Impact Report 2018–2019 - Picker · NHS in a decade. 2011 . Picker is the Department of Health’s . partner of choice to run the NHS National Staff Survey, among the largest workforce

Influence, inspire,empowerImpact Report 2018–2019

Impact Report 2018 – 19

ContentsImpact Report 2018–2019Foreword 3Introduction 4Mission, vision and values 5Picker Principles 6Our story 8 Our global impact 10Let’s look at the numbers 12

Influence Thinking longer term 14Transformation from ‘requires improvement’ to ‘outstanding’ 16 New initiatives for the Welsh Ambulance Service NHS Trust 18 Picker resources 20

InspireStaff education needs for supporting an ageing population 22 Experiences and needs of patients with pancreatic care 24 Achieving person centred care for cardiovascular disease 26 Upcoming projects 28

EmpowerSurvey coordination 30 International impact: supporting the World Health Organisation 32

Looking forward 33Funding sources and outcomes for beneficiaries 34Board of Trustees 35

Foreword


I am delighted and honoured to start my new role as Chair, as I have been passionate about person centred care and its value in empowering the individual for a very long time.

The work that Picker does is hugely valuable for health systems, for providers, and for staff and patients worldwide. The Picker Principles beautifully encapsulate our aims for person centred care and I am really looking forward to continuing our vital work into the future.

The past year has been one of great achievement, as I hope will become evident as you read this report. In particular, I would like to draw your attention to the work we have done in empowering NHS staff to provide better services for their users and to the research we have coordinated which puts a real focus on the individual — one really important piece of work is in prioritising the right care for older people.

Our work is not limited to the UK. Picker has been increasing its global reach over the past year which has resulted in important work alongside the World Health Organisation for example on mental health and standards of care.

All of these achievements have very much been a team effort, and I would like to congratulate all our staff for their very hard work. I would also like

to thank our outgoing Chair, Stuart Bell CBE, and Ann Abraham, for their distinguished service and contribution as Trustees. This year I also want to mention the sad death of Sir Donald Irvine, our long-serving ex-Chair and Patron, who put so much into Picker. We won’t forget his lasting impact on Picker and on the field of medicine as a whole.

Looking ahead, I have no doubt that Picker’s grounding in research evidence and data will continue to underline the strategic importance of our work, as well as our thought leadership in helping others to really understand person centred care. It is important for us that the NHS Long Term Plan emphasises patient and staff experience underlining the key relevance of our work. As we approach our 20th anniversary, it seems fitting that our commitment to individual empowerment and wellbeing is proving more valuable than ever.

Professor Aileen Clarke Chair of the Board of Trustees

IntroductionAt Picker, everything we do is guided by a simple but ambitious vision: person centred care for all, always. This core idea springs from a recognition that people receiving care want and deserve to be recognised as individuals, and that the best outcomes are created when care is designed around their needs. This is reflected in the “Picker Principles of Person Centred Care”, which are recognised around the world as a framework for the things that matter most to people receiving care.

Through all of our work, we seek to influence, inspire, and empower everyone involved in the design and delivery of health and care services. We work with policy makers, providers, practitioners, and the public to understand and measure people’s experiences of care – and to ensure that these experiences are valued andused to improve services.

In this, our Impact Report for 2018/19, I am delighted to share some of the most powerful examples of our recent activities with healthcare organisations, charities, research funders, and others. These examples showcase our work and demonstrate how listening to and acting on feedback from patients and staff can transform the quality of services.

Picker has built its reputation on high quality, actionable research and insight, and this continues. Groundbreaking research with charities such as the British Heart Foundation has helped to keep people at the centre of planning around some of our most prevalent long-term conditions. Similarly, our work with Pancreatic Cancer UK has created important new insights that will lead to better support for people affected by this serious and under-researched condition.

As well as investigating specific conditions, there is great value in involving patients and the public in the design of health and care services. This year we have worked with the Welsh Ambulance Services NHS Trust to understand public perceptions of how ambulance services should operate. Through a combination of in-depth qualitative research and a wider public opinion

study, we were able to identify priorities for ensuring a person centred ambulance service.

Our research in Wales has also involved feedback from health service staff, which is of ever growing importance as part of our work. Care services depend on positive therapeutic relationships between patients and staff, and research shows that staff wellbeing and engagement is an important driver of high quality patient care. We are privileged to have worked with service providers including Northamptonshire Healthcare NHS Foundation Trust to monitor and improve staff engagement, and to leverage this to improve standards for all.

These are just some of the examples highlighted throughout this report and I am proud to be able to share such a range of impactful projects. We will, of course, look to build on these successes in our upcoming 20th anniversary year. For now, I hope you will enjoy reading this report – and please don’t hesitate to contact us if you would like to discuss anything you read here.

Chris GrahamCEO

| ExcellenceMaintaining the quality and consistency of our work is our highest priority. We are not willing to accept the status quo and continuously look for new ways to understand, measure and improve the quality of health and social care.

| IntegrityWe ensure our independence using the best possible evidence to drive and support our decision making, our statements and our activities. Our behaviours match our words and we are accountable for all that we do. We only engage in activity which furthers our charitable aims.

| Valuing diversityWe recognise all people as equals, valuing individual worth and diversity. Ideas and contributions are judged on their merit not their source.

| CollaborationWe encourage ideas and knowledge to be shared freely. We believe that lasting change cannot be delivered in isolation and actively seek partnership opportunities to achieve greater impact.

Our missionWe are here to:

Influence Inspire

Empower Our visionThe highest quality

person centred care for all,

always.

Our valuesOur four core values underpin everything that we do, reflecting what we believe in and how we behave:

Impact Report 2018 – 19Influence, inspire, empower

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Picker PrinciplesSince 1993, our Picker Principles of Person Centred Care have been used internationally and continue to underpin the advancement of excellence in healthcare provision.

Rooted in research

The Picker Principles were developed from research originally conducted by Picker in the USA, starting in 1987. Their purpose was to outline the things that matter most to people who use care services; key elements which should remain non-negotiable in the delivery of care.

This piece of research was the first of its kind. The Principles were adopted in the UK, USA, and worldwide, going on to influence global conversations around person centred care. Then, as now, the Picker Principles embodied our belief that everybody deserves high quality healthcare, and that understanding the nature of each person’s needs and preferences is integral to providing this.

Fast access to reliable health advice

Effective treatment delivered by trusted

professionals

Continuity of care and smooth transitions

Involvement in decisions and respect

for preferences

Clear information, communication, and support for self-care

Involvement and support for family

and carers

Emotional support, empathy and respect

Attention to physical and environmental

needs

Picker Principles of Person Centred Care:Our team of project managers, analysts and researchers work in collaboration with world-leading academic and research institutions to deliver projects in line with our mission and vision:

| NHS National Survey ProgrammePicker is both a coordination centre and anapproved contractor for the survey programme,gathering and interpreting vital patient feedback.

| Always Events® frameworkAlways Events® are aspects of the patient experiencethat must be performed for every individual, everytime. We have produced a framework for thisin collaboration with the Institute of HealthcareImprovement.

| Patient, staff and user experience workshopsAttendees learn to make the most of their patientexperience data, and share best practices withtheir counterparts nationwide.

| Policy papers and trend analysisWe work with policy makers to put person centredcare at the core of health and social care systems.

| Specialist research and analysisWe design and deliver original health and social careresearch, creating evidence to advance thinkingaround person centred care.

How are we funded?

Picker is a registered charity, governed by a Board of Trustees to whom the Chief Executive and executive team report. All our funding is derived from our provision of independent surveys and research services.

What we doFrom coordinating groundbreaking research to working alongside healthcare commissioners to improve service delivery, we are committed to putting our Principles into practice.

The Principles today

The Picker Principles continue to be used as a world-renowned framework to support the delivery of consistent, high quality care. A core part of our mission is to ensure that people are placed at the heart of healthcare provision, and advocating for the delivery of each of the Principles is crucial to achieving this.

The Principles continue to direct our own research, providing evidence with which we can influence policy and practice for the better.

Our toolkits and improvement services also help individuals and organisations to ensure the Picker Principles are met in their own work.


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Our story Our commitment to putting people at the heart of care started with the personal experiences of our founders, Harvey and Jean Picker.

2000 Picker (then called Picker Institute Europe) was formally created and

based in the UK.

•

1986Picker Institute Inc established in

the USA. A non-profit organisation dedicated to developing and promoting a patient centred

approach to healthcare.

1993Publication of Through the

Patient’s Eyes: Understanding and Promoting Patient-

Centred Care.

1987 Development of the Principles of Patient Centred Care. These eight

principles become an internationally renowned framework.

•

2002 Picker named as the

NHS regulator’s partner of choice to design and establish

the NHS National Survey Programme, the first ever

national survey programme for patient experience.

Picker establishes a quality improvement service, dedicated to supporting organisations to

act on their user experience data to improve care quality.

•2003

Picker develops and coordinates the first ever survey of service users’ experience of mental health services

in England.

2014 Picker collaborates with the Institute

for Healthcare Improvement, bringing the Always Events® improvement programme to European health

and social care jurisdictions.

Picker works with the Care Quality Commission (CQC) to run the first

national Children and Young People’s experiences survey across the

NHS in a decade.

2011 Picker is the Department of Health’s

partner of choice to run the NHS National Staff Survey, among the

largest workforce surveys in Europe.

Picker creates a patient-reported experience measure for children and

young people. This wins an NHS Department of Health award and

is taken to the international stage with uptake in the USA

and Australia.

• 2015

The World Health Organisation (WHO) evaluates the quality of care

for adults with psychosocial and intellectual disability in the WHO region, with Picker contributing

analysis and reporting. The resulting report will be published in

2018 (see page 32).

2019 Picker signs a new contract to manage the national cancer patient experience

survey (NCPES) for NHS England.

Quality, Safety, and Outcomes of Health and Social Care Policy Research

Unit launched as a collaboration between Picker, the Universities of Kent and Oxford, London School of Hygiene and Tropical Medicine,

and Hull-York Medical School.

•2016

Launch of the first ever national patient experience evaluation in

Ireland, produced by Ireland’s Health Information and Quality Authority (HIQA), Health Service Executive (HSE), and Department of Health

with support from Picker.

• 2018Publication of 2015 research

on disability in the WHO region (see page 32).

Picker signs a four year contract with Mind to run their

“Big Mental Health Survey”.

2017 Picker’s national Children and

Young People’s experience survey secures a regular position on the

CQC evaluation roster.

In 1986, Jean was undergoing treatment for a long-term condition. Whilst the USA’s healthcare system was technologically and scientifically outstanding, Harvey and Jean did not feel that it was sensitive to the individual needs and preferences of its patients. This needed to change.

Later that year, Harvey and Jean founded The Picker Institute, a non-profit organisation dedicated to developing and promoting a person centred approach to healthcare. In 1987, the Institute began developing the eight Picker Principles of Person Centred Care - the full story of their groundbreaking development was later recorded in “Through the Patient’s Eyes” (1993).

In 2000, Picker was established as a charity to take our work and vision worldwide. The impact of Picker’s work over the years has established us as a leading authority on person centred care, and in 2019 we continue to advocate for the very same principles as Harvey and Jean in 1986.


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Our global impact…

World Health Organisation projectOngoing collaboration

World Health Organisation Europe evaluation into mental

health services

Research, analysis and evaluation programmes throughout the world.


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Influence, inspire, empower

10

Let’s look at the numbers

We published seven peer-reviewed articles, furthering the knowledge and understanding of person centred care

100+organisations using the Always Events® framework

74 local workshops with over1400 people supported with their improvement work and seven national workshops, with 194 people attending

Bloggers we worked with: Paul Devoy, CEO of Investors in People; Rebecca Moore and

Emma Svanberg, co-founders of the Make Birth Better network and Don Redding, Director of Policy and Partnerships for

National Voices

We partnered with AbbVie, University of Oxford,

University of Kent, British Heart Foundation, Mind, British Liver

Trust, Oxford Brookes University, Pancreatic Cancer UK, Royal College of Paediatrics & Child

Health (RCPCH) and The Dunhill Medical Trust.

225+We worked with over 225 organisations to support them to improve the quality of person centred care delivered by their organisation

Influence policy and practice so that health and social care systems are always centred around people’s needs and preferences.

Influence

We provided the opportunity for over 1.6 million patients, service users, and staff to evaluate their experience of care

1.6m+

139toolkits were downloaded globally


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As part of the NHS Long Term Plan’s vision for the next 10 years, there is a focus on what it terms our “biggest killers and disablers” – cancer, mental illness, multimorbidity, and age-related issues such as dementia. We understand that, as well as being a moral imperative, providing person centred care has clinical benefits on processes and outcomes for the above conditions and more.

Ensuring that people have good experiences is an important part of high quality care – and equally monitoring staff experience is vital to understanding challenges faced by the health service workforce. What do we know about the experience of care for people with long term conditions and for healthcare staff, and how can these experiences be best improved? Our work at Picker provides insights into these questions.

What we do

Our commitment to meeting patient needs and putting patient experience at the forefront of care underpins everything we do. We feel that the following projects in particular correspond clearly with the NHS Long Term Plan and its aims:

Understanding needs We understand the quality of care required for people with major health conditions. The Long Term Plan seeks to prevent 150,000 heart attacks, strokes, and cases of dementia, as well as spending at least £2.3bn more a year on mental health care. For this to be delivered successfully, we need to understand the needs of the individuals affected by these conditions. Turn to page 26 for more information on our partnership with the British Heart Foundation (BHF).

Caring for an ageing populationGeriatric care is a specialised discipline, with the NHS seeking to bring together different professionals to combine expertise and better meet the needs of an ageing population. Our work with the Dunhill Medical Trust has identified key areas of improvement for the care of their older patients, and sought to put in place additional mechanisms to support them.

Read more about our research commissioned by The Dunhill Medical Trust on page 22.

Thinking longer termThe NHS Long Term Plan was released in January 2019, amid widespread concern about funding, staffing, managing inequalities, and pressures from a growing and ageing population.

Our commitment to meeting patient needs and putting patient experience

at the forefront of care underpins everything we do.


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NHFT transformed their CQC rating in just three years, going from “requires improvement” in August 2015 to “outstanding” in 2018. They achieved this by implementing a vision “to be a leading provider of outstanding, compassionate care”, supported by Picker’s analysis of feedback from their staff.

Challenges

| “Requires improvement” CQC rating in 2015. | Staff engagement score decreased to 3.85 in 2016. | Vacancy rate >15%, resulting in financial deficit (due to excessive reliance on agency staff) and poor staff morale.

Actions

The Trust used Picker’s research to develop “Let’s Talk”, a two-year strategy focused on staff engagement. This was directly informed by key issues raised in staff surveys, such as listening to staff ideas and reducing instances of bullying and harassment.

Impact

| “Outstanding” CQC rating in 2018.

| Staff engagement score rose to 4.01 in 2018.

| NHFT awarded “Best Product or Innovation” at the 2018 Patient Safety Awards and “Trust of the Year” at the HSJ Awards.

| Won “Best Employee Experience Initiative” at the CIPD People Management Awards 2019.

Looking forward

NHFT continue to prioritise the wellbeing of their staff, and have added their own questions to the NHS Staff Friends and Family Test for 2019/20. Through the quarterly reports we produce, NHFT will be able to measure the progress of the actions they are taking.

Emotional support, empathy and

respect

Clear information, communication, and support for self-care

From ‘requires improvement’ to ‘outstanding’: transformation for the Northamptonshire Healthcare NHS Foundation Trust

“Working with Picker on the Staff FFT has enabled

us to effectively monitor staff engagement and by adding in questions that are directly relevant to our new strategy we can understand the effect

our changes are having”Matthew Asbrey,

Freedom to Speak Up Guardian/Staff Engagement Lead, NHFT

The Northamptonshire Healthcare NHS Foundation Trust (NHFT) offer more than 100 services including mental health, community nursing, and physiotherapy, supporting a population of 733,000 with over 5,000 staff.


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The “Red, Amber, Green” model for triaging incoming calls has meant that those in the “Red” category can experience a quicker response time. However, the length of response time for patients in the “Amber” category proved to be a patient safety and experience concern. As part of their comprehensive review of the “Amber” category, the EASC commissioned Picker to evaluate staff views of the category through one-to-one interviews and focus groups, as well as public opinion through an online survey.

Challenges

| High pressure on call handlers: they were both among the lower paid staff groups and working in difficult and challenging situations. Their roles also required them to follow a script, which made prioritising incidents difficult.

| Lack of resources, both in terms of staffing and available ambulances.

| Many of the calls were seeking advice rather than an ambulance, which wasn’t always feasible for operational staff.

Actions

EASC commissioned Picker to assess perceptions of how the ambulance service should be used. Picker conducted interviews with operations managers and focus groups with clinicians, call handlers, dispatchers, and paramedics. Public opinion was gathered via an online survey, which received 1000 responses. Analysis was fed back to and discussed with the EASC review team.

Outcomes

We found that WAST could improve staff and patient experience by providing more clinically trained staff in the control room. In response, they introduced the role of call handler supervisor.

Staff also suggested ways to minimise unnecessary calls, with the predominant suggestion being to educate the public on the purpose of the ambulance service and the availability of minor injury units and other primary care solutions nearby.

Impact

| Significant investment in clinical desk staffing.

| WAST are dealing with more people in the community or by referring them to other primary care options, offering a more tailored service for people who do not require a visit to hospital.

| Picker’s research reassured WAST that the public both understood and supported the “Red, Amber, Green” model.

| The introduction of the clinical response model made services “patient centric and quality focused”.

Looking forward

Initiatives have been put in place to address handover delays and staff sickness, with ambulance availability highlighted as a further point of focus. As requested by the public, the current ambulance quality indicators are to be reviewed to ensure continued commitment to quality of care. The public perception exercise is due to be repeated so that the service can react accordingly.

New initiatives for the Welsh Ambulance Service NHS TrustThe Emergency Ambulance Services Committee (EASC) are the commissioners of ambulance services in Wales. As a provider, the Welsh Ambulance Service NHS Trust (WAST) are under increasing pressure from a growing number of 999 calls.

“Picker’s research gave us a deeper understanding of

the perceptions around the clinical model, and how to develop our

policies in the future to the benefit of staff and patients”

Ross Whitehead, Paramedic and Assistant Chief Ambulance Services

Commissioner, NHS Wales

Fast access to reliable health

advice

Involvement in decisions and respect

for preferences


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Inspire the delivery of the highest quality person centred care, developing tools and services that enable people’s experiences to be better understood.

Inspire

“Time to network with colleagues from other organisations

– we identified some areas of innovation and good practice”

“Allowed for good communication and ideas to take back to

the workplace”

“Time well spent – thank you @pickereurope”

“The workshop went incredibly fast, because it

was so engaging and useful”

Katherine Holland @KatherinePPE . Nov 1, 2018

Great workshop with @pickereurope developing new ideas for @gloshospitals maternity services following women’s experiences. Really exciting discussions about why do we do it this way. @jossetttec @Aldersgrove04 @dawn_morrall @AnnaRarity3 @KayDavis2302 @suz_cro

| Workshops We run workshops at local and national level to help organisations learn about our survey findings and identify national trends. Participants can also network and share experiences with their counterparts from other organisations, and celebrate any areas that might be going particularly well.

| Accessible reporting We make our comprehensive analysis available through clear, actionable reports – emailed straight to our clients.

| Toolkits Downloadable from our website, Picker toolkits help organisations understand their patients’ views and improve their experiences.

| Quality improvement services From board facilitation to workshops and presentations, we can help your organisation to improve the quality of care it provides.

ResourcesPicker resources provide the clarity, tools, and data to achieve the buy-in needed to drive improvements in care standards.


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Dunhill Medical Trust explores staff education needs to support an ageing populationThe Dunhill Medical Trust wanted to understand the extent to which health and social care staff are equipped to provide high-quality care to older people, as well as identify potential deficiencies in education and training and the impact on the quality of care.

Emotional support, empathy and

respect

Effective treatment delivered by trusted

professionals

They commissioned Picker to research this and to provide credible evidence to encourage improvement in health and social care for older people – maximising the impact and reach of this new thinking. Our research found that for the care of older patients to have good clinical outcomes there needs to be continual training across organisations and sectors, so that patients receive effective treatment by professionals they can trust.

Challenges

| No integrated training programmes to equip staff to look after older patients.

| Our review exposed a gap in training for geriatric care that went back to medical school, with undergraduate courses differing wildly in the amount of time devoted to it.

| Staff felt that ‘siloed’ working between specialisms was not compatible with the multifaceted care required by older people.

Actions

| In response to these challenges, The Dunhill Medical Trust:

| Sponsored the British Geriatric Society’s new course “Quality Improvement in Healthcare of Older People”, enabling more nurses and allied health professionals to attend than would otherwise have been able to do so.

| Sponsored a new category at the 2019 BMJ Awards: “Care of older people team of the year”.

| Introduced an annual joint student competition with the Medical Schools Council offering prizes at UK medical schools – the objective is to design a teaching session on the topic of geriatric care.

Impact

| Fifteen medical schools took part in the competition, with the winning teaching session receiving overwhelmingly positive feedback.

| The competition winner – representing Brighton & Sussex Medical School – has been using pre- and post-session questionnaires and is hoping his session will be incorporated into the curriculum more widely.

Looking forward

| The Dunhill Medical Trust is using the evidence from Picker’s research to help organisations enhance their training programmes. They will grow the competition to incorporate more UK medical schools, and have agreed funding for a research fellowship at the University of Bristol which will specialise in developing undergraduate geriatric medicine training.

“We were really pleased that through this

research we have identified some great initiatives to improve

the quality of care for older people, and are delighted to be doing our

bit to encourage the systemic change that we think is needed”

Susan Kay, Executive Director, The Dunhill Medical Trust


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We developed a survey which ran from January to May 2018 and reached 274 participants.

Challenges

This study was the first time the supportive care needs of those with pancreatic cancer had been explored in this way. Pancreatic cancer is often not detected until it is fairly advanced, and consequently surveying patients over a prolonged period of time is not always possible.

Actions

The survey questions covered all aspects of care and asked about people’s physical and emotional support needs, and how well these were being addressed. We also published an e-book as a result of the survey, intended to raise awareness of pancreatic cancer patients’ needs and of the work of Pancreatic Cancer UK.

Impact

| As a result of the research, Pancreatic Cancer UK pledged to:

| Share the report findings with the pancreatic cancer community to ensure the best care standards.

| Work with clinical specialists and NHS commissioners so that patients have immediate access to care for physical and psychological needs.

| Appeal to research bodies to prioritise funding for the development of psychological interventions.

Looking forward

The researchers will be submitting a paper to BMJ Open for peer review, outlining the results of the survey. The data from the holistic needs assessment carried out as part of the research will be used to generate a publicly available dataset on patient needs and quality of life outcomes, which can then be used to inform the implementation of personalised care.

Findings from a national survey: experiences and needs of patients with pancreatic cancerPicker worked in collaboration with Pancreatic Cancer UK and Oxford Brookes University to increase understanding of the needs of those affected by pancreatic cancer, and measure patient experiences and awareness. We also sought to explore the attitudes of health professionals as experienced by patients, as well as measure patient awareness of Pancreatic Cancer UK and the charity’s information and support services.

“By ensuring people receive a holistic assessment at

diagnosis, finding and sharing best practice, and conducting research to develop effective psychological

interventions, we can better support people with pancreatic cancer.”

Anna Jewell, Director of Operations, Pancreatic Cancer UK


advice

Clear information, communication, and support for

self-care


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BHF worked with Picker to carry out a detailed analysis of the key challenges faced by people with CVD in the United Kingdom in order to understand the support BHF needed to give them.

The research identified a common need for psychological and emotional support across all participants, with the insight from the research then used to inform BHF’s strategic direction – specifically the work of the Healthcare Innovation directorate.

Challenges

The specific challenges faced by patients with CVD and their carers vary according to the type and stage of the disease, as well as the demographic profile of the individual.

The issues respondents described – through interviews and focus groups – fell into several broad categories relating to: overall quality of life, accessing care, physical and psychological needs.

Actions

Picker’s survey and analysis of individuals with CVD identified the following:

| 58% of respondents living with heart and circulatory diseases had experienced feeling sad, down, or depressed.

| 59% of respondents reported feelings of anxiety, fear, or uncertainty about the future.

If these results were representative of the 7.4 million affected by CVD, this would mean around 4 million people may have experienced feelings related to depression or anxiety.

The research also identified a common need for psychological and emotional support across all participants. Another key finding was the need for consistent care: a single coordinating role across treatment would help people navigate through services and feel more comfortable asking questions to manage their condition.

Impact

The BHF is now urging the NHS and UK Governments to ensure that emotional and psychological support is a core part of the care provided to those affected by CVD.

In their latest strategy, the BHF is calling for everyone to receive the support they need to make a good recovery and to live free from the fear of these conditions.

BHF’s resources were identified as invaluable by many participants. Where direct action is not possible, these have the opportunity to advocate on behalf of patients and their loved ones.

Looking forward

Empowering people to manage their condition and its consequences is going to be a crucial next step. Our survey identified the need for further provision of tools, support, and information from trustworthy sources – such as BHF – to encourage those self-care behaviours.

Giving patients greater continuity of care would also make them feel more confident about adjusting their lifestyles to aid their recovering, giving them more control over their condition and consequently reducing anxiety.

Achieving person centred care for cardiovascular diseaseThe British Heart Foundation (BHF) are striving to put patients at the centre of their work, setting a direction for greater patient involvement. This ensures the experiences of those affected by cardiovascular disease (CVD) are successfully converted into insights that can be acted upon across a wide range of BHF activities.


advice

Attention to physical and environmental

needs

“The BHF Heart Matters journal is

an excellent source of information, and a sort of constant

silent support.”Service user


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Empower those working in health and social care to improve experiences by effectively measuring and acting upon people’s feedback.

Empower

Upcoming projects2018/19 saw considerable strides forward in the advancement of person centred care, but there remains much to be done. Here are just a few of the projects we will be prioritising in 2019/2020:

Cancer Patient Experience Survey (CPES)

Picker has been awarded a three-year contract to work alongside NHS England and NHS Improvement in delivering the National Cancer Patient Experience Survey. First undertaken in 2010, this survey encompasses the experience of thousands of adult cancer patients across England and is a key resource for healthcare professionals looking to improve their services.

Continued focus on mental health

We will be working with NHS Wales to support a ministerial review into the impact of mental illness on urgent care access and conveyancing. This will take into account the perceptions and experiences of both the public and staff working in urgent care.

Person centred care in Gibraltar

In conjunction with the Gibraltar Health Authority, Picker will evaluate hospital patient and staff experiences. This will be the first systematic evaluation of its kind and, if successful, will lead into an ongoing programme to improve other Gibraltarian care services (e.g. primary care and mental health).

Lymphoma Coalition

A global project working with the Canada-based Lymphoma Coalition to adapt and translate patient and carer surveys into 19 languages for maximum reach. We will work with the Lymphoma Coalition to run the surveys and analyse and report on findings at global, Asia Pacific, European and country level.

Patient experience in hypothyroidism

A collaboration with Dr Petros Perros – a leading consultant endocrinologist – to explore patient satisfaction with treatment for hypothyroidism. Picker will provide questionnaire development and administration, cognitive testing, data handling, validation and analysis.

Research into skin conditions

Picker is conducting a piece of in-depth research on behalf of AbbVie Ltd, looking into the experiences of dermatology patients living with moderate to severe atopic dermatisis, hidradenitis suppurativa and psoriasis.


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Survey coordination: NHS EnglandEstablished in 2003, the NHS Staff Survey is carried out by Picker’s Survey Coordination Centre for NHS England.

Approximately 1.1 million surveys are sent out annually to NHS staff, providing an impressive wealth of data which can then be drawn upon to influence decision making over that year and beyond.

Picker develops the survey, providing an interactive dashboard and categorising the results into 10 key

themes. In addition to this, we are one of the five contractors who run the survey, affording us the unique opportunity to help the NHS to build on its results.

Each year we run workshops for key stakeholders, drawing on the survey results to assist organisations with staff wellbeing and retention.

@MedicineGovSte #NHS #MedLearn #TeamPatient @MedicineGovSte

Replying to @ChrisGrahamUK and @pickereurope

Sounds good. There is an amazing wealth of data in the #NHSstaffsurveyIncluding a possible relationship between response rates and organisational culture? #nss18 #pickerworkshop

Chris Graham @ChrisGrahamUK . Mar 8In London for @pickereurope national NHS staff survey workshop - great opportunity to work through some incredibly rich data and focus on staff experience #nss18 #pickerworkshops

Staff Engagement, Health & Wellbeing @SEWB_ESHT . Oct 17, 2018

We listened in 2017 and we are listening now @ESHTNHS - one of our priorities in 2017 was values based behaviour: We are embedding a culture that is open and honest, where members of staff live by our values and feel confident to raise their concerns. #staffsurvey18

ESHTStaffEngagementand Wellbeing

Adnan Masood @Adnan_Masood1 . Apr 4

Looking fwd to attend @NewhamHospital #thebigreveal & learning findings from their Culturechange journey. I’ll be at Market stall with all NUH #StaffSurvey18 info, pls come & find out how SS results are important for culture change @clairedavis45@NHSBartsHealth

Children and Young People’s Patient Experience Survey

| Looking at the experiences of children and young people admitted to hospital as inpatient or day cases.

Adult Inpatient Survey

| Looking at the experiences of adults admitted to hospital as inpatients.

Urgent and Emergency Care Survey

| Looking at the experiences of adults who received care from an emergency department or an urgent care centre.

Maternity Survey

| Looking at the experiences of women across the maternity pathway.

Community Mental Health Survey

| Looking at the experiences of people who received care in the community for a mental health condition.

Survey coordination: CQCWe compile, run, and analyse NHS Patient Surveys for the CQC. As well as being the survey coordination centre for these we are also an approved contractor, making us uniquely placed to handle and disseminate the data gathered.


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International impact: supporting the WHO

Looking forward

In June 2018, the WHO published its report on “Mental health, human rights and standards of care”. This ambitious project was three years in the making, encompassing research carried out by Picker since 2015.

Working alongside WHO, we analysed and reported on the findings from the phases of the research project, including a survey and site visits to institutions across the region.

Room for improvement

The resulting report assesses the quality of care for adults with psychosocial and intellectual disabilities in the WHO European Region. A total of 75 long-term institutions in over 20 countries were assessed, and the findings make a shocking read.

Of all the quality ratings made, only a quarter indicated compliance with international standards. This means there is enormous room for improvement and, most importantly, the need for transformation of long-term services toward community based care.

The findings identified the below in particular as lacking:

| Education around mental health and the protection of human rights.

| Personalised approaches to care.

| Rehabilitative activities for residents of the institutions surveyed.

| Legal representation for patients.

| Community alternatives to institutionalisation.

What’s next?

We have identified the below as the next steps or priorities required for progress on the above deficiencies:

| Revision of policies and legislation.

| Staff training in human rights, in addition to specialised modules where necessary.

| Evidence-based, independent monitoring of progress to inform and improve services.

| National and international knowledge exchange through joint initiatives and continuous policy dialogue.

Immediately following publication of the report, WHO began taking this quality assessment forward to a quality improvement phase. This has involved training national teams with the newly-developed WHO QualityRights training tools. This work is ongoing, with further trainings across more countries due to continue in 2020.

2020 marks Picker’s 20th Anniversary since its establishment as an independent charity: two decades committed to the pursuit and delivery of person centred care. As we move into a new year for Picker, we plan to continue our mission to influence, inspire, and empower by:

| Completing new work to further build on our highly influential Picker Principles of Person Centred Care, and to use these to understand the quality of care from the perspective of patients and service users.

| Supporting those working in health and social care to improve quality by measuring and acting on feedback from staff, patients and service users.

| Continuing to develop our sentiment analysis reports, identifying what people care about most. These reports are then delivered in an accessible format, allowing you to break down the findings by theme, location, strength of feeling, speciality or division.

| Incorporating innovative machine learning and text mining technologies to ensure our findings are unbiased, reliable and consistent.

“Two decades committed to

the pursuit and delivery of person

centred care”


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Board of TrusteesDuring all or part of the period April 2018 up to March 2019.

PatronSir Donald Irvine (until December 2018)

ChairmanStuart Bell CBE

TreasurerSally Sykes

Members of the BoardProfessor Aileen Clarke (Chair Designate)

Annie Laverty

Diane French

Elizabeth Hampson

Professor Gary Ford CBE

Paul Blunden

Ronny Odegbami

Suzanne Rastrick OBE

Professor Wendy Reid

Funding sources and outcomes for beneficiaries

Funding sourcesPrivate healthcare

providers

Royal Colleges

Patients, service users, healthcare staff, and public voices are heard and used in co-design of services

Improved patient, service user and staff experiences due to an understanding of the value of

person centred care

Sound evidence available to measure the impact of changes

and improvements

Best practice is shared in order to inspire the use of patient and staff experience data to improve person

centred care

Regulators and national bodies have access to reliable information

for performance and risk management

High quality patient experience data is made available in the public domain for researchers and policy

makers to use

Reliable data, products and tools facilitate improvements in patient

and staff experience

International partnerships and collaborations

Donations in kind

NHS organisations

Charities

Universities and academic institutions

LicensingProfessional bodies

Social enterprises and community partnerships

Outcomes for beneficiaries


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Registered Charity in England and Wales: 1081688Registered Charity in Scotland: SC045048Registered Company Limited by Guarantee: 03908160

Picker Institute EuropeBuxton Court3 West WayOxford, OX2 0JB

T +44 (0) 1865 208100E [email protected]

This report is dedicated to the memory of Sir Donald Irvine, Patron of Picker from 2013-2018 and Chair of our Board of Trustees from 2001-2013. He leaves a considerable legacy, shaped by his unwavering commitment to person centred care for all.

Documents

Impact Report 2018–2019 - Picker · NHS in a decade. 2011 . Picker is the Department of Health’s . partner of choice to run the NHS National Staff Survey, among the largest workforce