Patient Experience and Involvement Strategy

Transcription

1 Patient Experience and Involvement Strategy

2 Introduction 1. Foreword 3 2. Introduction 4 Current Position 3. National Context 6 4. Local Context 8 5. Current Position in the Trust 8 6. Engagement with Our Diverse Communities Patient Experience Feedback 10 Framework 8. Framework for Moving Forward Methods Governance Assurance/Structure The Eight s 15 References 12. References 19 Introduction 1.Foreword Patient Experience and Involvement is an extremely important and valuable resource to the Black Country Partnership NHS Foundation Trust. The Trust has built a good reputation of involving service users and carers over the years. That is why, more than ever, it is essential that the Trust develops an overarching plan for staff to work towards ensuring we continue to deliver on this key objective, especially with the introduction of the Friends and Family Test, and the continued expectations of how to measure good patient experiences. Our aim is to ensure that the services we provide are of high quality and that they are delivered in a comfortable, caring, compassionate and safe environment. Moreover, the Strategy sets out how staff can involve patients, carers and their families in the delivery and development of services. Their knowledge and rich source of feedback about their experiences are essential. The vision for this strategy is to achieve co-production, which is why we have set out the principles of the ladder of participation which identifies goals to work towards. We are grateful to Changing Our Lives who have co-produced this document. Karen Dowman - Chief Executive You have the right to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services The NHS Constitution 26 March

3 2. Introduction Black Country Partnership NHS Foundation Trust s (BCPFT) vision is to improve health and wellbeing for people of all ages across the Black Country. In Sandwell and Wolverhampton, we care for and support people of all ages who have mental health needs. We provide a range of specialist health services for people with learning disabilities in Dudley, Walsall, Sandwell and Wolverhampton. We also provide community healthcare services for children, young people and families in Dudley. We are committed to ensuring that service users, carers and their families are involved in developing, planning and monitoring services. The aim of the Patient Experience and Involvement Strategy is to develop and support a culture that places the quality of the patient experience at the very heart of all that we do, following the principle of no decision made about me, without me. The White Paper, Equity and excellence: Liberating the NHS, set out the Government s vision of patients and the public being at the heart of the NHS. Central to delivering this vision is ensuring that all patients are fully involved in decisions about their own care and treatment so that the principle of shared decision-making - no decision about me, without me - becomes the norm across the NHS. Department of Health 2012 Lord Darzi s report High Quality Care for All (2008) highlighted the importance of the entire patient experience within the NHS, ensuring people are treated with compassion, dignity and respect within a clean, safe and well-managed environment. Patient experience is as important to service users, carers and their families as clinical effectiveness and safety. Service users want to be supported and listened to so that they can make decisions and choices about their care. The Quality Strategy describes that the Trust s goal is to provide high quality care, in the right place, at the right time. Safety (the safety of treatment and care provided to patients) Clinical Effectiveness (effectiveness of the outcome of care) Patient Experience (the overall experience for patients) It defines quality as ensuring that people who use services have a good experience. This Strategy sets out the Trust s approach to developing and improving the way we measure, capture and improve patient experience for those involved with services provided by Black Country Partnership NHS Foundation Trust. To ensure people have a good patient experience, we will develop a cycle of continual listening, learning and service improvement; working together with our service users to ensure that the valuable feedback from their experience is routinely captured and put to use effectively. During my in-patient stay, staff never labelled me but treated me as an individual. Patient Interview This strategy outlines some of the positive ways in which we have already achieved this. We will continue to build on these foundations and implement and strengthen systems throughout the organisation, such as in the mental health and learning disability divisions. This document highlights how staff can involve service users, carers, and their families and discuss ways in which feedback can be received and will also show service users, carers and their families how they can become involved. Below is an illustration based on the ladder of participation. The ladder is aspirational; movement up the ladder shows greater degrees of participation and ultimately co-production. Co-production involves working together with people as equal partners in the design, delivery and evaluation of work. It is moving beyond consultation where people s views can be easily disregarded, and beyond active participation where people participate in something that is already decided or formed. Co-production is about working with people as experts in their own experience, so they can play an equal role in the design of a piece of work before the work is rolled out. The Trust recognises that our work will be at different levels on the ladder at different times, but acknowledges that the top of the ladder is the main goal. The idea for working in this way has come from our partners Changing Our Lives, who run Making Our Voices Heard and work with the Trust to ensure patient voices and experiences are heard in our services. They carry out Quality of Life reviews and a range of other services. Consultation Active Co-production Patients consulted with and asked their opinions. These opinions are taken into nconsideration The Trust set up meetings and activities with patients and carers that enable shared decisions. Patients drive meetings and activities. They make decisions that are acted upon by the Trust Currently we provide: PLACE Assessments Acute Care Forum Currently we provide: Expert by experience meetings Membership events Currently we provide: Patient Councils in the Learning Disabilities and Mental Health Divisions Divisions Patients attend meetings Non about them and have no say about decisions made. Participation nthe patients presence is not 4 adding value. 5

4 3. National Context Current Position Government policy has placed emphasis on the importance of personalising services, particularly within healthcare, where patient experience is recognised as an equal partner to safety and effectiveness in achieving quality, underpinned by national initiatives such as National Institute for Health and Clinical Excellence (NICE) who publish guidance on improving the experience of care for people using adult mental health services. There are a number of national policy drivers requiring healthcare organisations and professionals to continually measure and improve patient experience. The aim is to provide a patientcentred healthcare service that meets the physical and emotional needs of the population. The NHS Operating Framework 2012/13 specifically states that the NHS should collect and use patient experience information in real time and use it for service improvements. NHS organisations must actively seek out, respond positively and improve services in line with patient feedback. This includes acting on complaints, patient comments, local and national surveys and results from real time data techniques NHS Operating Framework 2012/2013 Patients are actively involved in making decisions about their care, and supported to make fully informed choices that reflect what is important to them NICE 2011 The purpose of the NHS Outcomes Framework is to provide a national level overview of how well the NHS is performing, to provide an accountability mechanism between the Secretary of State for Health and NHS England; and to act as a catalyst for driving quality improvement and outcome measurement throughout the NHS by encouraging a change in culture and behaviour. The NHS Outcomes Framework is structured around five domains, which set out the high-level national outcomes that the NHS should be aiming to improve. One of the domains is about ensuring that people have a positive experience of care. The mid-staffordshire NHS Foundation Trust Inquiry (Francis, 2013) also emphasises a change in culture, including a refocusing and recommitment from all NHS staff to put the patient first and to promote a common, patientcentred culture and fundamental standards of care. The NHS belongs to the people It touches our lives at times of basic human need, when care and compassion are what matter most. The NHS Constitution In light of the publication of the Winterbourne View and the Francis reports, the need for patient experience and engagement is high on the agenda. The NHS Constitution (2013), the Outcomes Framework ( ) and NICE (2011) reinforce the need for patient centred care. The Care Quality Commission recommends effective involvement with people who use services (CQC 2013) and promotes user involvement based on human rights, equality and in valuing what people say. The NHS Confederation 2010 have identified the need for improved patient experience and improved health outcomes. The Government signalled in its White Paper Equity and Excellence: Liberating the NHS (2010) that more emphasis needs to be placed on improving patients experiences of NHS care. We have always been treated with dignity and respect the staff empowered us and we have been fully involved in mum s treatment The strategy underpins the Trust s Patient Interview Vision and Values and supports the delivery of the key objectives. It will provide a framework to ensure that every voice is heard, individual choice and wellbeing is promoted and people are enabled to have the best experience of our service. It links with the BCPFT Quality Strategy and patient experience targets. Leadership for this strategy and patient involvement and implementation is led by BCPFT Board, Executive Director of Nursing and Medical Director supported by the Deputy Director of Nursing and a Divisional Director from each division. Clarifying values based on feedback from service users and staff and the responsibility for, and effectiveness of, healthcare standards: Patient feedback through compliments, concerns and complaints to be used at all levels of the organisation to ensure staff are aware of the impact that attitudes, behaviours and poor communication has on service users and their families. Francis Report (2013) 6 7

5 4. Local Context The Black Country is an ethnically diverse area made up of many different cultures and backgrounds. Black Country Partnership NHS Foundation Trust recognises the importance of responding to the diverse range of people we provide services to. The Trust is committed to providing accessible and effective services, taking into account the different needs that individuals within the Black Country have, that support our strapline Our community: you matter, we care and deliver on the key goals set by the organisation. The following four key goals were also agreed by the Trust: To reduce inequality by recognising diversity and celebrating difference To improve and promote the health and well-being of local communities To provide high quality care, in the right place, at the right time To put people and their families at the heart of care The Trust s vision is Our community: you matter, we care, supported through the Trust s vision statement: working with local communities to improve health and well-being for everyone. The Trust s collective values are: Honesty & Openness to act in a transparent way that supports honesty and openness Empowerment - to empower people who use services; carers and staff Dignity & Respect to treat people who use services, carers and staff fairly, with dignity and respect, appreciating their individuality. We will achieve our vision and goals through the following strategic objectives: We will improve access to a range of integrated services across the Black Country which are sustainable and responsive. Our local communities will value the contribution we make to improving people s lives. We will attract, retain and develop a capable and flexible workforce. 5. Current position in the Trust The Trust has a history of seeking feedback and consulting with users and stakeholders and has shown major success in the Mental Health and Learning Disabilities Divisions. We will strengthen the involvement of the Children, Young People and Families Division using some of the current methods below:- Staff, service user, carer and families stories Ward walk-arounds by non-executive directors and senior staff Concerns, complaints and compliments Patient Opinion and NHS Choices Cooperate with information requests from Local Healthwatch organisations. Ad-hoc local feedback systems many wards and departments have developed their own systems to receive feedback Trust volunteering service National Community Survey Patient Experience reports Changing our Lives Patients Experience Improvement Meeting - Experts by experience Patient Councils Patient Experience and Involvement (PEI) team database of Experts by Experience and Volunteers What makes us proud are: Some of the Make a Difference groups achievements: Raising awareness and banishing stigma in the Trust of the potential contributions of Experts by Experience Nothing about us without us : a user-focussed monitoring evaluation of community mental health appointments presented at the Royal College of Nursing Conference in September 2013 We re Here to Make a Difference :- Expert by Experience involvement in a mental health trust Make a Difference Research and Development Group shortlisted for the Nursing Times awards 2013 Design of out-patient evaluation project and delivery of first phase at Hallam Street Hospital out-patient clinics Transformation of Hallam Street Hospital Resource Centre Some of the Patient Council Achievements: Dragon s Den event led by Patient Council members in the Gerry Simon Unit brought about significant improvements to grounds. The Gerry Simon Patient Council have made significant improvements to the complaints process by creating an accessible process and developing direct communication to the PEI Team. Patient Council at Hallam Street Hospital resulting in a new working group being established to focus on improvements to ward environments so they are less clinical. The Patient Council in Newton House, step-down service has written a set of meeting standards signed off by the Chief Executive for use across in-patient and out-patient services and are on the Trust website Patient Council at Hallam Street Hospital are working on the design and content of a welcome pack alongside the Modern Matron and Service Manager. The Newton House and Gerry Simon patient councils carrying out patient led audits of their units. Some of the Changing Our Lives Quality of Health Audit Achievements: Audits showed that patients did not always understand what medication they were taking, why they were taking it and the side-effects. An accessible medication template has been developed that uses pictures and easy words to tell someone about their medication. Patients that struggled to identify their bedroom had photographs of them placed on the bedroom doors and for people who are visually impaired, a sensory object that the person identifies with is placed on their door. Accessible complaints processes developed on units. Environments across assessment and treatment units and acute mental health settings have been improved. Accessible care plans have been developed across the low secure, step down service and assessment and treatment units 8 9

6 6. Engagement with Our Diverse Communities 7. Patient Experience Feedback We recognise there are many diverse communities within the Black Country and we have had some successes in engaging groups. However we must continue to improve engagement, and will continue to drive this forward through this strategy and cross reference with BCPFT s Play Fair Equality Strategy focusing on areas such as: Black and Minority Ethnic groups Carers Children, Young People and Families Lesbian, Gay, Bisexual and Transgender Older people and people with dementia People with Learning Disabilities People in Secure settings Improving the relationship between individuals from black and minority ethnic groups and the emerging communities including asylum seekers and those from Eastern European countries who require support with their health and wellbeing. We will ensure that language and culture do not present a barrier. Carers will be valued in their own right and given the opportunity to express how their needs as a carer may differ from the person being cared for. We will encourage children and young people s involvement, and make their participation meaningful, ensuring that their own voice is heard and language will be appropriate. We will involve service users, carers and their families who identify as being from these groups in decision making and ensure that their specific views are represented. Older service users, carers and their families will not be excluded from decision-making. We will continue to ensure people with learning disabilities are involved and consulted with through participating in Patient Councils and working alongside partner organisations such as Changing our Lives. We will continue to ensure patients in secure settings are engaged with and involved in services through participating in community meetings and Patient Councils with Changing our Lives. The Equality Act 2010 provides an important legal framework to improve the experience of all service users using NHS services. Protected characteristics are age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. Equality Act Guidance (2010) A patient experience workshop was held in January 2014, you said: What makes a good patient experience? Listening to and acting on feedback Patient-led meetings Seeing same person throughout journey Activity groups/ social events Community support Treat as a person and not just a patient Appropriate environments Support and information for service users carers/relatives Communication Hearing about positive experiences Compassion/ empathy/ encouragement Why patient experience is important? To gain insight into patients experiences To find out what is working and what isn t So that best practice can be shared So people can learn from it To employ the right staff for the right job so that treatment can be tailored for each person Framework 8. Framework for moving forward for our service users, carers, relatives and staff We need to understand and learn from service users/ carers experiences and will review processes to establish what works well and where we may need to develop further. Examples of experiences are: Appointments e.g. with doctors and nurses Admission to hospital Outpatient appointments Community contacts Carers support How to involve and capture service user feedback Experience nvolvem Experie nce Involvement Service User, Carer, Relative, Staff Feedback Complaints, concerns and compliments Friends and Family Test Mystery shopper Real-time feedback Creative Strategy Group Surveys and questionnaires Patient, carer and staff stories Audits nt Your feedback is important to us, we will collect your feedback in the following ways: Service users, carers and relatives can get involved in the following ways: Sign up as: A member of BCPFT An Expert by Experience Help in creating a personalised care plan Attend: Patient Councils Events and local groups Patient-led assessments of sites Trust meetings Participate in service evaluations and audits

7 9. How will we do this 2014 onwards Feedback will be collected using a number of approaches to ensure all service users, carers and their families have the opportunity to have their say about their experience. Feedback model Concerns, Complaints and Compliments Healthwatch Patient Opinion and NHS Choices Websites National Surveys Locally - Patient facing areas Divisional Level Board Level Collecting Feedback Act to Improve Complaints Friends and Family Patient and staff stories Drop-in sessions Mystery shoppers Listen and Understand Measure and Disseminate Reporting patient feedback and improvement data 8.1 Collecting Feedback Collecting Feedback Opportunities for feedback Support multiple ways to involve service users, carers and families when collecting feedback. Support divisions in collecting and reviewing feedback, which will include development of the Friends and Family Test, national surveys, questionnaires, real-time feedback, patient, staff and carer stories and mystery shoppers. Concerns, Complaints and Compliments Provide a streamlined approach to responding to and handling concerns, complaints and compliments across the Trust. Capture, record and disseminate data. National Surveys Continue to commission the National Community Survey. Continuously review the value of the survey as services change and develop. Friends and Family Test Friends and Family Test to be rolled out from June 2014 to staff and patients. Patient, Carer and Staff Stories Build on the use of patient, carer and staff stories to make sustainable improvements to services. Support Divisions in utilising this rich source of feedback and use this information to influence behaviour and culture change. Involve local Service User and Carer Groups Patient Councils currently in Learning Disabilities and Mental Health. Expert by Experience Groups. Increase engagement and involvement activities with these groups to explore ways of working together to capture patient feedback and to inform service improvement. 8.3 Action to Improve Involve service users, carers and their families to enable patient-centred service improvement. Recognise good practice in relation to using patient feedback to improve patient experience and sharing this practice. Divisional action within Mental Health, Learning Disabilities and Children Young People and Families Divisions will work with service users, carers and their families in utilising feedback. The focus will include reducing the number of complaints and identifying gaps and recurring themes, along with demonstrating the impact of improvement activities. Ensure high quality action planning in response to complaints, monitoring actions and sharing learning. Board of Director actions The Board will agree the priorities for improving patient experience on an annual basis. The Trust will consider opportunities for wider involvement and sharing learning internally, within the local community and across the NHS. The Trust will work with service users, carers External sources and families to improve services, ensuring they 8.4 Measure and Disseminate Capture all feedback and recommendations found on NHS Choices/Pahave the skills and opportunities to do so. tient Opinion websites in collaboration with the Communications Team. Maximise the opportunities and benefits of working with Healthwatch, The Trust will share as best practice across The PEI Team will use themes that emerge NHS Choices and Patient Opinion to improve patient experience. Act to the organisation evidence of improvement gained improve to identify opportunities for improvement. from feedback. Some feedback will result in rapid and simple 8.2 Listen and understand improvement actions, other feedback will require Measure and The reporting of patient feedback and further planning and this activity will happen at a disseminate Feedback will be listened to and used to improvement data from ward and department level variety of levels: identify lessons learnt and provide evidence to to divisional level will allow benchmarking and Listen and Local action drive forward improvement. comparison both within the Trust and in comparison understand Build on and embed learning from the various projects. to other NHS health care organisations. Ensure that staff leaders and service users, carers and their families Continue to look at issues that can cause have the knowledge, skills and opportunities to undertake local service users, carers and their families to raise improvement work. complaints and work with service users to resolve and reduce complaints in a timely and sensitive manner

8 10. Governance Assurance Structure for quality and safety 11. The Eight s The illustration below is a proposed structure of reporting from division up to Board: Board of Directors Quality and Safety Committee Quality and Safety Steering Group Patient Experience and Involvement Steering Group Experience Not Satisfaction Simply collecting information in itself has no value; it is how the information is used that matters. Patient satisfaction and the perceptions of the public are important - the information used to really transform services comes from the experiences of people using those services. Many of our teams collect and use feedback to inform service improvement. BCPFT will report on the eight objective plan. 1 Collect timely and relevant patient experience information Information is an important part of service user, carer and families journeys and is central to the quality of each person s experience of our services. Learning Disabilities Division Service users, carers and families Mental Health Division Service users, carers and families Children, Young People and Families Division Service users, carers and families Work with each division to carry out an audit of current systems to collect information. Take stock of that feedback and evaluate what is working well. Report on the effectiveness of the information. Strengthen patient experience feedback mechanisms. Respond to feedback from other sources such as NHS Choices and Patient Opinion. Decide if further developments will be required for service users, carers and their families to share their views and experiences of services such as through network opportunities, drop-in sessions, web based feedback. Develop and circulate an agreed plan for each division to work towards

9 2 Learning from Concerns, Complaints and Compliments Concerns and complaints provide an opportunity for us to put things right and to learn new approaches in order to improve our services. Continue to build on lessons learnt. Set up the You Said, We Did posters initiative to inform proactive service improvement. Promote concerns, complaints and compliments including providing services with posters providing information to the divisions, highlighting themes and trends. Continue to provide divisions with themes and trends resulting from concerns, complaints and compliments. Act on information sources. Roll out the complaints Datix model to divisions to evidence where actions have been taken for a local resolution. 3 Access to information By providing information at the right time and in the right format service users, carers and their families will feel they are actively involved in their care with knowledge, understanding and confidence to make informed decisions about their care and treatment. To review what patient information in the Trust is currently available and to include input from service users, carers and families. Review current systems in place in partnership with the divisions, establishing what information is most used. To streamline policies and procedures to assist staff in producing appropriate information. Set up relevant audits to check information is easy to read and clear. 4 Increased staff involvement and awareness All staff have an impact on the experience of service users, carers and families and it is important that improving patient experience is not just seen as the job of clinicians but all staff who work for BCPFT. The Service User and Carer Involvement Policy to be reviewed in To give meaningful customer service driving a good customer service through involvement and feedback. Knowledge of this strategy will be included in staff induction programmes. Assist in promoting and monitoring Trust behaviours. Completion of staff Friends and Family Test. 5 Continuously improve leadership The Trust Board will play an active role in advocating improvements in patient experience. The Francis Inquiry (2013) sets out the importance of good quality Board of Director s leadership and the importance of actively listening to real-time patient experience feedback. Provide a summary of patient feedback activity to the Board of Directors, highlighting themes and trends. Devote time at Board and committee meetings to learn lessons from patient feedback. Continue to collect and present patient, carer and staff stories. The PEI strategy will be cross-referenced with the Quality Strategy and the patient experience targets. Review systems and processes that link service users, carers and families with teams to help make service improvements 6 The amount of involvement service users, carers and their families have in terms of patient experience varies from person to person. A range of options will be offered to those people who wish to use their experience to influence service improvements and to access views of current users of our services as Experts By Experience. Ensure that we have a fair and robust system for service users and carers to be involved in the Trust which we will continue to review and develop. Ensure that there is a patient experience contact in each division that links with the PEI team to ensure service users are involved in various activities such as being on interview panels etc. Continue to review the structure and format of any Expert by Experience involvement. Ensure divisions identify ways to involve service users to support service developments and improvement. Ensure regular communication between staff and PEI regarding service user and carer involvement in BCPFT. The PEI Team will work collaboratively and meaningfully with the Communications and Membership teams within BCPFT to ensure successful involvement of service users and carers to share and promote good practice initiatives. Divisions identify opportunities for improvement 7 Issues raised by service users, carers or families should be dealt with promptly and efficiently to include steps to be taken to locally respond to ideas or rectify issues to the satisfaction of those involved The PEI team will work with the divisions providing advice and assisting with the co-ordination of patient experience improvement projects. The divisions will provide information about their collection of information and disseminate and share good practice and lessons learnt from feedback collected

10 12. References 8 Engagement with Our Diverse Community To ensure equality issues are considered for these groups. The Trust will work closely with local charities, community and faith groups, and the Equality and Diversity Team to build and focus on developing relationships with BME and LGBT communities and to ensure all involvement activity is inclusive. To obtain support of key clinical staff within the divisions to implement the Triangle of Care model and ensure carers are an integral part of our service. The Triangle of Care is a therapeutic alliance between service user, staff member and carer that promotes safety, supports recovery and sustains wellbeing. To develop modern and accessible ways to communicate with, inform and involve children, young people and their families. Methods of communication and involvement activities to be developed that engage with older people and people with dementia in meaningful ways, taking into account specific conditions. Appropriate communication tools will need to be developed that will enable people to express their needs in creative ways. To engage with people in secure settings and to ensure people in this group have the same opportunities for communication and involvement. To continue to support people with learning disabilities using specific approaches, such as through Changing our Lives, Patient Councils and advocacy services, to provide people with the additional support to enable them to give us their views. Arnstein, Sherry R. A Ladder of Citizen Participation, JAIP, Vol. 35, No. 4, July 1969, pp Ashford and St Peter s Hospital NHS Foundation Trust, Strategy for Improving Patient Experience ( ) BCPFT, Quality Strategy, ( ) Care Quality Commission, Raising Standards, Putting People First ( ) Carers Trust The Triangle of Care Carers Included: A Guide to Best Practice in Acute Mental Health Care 2013 Department of Health, Equity and Excellence: Liberating the NHS (2010) Department of Health, Liberating the NHS: No Decision About Me, Without Me (2012) Department of Health, High Quality Care for All, Lord Darzi (2008) Department of Health, The Operating Framework for the NHS in England ( ) Government Equalities Office, The Equality Act - Guidance (2010) National Institute for Health and Care Excellence, Clinical Guideline CG138 Patient Experience in Adult NHS Services (2011) The Mid-Staffordshire NHS Foundation Trust Public Inquiry, Robert Francis QC (2013) The NHS Confederation, Feeling Better? Improving Patient Experience in Hospital (2011) The NHS Constitution, The NHS Belongs to Us All (March 2012) The NHS Outcomes Framework Domain 4 ( ) An Implementation plan is currently being developed to accompany this document

11 Patient Experience and Involvement Team Delta House Delta Point West Bromwich B70 9PL 20