Contents. 1. Introduction. 2. How this strategy has been developed. 3. Definitions. 4. National and policy context. 5. Research and evidence base

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2 Contents 1. Introduction 2. How this strategy has been developed 3. Definitions 4. National and policy context 5. Research and evidence base 6. Aims and objectives 7. Measuring experience 8. Linking service users/carers to Trust Board 9. Raising professional standards 10. Monitoring effectiveness and outcomes 11. References 12. Acknowledgements Page 2 of 12

3 1. Introduction 1.1 The purpose of this strategy is to describe how we will continue to improve services, through the ongoing involvement of Service Users and their carers in the development and delivery of services within Pennine Care Foundation Trust (PCFT). 1.2 The Strategy intends to support the trusts work in adhering to the Care Quality Commissions standards to continually enhance the care and treatment of those people who use our services. 1.3 PCFT continues to be committed to developing Patient Experience opportunities that are inclusive, appropriate and positive. The Strategy shares the values and aspirations of the Equality and Diversity work stream. The Trust s Equality and Diversity Leads are responsible for advising the Patient Experience Strategy on the demographics which represent our patient and carer population across the Trust s footprint. The local patient experience partnerships will innovate and initiate methods to obtain feedback from the diverse groups of each local population through engagement and, where possible, the local groups will analyse and report on feedback against the protected characteristics as set out in the Equality Act 2010, with the aim of ensuring patients and their carers have a positive patient experience regardless of demographic status. 1.4 The Strategy aims to influence the overall direction of services by giving a meaningful voice at all levels, to service users and their carers in making improvements to their own care and treatment. Ensuring we capture, understand and respond to service users and their carers, feedback will allow us to learn as a Trust from their experience and help drive forward improvements. 1.5 The strategy recognised that to get an accurate reflection of Patient Experience, the views of a broad and truly representative section of those that came into contact with the Trust s services need to be obtained. There are multiple reasons that a particular group of those that come into contact with Trust s services may be hard to seek feedback from: for example it could be language or literacy differences, the ability to understand the processes, the perceived value in providing feedback or the accessibility of the feedback mechanisms in place. The local Patient Experience Partnerships (PEPs) will engage with local communities, including those who are seldom heard. This will be done by working with the Trust s services, external local support networks and by monitoring where the feedback being provided is received from. The methods by which feedback is sought and then the manner in which the actions taken by the Trust to implement learning is communicated back to the public and will be continuously reviewed as a result of that engagement activity. Page 3 of 12

4 1.6 PCFT s approach to Patient Experience is to measure what happens to people when they use services and what they say about it. The strategy adds a quality improvement mode by measuring achievement against agreed standards. 2. Definitions 2.1 Patient Experience: is defined by The Intelligent Board (Dr. Foster, 2010) as. Feedback from patients on what actually happened in the course of receiving care or treatment, both the objective facts and their subjective views. The factual element allows comparison with what people say the experienced against what an agreed pathway or quality standard says should happen. The opinion element tells us how Service Users and their Carers felt about their experience. 2.2 Service User: for the purpose of this strategy, a Service User is defined as someone who is currently accessing the services of PCFT, or has used services recently. It is recognised that people may wish to identify themselves by other terms and this will be respected in the course of working with individuals and groups. 2.3 Carer: for the purpose of this strategy, a carer is someone of any age who provides unpaid support to family or friends who could not manage without this help. 2.4 PCFT recognises that the scope of this paper included families and carers 3. How this strategy has been developed 3.1 A series of engagement events were held with staff, service users, carers and partners, provided the opportunity to explore how we, as a Trust can further engage with those who use our services. 3.2 The Big Conversation engagement event for staff has informed the strategy and developed ways and means to gain feedback. All attendees were given the opportunity to make a personal or service pledge about what they will do to develop the Patient Experience agenda in their area of work. 3.3 The Big Conversation for service users and carers offered all attendees the opportunity to inform the strategy, by confirming what is important to them and what quality means on a personal level. Page 4 of 12

5 3.4 PCFT framework developed for The Big Conversation events explored how the Trust can consider the So What? of the learning from Patient Experience feedback. 3.5 At the Service user and Carer Big Conversation, attendees were asked what one word described the top indicator of a quality patient experience as: Empowered Informed Respected Involved Listened to Personalised Competent Safe Timely Helpful Capable Confident 3.6 The Trust s Council of Governors (CoG) has been consulted about the development of this Strategy. A development session was held with the CoG and the Patient Experience Leadership Team. The purpose of the session was to raise awareness of the strategy and the progress to date, as well as to seek the feedback from the CoG regarding the strategy s development. The comments provided by the CoG have since been incorporated into the strategy. The CoG will Page 5 of 12

6 continue to be updated and involved as the strategy is implemented and developed. A clearly defined role for Governors will be established within the Trust s Patient Experience structure to meet their desire to be involved in the collection of feedback, informed about what that feedback is saying and to receive assurance that improvements are implemented on the basis of the intelligence obtained. 4. National and Policy Context 4.1 Several significant national developments have impacted on the strategy, including the Frances Report which identified a number of cultural and organisational changes. The report included the importance placed on understanding and responding to Patient Experience. 4.2 NICE quality standards provides the NHS with clear guidance on the components of a quality patient experience. The standards give evidence based statements that provide the foundation for an NHS cultural shift, towards a truly patient centred service. With focus on Adult Services, Adult Mental Health and Dementia. 4.3 The Care Quality Commission s eleven fundamental standards and five key questions require PCFT to place great emphasis on the evidence gathered for Patient Experience work. 4.4 The NHS Outcomes Framework highlights Patient Experience as one of the key domains Ensuring people have a positive experience of care. 4.5 The National Quality Board s Patient Experience Framework outlines the elements which they describe as critical to the patients experience of NHS services. Their most recent publication in 2015 sets out why a good experience of care is important and provides eight statements that form a jointly agreed definition, of what a good experience should look like. 4.6 The Department of Health s document Quality Criteria for young people friendly health services will inform the standard questions for our younger client group. In addition to this, the Patient Experience Networks report for NHS England Improving Patient Experience for Children and Young People will help measure their feedback and ensure they have a positive experience of care. Page 6 of 12

7 5. Research and Evidence Base 5.1 PCFT s Knowledge Management Service have assisted with the development of the strategy, providing an evidence summary and review of best practice/care studies/innovations on four key questions: 1. How can we best engage staff in the patient experience process? 2. What collection methods can we use to maximise responses to patient feedback requests? 3. What methods can we use to effectively communicate/demonstrate how patient feedback has made an improvement for services? 4. How can we measure how patient experience information has influenced change? 5.2 The evidence base review conducted on how to engage staff in the process of patient experience highlights the importance of engaging with our staff to ensure they feel listened to and empowered. The work plans supporting the strategy articulate the staff engagement plans. 5.3 The work undertaken in the Literature search for What collection methods work best has informed the strategy on understanding the ethical and operational benefits and risks of using patient data to cold call and obtain patient satisfaction feedback. The evidence base demonstrates that interviewing by a person, has the most benefit when collecting patient feedback compared to written responses or SMS text messaging. The work plan supporting the strategy will set out the approach to developing this model across the services. 5.4 The evidence base for ensuring feedback influences improvements and change is not as strong. However the value of informing patients of improvements made as a result of their feedback will be realised by PCFT s You said, we did communications. 5.5 The Knowledge Management Service conducted a best practice review across NHS Trusts. Of particular interest to the work plans will be effective use of patient stories as part of the Board to Ward process. 5.6 Researchers working for the NHS Institute stated it was desirable to combine measures of experience with measures of outcomes to obtain a rounded view of the quality of care. The Institute went on to suggest that methods of collecting and reporting should be tied closely as possible to clinical services, so that clinicians can identify with the results. The work plans supporting this strategy set out how feedback collection and reporting will be meaningful to services. Page 7 of 12

8 5.7 Reports produced in relation to PCFT s patient experience will be relevant, accurate and timely to inform services of feedback from their own patients and how this compares with other services. The NHS Institute recommends bringing data together in a sophisticated way to identify hotspots, where services may not be providing the standard of care expected. The process of triangulation is PCFT s approach to considering the details providing a more complete picture including incident data, complaint details, PALS contacts, bespoke surveys and general feedback. 5.8 To seek greater understanding and to continue to inform the strategy PCFT Innovation and Research department are undertaking a piece of research to better understand what a good patient experience should be Working with INVOLVE, funded by the National Institute for Health Research (NIHR). 6. Aims and Objectives 6.1 The overall aim of this strategy is to engage with, listen to and learn from our service users and their carers. We will do this by implementing a work plan that will ensure: Service Users and their Carers are involved and engaged in their care Service Users and their Carers experience is captured, understood and responded to Service Users and their Carers experience influence the design and delivery of improvement initiatives 6.2 The strategy demonstrates PCFT s commitment to our Trust Vision Working Together, Living Well delivering the best possible care to patients, people and families in our local communities by working effectively with partners, to help people live well. The Patient Experience Strategy will, via the work plans, achieve the deliverables ensuring that Patient Experience is not just an end point of care, more that it is the start of improving care. 6.3 The Trust has a strategic goal to strive for excellence outlines the aim of delivering an excellent experience for service users and their carers. The strategy will ensure we use feedback to facilitate and continuously improve services across PCFT. Page 8 of 12

9 6.4 PCFT s transformation programmes 2014 to 2019 will be informed by findings and detail gained from patients and their carers via feedback which will tell us how well we are doing in achieving these. 7. Measuring Experience 7.1 PCFT s strategy for Patient Experience supports the measurement of what has happened by what patients and their carers said about it. This will be captured by a variety of feedback mechanisms detailed in the work plan. In addition, agreed standards of quality care will allow PCFT to focus on service improvement by measuring achievement against these. 7.2 Patient Recorded Experience Measures (PREMS) will be developed locally within the DBUs in conjunction with the Patient Experience Leadership Team. 7.3 PCFT Patient Advice and Liaison Service (PALS) AND Complaints Team have mechanisms in place to receive, record, address and report on concerns and complaints that have arisen from people experiences of the Trusts services. 8. Linking Service Users and Carers to Trust Board 8.1 The Trust will establish an overarching Patient Experience Steering Group and local Patient Experience Partnership in each Divisional Business Unit or Borough. The purpose of the groups will be to monitor the Patient Experience Strategy implementation. 8.2 There will be a range of local, condition specific or service specific groups across mental health and community services who will inform the Patient Experience Partnerships. Page 9 of 12

10 9. Raising Professional Standards 9.1 Raising professional standards is central to the Patient Experience Strategy. It directly impacts on a patient s experience of a service. Governance processes and effective links with PCFT Nursing and HCP Council will ensure that Patient Experience feedback is listened to, responded to and good practice shared. 9.2 The strategy and associated work streams will enhance PCFT s understanding of how we as a Trust, are performing on deliver a high quality service. 10. Monitoring Effectiveness and Outcomes 10.1 PCFT is committed to monitoring the effectiveness of this strategy and its intended outcomes. This will be visible through: Detailed action plans with identified individuals and forums leading on the objectives. Utilising existing Trust publications to share positive experiences, highlight success and encourage involvement. Introduction of You Said, We Did feedback loop Formal reporting to PCFT Quality Group Page 10 of 12

11 11. References 1. Care Quality Commission (2014) Eleven Fundamental Standards 2. Department of Health (2012) Liberating the NHS: No decision about me without me 3. Department of Health (2010) The NHS Outcomes Framework 2011/12 4. Department of Health (2011) Quality Criteria for young people friendly health services 5. Frances Report Institute for Innovation and Improvement (2013) Transforming Patient Experience: The Patient Experience Research 7. National Quality Board (2011) NHS Patient Experience Framework 8. National Quality Board (2015) Improving experience of care: our shared understanding and ambition 9. NICE (2013) Quality Standards 30 supporting people to live well with dementia 10. NICE (2011) Service user experience in Mental Health: Improving the experience of care for people using Adult Mental Health Services 11. NICE (2012) Patient experience in Adult NHS Services 12. Patient Experience Network (Accessed on ) Improving Patient Experience for Children and Young People 13. The Health Foundation (2013) Measuring Patient Experience 14. The Intelligent Board (2010) Patient Experience Page 11 of 12

12 12. Acknowledgements The trust would like to acknowledge and thank all those who contributed to this strategy, particularly its services users, carers, staff, governors and partners. Page 12 of 12