Corporate Patient Experience PlanSummary

21 February 2013Croydon Health Services

Summary of key priorities for Inpatients • Too many inpatients report that we did not manage their pain well • - Pain audits completed for all wards; reported to and monitored by the Nursing & Midwifery Board - Patients asked about pain management at Quality Rounds - pain management included in nurse training

• Too many inpatients say the toilets or bathrooms are dirty. - refurbishment of toilets and bathroom commenced on the Duppas wards delayed. Wards needs to

decant to allow work to progress .

• Too many inpatients report that different staff say different things when asked questions about their care.

- Juice Learning multi-professional training to improve team working around the patients commenced

- leaders event on 24 January, full programme from 11 February with positive feedback - ‘Patient Status at a Glance’ boards on wards are well used however daily team board rounds need to be strengthened -

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Summary of key priorities for Inpatient • Too many inpatients have low confidence and trust in doctors - Initial phase of communication project completed - Associate Medical Director for Clinical Governance appointed to lead on the project - A bid has been submitted for a Darzi fellow who will build on work already

undertaken incorporating the three components of quality into the Ward Round process.

• Too many inpatients have low confidence and trust in nurses - High calibre registered nurses have been recruited consequent to the removal to the

20% coverline. Recruitment to fill vacant ward leader posts - A coherent programme of audits have been developed to monitor the quality of care - A Lead Nurse for Practice Development and Education has been appointed and has

reviewed nurse and healthcare assistant (HCA) education and development programmes. New programmes to be launched in April 2013

- the number of practice development nurses has been increased to support nurse/HCA competency development

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Inpatient CQUIN 12/13CQUIN questions:Q32 Were you involved as much as you wanted to be in decisions about your care and treatment?Q34 Did you find someone on the hospital staff to talk to about your worries and fears?Q36 Were you given enough privacy when discussing your condition or treatment?Q56 Did a member of staff tell you about medication side effects to watch for when you went home?Q62 Did hospital staff tell you who to contact if you were worried about your condition or treatment after you left hospital?

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Trust code SHA name

SHA cluster

Year Q32 Q34 Q36 Q56 Q62 CQUIN

RJ6 LONDON SHALondon

2012 63.2 42.3 79.2 33.7 68.7 57.4

    

2011 63.8 44.8 76.1 40.4 68.1 58.6

    

2010 62 47.4 76 37.2 60.8 56.7

National Inpatient Survey 2012

Final results available in April 2013

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Summary of key priorities for Outpatients

Summary of key priorities for Outpatients• Before your appointment, did you know what would happen to you during the

appointment? - work has been completed on new patient templates to improve communication with

patients before their appointment. New IT system will improve the format and standardise across the organisation

• Did doctors and/or other staff talk in front of you as if you weren’t there? - the interaction of 53% of doctors with patients has been reviewed and

developmental feedback given individually. This is to be repeated in 2013/14

• Were you involved as much as you wanted to be in decisions about your care and treatment?

- the planning for this programme is largely complete

• Did hospital staff tell you who to contact if you were worried about your condition or treatment after you left hospital?

- Juice Learning multi-professional training has commenced. -

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Patient Experience Plan

Summary of Key Priorities for Maternity Services

Did you get enough information from a midwife or doctor to help you to decide where to have your baby?

• All communication training has been implemented – however this needs to be continued to ensure that new staff understand the importance of offering choice to women

• GP’s need to influence the choice agenda too• Adherence to generic SWL booking referral letter • Booking standard needs to be adhered to – audit against booking standard to be

considered 2013

Thinking about your antenatal care, were you involved enough in the decisions about your care?

• Decision made to commit to the CHS NHS Trust 5 promises• NICE guidance on antenatal care• Continued work to improve the communication skills (New staff) now included

Mandatory training program

Were you (and / or your partner or a companion left alone by midwives or doctors at a time when it worried you?

• Promotion of 1:1 care in labour to staff – NICE guidance • Accurate recording of 1:1 care in labour – Protos (Maternity system) • Continued support to achieve ratio’s 1:28 in line with Safer childbirth/CNST guidance • Robust recruitment – 17 midwives recruited in October last year • Recent recruitment drive – uplift in establishment (1:29) Posts offered• New leadership posts:

Consultant midwifeSafeguarding midwifeMatron for Maternity Uplift in Obstetric Anaesthetic PA’s

Thinking about your care during labour and birth, were you involved enough in decisions about your care?

• Continued reinforcement with regard to appropriate and effective communication – especially for new starters

• 5 promises and reinforce culture about importance of individualized care• Ability to use language line effective at short notice (Mobile phone) • Stable and sustainable workforce (reduce use of agency)

Thinking about the care you received in the hospital after the birth of your baby, were you treated with kindness and understanding?

Summary of A&E Survey ResultsPatients Attending March 2012

Survey Context

Fourth national survey of patients attending Accident and Emergency Departments (2003,2004,2008)

147 acute and specialist trusts in survey Sampling month Jan, Feb or March 2012 Response rate 38% (311) = national rate Demographic characteristic differences (age, ethnicity, religion) Results reported in 8 sections Each question is scored out of 10 Trusts are benchmarked as ‘Same’, ‘Worse’ or ‘Better’

Compared with the 2008 survey, CHS is ‘worse’ in 3 sections, the ‘same in 5

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Issues, themes, trends highlighted by patients

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Issues, themes, trends highlighted by patients

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Summary of patient Feedback

What CHS needs to improve ….

• Reduce patients waiting time to speak to a nurse/doctor after arrival

• Reduce patient’s waiting time to be examined by a nurse/doctor

• Improve information to patients about expected length of wait

• Improve overall length of time in A&E• Improve the cleanliness of the

department and toilets• Improve process for patients on

discharge from the Department by taking into account home situation

• Overall rating of care

What CHS is doing well ….• More questions improving than

worsening since last survey• Strong performance on doctors and

nurses relationships with patients• Strong and improving performance on

care and treatment

A plan of action is being developed to address these issues.

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