NOTTINGHAM UNIVERSITY HOSPITALS NHS TRUST Documentation Control Reference GG/CM/049 Approving Body Trust Board Date Approved 28 Implementation Date 28 Version Summary of Changes from Previous Version Changes to reflect the new organisational structures, to strengthen inclusive involvement and increased support for PPI volunteers. Supersedes PPI Policy version 2 Consultation Undertaken Date of Equality Impact Assessment Date of We Are Here for You Assessment Date of Environmental Impact Assessment Legal and/or Accreditation Implications Division Patient Groups, Patient Public Involvement Steering Group, Patient Partnership Group, Foundation Trust Members 01/12/2015 01/12/2015 01/12/2015 Care Quality Commission Fundamental Standards April 2015 Equality Act 2010 Health and Social Care Act 2012 NHS Constitution 2013 Staff, Patients and Public Target Audience Review Date March 2018 Lead Executive Mandie Sunderland Chief Nurse Author/Lead Manager Katie Moore, Head of Patient Public Involvement (PPI) Extension 76029 Further Guidance/Information Katie Moore Head of Patient Public Involvement (PPI) Extension 76029 1
CONTENTS Paragraph Title Page 1. Introduction 3 2. Executive Summary 3 3. Policy Statement 4 4. Definitions (including Glossary as needed) 4 5. Roles and Responsibilities 6 6. Policy and/or Procedural Requirements 9 7. Training, Implementation and Resources 13 8. Trust Impact Assessments 15 9. Monitoring Matrix 16 10. Relevant Legislation, National Guidance and 17 Appendix 1 Appendix 1A Appendix 1B Appendix 1C Appendix 1D Appendix 1E Appendix 1F Appendix 1G Appendix 1H Appendix 1I Associated NUH Documents Involvement Flow chart Questions to consider when planning PPI PPI Planning Processes PPI Planning Checklist PPI Costing Template PPI Volunteer Job Description PPI Volunteer Job Remit Request for Members PPI Volunteer Local Induction PPI Volunteer 12 Month Review Appendix 2 Patient Experience, how it fits in with PPI 33 Appendix 3 Getting Involved in Your Care 34 Appendix 4 Equality Impact Assessment 35 Appendix 5 Environmental Impact Assessment 37 Appendix 6 We Are Here For You Assessment 39 Appendix 7 Certification Of Employee Awareness 41 18 19 20 21 22 24 28 30 31 32 2
1.0 Introduction 1.1 This policy; Outlines the Trust s commitment and approaches to further developing Patient Public Involvement (PPI) so that the views and needs of patients and the public are at the heart of our decision making. Provides a framework to enable staff to listen and respond to the views of patients and the public and increasingly involve them in: - Their individual care. - The planning, provision and evaluation of services. 2.0 Executive Summary 2.1 2.2 To facilitate the Trust working in partnership with patients and public, staff will; Involve patients and public as partners in decision making so that the Trust provides services based on the needs of those we serve. Listen and respond to patients and the public, politely and respectfully, capturing and using their views to further improve the patient experience. Each division will be expected to work with patients and public to develop PPI appropriately to the needs of patients, public and their service. They will be expected to develop systems to involve patients and public from the range of diverse communities served and work towards meeting the following PPI promises made to patients and public; Individual Participation: We will involve you in the planning and co- ordination of your care, promoting a self-management approach and provision of personalised care plans that reflects your preferences and agreed decisions. Public Participation: We will involve you in planning, monitoring and development of accessible services and tell you what we have changed as a result of this. We will promote equality of opportunity for involvement. Insight and feedback: We will ask you your views on the service 3
] 2.3 we provide and tell you what we have changed as a result of this. Staff should follow the involvement flowchart (Appendix 1) and agree the following in partnership with patients and public; Why patients and public are being involved. The roles of those participating and what is expected of them. The expected outcome of the involvement and how and when the outcome will be fed back to participants. How participants will be recognised and rewarded for their involvement.this may include reimbursement of expenses, attending presentations/conferences and being put forward for special Trust recognition. How the views of the diverse range of people who may use the service are collected and listened to. 3.0 Policy Statement 3.1 This policy sets out a framework to enable the Trust to work in partnership with patients and public in the planning, development and day to day delivery of services. 4.0 Definitions 4.1 4.2 Divisions - In this policy the term division encompasses all clinical divisions Patient Experience - Patient experience at NUH results from a range of activities that all impact upon patient care, access, safety and outcomes. Patients have told us for a good patient experience at NUH, they want the Trust to; Provide good treatment in a comfortable, caring and safe environment, delivered in a calm and reassuring way. Give them information to make choices, to feel confident and to feel in control. Talk and listen to them as an equal and treat them with honesty, respect and dignity. 4
NUH has used the NICE quality standard for patient experience as the basis for defining the elements that make up patient experience at the trust which are; knowing the patient as an individual. Essential requirements of care. Tailoring healthcare services for each patient. Continuity of care and relationships. Enabling patients to actively participate in their care. For definition of patient experience at NUH and how it fits with PPI see (Appendix 2). 4.3 Patients and Public in this policy the term patients and public includes patients, other service users, carers, families, patient advocates, Foundation Trust (FT) members, individual members of the public, groups, communities. Depending on what we are working on, we may involve different groups of patient and public at different times. 4.4 Patient Public Involvement (PPI) - PPI is the process of engaging with the needs and expectations of patients and putting the public and members at the heart of Trust decision making, to ensure that the services and care provided are outcome driven and patient centred. Specifically it is concerned with exchanging information, mutual listening, and accepting that people should be allowed to influence their own care and the services they receive. PPI defines the way in which patients and the public have a voice in decisions about how healthcare services and research are planned, designed, delivered and evaluated. PPI must therefore operate on three levels; Involving individual patients and their carers as partners in decisions about their treatment and care and empowering them to make informed decisions about their healthcare wherever practicable. Enabling patients and the public to be involved and consulted on planning, monitoring, evaluating and developing services, proposals to change services and decisions about the way services operate. Involving and engaging patients and the public in planning, development, delivery and evaluation of relevant research and research related activities to the benefit of patients and public. 5
5.0 Roles and Responsibilities 5.1 Committees The Trust Board will champion PPI across the Trust, ensuring that the Trust will; Meet its statutory duty to involve patients and the public. Comply with the pledges made in the NHS Constitution. Meet the Care Quality Commission s standards. Implement its PPI policy through monitoring and review procedures. The Quality Assurance Committee (QUAC) (a Trust Board committee) will; Provide the Trust Board with assurance about the effectiveness of PPI arrangements. Monitor and review outcomes from national surveys and Trust real-time surveys approve actions and monitor improvements. Monitor, review and report Trust performance against CQC Outcome 1, Regulation 17 (PPI). Critically evaluate information on patient experience, including regular reports on Division performance in surveys and all other aspects of patient and public experience of Trust services. Critically evaluate information on patient experience, including regular reports on Division performance in surveys (and all other relevant modalities) of patient and public experience of Trust services. Identify actions and timescales to improve patient experience whenever required. Contribute to the development of the Trust s PPI Policy. The Senior Management Team will; Ensure that the PPI perspective is given consideration in developing all Trust projects and developments. Ensure appropriate frameworks are in place for staff to carry out their PPI duties, such as in recruitment and appraisal processes. Keep appraised of Division PPI activity. Receive reports from QUAC in relation to national surveys and Trust real-time surveys. 6
The PPI Steering Group (a committee of the Senior Management Team ) will; Develop and implement Trust PPI policy to ensure that the Trust is an exemplar of PPI activities. Monitor and evaluate the implementation of PPI policy and Division work plans. Ensure close working with local PPI community groups. The Patient Partnership Group (a committee of the Patient Public Involvement Steering Group) will; Gather and disseminate patient and public feedback, especially best practice, throughout the Trust. Undertake work programmes as agreed with the PPI Steering Group. Supports the PPISG in monitoring and evaluating PPI activity. The Divisional Patient Partnership Groups will; advise on patient and public involvement activity within the Division. Participate in inspection visits and observations of care. advise on service improvements and service redesign within the Division. publicise and raise the profile of patient and public involvement within the Division. The Divisional Teams will; Lead the implementation of the Trust PPI policy at Division level. Report to PPI Steering Group, QUAC and Division staff. Ensure that there are effective mechanisms and sufficient resources to implement the Trust PPI Policy within all Divisions. 5.2 Individual Officers The Chief Executive will; Be responsible for ensuring that the Trust complies with all statutory PPI obligations. Where possible facilitate the role of the Trust as an exemplar of PPI activity. 7
The Chief Nurse will; Be the Executive Director Lead responsible for PPI performance. The Trust Secretary will; Have overall responsibility delegated from the Chief Executive for PPI Ensure that systems are in place and are working effectively to enable staff to listen and respond to the views of patients and public. Ensure patients and public are involved whenever feasible in the planning, provision and evaluation of Trust services. The Head of Patient Public Involvement will; Be responsible for leading the Trust s PPI function Ensure that effective relationships continually develop with all relevant patient and public groups in the community. Develop mechanisms to routinely consider how inclusive planned involvement activities are. Develop mechanisms that ensure PPI views are integral to the development of services at the Trust. Advise on national and regional policy on PPI. Provide support systems to volunteers The Divisional PPI leads will; Champion the implementation of PPI policy best practice at Division level. Co ordinate with staff, divisions, patients and public to produce an annual Division PPI work plan. Report to PPI Steering Group and divisional management team. Act as the accountable divisional link to the PPISG. The Divisional Directors, Divisional General Managers and Heads of Service will; Ensure that their divisional annual PPI work plans demonstrate, appropriate and effective PPI best practice in all aspects of care they are responsible for. Monitor and evaluate monthly PPI activity in their area reporting the outcomes to the divisional PPI lead. 8
Individual Members of Staff will; Adhere to the Trust s requirements relating to PPI values and behaviours. Engage with patients and public by encouraging involvement in their care, providing them with appropriate information and promptly responding to their concerns. Seek patients and public s views about their services responding to feedback promptly and involving them to find solutions. Ensure that they highlight significant shortfalls in services, raised by patients and public with their manager or PPI leads. 6.0 Policy and/or Procedural Requirements 6.1 Staff will put patients and public at the centre of all they do. Staff need to enable patients and public to feel safe, cared for and confident in getting involved by: Individual Participation: Jointly setting goals with individual patients for their care and treatment. Encouraging patients to get involved in their care by promoting the 'How to get involved in your care' guidance for patients available in bedside folders and posters/cards in wards and departments (Appendix 3). Promoting a self-management approach (as appropriate) so patient care and treatment plan supports patients to develop the knowledge skills and confidence to manage their own health. Asking patients if they want staff to involve their carers, in their care. Public Participation Ensure the patient, public voice is heard and listened to. When involving patients and public, identify how the involvement is going to be inclusive and affect the service and influence decision making. Plan involvement activities, set objectives, create a plan and a 9
budget. Communicate to all those involved. Report record and evaluate the involvement including how inclusive it was. Collecting and Using Insight and Feedback Ask patients and public views on the service they provide through a range of different mechanisms e.g. through Friends and Family Test, national, local surveys, complaints, compliments and feedback received via social media and websites such as NHS Choices and Patient Opinion Use feedback to improve patient experience Feedback to patients and public the outcomes of their feedback/involvement Monitor and evaluate PPI activity There are many different ways in which patients and public might get involved in health depending upon their personal circumstances and interest. Staff will encourage involvement by: Devolving Placing decision-making in the hands of patients and public. Collaborating Working in partnership with patients and public in each aspect of the decision, including the development of alternatives and the identification of the preferred solution. Involving Working directly with patients and public to ensure that concerns and aspirations are consistently understood and considered. For example, partnership boards, reference groups and service users participating in policy groups. Consulting Obtaining patient and public feedback on analysis, alternatives and / or decisions. For example, surveys, consultations and focus groups. 10
Informing Providing patients and public with balanced and objective information to assist them in understanding problems, alternatives, opportunities, solutions. For example, websites, newsletters and press releases. 6.2 Divisional Annual PPI Work Plans and Reports. Every division must plan PPI activity in order to deliver the following involvement promises that the trust has made to patients and public; Individual Participation: We will involve you in the planning and co- ordination of your care, promoting a self-management approach and provision of personalized care plans that reflects your preferences and agreed decisions. Public Participation: We will involve you in planning, monitoring and development of accessible services and tell you what we have changed as a result of this. We will promote equality of opportunity for involvement. Insight and feedback: We will ask you your views on the service we provide and tell you what we have changed as a result of this. 6.3 6.4 This will be achieved through the implementation of annual divisional PPI work plans. Accordingly each division is expected to report on the implementation of these work plans and changes they have made as a result of the PPI activities to their Divisional team and PPI Steering group. Patient Experience Feedback. Every Division must actively listen and demonstrate that they have responded to patients and public s views, comments, complaints and compliments about their services. Every Division to participate in national and local surveys as appropriate and respond promptly to issues raised from participants in these surveys. Patient Public Involvement Steering Group (PPISG). 11
6.5 6.6 6.7 PPISG will meet monthly to advise and facilitate effective PPI involvement within the work of the Trust by; Ensuring that clinical and managerial expertise are brought to bear on developing PPI policies. Discharging its delegated responsibility in relation to PPI decision making. ensuring that all parts of the Trust are engaged in the PPI agenda Facilitating close working with the local community and ensuring that services provided by the Trust are as a result of genuine patient public involvement. Monitor and promote involvement activity that is inclusive and representative of the needs of the local community. Ensuring that best practice is effectively captured and shared across the Trust. Monitoring and reviewing the divisional PPI annual work plans and other reports. Patient Partnership Group (PPG). The PPG will meet monthly to; Bring together public and patient and staff representatives under the chairmanship of a patient and public representative. Ensure that patient and public representatives and staff representatives effectively work together to deliver the Trust PPI policy. Advise on PPI involvement by participating in inspection visits and observations of care and publicising and raising the profile of PPI across the Trust. Provide a range of peer support to volunteers. Divisional Patient Groups will; Run and manage a variety of PPI groups within their service delivery areas. Ensure that these groups will provide a base for staff, patients and public to meet together to undertake involvement work and to bring about changes to services. Foundation Trust (FT) Members. Staff will actively encourage patients and the public to consider 12
becoming FT members, emphasising that FT members can decide their own level of involvement and commitment. FT members will; Receive a member welcome pack when their registration has been logged. Receive invitations to events, conferences and other involvement events run by the Trust. Receive the Trust s bi-monthly newsletter Have the opportunity to be put forward as a Trust governor and vote in election for governors Be invited to participate in a diverse range of PPI activity including for example, readers panel, PPI surveys, staff interviews, inspection visits, volunteering on our wards and departments. Opportunities to get involved will be advertised to the FT members according to their service interest and level of involvement indicated on their membership form. 7.0 Training, Implementation and Resources 7.1 Support and Training for Patients and Public All patients and public who volunteer for involvement activities which involve patient contact will be required to register as volunteers and undertake volunteer recruitment process induction and mandatory training (Appendix 1). All patients and public who volunteer for PPI activities, must have in a language/format that is most accessible to them, a clearly defined role, a written PPI Volunteer job description/ppi volunteer brief (see and PPI local induction (Appendix 1). All patients and public who undertake one off involvement activities should be given a clear remit of what is required from them, the name of the person who will manage them during the activity they undertake and receive feedback following any such activities from their manager (Appendix 1). If additional training is required to meet a specific PPI activity, this specific training should be promptly offered to the particular individual/group. This training will need to be funded by the 13
relevant divisional. All volunteers who undertake PPI activities must receive appropriate on-going training, support and appraisals outlined in this policy and Voluntary Services Policy. Expenses for travel, car parking and meal vouchers will be allocated on an individual basis in accordance with the Voluntary Services Policy and funded by the relevant Division. 7.2 Support and Training for Staff A copy of the Trusts PPI Policy will be readily accessible to all members of staff. New members of staff will be told how it can be accessed. PPI Policy poster quick reference guide summarising key points for staff on what they need to do to implement the policy will be available on the PPI intranet site - http://nuhnet/communications_marketing/patient_public_involveme nt/pages/default.aspx. PPI handbook giving tools and techniques for staff on how to undertake PPI: http://nuhnet/communications_marketing/patient_public_involveme nt/ppi%20resources%20and%20toolkits/forms/allitems.aspx?r ootfolder=%2fcommunications%5fmarketing%2fpatient%5fpublic %5finvolvement%2fPPI%20Resources%20and%20Toolkits%2fPPI %20Toolkits&FolderCTID=&View=%7b051C4311%2d9095%2d46 93%2d8225%2d1C06D4AF0E19%7d All new staff will receive an introduction to involvement as part of the Trust induction DVD. All staff should be offered an opportunity to express a special interest in the Trust s PPI activities and if appropriate, be contacted by their Division PPI lead in order to capture and utilise this special interest. The Head of PPI will work with the PPISG and the PPI leads in each division to offer support and advice around PPI. The Head of 14
PPI will also offer support and advice to divisional teams across the Trust. 7.3 Implementation Divisional PPI leads in conjunction with their divisional teams will be held accountable for ensuring that this policy is implemented across their Division. Progress in implementing this policy will be monitored through divisional PPI monthly performance reports undertaken by the PPISG. A range of Policy implementation monitoring tools will be utilised by the PPISG including the amount and type of PPI activity within and across divisions, the outcomes from implementing PPI activity and relevant feedback from patients and public. 7.4 Resources Divisions are required to identify appropriate resources to enable them to fulfil their PPI duties, as specified in this policy. 8.0 Trust Impact Assessments 8.1 Equality Impact Assessment An equality impact assessment has been undertaken on this document (Appendix 4) and has not indicated that any additional considerations are necessary. 8.2 Environmental Impact Assessment An environmental impact assessment (Appendix 5) has been undertaken on this document and has not indicated that any additional considerations are necessary. 8.3 Here For You Assessment A Here For You assessment has been undertaken on this document 15
(Appendix 6) and has not indicated the need for additional considerations are necessary. 16
9.0 Policy / Procedure Monitoring Matrix Minimum requirement to be monitored Creation and implementation of annual PPI Divisional work plans Results of National Surveys Responsible individual/ group/ committee Divisional Team Relevant Divisional PPI Lead Process for monitoring e.g. audit Frequency of monitoring Responsible individual/ group/ committee for review of results Report Monthly PPI Steering Group Responsible individual/ group/ committee for development of action plan Divisional PPI Lead Report Annually QUAC Divisional PPI Lead Responsible individual/ group/ committee for monitoring of action plan PPI Steering Group QUAC Results of National Friends and Family Test Relevant Divisional PPI Lead Report Monthly QUAC Divisional PPI Lead QUAC Results of local surveys and feedback Individual divisional teams as appropriate Report Monthly QUAC Divisional PPI Lead QUAC 17
10.0 Relevant Legislation, National Guidance and Associated NUH Documents 10.1 Legislation Health and Social Care Act 2012 Equality Act 2010 National Guidance Care Quality Commission Fundamental Standards of Care NHS Constitution 2013 NHS Friends and Family Test Guidance 2014 Associated NUH Documents Carers Policy - GG/CM/043 Equal Opportunities Policy HR/E&D/001 Information Governance Policy GG/INF/001 Managing visits, audits, inspections, assessments and accreditations by bodies external to the trust policy - GM/CM/023 Management of Complaints, Concerns, Comments and Compliments Policy GG/CM/002 NUH Patient and Public Involvement (PPI) Handbook Patient Information Policy and Procedure GG/CM/003 Patient Advice and Liaison Service Policy- GG/CM/004 Voluntary Services Policy GG/CM/005 Voluntary Services Recruitment Policy - HR/R&C/009 18
Patient Public Involvement (PPI) Flow Chart for Staff Appendix 1 1 Plan your PPI activities (Appendix 1A, 1B, 1C) 2 3 Cost and Identify resources required (including staff time, travel costs, refreshments etc.) Appendix 1D) Complete PPI volunteer job description/ppi volunteer brief (Appendix 1E & 1F) 4 Advertise for members use request for members form (Appendix 1G) 5 Review response from members, interview assess and appoint as appropriate 6 Identify type of involvement and whether it involves patient contact. 7 Does activity involve patient contact? Yes No 8 Refer person to Voluntary Services Manager for full or guest volunteer recruitment process. Full recruitment process includes completion of application form, checking of references, Disclosure and Barring Service (DBS) and Volunteer induction. 9 Voluntary Services Department will contact you to inform you the volunteer recruitment and induction processes are complete. They will go through your responsibilities as manager of the volunteer and hand over file and get confirmation you will now take over the management of this volunteer. 8 Refer to Voluntary Services Manager if taking part in more than one activity e.g. staff interviews, readers panel for guest recruitment process. 8 Contact volunteer providing PPI volunteer brief, contact name who they will be accountable to, notice and location of sessions including directions/car parking and maps, information on expenses. 10 Contact person and arrange PPI local induction (Appendix 1H) including duties, expenses, support. 11 Arrange to review at twelve monthly intervals (Appendix 1I) 12 At end of Involvement arrange final interview/ meeting 13 Inform Voluntary services Please note: All PPI activity needs to be recorded on DATIX All templates and information are available on the PPI intranet site at the following link: http://nuhnet/communications_marketing/patient_public_involve ment/pages/default.aspx 19
Questions To Consider When Planning PPI Appendix 1A Planning for Success Questions to consider when planning PPI The following questions can help you to plan for successful patient and public involvement: Why use patient and public involvement? What do you hope to achieve by involving patients, carers and the wider public in a particular piece of work? Is everyone who needs to be clear about the objectives? What do you want from patients and the public? What level of involvement are you asking from them? Are you looking to understand their needs, to involve them in designing services, to get their feedback to proposals, or to measure how you are doing in delivering improvements? Are you clear about which approach to use and why? Who should you involve? Which groups of people should we engaged in your PPI? Do you need their consent to present their stories? Do you need to listen to any seldom-heard groups? How will you recruit people (complaints, flyers, groups?) How will you use their views and opinions? How are you going to analyse and present your findings? Which groups of people will you share the outcomes with? How will the views of patients and the public influence your discussions and decisions about planning and services? How will you let participants know the outcome? How do you plan to feedback to the individuals who have taken part and to the broader public and colleagues? Planning before you start Establish a planning team Bring together a small team of people to plan the exercise, set objectives and be clear about how the PPI is going to affect the service and influence Answer key questions What information is required? How will the information be used? What resources are available Who will you involve What method will you use How will you prepare for the Choose the right approach This should match the purpose and target audience. Check first if the information is available from current PPI activities. Develop and communicate your plans Plan your activity in detail. Plan to communicate to all those involved. Report and evaluation Consider and plan in advance how you will report and evaluate the activity. 20
PPI Planning Process Appendix 1B Are you clear about why you need to involve patients/public? YES NO Refer to pages 6 & 7 NUH PPI Toolkit: Why involve patients and the public? Have you effectively planned you PPI initiative and referred to the PPI Toolkit? YES NO Refer to pages 8 & 9 NUH PPI Toolkit: Planning for Success Have you decided which methods and approaches to use? YES NO Refer to pages 10 47 NUH PPI Toolkit: The PPI Circle Four types of PPI activities Do you know how you will recruit participants? YES NO Refer to section 3-7 on PPI flowchart (appendix 1 of PPI Policy) & pages 44-45 NUH PPI Toolkit: Involving seldom heard and diverse minority groups Do you know how you will evaluate and feedback on your PPI initiative? YES NO Refer to pages 50 51 NUH PPI Toolkit: Reporting and Feeding Back 21
PPI Planning Checklist Appendix 1C Gather feedback regularly and systematically Are you clear about what you want to find out? Are you clear about how you will use this information? Have you made use of existing data e.g. from the national patient survey or patient experience trackers? Do you know who you need to involve? Select the most helpful approach Are you clear where your activity sits in the PPI cycle, and whether you are looking: To learn about people s needs and views To design improvements and consult on changes To involve people in decision-making To monitor and measure progress Plan your PPI activity Do you have a clear implementation plan? Do you need the consent of the people you are involving, and have you downloaded the consent form? Have you planned ways to involve all of the diverse groups of people who need to use your services? Are you clear about how you will keep all stakeholder groups informed of findings and progress? Understand your findings Have you examined your feedback to identify priorities for improvement and success to celebrate? Have you decided how to analyse your results? Consider: Aspects of the patient journey Changes- or lack of changes-over time How you compare to other services Issues reported by large numbers of patients Positives and success to build on, as well as issues Action plan with patients, public and staff Do you have an action plan with priorities and timings? Do you have support of senior managers? Have you identified some project champions? Are clinical, managerial and support staff involved? How are you involving service users in action planning? Share results widely with staff and patients Have you identified stakeholders and how to involve them? Have you developed a practical communication strategy which identifies key audiences, messages and media? Maintaining progress Are you implementing quick wins to show progress, as well as long term changes that have greater impact? How will you measure the impact of your changes? How will you report and communicate progress? 22
PPI Costing Template Appendix 1D PPI Activity Details: Staff costs Hours (in decimals) Grade (select from drop-down list) Cost /hour Enter number of people at this band Total e.g. Matron 1.00 Band 8a 26.88 0 Staff costs total 0 0 23
Patient/public representative costs Enter amount spent on each item/activity Total Travel costs 0 Refreshments 0 Training 0 Other 0 0 0 Patient/public representative costs total 0 0 Other costs Enter amount spent on each item/activity Total Printing & 0 Stationery Postage 0 Other 0 0 0 0 Other costs total 0 0 PPE Grand Total 0 0 24
Patient / Foundation Trust Representative for the Patient Administration System (PAS) Replacement and Electronic Care Record (ECR) Project Job Description Appendix 1E Title: Division: Grade: Reports: Accountable: Commitment: Patient / Foundation Trust member representative on PAS Project Team ICT Services Volunteer (non-salaried) but entitled to claim reasonable expenses incurred in connection with their duties in accordance with the trust expenses policy. Business Change and Continuity Workstream Lead ECR Programme Deployment Manager Two half day sessions per month with flexibility as the project demands. BACKGROUND: Nottingham University Hospital Trust is deploying a new Patient Administration System (PAS). This will deliver a new single PAS system across both sites leading to significant transformational changes. The new PAS will also be a building block for a future Electronic Care Record contributing to the Trust s 2016 vision of being the best Acute Teaching Hospital in the UK. The Project Team is looking for four (two per campus) dynamic, enthusiastic and committed PPI representatives to give input to the project. The successful candidates will be required to work closely with the Business Change and Continuity Workstream Lead to ensure that the identified patient benefits are successfully delivered. Together the new PAS and ECR Programme will provide a unique opportunity to improve patient and public experience at NUH. Examples of some of the envisaged benefits to patients are: The rollout of a text message reminder service for Outpatient appointments. The introduction of patient self check-in kiosks in Outpatient areas to improve the patient experience. Improved communications including patient letters. By engaging with the people who use NUH services, the Project Team can ensure that patients and public are at the heart of our decision making. 25
JOB SUMMARY: To provide the PAS project team with guidance on its approach to implementing the new PAS and ECR strategy, ensuring that is consistent with the needs and views of patients/carers and the wider local community. To assist the PAS project team in understanding the perspectives of patients and public, including identifying other potential opportunities/roles for patients and public to be effectively involved throughout the process. To oversee and ensure the implementation of the new PAS and ECR strategy remains focused on our patients and service users. VALUES AND BEHAVIOURS: NUH has a set of values and behaviours to improve the experience for our patients and our staff (We are here for you). This means that in undertaking this role the post holder is expected at all times to behave is a way that demonstrates commitment to the delivery of thoughtful patient care and continuous improvement as detailed in the table below. Thoughtful Patient Care Caring and helpful Polite, respect individuals, thoughtful, welcoming Helpful, kind, supportive, don t wait to be asked Listening, informing, communicating Safe and vigilant Clean hands and hospital so patients are safe Professional, ensure patients feel safe Honest, will speak up if needed to stay safe Clinically excellent Best outcomes through evidenceled clinical care Compassionate, gentle, see whole person Value patients time to minimise waiting Continuous Improvement Accountable and reliable Reliable and happy to be measured Appreciative of the contribution of others Effective and supportive teamworking Best use of time & resources Simplify processes, to find more time to care Eliminate waste, investing for patients Making best use of every pound we spend Innovation for patients Empowerment to act on patient feedback Improvement led by research and evidence Teaching the next generation 26
KEY ROLE REQUIREMENTS: We are looking to appoint individuals who are either already IT literate and have an interest in IT and new technologies, and also individuals who are keen to learn. In general, the roles will require the following qualities: 1. An interest in introducing change and benefits through new IT technologies. 2. The ability to understand the broader range of patient/public perspectives beyond personal experience, and to use that to inform the work of the Project Team. 3. Good communication skills, the ability to listen to others, summarize issues and express views objectively with a constructive purpose. 4. Experience of working as a member of a team and with a broad range of people. 5. An understanding of the difficulties facing the NHS, as well as opportunities for improving the NHS in the future. 6. Time to commit to the work of the team (approximately 2 half days per month with some flexibility around the launch of the system) to attend monthly workstream meetings. 7. To liaise and report to the Business Change and Continuity Workstream Lead. 8. To give input to the design, test and implementation of the new system, e.g. design of outpatient letters/testing of text messages/testing of patient self check-in kiosk and support during the project launch period. 9. To contribute to project communications as appropriate e.g. patient notices regarding system launch, project newsletters etc. 10. To attend Trust wide project events such as stakeholder events e.g. go live launch briefing. 11. To set aside time for background reading for the project. 12. To respect and maintain confidentiality at all times. 13. Declare any conflicts of interest where appropriate. 14. Undertake training as necessary for the role. Identifying any personal needs for training or support. GENERAL DUTIES: In addition to the key job responsibilities detailed in this job description all employees at Nottingham University Hospitals NHS Trust are expected to comply with the general duties detailed below: Infection Control To ensure adherence to the Trust s standards of cleanliness, hygiene and infection control when in clinical areas. Safeguarding children, young people and vulnerable adults Nottingham University Hospitals is committed to safeguarding and promoting the welfare of children, young people and vulnerable adults. All staff and volunteers are therefore expected to behave in such a way that supports this commitment. 27
Information Governance All staff have an individual responsibility for creating accurate records of their work and for making entries into and managing all NHS records effectively in line with the Health Record Keeping Policy and other Health Records and Corporate Records Management policies and procedures in order to meet the Trust s legal, regulatory and accountability requirements. Health and Safety To take reasonable care to prevent injury to themselves or others who may be affected by their acts or omissions. To co-operate fully in discharging the Trust policies and procedures with regard to health and safety matters. To immediately report to the Trust any shortcomings in health and safety procedures and practice. To report any accidents or dangerous incidents to their immediate manager and safety representative as early as possible, and to submit a completed accident/incident form. To use protective clothing and equipment where provided. Whilst the aim of the Trust is to promote a co-operative and constructive view of health and safety concerns in the organisation, all staff must be aware that a wilful or irresponsible disregard for safety matters may give rise to disciplinary proceedings. General Policies Procedures and Practices To comply with all Trust policies, procedures and practices under the guidance of the group, where applicable. WORKING CONDITIONS: Volunteer/Corporate. JOB REVISION: This job description should be regarded as a guide to the duties required and is not definitive or restrictive in any way. The duties of the post may be varied from time to time in response to changing circumstances. 28
Patient Public Involvement (PPI) Volunteers Brief Patient Led Assessment of the Care Environment (PLACE) WARD/DEPARTMENT - Estates and Facilities Appendix 1F Name/Position of officer responsible for volunteer Laura Bolton/Paula Charlton Extension Number Laura Boulton ext. 76177/ Paula Charlton ext. 57282 Volunteer s Role - Description of duties The Role of the lay member of the PLACE audits Patient Led Assessments of the Care Environment (PLACE) are new and replaces the Patient Environment Action Team (PEAT) programme. This process and assessment is a collaboration between hospital staff and patient assessors, focussing on the four key areas: Cleanliness including hand hygiene Buildings and facilities condition, appearance and maintenance of the building, fixtures and fittings Privacy and Dignity Food and hydration There is a greater involvement of patients in the assessment than ever before both in terms of their role and numbers which sees equal numbers of staff and patients. The term patient assessor in this context applies to anyone whose experience of healthcare is as a user of the services. Therefore patients, service users, their family, carers, patient advocates and volunteers all qualify to act as patient assessors. All of the Trust s inpatient facilities will be subject to a patient led assessment. Those who take part are asked to walk around the site looking at the wards and public areas, and each determining how they would rate standards against a set criteria. They look at the environment and cleanliness and the quality of food provided at the unit. The results are made public and are used to measure the Trust performance by the Care Quality Commission. A two hour training session is provided in advance of the visit. Dates for the visits are announced 6 weeks prior notice of the date on which we will be expected to perform the assessment, between April and June, with training in March. 29
The assessment teams will be split into several groups and the assessment will take place over two days to cover both sites. We are now looking for people to take part who have experience of inpatient units and who can work with others and follow the assessment programme. Volunteers undertaking this role are required to be registered as volunteer with NUH, have undergone a Criminal Records Bureau check and be up to date with their mandatory training requirements. Travelling expenses will be paid in accordance with volunteer policy and will be authorised by the member of staff responsible for the volunteer and a light lunch provided. 30
Request for Members Date of request: Name or requester: Division : Appendix 1G Details of request I have attached a PPI Volunteer Job Description / PPI Volunteer brief (You must complete and attach at least one of the above forms) Y/N Number of members you require- (Please specify the number of members you want to involve): Please specify demographics of the members you want to contact (if applicable): please tick: Gender: Male Female What timescales are you working to - i.e. when do you wish to start and finish involvement? What are the anticipated outcomes of this Involvement? Is there any other relevant information you wish to add Division details for members to contact: Name: Job title: Contact details: Please tick to confirm that you have discussed this member request with your Divisional PPI Lead 31
Patient Public Local Induction Appendix 1H As a patient or public representative, you can expect: personal information about you to stay confidential and anonymous the chance to see how we work before you decide to become a representative (for example by attending a meeting) a clear remit of your responsibilities. an induction, and any on-going support you require a named contact manager to whom you can address any issues clear information about your chosen area of involvement to be consulted about decisions that affect you to know how to claim travel expenses and receive the necessary forms to receive papers of meetings in advance of the meeting honesty about what you can and cannot achieve the Trust, through your DivisionPPI lead to listen to your suggestions and criticisms your points of view to be taken seriously a work in safe and comfortable place which allows people to talk and work effectively together to choose how you want to be involved to be told what has happened as a result of your involvement What we expect from you: to have an active interest in the NHS to have an interest in Trust related issues to be able to work in a team and with any relevant working groups to be able to view things with an open mind to adhere to Trust policies and procedures, as made known to you. Your role as a patient or public representative is to: help us to improve services for patients and the public use your experience to give a patient s or public s view on services, including proposed change be willing to help change and influence services Your manager is:... Job title:... Contact details:... 32
PPI Volunteer 12 Month Review Appendix 1I Name: Name of Manager: Date of Meeting: Last Review Date: Type of PPI Volunteering: Over the last 12 months what has gone well? Over the last 12 months what would have been even better if? What will be achieved over the next 12 months? What support will be required over the next 12 months, by whom and when? Training Record Any other comments/actions Managers Signature: 33
Patient Experience and Patient Public Involvement How it fits together Appendix 2 - Elements that define patient experience at NUH - Tools NUH staff will use to deliver patient experience at NUH Definitions Patient Experience Patient experience at NUH results from a range of activities that all impact upon patient care, access, safety and outcomes. Patients have told us for a good patient experience at NUH they want us to: Provide good treatment in a comfortable, caring and safe environment, delivered in a calm and reassuring way Give them information to make choices, to feel confident and to feel in control Talk and listen to them as an equal and treat them with honesty, respect and dignity. NUH has used patient public feedback and the NICE quality standard for patient experience as the basis for defining the elements that make up patient experience at NUH. See blue section of the diagram. The NICE quality standard for patient experience in adult NHS services sets out how a high-quality service should be organised, so that the best care can be offered to people using NHS services in England. The quality standard for patient experience in adult NHS services is made up of 14 statements that describe high-quality care for patients. www.nice.org.uk/guidance/cg138. Patient Public Involvement (PPI) PPI at NUH is the process of engaging with the needs and expectations of patients and putting the public and members at the heart of NUH decision making, to ensure that the services and care provided are outcome driven and patient centred. Specifically it is concerned with exchanging information, mutual listening, and accepting that people should be allowed to influence their own care and the services they receive. PPI defines the way in which patients, carers and the public have a voice in decisions about how healthcare services and research are planned, designed, delivered and evaluated. PPI must operate on three levels: Involving individual patients and their carers in decisions about treatment and care and empowering them to make informed decisions about their health. Enabling patients, public and members to be involved and consulted on planning, monitoring, evaluating and developing services, proposals to change services and decisions about the way services operate. Involving and engaging patients, carers and the public in planning, development, delivery and evaluation of relevant research and research related activities 34 to the benefit of patients.
Appendix 3 35
Equality Impact Assessment (EQIA) Form (Please complete all sections) Appendix 4 Q1. Date of Assessment: 1/12/15 Q2. For the policy and its implementation answer the questions a c below against each characteristic (if relevant consider breaking the policy or implementation down into areas) Protected Characteristic a) Using data and supporting information, what issues, needs or barriers could the protected characteristic group s experience? I.e. are there any known health inequality or access issues to consider? The area of policy or its implementation being assessed: Race and No further changes to draft policy Ethnicity required. Gender No further changes to draft policy required. Age No further changes to draft policy required. Religion No further changes to draft policy required. Disability No further changes to draft policy required. Sexuality No further changes to draft policy required. Pregnancy and No further changes to draft policy Maternity required. Gender No further changes to draft policy Reassignment required. Marriage and No further changes to draft policy b) What is already in place in the policy or its implementation to address any inequalities or barriers to access including under representation at clinics, screening 36 c) Please state any barriers that still need to be addressed and any proposed actions to eliminate inequality
Civil Partnership required. Socio-Economic Factors (i.e. living in a poorer neighbourhood / social deprivation) No further changes to draft policy required. Area of service/strategy/function Q3. What consultation with protected characteristic groups Inc. patient groups have you carried out? Consultation has been undertaken with Patient Partnership Group, Members and Divisional Patient Groups. Q4. What data or information did you use in support of this EQIA? Feedback from National and local surveys and audits and patient groups. Q.5 As far as you are aware are there any Human Rights issues be taken into account such as arising from surveys, questionnaires, comments, concerns, complaints or compliments? No Q.6 What future actions needed to be undertaken to meet the needs and overcome barriers of the groups identified or to create confidence that the policy and its implementation is not discriminating against any groups What By Whom By When Resources required Q7. Review date March 2018 37