Patient Experience, Safety and Quality Report. For the Board to receive for information. To deliver high quality, safe and accessible services

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1 Meeting: Board of Directors Date: 24 February 2015 Agenda Item Number: 9 Report Title: Patient Experience, Safety and Quality Report Presented by: Sharon Linter, Director of Quality & Governance / Executive Nurse Author: Sharon Linter, Director of Quality & Governance / Executive Nurse Recommendation(s): For the Board to receive for information Trust Objective(s): To deliver high quality, safe and accessible services To maximise the potential of our workforce to deliver high quality patient care To diversify and develop services that meet commissioner and service user needs and expectations Page 1 of 6

2 Patient Experience, Safety and Quality Report 1. Introduction This report covers the month of January A Patient Experience Story As a Trust we aim to work together with our patients and partners, to ensure that the precious feedback from experience is routinely captured and put to use most effectively (Patient Experience Strategy, Cornwall Partnership NHS Foundation Trust, January 2013). The Patient Experience Lead with Service Lines is collating a library of patient stories to share with Board members on a regular basis. 3. Serious Incidents There were 5 confirmed serious incidents identified during January 2015, all 5 were reported as Grade Incidents The total number of incidents reported for January 2015 is 326 with the highest reported area recorded as disruptive, aggressive behaviour patient on staff. It is of note that Longreach Hospital, Redruth opened in early December and this has resulted in an increase in incidents as would be expected. 5. Patient Experience 5.1 Complaints / PALS Contacts January 2015 Complaints January 2015 PALS Total contacts for each Service Line Service Line Concerns Info/Advice Children s Services Inpatient Community Complex Care & Dementia Learning Disabilities Corporate/misc Total Page 2 of 6

3 5.2 Complaints and PALs trends 5.3 Complaints and PALS by Service Line and Category for January 2015 Access to Clean safe Patient Care Information Relationships Total Services place to be Childrens Services Functional Inpatient Functional Community Complex Care & Dementia Learning Disabilities Corp/Misc Themes during January: Communications: o Staff members not returning calls to community patients/patients chasing for a response. o Lack of cover for community staff absent from work and patients having to chase to find out who is supporting them. Concerns regarding waiting times for CAMHS appointments Lack of inpatient facility for children with mental health problems in Cornwall and issues with travel costs to see children placed out of county. Page 3 of 6

4 All themes are cascaded to service lines on a monthly basis to be discussed, and appropriate actions taken within the clinical cabinets. A weekly report of contacts received by the PALS team is presented to the Executive Management Team, and a monthly report to the Executive Management Group. A quarterly Patient Experience report is presented to the Quality and Governance Committee. 5.5 Friends and Family Test (Patients) From January 2015, saw the introduction of reporting of the Friends and Family test for CFT patients. CFT services sit across two areas namely Mental Health and Community. CFT introduced the key questions from 30 th September 2014, but formal reporting via UNIFY has now commenced on a monthly basis. The questions are prescribed by NHS England but are also adapted to meet the various patient groups (for example in-patient mental health and children s), however the stem of the questions are: 1. How likely are you to recommend our ward/service/team to friends and family if they needed similar care or treatment? Rating from extremely likely to don t know. 2. Thinking about your answer to Question 1, would you like to tell us the main reason for your answer today? Free text These questions are asked at prescribed times and are dependent on each individual service, and were agreed with consultation with those services as defined in the guidance The Friends and Family Test (July 2014 Gateway reference No ). Attached in Appendix 2 is the first month of the patient FFT results. In the coming months as more data is collected, a thematic review of the free text will be reported. 7. Staffing In May 2014, all Trusts were notified of their requirement to publish staffing data on NHS Choices website. This was for inpatient areas only and was in regard to their fill rates (actual versus planned) in hours. This data needs to be submitted site by site and by ward. As no tool is available nationally, CFT s staffing numbers have considered the therapeutic relationship and skilful interaction between staff and individual patients. This ethos, models of care and philosophy are important factors when determining CFT s staffing establishments. The composition of the multi-professional team in mental health settings, for example the presence of occupational therapists and psychologists, has a direct impact upon nurse staffing requirements and patient outcomes. We have considered all these elements when establishing CFT s staffing numbers. However, key to the staffing risk assessments is the numbers required to deliver safe and high quality care. Therefore CFT s staffing numbers (planned) are based on these and are not minimum numbers. We also acknowledge that the ward situation changes due to the number of patients (particularly the number of line of sight observations ) and the complexity of care they require. Therefore, the plan changes and this is based on professional judgement of the shift leader. The Trust is able, through the Trust s Electronic Rostering System, to track when the plan changes and these amendments are reflected in CFT s planned versus actual numbers that are submitted to NHS England. Page 4 of 6

5 Appendix 1 identifies CFT s staffing hours (January 2015) as required by NHS England, with planned versus actual and the corresponding fill rates. The fill rates are automatically populated when the data is entered into the required submission form. There were a number of exceptions/ issues that the Trust Board needs to be aware of. These are: There are a number of occasions where staffing ratios were altered resulting in a decrease in fill rates for Health Care Assistants. These occurrences were mitigated by a decrease in Health Care Assistant hours and an increase in RMN hours altering the ratios. During December, two new wards re-opened on the Longreach hospital site at Redruth (Carbis and Perran). These wards utilise their staff flexibly between the two wards. Increase in the number of staff required due to the number of lines of sight that were required, particularly on the acute wards. Impact of staff sickness, which was over the Christmas period. However, all wards were within their safe and quality of care numbers as per their risk assessments. 8. Recommendation The Board is asked to receive this report for assurance. Sharon Linter Director of Quality & Governance / Executive Nurse February 2015 Page 5 of 6

6 Appendix 1 Page 6 of 6

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