09/26 NHS BLOOD AND TRANSPLANT MARCH 2009 RESPONDING EFFECTIVELY TO BLOOD DONOR FEEDBACK EXECUTIVE SUMMARY From April 2009 an NHS wide common approach to complaint handling comes in to effect. This provides an opportunity for Blood Donation to review their approach so they can both respond flexibly to complaints, concerns and compliments and feed the resulting lessons into our objective to improve the donor experience. Department of Health guidelines issued in February 2009 in advance of the legislation (Listening, Responding, Improving- A guide to better customer care) encourages organisations to ask people what they think of their care, to sort out problems more effectively and to use the opportunities to learn. Blood Donation plan to adopt the DOH six step approach to customer care as follows: 1. Getting it right 2. Being customer focused 3. Being open and accountable 4. Acting fairly and proportionately 5. Putting things right 6. Seeking continuous improvement Repeat high levels of complaints about the same issues are not acceptable. Blood Donation has a range of initiatives planned to address this. A new management and team structure is being built that will be donor centric. A new Donor Advocacy function will champion the donors cause, working with line management to improve the donors experience. A new customer care strategy is being developed which will include accountability for the donor experience. Improvement plans are focussed on addressing the route cause of complaints, reducing the time it takes to respond, and improving donor satisfaction. In everything we do we will consider the impact on our donors. RECOMMENDATION - That the Board receives this report for information
Background High complaint levels are currently coupled with flat levels of donor satisfaction for the blood donation session experience. Over a three year reporting period, donor complaint volumes within NHSBT have averaged at around 5000 complaints per million donations. Service industry benchmark stands at 2380 per million and an NHS Trust typically at 1900 per million. Consistently, waiting time, staff attitude, and being turned away from session are the main causes of complaint for donors. High levels of media and marketing activity prior to Christmas led to peaks in donor complaint levels during January. Specific activity is taking place to review planning and marketing activity to mitigate the risk of resorting to emergency media activity in future. Industry best practice suggests targets to reduce complaint levels drive inappropriate staff behaviour and instead management teams should focus on root cause analysis, resolving the cause of main complaint categories and ensuring complainants return. Focusing on complainant donors returning is aligned to our aim to optimise donor loyalty. It is also more cost effective than recruiting new donors from an increasingly competitive market. Planned improvements Implementation of a performance management system to address donor issues and improve donors experience. Recognition and reward for excellent service. Prioritisation of donor advocacy strategy. Implementation of donor engagement initiatives which will include raising the profile of the donor internally. Implement staff training to empower front line staff to address and remedy donor complaints at source. Identify and deploy success measures through the Blood Donation Innovation and Improvement team. Involve senior managers actively in complaint resolution. Build capability in responding to donor complaint letters and feedback. 2
Table 1. Complaint/donor ratio Complaint/ Donations Ratio Collections/250 Complainants Complainants/million donations NBS Benchmark Total numbers - for Complainants & Colls/250 1,800 1,600 1,400 1,200 1,000 800 600 400 200 0 Feb-07 Mar-07 Apr-07 May-07 Jun-07 Jul-07 Aug-07 Sep-07 Oct-07 Nov-07 Dec-07 Jan-08 Feb-08 Mar-08 Apr-08 May-08 Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08 Jan-09 Feb-09 Table 2. Top categories for donor complaint 10000 9000 8000 7000 6000 5000 4000 3000 2000 1000 0 Ratio/ million In line with other service industries, donor s expectations are constantly increasing in line with service improvements. The Operational Transformation Programme (OTP) has implemented a new queue management system and a standardised approach to donor appointments. This has resulted in average queue times being reduced by 19% with a target for all teams to have a maximum queue time of under 20 minutes. 3
Learning from the OTP programme, further work is planned to embed the performance management culture. Managers and staff will be given specific customer focused objectives that show clearly their personal and team contribution to improving the donor experience. However, a significant amount of work is yet to be completed to shift mindsets and behaviours to enable the process improvements to be fully translated in to increased levels of satisfaction and reduced levels of repeat complaints. Despite access to adequate data, historically the directorate has not prioritised complaints and root cause analysis in a structured and systematic way. The challenge within Blood Donation to move to a customer centric culture, with a leadership team able to drive consistent improvements in donor and staff satisfaction, should not be underestimated and will take some time to be fully deployed. Blood Donation Structure A new senior management team will focus on improving the donor experience and delivering tangible benefits in relation to customer complaint issues and management. A refreshed focus on personal accountability and performance management will begin to drive improvements. Plans are at their final stage to transfer the Customer Service and Service Quality Functions to Blood Donation. Reporting to the Assistant Director of Business Development, this new team will lead a donor advocacy function that will work with operational management, donation team staff and donors. A new Innovation and Improvement team supported by the corporate Business Transformation Team will harness new and developing ideas in service improvement. A strengthened customer centric operational management team will work with Business Development and Nursing to create a much stronger customer service ethos within the Blood Donation directorate. Initiatives include: Moving towards a zero tolerance approach to staff attitude complaints. Monitoring of team specific waiting time data to identify operational or planning shortcomings. Weekly reporting routines being deployed to enable earlier response to issues and improved focus on complaint closure within the twenty day guidelines. 4
Coaching for performance directed support to manage waiting times at team level accompanied with a structured approach to performance management. Excellent service encouragement and recognition ongoing certification process and annual award scheme with active staff engagement Modelling behaviour - senior managers spending time on front line Executive Team assigned one complaint per quarter to investigate and provide a response to the donor. A renewed focus on clinical adverse events on session from the nursing team, supported by more robust reporting of performance metrics to allow team appraisal Donor Advocacy Led by a new Head of Donor Advocacy, the team will support nursing and operational teams to develop a new culture of advocacy. The team will actively engage with donors to drive service improvement. Specific plans include: A review of where and when we ask satisfaction questions to ensure we are measuring the whole donation experience not just the session experience The Donor Advocates will be tasked with using donor feedback to highlight areas of achievement and concern; meeting with relevant managers to identify root causes for service deficiency and influence service improvement. Donor Advocates will plan and deliver regular complaint handling review workshops for each area team actively engaging donors Donor Advocates will directly support complainant recovery processes, so that more donors who have had cause to complain are satisfied with our response and return to donating. Milestone Planning 23 rd March 2009 formal consultation begins to set up new Donor Advocacy Function and Innovation and Improvement team 1 st July 2009 posts filled and new team in place. Quarter one 2009 BD Develops new Customer Care Strategy including prioritisation of all above recommendations Quarter two 2009 - Customer Care Strategy options finalised and testing complete Quarter three and four 2009/2010 Customer Care Strategy rolls out across BD. Andy Young Director Blood Donation March 2009 5