Report submitted to: Trust Board Wednesday 25 th July Martin Emery, Head of Patient Experience Denise Flowers, AD Clinical Governance

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1 Southend University Hospital NHS Foundation Trust Board of Directors Meeting Report Agenda item 3/1 Agenda item 3/1 Report submitted to: Trust Board Wednesday 5 th July 1 Title: Complaints Quarter 1 report 1 Author: Martin Emery, Head of Patient Experience Denise Flowers, AD Clinical Governance Presented by: Sue Hardy, Director of Nursing Executive summary: To provide the Board with an update regarding the number and type of complaints reported during the previous quarter and actions taken. Implications: Governance Board action required: This report is for information and discussion.

2 1. Overview: The data collated between 1 st April and 3 th June shows that the Trust received a total of 3 complaints (verbal & written), 1 claims, 5 compliments and inquests. 15 of the complaints were written and 9 were verbal.. Complaints:.1 During Quarter 1 the Trust received 15 written complaints of which 5 have been closed. If this is compared to in patient admissions in the same period it equates to.% of attendances. Section 3 gives further information in respect of the key performance indicators for written complaints and section for verbal complaints. Figure 1: Number of PALS and Complaints (combined) received during the last 9 quarters. This can be further broken down to the number of complaints received per Busines Unit: Figure : Verbal & Written complaints recevied during the last 5 quarters by Business Unit

3 . During the first quarter of 1/13, the Trust commenced the collection of compliments; during this period there were 5 compliments received. Collation is undertaken by each area informing the complaints and PALS department weekly on the number received by either cards or letters of thanks. Results at present are sporadic. However as results for departments and wards are disseminated, it is envisaged that the reporting will increase. 3. Key Performance Indicators (KPI s) written complaints (Levels 5). The Trust has two performance measures within the local resolution process for written complaints, compliance with which must be 5% or above for acknowledging letters of complaint within 3 working days and responding to the complainant within the negotiated deadline Timeframes are flexible and are negotiated when the letter of acknowledgement is sent, currently the complaints team are working to the following timescales: Complaints with 1-5 issues to be addressed - 5 days Complaint with -1 issues to be addressed - 3 days Complaints with issues to be addressed days Complex more than issues to be addressed - days Complaint includes more than 1 organisation - days The hospital achieved compliance with: 15 (1%) of acknowledgement letters acknowledged within 3 working days. 3 (%) of complaints were responded to within the negotiated timeframe. For the complainants (1) who waited longer than the agreed timescale for a response the majority agreed to an extension of time, in line with the NHS Complaints Procedure (within agreed timescales) and all were offered a written apology and explanation for the delay. The Complaints manager is actively working with the Business units to achieve our internal compliance timescales through a range of approaches, attending BU comm cell briefings to keep the emphasis on the timescales and resolving issues around sharing of the patient s records when there is more than one service involved in a complaint. The projected trajectory for quarter 1 1/13 is % compared to % for the same quarter 11/1 : Key Performance Indicators (KPI s) verbal complaints (Levels 1). The Trust recevied 9 verbal complaints during quarter 1 of which 9% were responded to within a mutually agreed timscale (usually 5 working days). The remaining 11% were unable to be resolved as a verbal compliant and escalated to level (written complaint). 5. Trust wide themes and learning from complaints (%) of the action plans related to complaints recevied during quarter 1 (April / May data only) have been completed todate. A break down per BU is summarised in the following graphs. For further information please contact the Head of Patient Experience on lessons learnt 3

4 The overarching theme and lesson that can be learnt from complaints is that communication and the attitude of staff is the key to the effective care of our patients, with most of the action plans identifying this as an action, it remains clear that this is still an on-going issue. A trust wide plan is for this is to be disscussed and plans formulated through a workshop involving all Business Units and departments led by the AD for Clinical Governance and head of patient experience, to undertake a detailed analysis of the action plans and formulate a forward plan. Examples of actions taken to date are discussions both at ward meetings, customer care training and discussions with individual staff. The first patient story at ward level is being introduced on Balmoral ward as part of the Model Ward project in September 1, which relates to the experiences that a patient had both positive and negative whilst an in patient on the ward. The idea to complete a patient story at ward level was taken by the wound management team when they heard that patient stories were to be held at board. It was thought it would be a great opportunity to complete at ward level with the emphasis on clear lines of communication. The following graphs show the main themes by Business Unit that have emerged during A&A Business Unit (complaints/main Accuracy of Diagnosis Attitude A&A Business Unit Medical Treatment 11 Waiting times 3 Discharge and Follow up The main reasons were related to waiting times in A&E and staff attitude across A&E and AMU. The other main concerns related to discharge / follow up, accuracy of diagnosis and the standard of medical treatment given to the patients. Lessons Learnt: The process for faxing referrals to other services from this department has been enforced and individual staff addressed. Staff have discussed at a team meeting how discharging process for patients can be improved and all A&E staff will attend customer care training by the end of 1. were recevied during

5 D&T Business Unit (complaints/main D&T Business Unit The main reasons were related to ineffective communication given by radiology x-ray staff and the attitude of staff in the phelobotomy clinic. 1 1 Attitude Communication Environment Information Waiting times Lessons Learnt: In relation to attitude a plan is being undertaken by the Business Unit Governance Lead and expected standards are being communicated to all staff. none were recevied during Medicine Business Unit Cancellation of appointments Communication Discharge / Follow Up Information Given Nursing Care 51 Medicine Business Unit (complaints/main The main reasons were related to ineffecitive communication with patients and their families in elderly/general medicine; followed by insuffienct information given by staff in general medicine and the gasterology department. Lessons Learnt: Improvements in communication were discussed at a ward meeting and will stand as an on-going agenda item. Staff are to maintain accurate and up-to-date patient records and dignity and respect teaching session was given to staff as a result of a complaint. 51 were recevied during 5

6 MSK Business Unit MSK Business Unit (complaints/main The main reasons were related to ineffective communication given to patients by staff across the Business Unit and problems with the orthopaedics admission process. Admission Attitude Communication Discharge Follow up Waiting times Lessons Learnt: Staff are attending customer care training. The handover process is being reviewed initially on one ward with the vision that it will be rolled out to the other wards within the BU. 11 were recevied during Ophthalmology Business Unit Attitude Cancellation Communication Referral Issues Waiting times Ophthalmology Business Unit (complaints/main All of the complaints relate to the outpatient clinic with the main reasons being prolonged waiting times to be seen by clinical staff followed by staff attitude. Issues have also been raised with partial booking appointments being sent Lessons Learnt: Communication between clinic staff and patients has been inconsistent and difficulties found due to the number of patients attending for different clinics. Clinical staff are updating patients and reception staff on potential delays so that all are aware of issues that are ongoing, this has already commenced and will be evaluated through compliments and complaints during the next quarter. Operational leads for the department are currently reviewing the partial booking process as this is a new trend identified in the past month. none were recevied during

7 Surgical Business Unit Surgical Business Unit (complaints/main 5 The main reasons were related to waiting times in urology and insufficent information given to patients and staff in urology and ENT clinics. 3 1 Admission Arrangements Cancellations 1 Communication Information 11 Waiting times Lessons Learnt: The booking team were advised that they needed to inform patients that are overbooked into clinics that clinics could overrun. A member of staff was informed of the need to ensure that communication with relatives needed to improve. were recevied during W&C Business Unit W&C Business Unit (complaints/main The main reason for complaints relate to the quality of medical treatment given by paediatricans and the attitude of staff across the Business Unit. 3 Attitude Cancellation Medical Treatment 3 3 Nursing Care Waiting times Lessons Learnt: Booking clerks are to take account of previous cancellations and customer care standards when rebooking appointments. 1 were recevied during. Status of Parliamentary & Health Service Ombudsman (PHSO) Cases to date cases have been opened by the PHSO to date and no decisions have been given and no other outstanding cases have been closed in. Claims and Inquests For NHSLA reporting timescales, we received a total of 1 claims in quarter 1 and we achieved 1% compliance in reporting the claim within hours to the NHSLA.

8 inquests were held in quarter 1 and the Trust received no Rule 3 letters from the coroner which seeks reassurance from an organisation that future deaths can be avoided. No learning has been identified for the Trust from either of the outcomes. Learning from Litigation MSK Business Unit Learning CNST Areas of concern: Conflict of information. Clinical records needs to be reflected in consultant letters Browne Jacobson Solicitors found that the inconsistency between letter written to the GP and theatre records over the reason for the cancellation of surgery hampered the defence of this claim.