Service User Experience Strategy

Service User

Experience

Strategy 2013-2014

[email protected]

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Version Control

Version V1.5

Ratified By Trust Board

Date of Approval 27 November 2013

Document Author Marie Allen, Patient Experience Lead

Name of Responsible Committee Effectiveness Committee

Executive Director Siobhan Heafield

Date Issued 27 November 2013

Expiry Date (Maximum Two Years) 27 November 2014

Target Audience All staff across the Partnership Trust

Contents

1. Executive Summary ............................................................................................. 3

2. Introduction .......................................................................................................... 4

3. Purpose .................................................................................................................. 7

4. Vision ................................................................................................................... 8

5. Aims and Objectives Measures 2013/14 .............................................................. 10

6. Implementation ..................................................................................................... 31

7. Monitoring ............................................................................................................ 31

Equality Assessment ................................................................................................ 33

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1. Executive Summary

Setting the scene This strategy provides national and local context and provides an evidence base and background for the work ahead. The National Institute for Health and Clinical Excellence (NICE 2012) has condensed 65 recommendations contained in their User Experience Clinical Guideline into 14 quality statements and these have been used to provide the framework for this strategy. It is our intention to be better informed by what our users and carers think, feel and experience about the care, treatment and services they receive by Staffordshire and Stoke on Trent NHS Partnership Trust. To achieve this we have described our commitments and promises in this strategy. Our users and carers are placed at the centre of services providing care to the people of Staffordshire. For this reason it is important to us to demonstrate genuine commitment to providing services needed by users and carers, delivered in a manner expected for 21st century Health and Adult Social Care. All Partnership Trust staff has a responsibility to be courteous, humane and compassionate in the care we deliver, without exception. To support our drive to achieve this ambition our Director of Nursing and Quality is the Director Lead to ensure that every users voice and their experience is brought to bear on our learning, to help inform planning and test out how we deliver care and services. Becoming a user focused organisation with key priorities in a time of continued and radical change in how Health and Adult Social Care Services are both planned and delivered. Users will have greater choice in who provides the care they need and when that care is delivered. This strategy seeks to demonstrate our willingness to provide services that are in the right place at the right time to provide the best possible Health and Adult Social Care experience for our users. The outcome of this strategy will be that 95% of all users, carers and families cared for by the Partnership Trust tell us that they had a good and safe experience provided by a caring and compassionate workforce. The Partnership Trust’s Current Position The Safety and Effectiveness Operational Groups, User and Carer Forum and the Safety and Effectiveness Sub-Committee will provide the oversight, steer and monitoring of achievement against this strategy whilst providing assurance to the Quality Governance Committee and the Partnership Trust Board on the progress of embedding a positive experience for all our users and carers within the Partnership Trust. Implementation Plan and Action Planning This section will set out how the User and Carer Experience Strategy will be implemented and monitored over 2013/2014. This will detail the specific aims that

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have been identified for the Partnership Trust and provide an understanding as to how those aims will be monitored and their performance against them. Core objectives Using the 14 statements of the NICE guidance as the framework, headline plans have been identified that will be enlarged and built upon within the overarching user and carer experience scheduled work programmes. Adult Social Care Outcomes Framework The Department of Health ‘Adult Social Care Outcomes Framework’ (ASCOF) for 2011/2012 provides a focus on the development of outcomes of both national and local driven performance indicators. The development of this framework will assist to achieve transparency in outcomes for the community and benchmark upon performance with other Local Authorities. CQUINs 2013 / 2014 The Partnership Trust has CQUIN targets relating to every user and carer’s experience; a regional target for the implementation of the Family and Friendly test and national target for improving responsiveness to the user’s needs. These are important stretch targets for the Partnership Trust. Framework Knowing how we are doing against this strategy is pivotal in knowing how well the Partnership Trust is doing in achieving the core objectives. The Partnership Trust will collate and utilise experience information to measure and monitor our improvements along with initiatives in this strategy. To support these objectives the NICE Patient Experience Guidance will be the framework with an emphasis on learning and implementing solutions to ensure that user’s, carer’s and families accessing high standards of Health and Social Care services provided by the Partnership Trust.

2. Introduction

The user, carer or family experience is integral to Staffordshire and Stoke on Trent

Partnership Trust’s core business and therefore all staff working within the

Partnership Trust has a duty to ensure that all people who may use these services

receive an experience that meets or exceeds their physical and emotional needs and

expectations. The Partnership Trust knows that the people’s experience who use the

service is critical to the individual person who may access services along with their

families.

This strategy sets out the Partnership Trust’s shared purpose for all staff to deliver high quality, compassionate care, and to achieve excellent Health and Social Care outcomes. This builds on the Partnership Trust’s values along with compliance to the NHS Constitution Rights.

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The Picker Institute (2009) reports the following eight aspects of care as being most important to users, as set out in table below.

Figure 1: Picker’s (2009) Eight Aspects of Care

What do we mean by user/carer or the Family Experience? The Partnership Trust’s Health and Social Care staff are highly motivated and committed to care for users and carers with compassion and dignity, identify strongly that they will care for users in a way they would want a member of their family to be treated. Users and their families are uniquely placed to judge the care that they receive and whilst we may think that we are doing a good job in terms of delivering a good user experience, the views of our users and carers may be entirely different. For the Partnership Trust it is important that we capture the views and opinions of users and carers about the services that we provide to become the provider of choice. For most, experiences of care are mixed. Few are wholly good or wholly bad. User’s stories typically describe variability in the experience of care, hour by hour, shift by shift, day by day and from department to department.

Eight aspects of care identified as

being most important to

users

Fast access to reliable health and Social Care

advice

Effective Services provided by

trusted professionals

Continuity of care and smooth

transitions

Involvement in decisions and

respect for preference

Clear, comprehensible information and support for self-

care

Attention to physical and

environmental needs

Emotional support, empathy

and respect

Involvement of, and support for, family and carers

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“Users experience of hospital is intrinsically difficult to grasp. It is richly textured and complex. By definition subjective, the experience is such that no one else can know how it works from one moment to the next, how the different aspects of the experience (the process of care, the manner in which it is delivered, the environment in which it occurs, the physical sense of the place) come together, or what they mean for this particular person at this particular moment in their life” (Kings Fund 2008).

Examples of user, carer and families’ experience of care are illustrated in Figure 2, below. Through the introduction of real time feedback, suggestions and comments are captured monthly empowering the people of Staffordshire to actively be involved in the change of culture through shaping the Health and Social Care model of care provided by the Partnership Trust.

Figure 2: Summary of Health and Social Care experience within care for user, carers or families

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National context The NHS Constitution promotes ‘high quality care for all’. In setting out clearly what Professor Lord Darzi (Department of Health 2008) saw as the enduring principles and values, the constitution provided clear signposting to the rights and responsibilities for users, public and staff. Key aspects of this important legislation are:

Figure 3: NHS constitution rights and responsibilities

Figure 4: High Quality of Care for All

3. Purpose

While significant investment nationally has created new learning in relation to effectiveness and safety, our understanding of what matters to users in relation to their experience of Health and Social Care and how this can be improved is still developing (National Institute for Clinical Excellence 2012). The NHS Outcomes Framework 2012/13 (“Domain 4” relates to Patient Experience) which renews the focus on improving results. The NHS will be measured against a number of areas including whether the user’s treatment was successful, whether they were looked after well by Health and Social Care staff along with if the user has recovered quickly after treatment. The standard focuses on ensuring people have a

Strengthening accountability through national standards for

users

Empowering and valuing staff

Creating shared purpose, values and principles

Empowering all users and the

public

Safety

Effectiveness Patient

Experience

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positive experience of Health and Social Care with an overarching indictor to clearly identify actions for improvements. The Department of Health (2012) has published the NHS Users Experience Framework, which outline the area’s most important to the user experience of Health and Social Care services. Improving the users experience is a key aim for all Health and Social Care providers. By asking, monitoring, and acting upon user and carer feedback, organisations are able to make improvements in the areas that users say matter most to them.

4. Vision

The vision of the Experience strategy is to promote and embed the experience as

key elements in the following areas in line with the Quality Framework. This will

promote and respect the user and carer’s values, preferences, and expressed

needs. This will be developed through the following areas:

Cultural issues; the dignity, privacy and independence of service users; an awareness of quality-of-life issues; and shared decision making

Coordination and integration of care across the Health and Social Care systems

Information, communication, and providing an understanding on clinical status, progress, prognosis, and processes of care in order to facilitate autonomy, self-care and health promotion

Physical comfort including pain management, help with activities of daily living, within clean and comfortable surroundings

Emotional support and alleviation of fear and anxiety about such issues as prognosis, along with the impact of illness on users, their families and their finances

Welcoming the involvement of family and friends, on whom service users rely, in decision-making and demonstrating awareness and accommodation of their needs as care-givers

Transition and continuity of information that will help users care for themselves. The Trust will coordinate, plan, and support every user and carer to receive ealth and Social Care services in the environment of their choice

Access to care with attention for example, to receiving individualised care at the right place, at the right time

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Figure 5: The User Experience Feedback – DOH (2011)

The users experience occurs at three primary levels:

Involving users and families in their own care and supporting them to make informed choices about their treatment and care

Using the user experience in a particular area to improve services

At a strategic level to ensure the public are able to actively contribute to the Partnership Trust strategic direction

Local context High quality and safe user and carer experience remains the first priority of the Partnership Trust. The Partnership Trust is also working towards achieving Foundation Trust (FT) status. This will require intensive focus on continual improvements within the experience of users and carers, access to services, and specific qualitative improvements across all aspects of clinical and non-clinical services. The Partnership Trust is committed to listen and learn from users, staff and partners as we develop and deliver high quality Health and Social Care services to the people of Staffordshire. This strategy will work alongside the Communication and Engagement Strategy and the Partnership Trust Annual Plan. This will provide key messages through a variety of effective communication tools. These will underpin principles which will guide our user and carer experience work programmes year on year:

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Table 1: The Partnership Trust’s User and Carer Experience Goal and Objectives.

Equality and Diversity Equality is about creating a fairer society in which everyone has the opportunity to fulfil their potential. Diversity is about recognising and valuing difference in its broadest sense. Staffordshire and Stoke on Trent Partnership Trust are committed to promoting equality and challenging discrimination in all service provision, recognising and meeting the needs of the diverse communities we serve. Whilst every single person has their own individual needs, in some cases, for some groups of people, the Partnership Trust needs to go further to ensure access is equitable.

Working with partners Whilst this strategy sets out how we will work to ensure that the user experience of the Partnership Trust is a positive one. We also understand that the experience of our Health and Social Care services make up only one stage of the whole user’s journey. We will therefore work closely with partners such as the Acute Hospitals, West Midlands Ambulance Services, Voluntary and Community Sector organisations to commission and develop accessible, appropriate and seamless services.

5. Aims and Objectives Measures 2013/14 The range and scope of objectives relating to the user and carer experience are understandably large. It is Staffordshire and Stoke on Trent Partnership Trust’s vision that a positive user and carer experience is integral to all we do as opposed to an added extra. This strategy is built around the 14 NICE Experience guidelines along with the Adult Social Care Outcomes Framework (ASCOF) which identifies the headline actions that will be undertaken to achieve them. Monitoring of work programmes highlighted in the Strategy will be reviewed by the User and Carer Forum and reported to Quality Governance Committee and Partnership Trust Board. Aim and objectives The National Institute for Health and Clinical Excellence (NICE 2012) have condensed the 65 recommendations contained in their User Experience Clinical Guideline into 14 quality statements along with the integration of the four standards of the Adult Social Care Outcomes Framework (ASCOF). Dignity, Kindness and Compassion

Goal Objectives

To ensure that all contacts with our services deliver a positive experience for users and carers

Deliver the improvement priorities within the Partnership Trust’s Quality Accounts

Deliver services in accordance with National and Local Quality indicators

Ensure compliance with indicators of the users experience

Embed a culture of continuous improvement by seeking out, learning from, and acting upon users and public feedback along with formal complaints, comments or concerns

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Partnership Trust Aim No. NICE Service User Experience Outcomes

1 Users, carers and parents are treated with dignity, kindness, compassion, courtesy, respect understanding and honesty. Providing easier access to efficient services.

Objectives: The Partnership Trust will capture the user and carer feedback from

Specialist Services, Community Teams, Children’s and Families services.

The Partnership Trust will achieve a monthly score of 95% through real time user and carer reporting along with developing action plans for improvement.

Triangulation of complaints concerns and experience data will be analysed to identify monthly trends and themes along with driving actions of improvement.

Monitoring of trends and themes will be immediately escalated as an early warning signal for the implementation of onsite Quality visit.

Annual onsite external inspections will demonstrate the Partnership Trusts compliance to the 57 standards of the Customer Service Excellence (CSE) Award.

A CSE central database will demonstrate evidence of best practice and compliance to the 57 standards of every individual Health and Social Care team.

Real time reporting will capture the users and carers experience of access to services along with waiting times.

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Measure

Aim Outcome Assurance Mechanism

Date

Users are treated with dignity, kindness, compassion, courtesy, respect, understanding and honesty:

95% of all users /carers state that Partnership Trust staff are polite and courteous

Monthly reporting to Safety and Effectiveness Groups, Quality Governance Committee and the Partnership Trust Board

April 2013

Effective Interactions First impressions influence the user and carer’s trust and confidence. This includes the professional appearance and attitude of every staff member. The courteous and helpfulness of staff, will ensure that every user receives a warm welcome and appropriate support and information throughout their interaction with Health and Social Care services. All staff members will maintain a positive approach where visitors do not feel intimidated to ask for help or information and staff members seek to attend to the needs of all visitors. These standards are expected for all interactions with user’s and their families; whether they are verbal, face to face, over the telephone or written – and all staff will at all times consider the specific communication needs of every users for example language, cognition and communication ability.


2 Users experience effective interactions with staff who have demonstrated competency in relevant communication skills.

Objectives: The Partnership Trust to introduce the Mystery Shopper Programme across

the organisation and third party Contracts by 2013/14.

The Partnership Trust to introduce a Mystery Shopper Communication monitoring tool by 2013/14.

70 users will be recruited to become Mystery Shoppers through the introduction of an internal Mystery Shopper programme by 2014.

The Partnership Trust will review the written and verbal communication through monthly rapid audit cycles and annual audits by 2014.

Communication tools will be monitored and gain consultation by its service users. Including users for whom English is not their first language/sensory impairment/learning disabled/or low levels of literacy through the publication of easy read information.

The Partnership Trust to introduce Easy Read and Picture Surveys to be implemented from April 2013 and reviewed annually with the Learning Disability Forums.

The Partnership Trust to provide Customer Service Excellence and a Communication Training Programme by 2013.

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Measure


Date

Users experience effective interactions with staff who have demonstrated competency in relevant communication skills.

Monitor the number of PALS contacts and Complaints relating to communication

Monthly PALS and Complaints reporting

April 2013

Collate the number of Easy Read and Picture surveys across the Trust

Monthly reporting to Safety and Effectiveness Groups, Quality Governance Committee and Trust Board

April 2013

Roles and Responsibilities Users can often be confused by the myriad of people that they meet whilst in hospital and in community teams. Whilst uniforms often designate roles these can be confusing. The elements of a role can also be difficult to appreciate and the need to have different staff involved for different reasons. Partnership Trust Aims

Measure


Date

Users are introduced to all health and social care professionals involved in their care, and are made aware of roles and responsibilities of members of the health and social care teams

Monitored through announced and unannounced quality visits

Quality visit reports

April 2013

No. NICE Service User Experience Outcomes

3 Users are introduced to all health and social care professionals involved in their care, and are made aware of roles and responsibilities of members of the health and social care teams

Objectives:

All Partnership Trust staff to wear name badges at all times

All Partnership Trust staff to introduce themselves and describe their role and responsibilities on the first initial contact with every user, carer or family member.

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User Values and Beliefs Different users will make different choices about their care based on their values and beliefs. They take into account their previous and current health and social care experiences and what is important to them. Users have a fundamental legal and ethical right to determine what happens to their own bodies and health and social care professionals must respect their views and decisions even if it differs from what they themselves believe. Trust Aim No. NICE Service User Experience Outcomes

4 Users have the opportunities to discuss their health and social care belief, concerns and preferences to inform their individualised care. Ensuring users receive high quality personal care and support

Measure


Date

Users have opportunities to discuss their health and social care concerns and preferences to inform their individualised care. Ensuring users receive high quality personal care and support

95% of all users /carers state that they were involved in their individualised care

Monthly reporting to Safety and Effectiveness Groups, Quality Governance Committee and Partnership Trust Board

April 2013

Objectives:

Every user will have an individualised plan of care specific to their individual needs

The Partnership Trust will provide quarterly data on the Patient Empowerment CQUIN. This relates to the decision making of users within all aspects of their individualised plan of care

All Carers will be referred for a Carer Assessment dependent upon their individualised needs

Triangulation of user and carer insight data will monitor any trends and themes which will be immediately escalated to ensure actions of improvement are implemented

Users and carers recommendations/suggestions of improvements will be captured and presented to Operational Teams to determine appropriate actions for improvements

Annual onsite external inspections to demonstrate compliance to the 57 standards of the Customer Service Excellence (CSE) Award

Quality announced and unannounced visits will review individualised care plans and information upon all onsite visits

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Enable Users to live their Life that they want and be safe

The NHS Constitution informs users that they have the right to be given information about proposed care in advance, including any significant risks and any alternative treatments which may be available, and the risks involved in doing nothing (Department of Health 2012), thus enabling an informed choice. Once users have the information they require, health and social care professionals play a critical role in discussing the views and wishes of the users so that choices made about their care fully reflect their wishes and beliefs. Trust Aim No. NICE Service User Experience Outcomes

5 Users are supported by health and social care professionals to understand relevant treatment options, including benefits risks and any potential consequences. Enabling users to live the life they want and be safe.

Objectives: 95% of all users undergoing treatment and care are given all of the

accurate information they require in a format they can understand, to enable them to make informed choices

The Partnership Trust consent policy provides clear and precise information upon consent which all staff adhere to demonstrate compliance by April 2013

Maintain the Partnership Trust’s Customer Service Excellence accreditation under the Information Standard scheme and further developing its range and scope of information leaflets by March 2014

95% of User, Carer and Family members are provided with adequate information including any risk assessments to be empowered to make informed choices about their care or treatment. Health Care Professionals will provide advice through scheduled face to face meetings, telephone advice or written information at the request of the User/Carer or Family member

The Partnership Trust will provide a duty of candour clearly identifying to user and carer any potential risks within their lifestyle choices through multi-professional meetings

All Professionals will incident report to constantly improve the safety culture across the Partnership Trust

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Measure


Date

Users are supported by Health and Social Care professionals to understand relevant treatment options, including benefits risks and any potential consequences. Enabling users to live the life they want and be safe.

95% of all users undergoing treatment and care are given all of the accurate information they require in a format they can understand, to enable them to make informed choices.


March 2014

Shared Decision Shared decision making is a process in which clinicians and users work together in partnership taking into account the user’s wishes, beliefs and views; clinical evidence; treatments and options available; and the desired outcomes. There is also compelling evidence that those users who are active participants in managing their Health and Social Care has better outcomes than users who are passive recipients of care (Coulter and Collins 2011).

Shared decision making may involve a degree of negotiation between professionals and users where the professional brings the Health and Social Care expertise and the users experience of living with their condition and the knowledge of the circumstances in which they live and their lifestyle. As in Objectives 4 and 5, users need to be given the information they need to support them to make informed choices about their care and treatment and given time and support to discuss their views, and preferences.


6 Users, carers and Parents are actively involved in shared decision making and supported by Health and Social Care professionals to make fully informed choice about investigations, treatment and care that reflect what is important to them. Enabling users to take personal responsibility.

Objectives: 95% of users state that they are fully involved in shared decision making at key

decision points in the users care pathways

To review the way that shared decision making is recorded in user’s care plans through the rapid audit cycles

To ensure that the Users Constitution Rights are displayed and shared with all Health and Social Care Professionals

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Measures


Date

Users, carers and Parents are actively involved in shared decision making and supported by Health and Social Care professionals to make fully informed choice about investigations, treatment and care that reflect what is important to them. Enabling users to take personal responsibility

95% of users state that they are fully involved in shared decision making at key decision points in the users care pathways


March 2014

Every Trust location to display leaflets on the NHS Constitution rights for Users and Carers

Quality Visits March 2014

Consent The NHS Constitution states users have the right to accept or refuse treatment that Is offered, and not to be given any physical examination or treatment unless they have given valid consent. If they do not have the capacity to do so, consent must be obtained from a person legally able to act on their behalf or the treatment must be in their best interests (Department of Health 2012).


7 Users are made aware that they have the right to choose accept or decline treatment and these decisions are respected and supported. Enabling people to be as independent as possible

Objectives: To support users to make informed decisions about their care and

treatment

Supporting people who lack mental capacity either temporarily or for the longer term through enabling others to make decisions on their behalf if that is in their best interests

Monitor the compliance rates of the Trust to ensure 95% of all Health and Social Care Health Professionals are trained in Mental Capacity and DOLS training

The Partnership Trust staff will demonstrate compliance to the Consent Policy dated April 2013

All staff to capture user consent before treatment which is clearly documented in every users care plan

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Measures


Date

Users are made aware that they have the right to choose accept or decline treatment and these decisions are respected and supported. Enabling people to be as independent as possible

95% of all Health and Social Care Health Professionals are trained in Mental Capacity and DOLS training.


March 2014

Rapid audit cycles identify consent obtained in the care plan

Annual March 2014

Second Opinions

Any user can ask a Health or Social Care professional for a second or further opinion and the request should be supported. The General Medical Council (2006) states “in providing care you must respect the user’s right to seek a second opinion. Partnership Trust Aim No. NICE Service User Experience Outcomes

8 Users are made aware that they can ask for a second opinion

Objectives:

• The Partnership Trust will actively support users who are requesting a second opinion

• User Constitutional Rights Information literature to be clearly displayed in all health centres and Community Hospitals by July 2013

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Measure


Date

Users are made aware that they can ask for a second opinion

Every Trust location to display leaflets on the NHS Constitution rights for Users and Carers

Quality Visits March 2014

Responsive to the needs of Users and local communities

The care of every users should be tailored to their needs and personal preferences, taking into account their circumstances, their ability to access services and their coexisting conditions Whilst every single person has their own individual needs, in some cases and for some groups of people the Partnership Trust needs to go further to ensure access and care is equitable. The specific needs of individual users who access Partnership Trust services must be considered and taken into account when planning care. This will include taking into account people’s physical and learning disabilities, sensory impairment, language and communication difficulties, and religious beliefs. The Partnership Trust aims to provide quality Health and Social Care to all users, regardless of their individual needs. We recognise those users may face barriers in accessing our services and these barriers may change for them over time. In order to provide quality Health and Social Care we will ensure that all potential discrimination is removed through carrying out equality impact assessment screening and full equality impact assessments were necessary.

Partnership Trust Aim


9 User care is tailored to their needs and personal preference taking into account their circumstances, their ability to access services and coexisting circumstances. Creating a seamless experience for users between Health and Social Care. Providing a modern, responsive, and consistently high standard of care which is responsive to the needs of Users and local communities and is based on identified and/or evidenced needs

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Measure


Date

User care is tailored to their needs and personal preference taking into account their circumstances, their ability to access services and coexisting circumstances

Monthly performance data on home visits/ Outpatient Appointments PALS and Complaint monthly trends and themes

Monthly User and Carer Reports

April 2013

Nutrition, Hydration and Pain Relief. Users have a wide range of varying needs during their treatment. Assumptions cannot be drawn and health and social care teams need to continuously assess the needs of their users through partnership with them. In the Essential Standards of Quality and Safety (2010) the Care Quality Commission outlines its expectations of organisations that planning and delivery of care will meet individual needs, ensure welfare and safety, reflecting appropriate research and guidance and make reasonable adjustments to meet individual needs.

Objectives: The Partnership Trust will ensure the layout of Health Centres, Hospital and

Healthcare in Prison locations are accessible for all users. The Equality Act re-enforces the requirements of the Disability Discrimination Act.

Provide information in an accessible format such as Braille, large print or email. Reasonable adjustments for blind or partially user could include providing information in large print or Braille

To demonstrate compliance to the Trust equality and diversity structure and Single Equality Scheme. This will be monitored by the CHAN group upon review of equality impact assessments upon the Partnership Trust work programmes

Demonstrate compliance to the Equality Act 2010 which covers nine "protected characteristics". These are age, disability, gender reassignment, being married or in a civil partnership, race, religion or belief, sex and sexual orientation

Users to be offered with support to maintain their spiritual belief with in a Community, Hospital or Prison setting

All users to be placed at the heart of service provisions and be provided with individualised plans of care. This will be monitored through the annual records audits

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10 Users have their physical and psychological needs assessed and addressed, including nutrition, hydration, pain relief, personal hygiene and anxiety.

Measure


Date

Users have their physical and psychological needs assessed and addressed, including nutrition, hydration, pain relief, personal hygiene and anxiety

95% of Inpatients state that they are provided with excellent choice of food and beverages through real time reporting


April 2013

Continuity of Care Continuity is fundamental to high-quality care. Without it, care is unlikely to be effective, safe, personalised, efficient or cost-effective. Continuity is not just about the same staff providing care for the user and carer; it’s also about effective and timely communication, handover from one shift to the next and to members of the multidisciplinary team and record keeping.

Objectives: Every user will gain a holistic assessment of their individual needs through

collating and documenting the user’s case history upon the Single Assessment documentation

Every user will be assessed within 24 hours of admission or upon their initial visit through evidenced based assessment tools in accordance to best practice. The appropriate assessment tools will be dependent upon the individual needs of the user and clinical reasoning of the Health or Social Care Professional

100% monthly compliance of all wards and community teams through the quality dashboard upon assessment and quality of care

Every user will gain appropriate on-going assessments and evaluation dependent upon their individual needs which is clearly documented within their plan of care.

The user’s preference beliefs and wishes will be clearly documented in every user’s plan of care

Ever user will have clearly documented rehabilitation goals which will be devised with the user and carer. The individualised care plan will ensure continuity of care upon the user’s individual needs personal preference and beliefs

LINK Food Watch Project will implement on site observations on the quality of food and beverages users receive within the Trusts care

95% of Inpatients will score the Partnership Trust of providing excellent

choice of food and beverages through real time reporting

Matron’s onsite observations will monitor the quality of food/ beverages and

serving across all Community Hospital sites

PLACE onsite user assessments upon the Community Hospital sites from April 2013.

Annual Carer audit and review

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Partnership Trust Aim

Measure


Date

Users experience continuity of care delivered whenever possible by the same healthcare professional or team throughout a single episode of care

95% of all users to state that they were “extremely satisfied” with the quality of care


April 2013

Coordinated Health and Social Care Multidisciplinary team working is crucial to ensuring an integrated approach to personalised care planning, especially for those with complex care needs that are more likely to require care from a range of different agencies/Health and Social Care staff. Whilst this is crucial at all stages of the user’s journey, it has been shown to be particularly important when care is transferred between organisations on discharge. No. NICE Service User Experience Outcomes

12 Users experience coordinated care with clear and accurate information exchange between relevant Health and Social Care professionals. Reducing Health and Social Care inequalities


11 Users experience continuity of care delivered whenever possible by the same healthcare professional or team throughout a single episode of care.

Objectives: To improve the flow of users through care pathways to ensure that users are

cared for in the right place at the right time and by the right people through multidisciplinary teams

The Partnership Trust to introduce Integrated Long Term Condition Health and Social Care Community Teams in July 2013. With the introduction of integrated teams this will improve the continuity of care and integration of health Social Care and external partners.

The Partnership Trust to introduce the Children’s and Young Family division across the health economy

95% of users to state that they are extremely satisfied in the quality of care

The Partnership Trust to capture and monitor compliments along with positive real time feedback of users within continuity of care

Objectives: 95% of users/carers to identify that they have received a positive and safe

discharge from the Partnership Trust.

The Partnership Trust to ask every user/ carer to complete randomised along with the Family and Friendly Test upon discharge from community services.

The Partnership Trust to gain an overall monthly net promoter score from users and carers of +72.14

The introduction in May 2013 of User and Carer Comments cards upon their experience of care

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Measures


Date

User experience coordinated care with clear and accurate information exchange between relevant Health and Social Care professionals. Reducing Health and Social Care inequalities

The Partnership Trust to achieve a 10 point improvement in Q4 of the net promoter score from the April 2013 baseline


April 2013

Sharing Information It should be clarified with the user at the first point of contact whether and how they would like their partner, family members and/or carers to be involved in key decisions about the management of their condition and how they would like this to happen. There will be some cases where the user does not wish their information to be shared with the family or with friends and in these cases the staff need to ensure they deal with this sensitively, respecting the users confidentiality without seeming difficult or obstructive. Family and friends that will have a significant caring role to play in the users care when they return home will need to have the information they need to enable them to fulfil this role and again this needs to be discussed with the user. Young carers (usually aged 5-18) who have a significant caring role are also likely to need to have information shared with them to enable them to carry out their caring role, but it may need to be delivered in an entirely different format or at a different level to that usually given to an adult carer. Partnership Trust Aim No. NICE Service User Experience Outcomes

13 Users’ preferences for sharing information with their partner’s family members and/or carers are established, respected and reviewed throughout their care. People to be active citizens and live “normal” lives taking control of their own care

Objectives:

Every user will be clearly asked upon admission or upon the first initial visit key issues relating to the sharing of information which will be clearly documented in the plan of care

Every user will be assessed within their mental capacity dependent upon their individual needs

The Partnership Trust to receive a score of 95% upon the involvement and quality of care of carers and their family member’s experience of services

All users and carers will be actively involved within the plan of care and provided with adequate information along with education and support for discharge

The Partnership Trust to introduce and recognise the young carers’ identity card

The Partnership Trust to introduce and recognise a Learning Disability Passport

Ensure that all carers gain an appropriate assessment of their individual needs

All staff to be compliant to the Partnership Trusts Sharing of Information Policy along with Information Governance Policies

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Measures


Date

Users’ preferences for sharing information with their partner’s family members and/or carers are established, respected and reviewed throughout their care. People to be active citizens and live “normal” lives taking control of their own care

95% of Carers provide positive feedback upon their involvement and quality of care of their family member’s experience


April 2013

100% of all Carers are offered an a Carers assessment which is clearly documented in the plan of care

Performance data

March 2014

Rapid audit cycle of the users plan of care

Annual reporting

March 2014.

Contact Details Users discharged following care and treatment can often feel very vulnerable, and this can be alleviated if they are only given a name to contact on discharge or for emergency out of hours support. In some cases the appropriate signposting will be to the GP, it should be made clear to the user of any emergency contact numbers for out of hours Partnership Trust Aim No. NICE Service User Experience Outcomes

14 Users are made aware of who to contact, how to contact them and when to make contact about their on-going Health and Social Care needs.

Objectives: Discharge information along with the formatting will be reviewed on Quality

Visits to ensure it is accurate and contains correct contact details for all users

Operational Teams to provide all appropriate contact details upon their first visits or admission to Hospital sites

The users care plan to clearly identify all relevant telephone contact details

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Measure


Date

Users are made aware of who to contact, how to contact them and when to make contact about their on-going Health and Social Care needs.

95% of users will know who to contact for Out of hours services on admission and who to contact following discharge

Quality Visits April 2013

Rapid Audit cycle of care plans

Quality reports

March 2014

CQUINs 2013/14 Net Promoter Question/Family and Friends Test NHS Midlands and East have introduced the ‘Net Promoter’ question as a method of determining the level of user satisfaction in an organisation and this is now being rolled out nationally. One benefit of applying the Net Promoter Score to the NHS lies in its abilities to measure positive ‘word of mouth’; to understand an outcome of user experience using a simple understandable metric that has been used for many years in business and commerce and to track changes in user experience over time. The Net Promoter Score is obtained by asking user’s a single question, “How likely is it that you would recommend this service to friends and family?” Based on their responses, customers are categorised into one of three groups: Promoters, Passives, and Detractors. The percentage of Detractors is then subtracted from the percentage of Promoters to obtain a Net Promoter score (NPS). NPS can be as low as -100 (everybody is a detractor) or as high as +100 (everybody is a promoter). This takes into account that a number of users may report that they had a reasonable experience, which could be interpreted in traditional surveys as being a positive experience, but if asked to recommend a service, they would more likely be a “passive” responder. Only those that are “promoters” should be considered to have had a good experience. In the 2013/2014 CQUIN scheme, this question is expected to be asked randomised along with upon discharge for the Community Hospital sites along with every health and social care community team. Data is filtered monthly to ensure the overall score only contains data from adults of 18 and over. The data is submitted to the Partnership Trust Board on a monthly basis. The Partnership Trust will then be expected to demonstrate a 10 point improvement from the baseline to quarter four.

The Partnership Trust is an early implementer of the Department of Health national initiative of the family and friends test across NHS community providers.


15. To improve the Partnership Trust’s Net Promoter baseline target of +72.14 in April 2013.

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Objectives: The Partnership Trust to publish the monthly Net Promoter Score on the SSOTP

website

A minimum of 1000 surveys to be captured a month by the Partnership Trust in accordance to the Commissioners Quality Schedule of contracts for 2013/14

Every Community team to have an individual net promoter score for monthly monitoring and comparative data

Community Team/Ward will receive a user and carer experience individual report and develop actions of improvement from the collection of data

The Partnership Trusts net promoter score to be shared with other NHS organisations for Foundation Trust Bench Marking. The national benchmarking average score is +72.10

Monthly gold, silver and bronze User Experience certificates are awarded to individual teams to demonstrate their monthly achievements of the Family and Friends Test to acknowledge their success

The Partnership Trust to provide monthly CQUIN Reports upon the family and friendly test to demonstrate achievement to the set milestones upon themed questions

Knowing how we are doing The Partnership Trust is committed to ensuring all of its users have a good experience. The key to developing a reliable and informative picture of user’s experiences of our services is to ensure a range of feedback is gathered in a variety of ways and at different times. Quantitative and qualitative information is vital and when considering the actions listed above alongside the detailed overarching action plan, a varied ‘toolbox’ of data collection methodologies is required. There is real value in collating this information across the Partnership Trust to benchmark services, measure performance, inform commissioners about service quality, improve public accountability and provide evidence for regulators

Objectives: • Monthly Quality schedules data for Contracts 2013/14 • Monthly User and Carer reports to the Commissioners • CQUIN monthly monitoring for the User and Care Experience of service

provisions • Development and introduction of a systematic approach to listening,

responding, sharing and learning from feedback from NHS Choices. • Patient Opinion website • Monthly Regional Community Foundation Trust (CFT) benchmarking • KO14 Formal Complaints audit by the Department of Health • Monitoring of monthly Parliamentary Health and Local Government

Ombudsmen • Annual Customer Service Excellence compliance through onsite external

inspections • Mentor and Care Quality Commission (CQC) basic standards of compliance

audits • Unannounced inspections by CQC or Mentor • LINk Enter and View unannounced onsite inspections • Directors and Commissioners quality visits • Introduction of the national DOH Patient Lead Assessor Care Environment

(PLACE) programme • Monthly comparative review of the SSOTP Net Promoter Score with private,

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Patient- Led Assessment of the Care Environment – PLACE

Patient Led Assessor Care Environment From the 1st April 2013, Staffordshire and Stoke on Trent Partnership NHS Trust has implemented the introduction of PLACE, which is the new system for assessing the quality of the user’s environment. This Department of Heath PLACE programme will replace the old Patient Environment Action Team (PEAT) inspections. The initial PLACE programme has implemented assessments which have been applied to hospitals, outpatients and day treatment centers which provide NHS funded care. The Partnership Trust has provide publication through local media along with inviting voluntary organisations to work in collaboration with our health care professionals to help assess the quality of our patients environment, particularly in the five community hospitals sites. A Patient Assessor can be anyone who has visited our community hospitals as a service user or patient, relative, carer, friend, patient advocate, or even a volunteer. The Partnership Trust has also invited Non- Executive Directors to participate in the onsite PLACE assessments. The role of the user assessor is to be objective and unbiased; have a clear commitment to quality and most of all those who are determined to help the Trust as a provider of NHS-funded care to improve and for assessors to be prepared to make their voices heard in a constructive and supportive way. The introduction of onsite assessment will enable members of the PLACE assessment team to observe and provide a score on user’s privacy and dignity, food, cleanliness and general building maintenance within any of our five community hospital settings. All observations and scores were actually upon the volunteers observations at that time of the assessment. The scoring will be based on what the volunteer assessors observe on a set day where they have been accompanied at all times by health and social care professionals. Every onsite assessment consists of a PLACE team that contains 50% volunteers and 50% staff. National guidance has been distributed from the Department of Health which is the initial training programme. The PLACE assessment does not cover any observations of clinical care or treatment. The programme does not include any review of the staffing establishment or competency of health or social care professionals. Number of Training Sessions The Trust has now provided four training sessions with 29 volunteers who have subscribed to the PLACE training programme. In quarter one, 17 volunteers have undertaken PLACE training by the Trust and have participated in the onsite assessments.

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Onsite Place Assessments

The following Community Hospital sites identified in the table below have all

completed the PLACE onsite assessments. Following the assessments the results

have been uploaded onto the Department of Health (DOH) database for analysis.

Table 1: Completed onsite PLACE Assessments.

Community Hospital Date of Onsite

Assessment

Results uploaded

to the D.O.H

Status

Longton Cottage Hospital 09/04/13 √ Completed

Haywood Hospital 30/04/13 √ Completed

Bradwell Hospital 23/05/13 √ Completed

Leek Moorlands Hospital 30/05/13 √ Completed

Cheadle Hospital 18/06/13 √ Completed

PLACE Results for the Trust.

The results for the Trust are published on the DOH analysis and publication website. To ensure that all our Users and Carers are fully aware of the Trust results they are also available to view on the Staffordshire and Stoke-on-Trent NHS Partnership Trust Website.

Hospital Site Cleanliness Food Privacy/Dignity/

Well Being

Conditions/Appearance

/Maintenance

Bradwell

97.12% 93.96% 86.25% 97.03%

Cheadle

93.09% 91.58% 96.15% 95.41%

Haywood

99.56% 91.36% 98.71% 97.13%

Longton Cottage

96.98% 93.16% 90.72% 94.40%

Leek Moorlands

98.10% 92.60% 91.49% 96.71%

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From the results every Community Hospital sites has devised an action plan of service improvements.

Next Steps for the Patient Experience Programme.

The Trust will be rolling out the scheme into the Health Centre across Staffordshire which is not a national development but a Trust commitment to ensure the voices of all our Users and Carers are heard. The Trust will be developing the assessment tools to ensure we can use a similar scoring outcome to ensure that the Trust is providing high quality services closer to home in the location of our patient choice.

Complaints, comments, concerns and compliments Complaints and other feedback mechanisms offer a valuable chance for the Partnership Trust to understand how our services are performing. The number of complaints should not be seen as a marker in itself to how well or how poor the service is perceived but repeated trends and issues should be addressed to stop them from reoccurring. The Partnership Trust has recently reviewed its process and policies for responding to Health and Social Care complaints following feedback from users, regulators and staff through integrated workshops. PALS are currently at the forefront of the organisation resolving contacts with 24 hours or signposting users to the relevant services or providing information. NHS Choices and Patient Opinion can be a rich source of qualitative user

experience data and the information is in the public domain so can significantly affect

the public perception of the organisation.

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Comment cards To expand the methodology of capturing the user, carer and family experience pre- paid anonymous comment cards have been introduced. Comment cards have been used successfully in a number of areas, particularly women and children’s services. The beauty of these cards is in their simplicity in that it asks very simple open questions “What did we do well?” and “What could we do better? The comments left are used to identify issues that potentially would be considered minor by the user to complain or where the overall experience has been positive but where one issue has been identified. Many of the cards may contain very positive comments, these can be a great boost for staff that otherwise may not have been aware so many of their users were very happy with their experience.

Objectives: • Comment cards to be distributed and piloted across community teams. • Findings and outcomes will be displayed within the departments, Health

Centres and Community Hospital sites. This will ensure that users, carers or families will know that their comments are valued, using the “You said- We did” format

Objectives: • The Partnership Trust to introduce a centralised Customer Service Department • The introduction of a management of change structure to review existing roles

and skill mix for the introduction of new Customer Service roles. • PALS to be visible, accessible, and on site in the Community Hospitals sites

through a robust rotational plan. • The introduction of the Customer Relations and Complaints Policy along with

robust Complaints, PALS and Experience Standard Operating Procedures. • The Partnership Trust to demonstrate 100% compliance to the National

Complaints and PALS targets. • All formal complaints to have response timescales agreed with the complainant

in accordance to Health and Social Care Complaint Regulations. • All complaints and PALs concerns to be severity scored for immediate

escalation of all high risk complaints for Director Leadership. • All complaints investigation reports along with response letters to be quality

assured and signed by the Chief Executive. • The introduction of external complaint panels for the approval of all closed

complaints • The Partnership Trust to introduce independent Investigating Officers for high

risk complaints in accordance to the complaints statutory criteria • The Partnership Trust to publish complaint reports through consent of

complainant upon the Trust Website along with actions of improvement. • Monitoring of the Local Government Ombudsman and Parliamentary Health

Ombudsman upon complaints upheld for the Partnership Trust along with recommendations for improvement.

• Utilisation of the Patient Opinion Website with responses to comments been answered in a timely response by the Customer Service Department by November 2013

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6. Implementation Overall approach to implementation The Nursing and Quality Directorate will coordinate this annual strategy and the key priority areas for each year. The plan will contain actions shared across other directorates. The implementation of this strategy will:

The basis of the patient experience strategy for 2013-2014 and will be linked to the Effectiveness and Safety strategies by the overarching Quality Framework.

Form the basis of a phased approach for subsequent years, ensuring progress against each of the theme areas while maintaining in-year flexibility for responding to quality issues

Supporting strategies and work streams for implementation Key strategies and work streams to implementation, which will be developed by the Quality Directorate, are:

Safety Strategy

Effectiveness Strategy

Experience Strategy

Quality Assurance Programme Supporting strategies and work streams above provide detail on policies, systems and processes that will be developed or refined to achieve the six quality goals in this framework.

7. Monitoring Monitoring the implementation of the Safety Strategy under the Quality Framework The experience strategy will be submitted to the Quality Governance Committee and thereafter will be monitored under Safety and Effectiveness Operational arrangements. Monitoring the experience of care Monitoring of the experience of care will take place primarily using the real time reporting on a monthly basis at a team level. Audits and multiple methods of testing the user and carer’s experience of service along with improvements will be evidenced in accordance to the 57 Customer Service Excellence compliance standards. Each year the Partnership Trust will produce a quality account, in parallel with the annual report and financial accounts.

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After consulting and involving staff, service users and carers we will draw the priorities for each year’s quality account from this framework The Experience Strategy has been sent for consultation to all voluntary and charitable organisations and members of the User and Carer Forum. Consultation around the experience strategy has been undertaken and comments noted and acted upon. The Service User Experience Strategy will provide a valuable information stream for the annual quality account and will also feed into Quality Framework annual report. This will summarise the progress that has been made in implementing the framework. The user and carer experience is monitored by the Trust Board on a monthly basis, and the strategy will be driven by the Quality Governance Committee. Detailed implementation actions are included in the Quality Framework Implementation Plan The brief summary of the implementation in table 2 below identifies the number of actions in the quality framework linked to this experience Strategy, by quality goals along with Monitoring Committee. Table 2: Implementation plan

Patient Experience

Quality Goal Effectiveness

Group OD

Matters

Quality Governance Committee

Patient Experience and Effectiveness Subcommittee

Partnership Trust Board

Assuring Quality

2 17 1

Delivering Excellence

2

1 1

Integrating Quality

13

Quality at the Front Line

3 2

2

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Equality Assessment

STEP 1: What is the background and starting point for this policy? The Partnership Trust’s primary objective over the next five years is to have fully integrated its Health and Social Care services to drive up the quality of care and services provided and to deliver our five strategic goals. All of this is detailed within the Quality Framework. The Experience Strategy is one of the strategies that is required to support implementation of the Quality Framework.

STEP 2: What do we want to achieve? The Experience Strategy sets out how we are to achieve our Experience aims within 2013-14. Each aim includes the objectives and measurement outcomes for the year. On the basis of the aims, definition of experience, and strategic goal areas it is evident that all staff, service users, and carers will be affected by the development and implementation of this strategy.

STEP 3: What do we know? Procedural documents should not be developed in isolation and their introduction should be balanced against the priorities of the Partnership Trust. These help to clarify strategic and operational requirements and they can improve the experience work programmes and increase the successful achievement of objectives. This strategy is being developed to support the implementation of the Quality Framework.

STEP 4: What consultation has been taken: engagement and involvement The Experience Strategy has been sent for consultation to all voluntary and charitable organisations and members of the User and Carer Forum. Consultation around the experience strategy has been undertaken and comments noted and acted upon.

STEP 5: The Experience Strategy is not anticipated to have any differential impact on equality groups. The introduction of the strategy will ensure that we are providing information and recording evidence against each equality group across Staffordshire This policy is applicable to all staff with the aim to promote a single consistent approach, avoiding confusion. Advice on this policy is available with a view to promoting good relations between groups, particularly during the development, consultation and approval procedures.

STEP 6: Have you identified any actions: The comments received as part of the consultation procedure have been taken into consideration and subsequent amendments have been made as outlined in the Version Control section of this document.

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Resources are available to provide advice and support on this policy which will be available to all members of staff.

STEP 7: How will we know that the policy has been successful? Monitoring the progress against the strategy measures will take place primarily via the appropriate committees. Monitoring of the overall strategy will take place at the Effectiveness Group.

STEP 8: Executive Summary Due regard has been taken into the development of this strategy as all staff, service users, and carers will be affected by the implementation of the strategy. An equality assessment has been conducted in line with organisational requirements for procedural documents.

Documents

Service User Experience Strategy