Experience Led Commissioning

Experience of Maternity care January 2015

Christine Armstrong, Regional Lead 10,000 Voices

Context of Patient/Client Experience in NI

Central to strategic drivers – A Strategy for Maternity Care in Northern Ireland 2012 - 2018 /Quality 2020

Response to high profile inquiries

“The patient voice should be heard and heeded at all times” (Berwick 2013)

Overview of 10,000 Voices

Improve patient experience

Influence how services are commissioned

Aim of 10,000 Voices

Core Principles of Experience-based Design

Partnership approach between patients, staff and carers

Emphasis on experience rather than attitude or opinion

Narrative and storytelling approach to identify ‘touch points’

Emphasis on co-design of services Systematic evaluation of improvement and

benefits

Experience-Led CommissioningA new model of commissioning

Experience-based Design is about: -

Capturing the experience Understanding the experience Improving the experience Measuring the improvement

Experience-Led CommissioningA new model of commissioning

Person and their experien

ce

Listening

Learning

Improving

Influencing

“Working together to make positive

change”

Trust action plans

Regional action plans and commissioning priorities

Patient stories

Phase 1 – Unscheduled care Phase 2 – Care in Home Phase 3 – Staff experience

Experience of nursing and midwifery care (regionally agreed Key Performance Indicators)

Phases of 10,000 Voices

Consistent delivery of midwifery care against identified need

Confidence in the knowledge and skills of the midwife

Sense of safety whilst under the care of the midwife

Involvement in decisions about midwifery care

Experience of Nursing and Midwifery Care - Key Performance Indicators (KPIs)

Time spent by midwives with the woman

Respect from the midwife for the patients preference and choice

Midwives support to care for themselves, where appropriate

Midwives understanding of what is important to the woman

Experience of Nursing and Midwifery Care - Key Performance Indicators

(KPIs)

A Strategy for Maternity Care in Northern Ireland 2012 - 2018 A quality maternity service is one which is

both safe in terms of the physical and emotional needs of women and their babies, takes account of their opinions and experiences

Any quality monitoring must include patient experiences.

Listening to experiences of maternity care

• Stories collected across all 5 Trusts

• All areas of maternity care

• Experience of MLUs to inform regional guidelines

• Data collected in a variety of settings, for example: clinical settings/community groups/roadshows

10,000 Voices Experiences of Maternity Care

How safe did you feel while being looked after by the midwife…

I felt safe all the time

It depended on who was looking after me

I always felt vulnerable and unsafe

Strongly positive/ positive – 92% Neutral/not sure – 5% Strongly negative/negative -2.5% Missing data – 0.5%

How the overall experience of maternity care was rated

Theme – Feeling safe

• Safe in a crisis situation• Keeping woman and her partner calm and

relaxed• Understanding anxiety of first time parents• Providing reassurance

“At all times I felt safe and in a controlled environment”

Stories rated as strongly positive/positive

Theme – confidence in the skills of midwives• Professionalism of staff • Highly experienced staff• Excellent clinical knowledge

“Professional and personable staff with excellent clinical knowledge”

Stories rated as strongly positive/positive

Theme – Communication with women and their partners• Introductions and explanations of what was

happening • Listening to concerns and answering

questions • Keeping woman and partner informed• Respectful of choices of women“For each person it is a unique experience , so no question felt too silly to ask”

Stories rated as strongly positive/positive

Theme - Providing compassionate care• Staff going the extra mile• Dedication of staff to work• Very helpful and friendly staff • Made to feel very welcome• Good teamwork“We had total trust in the hands of the professionals, who showed empathy, clarity, integrity and teamwork”

Stories rated as strongly positive/positive

Theme – Staffing levels

• Staff overworked • Staff have a lot of paperwork to complete• Staff staying on after shift was finished

“Felt that the staff had no time to spare”

Stories rated as neutral/not sure

Theme – Staff attitude

• Staff appeared rude and abrupt• Made to feel uncomfortable• Not offering enough support

“I experienced a lack of empathy and care that left me in tears”

Stories rated as negative/strongly negative

Theme – Communication• Mixed messages from midwives• Women felt that they were not being listened

to• More information needed, for example

miscarriage, consent for theatre “ I wish now that I had been more forthcoming and demanded that my voice be heard”

Stories rated as negative/strongly negative

Regional workshop and further analysis

Development of local and regional action plans

Further period of story collection

Next steps

Christine Armstrong, Regional Lead 10,000 Voices

Email: Christine.Armstrong@setrust.hscni.net

Telephone: 07711002069

Contact details