Patient experience Litigation/Inquests April 216 The receipt of a formal letter of claim is the trigger for both clinical and non-clinical negligence claims against the Trust. The litigation team also use other indicators to assess the likelihood that the Trust may receive a claim in the near future. One of the key indicators used is the receipt of a request for notes from an interested third party as this is often the precursor to a claim. The summary of litigation activity In March 216 is below: 6 requests for notes from interested third parties that have the potential to develop into a claim. There was no clinical negligence letters of claim received There were 2 non-clinical request for notes received There were no inquest verdicts in March 216 Healthcare NHS Trust March 216) Requests for Notes March 216 Patient Experience Litigation summary of claims & Inquests opened in March 216. There were 6 requests for notes received in March 216. the 6 cases include failure to provide adequate treatment, failure to diagnose and incorrect diagnosis from a scan. There are two non clinical related request for notes in March 216. one relates to a trip over a telephone cord and one relates to potential harm cause by noise exposure in 1984. 3.5 3 2.5 2 1.5 1.5 Requests For Notes March 216 (Potential Clinical Claims) SURCC Womens INTMED SPSER Letters of Claim - Clinical Negligence There were no letters of claims received in March 216. Non Clinical Claims. Non Clinical Negligence Requset For Notes March 216 1.2 1.8.6.4.2 SURCC BHT

% % % Quality Issue Provider Action CCG Assurance Patient Experience-Friends and family In March 216 the patient experience manager presented a plan to trial a mobile phone text message service to the Caldecott committee. Following approval at that committee a trial was started in. the decline in approval rating is being monitored and possible reasons are increase in responses collected contributing to a more accurate reflection of our performance. This will be monitored over April 216 and reported on next month. FFT performance remains a challenge and in the fourth quarter of 215/16 the patient experience manager has continued to support improvement in FFT performance by weekly feedback/observations of service FFT performance and immediate feedback to encourage and ensure uptake of the FFT with the aim to achieve 3% or greater response rates. The Trust response rate for March 216 was 17%. Healthcare NHS Trust February 216) March 216 - Results of proactive action for improved FFT Response FFT total responses (Oct 15) = 714 (Nov 15) 1149 (Dec) = 156 (Jan) = 997 (FEB) = 1131(Mar) 117 FFT Trust total responses (Oct 15) = 292 (Nov 15) 2962 (Dec) = 3483 (Jan)= 2422 (FEB) = 2769 (Mar) 221 FFT Approval Rating (Oct 15) = 95% (Nov 15) = 96% (Dec) = 96% (Jan)= 95% (FEB)= 96% (Mar) 9% Action taken : A program of weekly reporting of FFT performance has been developed to assist all services track improvement. Weekly updates are provide to the executive team. The Trust is currently trialling a text messaging service in for FFT. This commenced 14.3.216, 224 responses were received by text in March 216 (34%) of the total responses received. A!% rise in activity in March 216 meant that the additional responses received by text did not have the expected visible impact in March 216. 5 4 3 2 1 Response Rate Against 215/216 Target Nov Dec Jan Feb Mar Apr Matern ity Target Target Target Mat 5 4 3 2 1 216/17 Response Rate % (unify) Nov Dec Jan Feb Mar Apr 12 1 8 6 4 2 216/17 FFT Approval Rating Nov Dec Jan Feb Mar Apr Materni ty

Patient Experience-The Patient Voice Better safeguards for continuity of care when discharging elderly patients You pointed out that we needed to make sure all elderly patients will be appropriately cared for before discharge from hospital is considered. Improvements are being made to our mental capacity assessment, systems and our processes for planning discharges have been reviewed and strengthened. Obstetrics and gynaecology Feedback indicated that the care given to post natal patients regarding their urinary care and medication could be improved. We ve therefore reviewed and updated our clinical guidelines regarding this care. Healthcare NHS Trust April 216) Patient Experience- Patient Engagement Patient Engagement Highlights Our End of Life (EOL) care showcase event which demonstrated evidence of change and improvement shaped by patients and carers who have engaged with us in our programme of quality improvement. This recent event included five members of our EOL patient reference panel co - presenting with us to report back to those who engaged with us last year, on our progress, that they have helped to shape. This included both development of documentation to support staff and helping to set the priorities for change. Healthcare NHS Trust April 216) *Complaints 215/16 - PALS 215/16 - Patient Experience Survey 215 - Friends & Family 215/16 - National Survey 25/13 - National Survey 214 - Maternity Survey 214 - PLACE Survey 215 - BHT Patient experience Audit 215 National children survey 214- National Neonatal Survey 214

Nov Dec Jan-16 Feb-16 Quality Issue Provider Action CCG Assurance Patient Experience Complaints & PALS Performance PALS Issues by Division April 215 to Feb 216 1 8 6 4 Nov 2 Dec Jan-16 Feb-16 Top 6 PALS "Issues" April 215 to Feb 216 6 5 4 3 2 1 Delays/Cancellations Communication with patient or relative/friend Access by phone to Appointment/Ward/Secr etary Information & General Enquiries Discharge/Transfer/Refer ral Behaviour and Attitude of staff Action Taken based on PALS data. Action 1 Communication with the Trust by telephone - in conjunction with the general manger of patient access we now have systems to ensure that no caller to BHT at the end of the day who is waiting in a telephone queue is cut off without being helped as a result of the switchboard closing. Action 2 - Issues that arise out of poor communication are being addressed by an on-going rolling training program across all grades of staff given by the Complaints/PALS and PE manager and by highlighting key communication failures and learning points identified in complaints action plans that are internally shared. Behaviour and attitude of staff, access to services by telephone and delays and cancellations have increased over January s position. Issues relating to discharge and referral have continued to show a downward trend since November 215 and decreased again in February 216 Healthcare NHS Trust February 216) A quarterly complaints survey is conducted on our complaints performance to understand the patient experience of using our complaints service. The results seen below are aggregated for 215/216 Satisfaction Survey of Complainants 215 to date 113 responses received based on 31 sent (36% response rate) Average overall score of 6.9 1% received a written response 81% believed it addresses the matters raised 97% found responses polite and easy to understand 59% were satisfied with the response received

Patient experience-complaints Performance In March 216 there were 53 formal category 4/5 complaints this compares with 5 complaints in February 216. For category 5 cases these relate to multi divisional/trust complaints that are allocated 4 days to resolve. The Trust has set a target of 85% of our complaints are to be responded to within 25 working days by March 216. The response rate in February 216 was 58% (Jan 83%). Steps taken to improve and reach the target include, weekly meeting with the chief nurse, chief operating officer and the medical director to review the position and get director level assistance, and a weekly tracker provided for the divisional chief nurses to update them with details of the current position Patient Experience-Complaints Q (Quality Improvement Plan) 1. 85% of complaints responded to within 25 working days 2. 5% reduction in reopened complaints 214/15 against 215/16 3. No complaints to take over 9 days to respond to The 5% reduction remains a challenge with total number of reopened complaint levels are lower when compared with Nov/Dec/Jan 215/16. February 216 is forecast to increase. Complaints Process Changes Complaints performance measured against the 215/16 Q targets was unsatisfactory. An executive intervention has led to some changes in the roles and responsibilities of key stakeholders who are part of the internal complaints investigations. Changes agreed include: During the 3 day acknowledgement period all complaints received are to be risk assessed using the NPSA risk assessment tool by an appropriate complaints team member. (Source: Patient Experience Manager Buckinghamshire Healthcare NHS Trust March 216) Healthcare NHS Trust March 216)

Patient Experience-Learning from complaints Feedback February 216 To help us learn from the way we handle complaints a complaints committee that uses the Trust Chair, a NED and the complaints manager was set up in 214 to ensure we learn from our complaints. A random selection of 5-6 complaints are reviewed bi-monthly synchronised with the dates for the Trust quality meeting. The complaint process and responses are reviewed for quality. Any learning from action plans developed as a result of a complaint is logged and tracked by the complaints team and some recent examples are found below. We invite complainants to participate in our Listening Events and get involved in our patient engagement group. the Board also continue to gather invaluable information through initiatives such as patient video stories. The you said we did patient feedback programme, which is now embedded across the Trust has produced the following recent changes to practice that are highlighted on our public website. Key themes & learning from a complaint closed in March 216