a voice of experience on behalf of clinical networks. The first Hull and East Riding forum took place in October 2017 and meets every two months. Staff (Patient and Carer Experience Champions) are the conduit between the Patient Experience Team and individual teams to help support and deliver the patient and carer experience priorities. Widening Participation forum to build stronger relationships and partnerships with third sector, public sect, commissioners and hard to reach groups who provide a voice for the communities and groups they serve. This forum will meet for the first time later this year. The aim is for the Patient and Carer Experience forum and Staff Champion of Patient Experience forum to be established before this third forum is established. Individuals are being invited to join a Patient, Carer and Staff Experience network. A database has been created to include individuals who have expressed an interest in Page 4 of 27

sharing their lived experiences in a particular service area. From time to time individuals will be given the opportunity to participate in events or workshops aligned to their area of interest (e.g. Adult Mental Health services). Over time the network will evolve and will not be an exhaustive list. We are exploring options for patient and carer experience forums and a network in Whitby, Scarborough and Ryedale and it is intended to hold the first forums in the Autumn of 2018. b) Friends and Family Test (FFT) Survey Over the past twelve months, a significant amount of work has taken place to improve the FFT survey system and process. A live data dashboard has been created to enable all staff to view results of FFT surveys received from patients and carers in real time. This means that as soon as the completed survey form arrives in the Trust, the information is inputted and downloaded to the dashboard. Teams can see this data the next day. The information shows how we are performing at organisation, care group and team level and includes; number of survey forms received percentage of people who would recommend our services by month breakdown of positive, neutral, negative and don t know responses a random selection of feedback comments including; main reason for recommending/or not, what we do well and what we could do better. A strengthened process has also been designed including a new pathway for staff to follow to standardise across all teams (from handing out the survey to acting upon the feedback received, whether this be to share good practice with staff or to learn and act upon feedback which requires an improvement to the service provided). An information leaflet has been designed for patients, service users and carers to highlight the different ways in which they can complete the FFT survey (e.g. electronically via our website or paper form). A poster is available for teams to display, advertising the FFT survey to encourage the public to provide feedback on the service. Friends and Family Test (FFT) Results for 2017/18 Overall the FFT scores for year April 2017 to March 2018 were very good; satisfaction results were above the 90% target for all care groups. The Primary Care, Community, Children's and Learning Disabilities care group achieved excellent results for the year with a 99.1% year to date recommendation score. In the first few months of the year there were a limited number of returns for the Specialist Services care group. However this was addressed by: The introduction of a rota system for Humber Centre patients was introduced. Each month two patients from each ward are identified on the rota to complete the FFT survey forms. This prevents the same patients completing the FFT survey every month and subsequently getting survey fatigue. Page 5 of 27

Addictions services have developed an internal process for the distribution and return of FFT survey forms to influence better response compliance. FFT Likely to Recommend From September to December there was a decline in patients saying that they are likely to recommend our services to their friends and family, with a gradual increase for the last 3 months of the year. FFT Felt involved in the decision making of my care The Trust performs extremely well where patients feel involved in the decision making of their care. The lowest score over year was 97% in November 2017 and the score peaks at 99.5% in April 2017 and March 2018. Page 6 of 27

FFT Staff were friendly and helpful The Trust performs extremely well for staff being friendly and helpful. In June 2017 the Trust scored 100% and the lowest score for the twelve month period was 98.1% in November 2017. FFT Received appropriate information regarding care The organisation scores well where receiving appropriate information regarding care is concerned and peaked in April 2017 with a score of 99.8% and the lowest score for the year was 96.8% in August 2017. NHS England is reviewing the FFT survey and the Trust has contributed towards the review. It is anticipated that a refreshed set of survey questions will be introduced later this year. The Patient Experience Team will continue to work with the established Patient and Carer and Staff forums and the care groups to continue to identify actions and improve reported experience of our services. Page 7 of 27

Friends and Family Test Results (April 2017 to March 2018) Page 8 of 27

Friends and Family Test Feedback (April 2017 to March 2018) c) Bereavement Survey Package In line with the Care Quality Commission (CQC) Key Line of Enquiry (KLOE) C3.2 ( do staff respond in a compassionate, timely and appropriate way when people experience physical pain, discomfort or emotional distress? ) a bereavement package has been developed to support the bereaved. The package has been developed to capture the quality of care and support from our services and focuses on adults only. This will be a phased approach with phase one commencing in Spring 2018 including, community services teams in Pocklington and Whitby, Whitby Community Hospital and Market Weighton General Practice. The bereavement package includes: A bereavement card (designed by our Recovery College students) A bereavement booklet (bespoke to the service) detailing help and support available in the local area Clinicians can play a pivotal role in providing care to bereaved individuals. They will ask two questions when visiting the bereaved and will populate a template with the responses: Would you have liked any further support with regards to your bereavement? Was there anything we could have done better or differently, as hearing about your experience can help us to progress? The Patient Experience Team will collect feedback from the clinical teams to identify what is working well and where improvements can be made. Teams will learn from the feedback and act upon it accordingly to make improvements and share best practice. Page 9 of 27

Bereavement cards created by the Recovery College and funded by Health Stars d) Quality Health Surveys Over the past twelve months the Trust has participated in two surveys managed by Quality Health to capture patient views and perceptions of care from inpatient and community mental health services. Quality Health manage the process from distributing the questionnaire to analysing the information and making recommendations. Their surveys are developed after extensive discussions and testing with patients, service users, carers and managers. Adult Mental Health Inpatient Survey 2017 The Trust had 78 respondents, compared with to average of 1,260 respondents from other Trusts; approximately 16 times lower than other Trusts. The Mental Health Services care group identified the following improvements from the recommendations presented by Quality Health and are working on the following: To ensure that staff orientate service users to the ward effectively, taking into account service users' specific needs. To ensure that all service users are given information about how to make a complaint if they were to have one. To ensure that all service users have an effective, local, out-of-hours phone number before they leave the ward. Adult Mental Health Community Survey 2017 At the January 2018 Board meeting, a Business Development Consultant from Quality Health attended to present the results of the 2017 National Community Mental Health Service User Survey. The Trust response rate was 27% (224 respondents from a final sample of 825 people). Overall, the section scores for the Trust were either towards the top end of the expected range or were better than expected. This was a noticeable improvement on the 2016 scores. The Trust is one of only three in the country where patient s experience of care is better than expected. The Trust was congratulated by Quality Health on the progress and improvements made since the 2016 survey. The Trust recognises the challenge to build on and maintain these improvements and is progressing recommendations made by Quality Health including: Page 10 of 27

To ensure patient experience data and patient outcomes data is collected to measure impact change has on care and take action as required. To seek ways to improve participation of service users in decisions about their medication, paying attention to establishing what level of involvement in decision-making the patient would like. To review what information is given to service users when they are prescribed new medication. To establish the most effective way of communicating with each service user and, if necessary, consider ways of making information accessible and understandable. To continue to review and monitor the offer of support given to service users. e) Patient and Carer Stories We are committed to learning from patient, service user and carer experiences and listening to people s stories is one way to help achieve this. Stories can help build a picture of what it is like to be in receipt of our services and how care can be improved or best practice shared. Every month the Board receives a patient story or briefing to help contextualise their decision making. Edith s Story (appendix 2) was presented to our Trust Board in September 2017. Edith is a patient receiving care from one of our Neighbourhood Care Teams and also Social Services. She asked to tell her story about the great care she is receiving. Her story represents excellent integrated working between our Neighbourhood Care Team, GP surgery, Social Services and hospital. Absolutely everybody was courteous, approachable and professional, I felt so supported on every single visit. Looking back now, it saved my life and I can t emphasise that enough. The best way I can describe the whole experience was like a hug without the physical touch. Patient Story A framework has been developed to support patients, carers and staff involved in patient and carer stories and it is hoped to help make the process clear and streamlined. To support the framework, a step by step pathway has been designed to create a simplistic guide for individuals to follow (appendix 3). f) Complaints and Patient Advice Liaison Service (PALS) and Compliments Feedback from complaints and concerns provides a valuable opportunity to demonstrate to patients, service users and carers that we are actively listening and acting upon the concerns they may raise. Feedback can influence improvements across the whole organisation, not just in the teams concerned. Complaints and concerns contribute to a culture of continuous service improvement within the Trust. Page 11 of 27

Feedback from compliments gives us valuable information on what is working well in our services. This year we have started sharing compliments of the month on our staff email communication system to share with all staff across the organisation. It is very important to share positive feedback across teams as well as learn and act upon feedback where improvements are needed. Refer to section 3 which provides an overview of the Complaints and PALS activity for 2017-2018. g) Perfect Ward Patient Experience Audits The Perfect Ward is a smart audit app that makes audits quicker, easier and more effective. The audits and questionnaires are very simple and are in electronic format. Two sets of questions have been developed for the patient questionnaire element to capture qualitative data in real time to better understand the patient experience; a set for mental health inpatient units and a second set for physical health community hospitals. The questions are asked by clinicians using the Perfect Ward App during the patients hospital stay. Results are shared with the nurse in charge to address issues or concerns raised. Issues are discussed at Multidisciplinary Team (MDT) meetings. h) Working across Care Groups Each care group has produced a Quality Improvement Plan including Patient and Carer Experience and Involvement priority areas. Work continues across the care groups to deliver on the identified actions with support from the Patient Experience Team where required. 2.2 Goal 2: Enhancing Prevention, Wellbeing and Recovery Progress continues to empower individuals to work with us to better manage their own care, this includes our patients, service users and carers being involved in care planning and decisions about their care or care of a loved one. 2.2.1 Identifying Carers and Carers Assessments The Trust recognises the importance of carers having support. Therefore it is necessary to identify carers (somebody who the patient or service user relies on to support them with their daily activities) and offer a carers assessment where required. Work is continuing to ensure staff are identifying and signposting carers for assessments as appropriate. Information has been collated from across Trust services regarding the number of carers identified and signposted. A strengthened process has come into effect for all clinicians with the exception of Whitby Minor Injury Unit and children s services. When a clinician comes into contact with a patient, service user or their carer, they must identify whether there is a carer and then complete the relevant documentation. Where a carer s assessment is offered and accepted, the clinician must signpost the carer to the local carers support services in the Trust s geographical area. From Summer 2018, a quarterly report will Page 12 of 27

be produced to provide an update on teams who are recording carers and offering carers assessments. Any teams who are not following this process will be identified and the Patient Experience Team will provide additional support where required. 2.3 Goal 3: Fostering Integration, Partnership and Alliances A new Equality and Diversity lead for patients and carers commenced June 2017 and a new Equality and Diversity lead for staff commenced September 2017. The two leads have formed a strong and effective working partnership where both agendas have been developed into a joint action plan. The leads meet on a monthly basis to progress the Equality and Diversity joint agenda. Relationships with partner organisations continue to strengthen. The Trust attends a number of forums and has an active role in the wider community to support the diverse groups we serve, thus creating more meaningful and active partnerships. We continue to ensure that at all times our information is accessible so that everyone can understand what we are saying and doing. 2.3.1 Partnership Working We are fostering stronger relationships with our local Healthwatch organisations who work with local communities including hard to reach groups to ensure their voices get heard. Quarterly meetings have been established with all four Healthwatch organisations within our geographical boundary and the Head of Patient and Carer Experience and Engagement has been identified as the central contact point for the Trust and Healthwatch communications. At the meetings work plans are shared and relationships are developing to support each other s agendas. We attend regular forums across the local area to engage with partner organisations and community members where a range of protected characteristics are represented; the forums include; Hull & East Riding Lesbian, Gay, Bisexual and Transgender (LGBT) forum, East Riding Disability Advisory Group, East Riding Equality Network, Equality and Diversity Locality Network and Cross Sector Engagement Group. The forums are actively used for information sharing, policy and document consultation, sharing of best practice and provide an opportunity to learn from the individuals/communities themselves. The groups are given the opportunity to actively engage with the Trust to help to make improvements and provide a voice for work the Trust is pursuing. The Head of Patient and Carer Experience and Engagement continues to network with other patient experience leads across the country and is a member of the National Patient Experience Network. Valuable networking opportunities have taken place over the last twelve months where the Head of Patient and Carer Experience has visited patient experience leads in other NHS Trusts and leads have visited our Trust. The networking opportunities have provided a pivotal opportunity to share good practice and learn lessons from each other. Page 13 of 27

2.3.2 Accessible Information We are keen to ensure our information is accessible to all of our patients, service users and their relatives, carers and friends. To help achieve this, we are considering using computer software able to convert the information into formats which will meet differing needs. One option, Browsealoud, provides easy-to-use tools such as textto-speech, translation for people who use English as a second language, text highlighting (including making fonts larger), and audio file creation. We will continue to explore options during the next year. The Patient and Carer Experience forum and East Riding Healthwatch (Read Right project) provide feedback on new patient information materials to ensure information is in plain English and understandable. 2.3.3 Chaplaincy Services Within the Patient Experience Team is a Chaplaincy Manager who provides a range of spiritual and pastoral care needs to service users, carers and staff and has knowledge of a range of religious faiths and practices and supports individuals on a variety of issues, often complex and multi-cultural. During the past twelve months the Chaplaincy Manager has introduced Spiritual Care forums to support members of staff with spiritual and religious matters. As a result of this forum, staff are coming forward to be Spiritual Champions and are attending the forums to discuss, promote and receive education on all matters of faith and spirituality. 2.4 Goal 4: Developing an effective and Empowered Workforce Our staff are at the heart of our organisation and patient and carer experience is the business of everyone who works for us. Our Staff Champions are excellent advocates for sharing the learning and best practice realised from the forum meetings, with their teams. 2.4.1 Collaborative Working Collaborative working has developed across the Trust with voluntary services, research and development, infection control care and patient and carer experience leads meeting on a bi-monthly basis at the Staff Champions of Patient Experience forum. Global communications are cascaded to all staff on a regular basis to involve and update on the patient and carer experience agenda including updates on what is happening in our diverse communities on a local and national level. The Patient Experience Team works across the Trust s care groups and attends regular meetings in the various service areas to raise the profile of patient and carer experience by informing teams of the programme of work and how staff can support the agenda. Page 14 of 27

2.5 Goal 5: Maximising an Efficient and Sustainable Organisation 2.5.1 Development of the Patient and Carer Experience Strategy (2018-2023) During this year we have produced our second Patient and Carer Experience Strategy (2018-2023), a five year plan further building on the work done with our patients, service users and carers since our initial strategy in 2016. The strategy highlights how the Trust will continue to actively engage and involve patients, service users and carers in Trust business and highlights how we will actively listen and act upon the information we hear. The strategy not only promotes working together but also sets out how we will do this to ensure maximum involvement and engagement. The Working Together to Enhance Health and Wellbeing event was held on 14th February 2018 to co-work with patients, service users, carers and our partners to support the development of the patient and carer experience strategy 2018-2023 and identified the priorities for patient and carer experience and engagement over the next five years. A plan on a page was developed to work alongside the strategy highlighting the twelve priorities identified. 2.5.2 Always Events Framework One of the ways we are improving our Quality Improvement process is by participating in the national Always Events programme. Always Events are defined as those aspects of the patient and family experience that should always occur when patients interact with healthcare professionals and the delivery system. An Always Event is about patients, families and health professionals working together to decide what matters most to them. The Learning Disabilities inpatient team at Townend Court commenced their journey September 2017. In January 2018 they received a visit from NHS England s Always Events team who commended them on their progress to date. The team have moved forward with their first Always event; we will always be able to contact people who are important to us 24hrs a day. The next Always Event has been identified by the patients with potential ideas already taking shape. NHS England is keen to support the team and publicise their work to date and have invited the team to present at a National Learning Disability Patient Experience Conference later this year. The second team to participate in the programme is the PSYPHER service who attended their launch event 1 st February 2018. The team has identified champions to move the programme forward and the Always Events lead for Townend Court has agreed to provide mentorship to PSYPHER. Over the coming months the team will work closely with patients and carers to capture what matters most to them and will then move forward the priorities identified and turn them into Always Events. Over the next year we will be looking for additional teams across the Trust to participate in the Always Events programme. Page 15 of 27

2.6 Goal 6: Promoting People, Communities and Social Values Communication is key and our aim is to ensure we reach out to as many people as possible to raise the profile of patient, service user and carer experience whenever we can. 2.6.1 Trust Internet The patient and carer experience pages on the Trust s website http://www.humber.nhs.uk/ have been refreshed. Individuals can find out how to get involved with the patient and carer experience and engagement agenda, how to feedback on our services and learn more about how the Trust is involving patients and carers from all backgrounds in Trust business. 2.6.2 Trust Intranet The patient and carer experience area on the Trust intranet site has been improved. Staff can now access the pages to find the latest, most up to date information on what is happening in the Patient Experience Team and the care groups. 3. Complaints and Patient Advice Liaison Service (PALS) The Complaints and PALS department continues to record and respond to complaints, concerns and comments received from all areas of the Trust. We follow the guidance for The Local Authority Social Services and National Health Service Complaints (England) Regulations 2009 for all formal complaints. It is our procedure to allow the complainant/caller to decide whether they wish to have their concerns handled informally through PALS or whether they wish to have their concerns considered through the formal NHS complaints procedure. Having a combined department allows the Trust to monitor all concerns raised whether informally or formally and enables the Trust to provide a consistent approach to complainants/callers. We deliver a range of diverse services across a large geographical area, which covers Hull, the East Riding of Yorkshire, and the Whitby area of North Yorkshire. During 2018/19 this will be expanded to include the Scarborough and Ryedale area of North Yorkshire. Due to the vast range of diverse services we provide, we believe that there is an immense wealth of knowledge that we can access from our patients, service users and carers to help us with our improvement journey and transformation plans; this includes the information we receive from patients, relatives and carers regarding their experiences of our services. This report will demonstrate the issues raised with the Trust over the past year and what we have learned as a result. Page 16 of 27

3.1 Formal complaints 3.1.1 Formal complaints received For the period 1 April 2017 to 31 March 2018, the Trust received 191 formal complaints which compares to 239 for 2016/17. However it should be noted that the previous year contained all formal complaints for East Riding Community Services which transferred to City Health Care Partnership CIC on 1 April 2017. 3.1.2 Formal complaints responded to The Trust responded to 185 formal complaints for the period 1 April 2017 to 31 March 2018 which compares to 234 for the previous year. The reason for the decrease is noted in 3.1.1. 3.1.3 Complainants who were dissatisfied with the Trust s first response When complainants are dissatisfied with the outcome of our initial investigation various options are considered including; reopening the complaint and undertaking a second investigation; meeting with the complainants or a telephone call with the investigating manager. If it is felt that the Trust cannot do anything further, the complainant will be directed to the Parliamentary and Health Service Ombudsman. In 2017/18, 30 complainants ie 16.21% were dissatisfied with the Trust s first response which compared to 10.68% in 2016/17 and 13.44% in 2015/16. 3.1.4 Response times For the period 1 April 2017 to 30 September 2017, the Trust worked to 25 working days for a response to be sent to formal complaints. During this period the Trust responded to 96 formal complaints and 58 ie 60.41% of the responses were sent late. On 1 October 2017, the Complaints and PALS team commenced a pilot where the response times changed to: Page 17 of 27

Up to 30 working day response time for complaints about one team/service area and up to 6 straightforward issues. Up to 40 working day response time more than one team/complex case/multiple issues; more than 6 issues and/or less than 6 issues if they are complex. Up to 60 working day response time very complex cases/complex complainants and/or more than 15 complex issues (it is not anticipated that there will be many formal complaints that meet this criteria). For the period 1 October 2017 to 31 March 2017, the Trust responded to 89 formal complaints and 35 i.e. 39% were late however 15 of these were recorded prior to 1 October 2017 and therefore were responded to under the 25 working day timescale. The increased investigation time ensured that a higher percentage of complainants receive the response to their complaint by the original date given to them. 3.1.5 Top primary subject for formal complaints received 2017/18 Of the 185 formal complaints responded to during this period, the top 5 subject areas were as follows: Subjects are recorded on the issues raised within the formal complaint and do not necessarily reflect the findings from the investigation. A comparison with the previous year s top primary subjects shows these are broadly the same however clinical treatment has dropped out of the top 5 and admission/discharge arrangements is now included. Communication continues to be a key reason why people raise formal complaints and this is reflected in other Trusts i.e. patients/carers not feeling listened to; calls not being returned, staff not communicating sick/annual leave to them. Page 18 of 27

Patient care is predominantly about patients feeling their needs had not been met. Admission/discharge is mainly about patients being unhappy at being discharged from services. Complaints about appointments include appointments being cancelled, staff not turning up and a delay in being seen. 3.1.6 Complaint outcomes Of the 185 responded to, 39 were upheld (22%), 61 were partly upheld (33%) and 85 were not upheld (45%). In the previous year, 25% were upheld, 29% were partly upheld and 46% were not upheld. Upheld complaints are those that when investigated, it has found through investigation that the majority or all of issues raised were well founded; partly upheld complaints are where some of the issues raised were well founded and not upheld complaints are where the issues raised could not be substantiated through investigation. 3.1.7 Actions arising from formal complaints All actions identified from formal complaints are monitored by the Complaints department and for each action; confirmation/evidence is requested from the lead person identified for that action that the action has been completed by the specified time. Once this has been received, the action plans are reviewed and approved by the relevant Care Group Director. An overall tracker for all actions from formal complaints is being developed. Page 19 of 27

The following are some examples of actions/learning from complaints responded to this year. Patient specific actions have been excluded: Adult Mental Health Community To ensure that client related telephone calls are recorded to ensure that practice is defensible. Adult Mental Health, Inpatient - Remind team to be mindful as patients are admitted daily, staff may lose sight of new experience for patients/carers. Ensure welcome book given and information gathering at point of admission if possible. If high patient activity, inform and apologise to patient/carers so they understand the reasons for delay. Legal Services - When case files are reproduced for legal purposes, eg claims and inquests, the clinician who screens the records will be asked to sign a form to say that the records and been thoroughly checked and there are no documents filed relating to other patients. The current form will be adapted. Paediatric Speech and Language Therapy - To review Special School care pathway, including assessment and to review Education and Health Care plan reports submitted within Special Schools. Addictions - Ensure anyone due for admission to a detox unit for treatment regarding dependence on alcohol and/or substances is fully informed re: environment and reasons for security etc. Emotional Wellbeing Service - Ensure administration processes are developed and implemented in relation to - access rights to service email accounts to be reviewed and amended as necessary; use of different email accounts within the service; telephone script describing the content of the 45 assessment process; patient template letters on PCMIS are reviewed to ensure these are appropriate for all eventualities CAMHS - Non -attendance at multi-agency meetings. A reminder will be sent to the teams to ensure that when they are a critical member of a meeting and expected by the family that their non-attendance is communicated with the family to avoid the family feeling let down. 3.2 Parliamentary and Health Service Ombudsman Of the formal complaints responded to in 2017/18, two complainants have taken their case to the Parliamentary and Health Service Ombudsman and they are under review. Another case which was responded to in 2016 (District Nursing; service no longer with this Trust) was considering during this time. This complaint was partly upheld and the Ombudsman asked the Trust to provide a further apology which was completed. Page 20 of 27

3.3 Patient Advice and Liaison Service (PALS) For the period 1 April 2017 to 31 March 2018, the Trust responded to 431 PALS contacts which compares to 655 for the previous year. Part of this reduction is due to the transfer of community services and compliments are no longer recorded on the PALS database; they are recorded directly by the service/team. Of the 431 contacts, 176 were referrals to other Trusts and therefore there were 255 concerns, queries or comments for this Trust. The top primary subjects for PALS contacts are as follows:- Clinical treatment 80 (31%) Advice and information (general) 35 (14%) Appointments delay/cancellation 35 (14%) Attitude of staff 18 (7%) Communication to patients 16 (6%) Medication 13 (5%) Advice and information (clinical) 11 (4%) 4. Reporting Arrangements We have designated groups with operational oversight and monitoring of patient and carer experience including complaints and PALS. A quarterly report is shared with our Quality and Patient Safety Group and the Quality Committee. Concerns, complaints and Friends and Family Test results are included and discussed at board meetings and Council of Governor meetings; they are included in the Trust s Integrated Quality Performance Tracker. Our services discuss patient and carer experience including complaints and PALS in team meetings. Best practice is shared and where improvements are needed, action plans are implemented to learn lessons. 5. Conclusion We aim to provide our patients, service users and their carers with the best possible experience when in our services. We recognise that there are links between patient experience, clinical safety and effectiveness and we will continue to improve quality and patient safety and enhance prevention, wellbeing and recovery by listening to what individuals think, feel and experience throughout their journey and beyond. This report highlights a number of areas of good practice to be celebrated but it must be recognised that there is still a lot more work to do. We realise that the best way to improve quality in an organisation is by finding out what patients, service users and carers say through their lived experiences. Building on the success of the Friends and Family Test live data dashboard, during the next twelve months will see the development and implementation of a patient experience dashboard which will provide information on complaints, concerns and compliments at organisation, care group and team level. Teams will be able to access the patient experience dashboard information together with the Friends and Family Test data to identify Page 21 of 27

common themes to share best practice and develop action plans to make improvements. An internal audit report for patient experience and involvement was issued in December 2017 and the assurance level was found to be good. Areas covered in the audit included: Are there adequate means of measuring patient experience? Are there clear roles and responsibilities regarding patient experience? Are there recording and reporting processes in place to measure patient experience outcomes? The Trust is now well placed to ensure that patients, service users and carers are at the forefront of the Trust s priorities through the launch of our second Patient and Carer Experience strategy (2018-2023). During the next year an action plan will be developed and implemented to begin to deliver the twelve patient and carer experience priorities identified within the strategy. We will know that we are making a real difference by measuring ourselves against the milestones identified in the strategy. A set of measures will be determined and these will be aligned to the twelve priorities. There will be a mixture of qualitative measures (to measure quality) and quantitative measures (to measure numerical information). Monitoring and review of the strategy will be through the delivery and implementation of the associated action plan with bi-annual updates to the Patient and Carer Experience forum, the Staff Champions of Patient Experience forum and Healthwatch meetings and quarterly updates to the Quality and Patient Safety group and Quality Committee. This strengthened approach has been endorsed by our Trust Board and will play a pivotal role in moving forwards our Quality Improvement agenda. The Trust will continue to manage and respond to complaints, concerns, comments and compliments for all our services. We will ensure that staff listen carefully to the information raised with them and aim to resolve issues as they arise as close to the delivery of the service as possible, however, if a formal complaint is raised, we will ensure staff are aware of the importance of a professional, open, honest and informative response to patients and carers when they raise a concern or complaint. To this end, more training will be given to those staff directly involved in investigating formal complaints and those staff involved in resolving concerns and queries via the Patient Advice Liaison Service (PALS) or directly with patients/carers/families. It is also important that services/teams review the themes/issues arising from their formal complaints and PALS contacts to ensure that learning is embedded in their delivery of care and treatment. This will be included in the training being delivered to teams/services. Page 22 of 27

This annual report is available in alternative languages and other formats including Braille, audio disc and large print by contacting us in the following ways: Humber Teaching NHS Foundation Trust Trust Headquarters Willerby Hill Beverley Road Willerby East Riding of Yorkshire HU10 6ED Tel: 01482 301700 Email: hnf-tr.contactus@nhs.net Twitter: @humbernhsft Facebook: @humbernhsft If you would like any further information relating to this annual report, please contact the Patient Experience Team as follows: Humber Teaching NHS Foundation Trust Trust Headquarters Willerby Hill Beverley Road Willerby East Riding of Yorkshire HU10 6ED Tel: 01482 389167 Email: hnf-tr.patientandcarerexperience@nhs.net Page 23 of 27

Appendix 1: Patient Experience Team Structure Page 24 of 27

Appendix 2: Patient Story Edith s Story Edith first became involved with the Neighbourhood Care Team (NCT) following a referral for a mobility assessment. Staff visited Edith and found her on the floor having fallen two days previously. Edith attended A&E and was discharged home with antibiotics and diagnosis of a UTI with no care package in place. Edith was admitted to the Neighbourhood Care Team s hub bed at the Residential Home where she received physiotherapy, occupational therapy and nursing input to improve her mobility, progress her independence with meal preparation and assess her continence needs and pressure area care. Edith self-discharged and was referred to Red Cross services and Social Services for aids and adaptations and ongoing care. A few months later, Edith became involved with the Neighbourhood Care Team once more following a fall at home. Edith had cancelled her daily calls through social services and at this point was referred for physiotherapy and occupational therapy for falls prevention but wanted to cancel these visits also. Staff agreed to visit her for assessment anyway. Edith was found on the sofa where she had been for around 48 hours, unable to weight bear due to pain. Following discussion between Edith s Physiotherapist and the duty GP at her surgery, Edith s Physiotherapist arranged for her to attend A&E for assessment and she was subsequently readmitted to the hub where she received physiotherapy and occupational therapy, a nursing assessment and social services assessment. Edith progressed well in the hub and was able to mobilise independently with an aid and complete her own personal care with supervision on discharge. Edith was able to return home once more with three calls a week through the intermediate care team. During NCT intervention, weekly meetings were held with Edith s GP and social service to help Edith identify when her health is deteriorating and to ensure a minimum care package of one call per day is maintained in the long term to enable Edith to manage better at home. Through close working with the GP, onward referrals have been made to mental health services and urology. Edith continues to receive support from the Long Term Conditions Nurse and also the District Nursing team. She also continues to receive physiotherapy and occupational therapy to improve her independence and allow her to return to outdoor mobility which Edith is keen to do. When telling her story, Edith told us that the staff always have her best interests at heart. She said, The services and support I have had have been extremely good and I can t fault any of them. I feel very well looked after. Sometimes I think to myself, I have all these people coming in, helping and doing things for me, I think I m the Queen of Sheba!. Page 25 of 27

Appendix 3: The Patient, Carer and Staff Stories Pathway Page 26 of 27

Appendix 4: Patient and Carer Experience Strategy 2018-2023 (Plan on a Page) If you would like the full strategy please contact the Patient Experience Team as above. Page 27 of 27