Patient Experience 08 Annual Report...Sussex Community NHS Foundation Trust – Annual Patient Experience Report 2016/17 Page 5 Source: SCFT Compliment Database (14th April 2017) Greeting

08 Fall

Patient Experience Annual Report 2016/17

Sussex Community NHS Foundation Trust – Annual Patient Experience Report 2016/17

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Table of Contents 1. Introduction............................................................................................................. 3

2. Patient Experience Strategy ..................................................................................... 3

4. Compliments ........................................................................................................... 4

5. Complaints .............................................................................................................. 6

6. Parliamentary Health Service Ombudsman (PHSO) ................................................. 15

7. Patient Advice and Liaison Service .......................................................................... 16

8. Friends and Family Test (FFT) ................................................................................. 18

9. Training ................................................................................................................. 21

10. Assurance .............................................................................................................. 22

11. Conclusion ............................................................................................................. 22


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1. Introduction This report provides a summary of patient experience activity undertaken during 2016/17 and includes details of the feedback received in 2016/17 via compliments, complaints, Patient Advice and Liaison Service (PALS), Parliamentary & Health Service Ombudsman (PHSO) and the Friends and Family Test (FFT). In each section there is detailed information on the current situation and analysis including trends and themes from contacts, response times and lessons learnt.

2. Patient Experience Strategy The revised ‘Patient and Carer Experience and Involvement Strategy’ is now complete and has been streamlined into three overarching ‘ambitions’ for patient and carer experience, which we (SCFT) will strive to achieve over the next 3 years. These are:-

Communication – ‘We want to improve the way we communicate with our communities, and modernise the way we collect and respond to feedback.

Working together - We want to make the best use of feedback from patients and carers and to support people to work together to improve our care and services.

Excellent Compassionate Care - We want our patients and carers to have a positive experience, first time and every time they come into contact with our staff.

The revised strategy was developed via the Patient Experience Group. Wide consultation occurred including the involvement of Public Foundation Trust members which also provided an opportunity for our Public Members to volunteer to be included in future work. 35% of respondents offered their services to be involved with SCFT future patient experience developments.

3. Patient Experience Group The Patient Experience Group (PEG) was held on 6 occasions during 2016/17.

o April 2016 o June 2016 o September 2016 o November 2016 o January 2017

The group, which is chaired by the Deputy Chief Nurse, has membership from operational and corporate staff, Healthwatch and Independent Health advocacy representatives and the elected Foundation Trust Public Governor.

In 2017/18 the group will move to Quarterly meetings. The PEG reports into the Trust Wide Clinical Governance Group. The revised terms of reference will be presented to the Trust wide Clinical Governance group in August 2017.


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4. Compliments 4.1 Number of Compliments

There were 2007 compliments recorded on the Trust’s compliments database in 2016/17; a 9% reduction on the number of compliments (2225) recorded last year. There is no identifiable theme for the reduction in compliments although we are aware that services have had issues accessing and using the compliment data base. We have introduced a new compliment recording system for 2017/18 which is part of the Datix recording system used to record incidents, which more staff can access and are familiar with. We are anticipating an increase in recording of compliments throughout 2017/18 due to this improved system. Feedback received from other services/partner agencies can also be captured by this route. Chart 1: Number of Compliments received each Quarter 2015/16 - 2016/17

Source: SCFT Compliment Database (14th

April 2017)

The red trend line in Chart 1 reflects a fairly stable trend over the past two years. On 1st April 2017, the Trust introduced a compliments recording module on the Datix recording system. The Datix recording system is familiar to operational staff and will make the process of recording and reporting on compliments more efficient for services.

4.2 How compliments are received

Compliments are received from various sources. Chart two details how the 2007 compliments for 2016/17 were received into the Trust. Chart 2: How compliments were received in 2015/16 compared to 2016/17

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Greeting Cards have been the most widely used method of paying a compliment to SCFT staff, with nearly 30% of all compliments being made by this means each year for the past two years. Email has consistently been the second most popular method to pay a compliment over the past two years.

4.3 Who was the compliment aimed at?

Over the past year, 43% of compliments were for individual staff members and 57% were in praise of teams. In the previous year 46% of compliments were aimed at individual staff members and 54% were in praise of teams. Chart 3: Who are the compliments aimed at?


April 2017)

4.4 Examples of compliments received

On recording compliments, staff are given the opportunity to highlight if there are lessons from the compliment commentary that can be identified and shared. Below is a small selection of the complimentary comments received in 2016/17:

‘’I would like to thank everyone involved in listening to my problems and addressing my issues promptly and thoroughly. I am reassured I will finally get fixed thanks to these lovely people and their professionalism.’’ Bognor Physiotherapy

‘’I called up about a concern for my granddad regarding pressure areas, your district nurses came out the next day just to check up on him. Myself and my grandparents appreciate it greatly as it is hard work for my them to get out of the house and visit their GP. Your service helps give them once less thing to worry about. Your staff are always so lovely to them and we can't thank you enough.’’ Chichester South Proactive Care Team

‘’To all community nurses that had a hand in caring for my wife (NAME). We are eternally grateful for your tireless efforts to tend to (NAME) carefully administering drugs to keep her pain free and treating her with the utmost dignity and respect and kindness. These qualities are not learned they are an integral part of your personality and natural and spontaneous. We can only count it a privilege to have had that level of care and we would like to take this opportunity to express our deep heartfelt thanks to you all.’’ Virtual Ward Arun East

‘’I wanted to record our gratitude to you for the sensitive and sympathetic way you engaged with us and with (NAME). He could not have received better care and was able to retain his dignity to the end. We thank you with affection and respect’’ Specialist Palliative Care Brighton & Hove

‘’I really feel grateful for having attended the group. I feel that it has given me the closure & dignity of mind to accept and understand the illness I have & how it affects my life and those around me. It has helped me make the needed

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changes to how I deal with my illness with aim and belief that I can and will make a full recovery.‘’ Chronic Fatigue (ME)

‘’I had AAA screening carried out this afternoon at my GP's in Burgess Hill and am letting you know that I found the whole process to be excellent. The appointment was dealt with in a very friendly and professional manner from start to finish, it was interesting to be able to see the result, which was a good one, so naturally I came away feeling pleased. Had there been an issue I would have been even more grateful that this whole scheme and everyone involved in setting it up had helped identify the problem before it caused me harm. All the experience of care I have received from the NHS in the past would mean I would remain confident that, had further treatment been required it would be of a caring and high standard. Thank you again to the whole team’’ AAA Screening.

‘’To Learning Disabilities Nurse and hospital for seeing me and thank you for all you have done being kind and helping me.’’ Learning Disabilities Health Facilitation Team

5. Complaints 5.1 Number of Complaints

The Trust received and responded to, or is responding to, 228 formal complaints in 2016/17. The breakdown for each month is shown in table 1.

Table 1: Number of Complaints Received by Month for 2016/17 Compared To 2015/16

April 2015 – March 2016 No. of complaints

April 2016 – March 2017

No. of complaints

April 2015 18

April 2016 28

May 2016 15

May2016 24

June 2015 33

June 2016 24

July 2015 22

July 2016 13

August 2015 16

August 20126 20

September 2015 22

September 2016 16

October 2015 27

October 2016 19

November 2015 20

November 2016 15

December 2015 15

December 2017 14

January 2016 22

January 2017 18

February 2016 29

February 2017 16

March 2016 17

March 2017 21


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256 228

Source: Datix and Safeguard Database (14/04/2017)

The number of complaints has decreased by 28 from the same reporting period last year when 256 complaints were received. During 2016/17, staff have received complaints awareness training and they may be better placed to handle complaints at a service level prior to it escalating through a formal route. Additionally the friends and family test is capturing feedback at the point of service delivery and as such issues are being dealt with locally and swiftly. This may be the rationale for a reduction in formal complaints during 2016/17.

5.2 Number of complaints against SCFT activity.

To contextualise the number of complaints received against SCFT monthly activity; the activity is determined by the number of patient contacts in community services (including Minor Injury and Urgent Treatment Centres) and in community beds, along with the number of admissions and discharges each month. The percentages of complaints rates are shown in table 2.

Table 2: Number of complaints against monthly activity in 2016/17

Month No. of complaints

Activity Contact

Average Complaint rate per

contact

April 2016 28 176,352 0.015%

May2016 24 183,877 0.013%

June 2016 24 184,695 0.012%

July 2016 13 179,033 0.007%

August 2016 20 180,332 0.011%

September 2016 16 184,142 0.008%

October 2016 19 179,906 0.010%

November 2016 15 183,684 0.008%

December 2017 14 167,236 0.008%

January 2017 18 176,840 0.010%

February 2017 16 161,789 0.009%

March 2017 21 167,881 0.012%

Totals 228 2,125,767 0.010%

Source: Scholar Performance (Data 21.04.17)

5.3 Number of Complaints by Operational Areas.

Complaints are reported on by operational area. Chart 4 shows the number of complaints each of the areas received in 2016/17.


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Datix and Safeguard Database (14/04/2017)

5.4 Complaints by Service Type

Chart 5: Service Type receiving highest number of complaints in 2016/17

Datix and Safeguard Database (14/04/2017)

Community nursing services, Trust wide, received the highest number of complaints in 2016/17. These are spread across 28 services/teams. The 24 Community inpatients complaints are across 15 wards and services and the 24 Minor Injury/Urgent Treatment Centre complaints pertain to 6 services. The Urgent Treatment Centre received 15 of these complaints. The activity for the Urgent Treatment Centre for the year was recorded on scholar as 119,063, therefore 15 complaints represent a complaint rate of 0.012%.

5.5 Complaint Themes

Complaints are categorised to assist with identifying themes where improvements may be necessary. Chart 6 shows the number of complaints received by categories in 2016/17, the highest number concerning aspects of clinical provision, communication and appointments.

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Chart 4 - Complaints By Area in 2016/17

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Chart 6: Number of complaints by category 2016/17

Source Datix 13/04/2017

Categories of complaint are recorded on Datix recording system and align to national reporting. Complaint categories recorded in the Quality account have been broken into some sub categories to ensure comparisons can be made with previous quality account figures for complaints of the same nature. Clinical provision covers a broad category of complaints. National data (KO41) is collected under this broad category. For internal use, to enable more accurate trend analysis, sub categories are used in line with our incident reporting categories. This enables us to identify areas that have high numbers of incidents and complaints and provide targeted support. Clinical Provision sub categories: • Diagnosis Problems • Access to Medication • Discharge • Duty of Care • End of Life • Incorrect Treatment • Medication Error • Nursing Care Falls in Wards • Operation–Adverse Outcome Chart 7 shows the breakdown of the 80 complaints received under the category of clinical provision.

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Chart 7 – Clinical provision breakdown.

Source Datix 13/04/2017

Nursing care complaints are across 25 different teams and where there was more than one complaint for the same team; it was a different subject matter and therefore cannot be identified as a theme.

5 complaints were received regarding the relocation of diabetes services in the East locality. These complaints followed a decision by the Clinical Commissioning Groups (CCGs) to reorganise diabetes services and SCFT worked with the CCG’s to provide consistent information to patients who had cause to raise a complaint.

There were 17 complaints where people had cited there were problems with their diagnosis. 9 teams received 1 complaint each and the Urgent Treatment Centre in Crawley received 8 complaints of this nature. All were independently investigated and whilst the main theme was diagnosis problems they ranged over different disciplines and clinicians and did not highlight any identifiable problematic theme.

Clinical treatment was identified as the main category in 11 complaints although these complaints pertain to 9 different services.

There has been a significant reduction in the number of staff attitude complaints over the past 4 years. Staff attitude complaints were the top category of complaint throughout 2013/14/15. The complaints team introduced ‘Improving the Patient Experience’ training to teams in May 2015, which is now part of the Annual Mandatory Training Day for all staff. Since the introduction of this course the trend (indicated by the red line on Chart 8) of staff attitude complaints has been reducing steadily and more so over 2016/17.

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Chart 8 – Reduction in staff attitude complaints

Source Safeguard and Datix Databases 2013 – 2017

5.6 Risk Assessment – level rating

A risk assessment is carried out for each complaint received. This helps us understand the range of risks that may be present to the Trust, the level of ability to control those risks, the likelihood of occurrence and the potential impact. Complaints are risk assessed initially by the complaints team and then by the service involved. SCFT uses the Department of Health risk assessment matrix to risk assess complaints. The rating may be adjusted based on further investigation. Chart 8 shows the initial risk ratings of complaints received in this reporting period. Chart 9: Proportion of complaints by risk rating 2016/17

Source: Datix Reporting System 1.4.17

5.7 Performance for Complaint Response Times

Current complaint regulations do not state the length of time a complaint investigation should take, as there is an expectation that target dates for completion are agreed between the complainant and the complaints team. There is an expectation that the complaint should be concluded within six months from receipt, where possible. The key reason for extended response times can be due to concurrent processes taking place. For example, a Serious Incident Investigation or a Safeguarding Investigation. During this reporting year, we have

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reviewed our response times in an effort to provide complainants with a response as soon as possible. Currently we aim to respond to different risk rated complaints within the following response times. This reflects the complexity of investigation required.

Level 1- within 15 workings

Level 2 – within 35 working days

Level 3 –within 60 working days Complaint response timeframes was an area of concern in 2015/16 therefore improvement within this area was one of our key initiatives for 2016/17. Processes were therefore reviewed and a performance indicator to monitor the impact of these changes was included in the monthly Integrated Performance and quarterly Patient Experience Report to the Quality Committee. Complaint response times have improved significantly, meeting target response times since July 2016. Table 3 shows the position from Q1 2016/17 to Q4 2016/17. Table 3 – Progress against plan for improving response rates.

5.8 Outcome of complaints

In 2016/17, of the 228 level 1, 2 and 3 risk rated complaints received, 205 were closed. At the time of writing this report the remaining 23 are still open and on target to be resolved within the allocated target response time. Following investigation, complaints will be determined to have been upheld, partially upheld or not upheld.

Not Upheld Rationale Complaints recorded as ‘not upheld’ indicate that the patient received the appropriate level of clinical care within the confines of the service specification, so there was no lapse in care. Learning from these complaints would be around managing service user expectations by providing leaflets and discussion at the point of engagement with the service. Ensuring other organisations who refer to SCFT are aware of the extent of the SCFT service also assists service users.

Where a complaint is not in relation to clinical care and the allegations are investigated and unfounded the complaint will be deemed as not upheld.

Upheld Rationale

Risk Rating

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Target Response

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Q4 2016/17

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25% 10.3 days 100%

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35 days 55 days 26% 23.4 days 100%

Level 3 60 days 79 days 27% 27.4 days 100%


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Complaints recorded as ‘Upheld’ are where the complainants’ allegations are investigated and founded.

Partially Upheld Rationale Partially upheld is a category recognised by NHS England and reported on in NHS Trusts quarterly report submissions (known as KO41a). Partially upheld complaints are where allegations made in a complaint are investigated and where elements of the concerns raised are upheld and where other aspects of the complaints are not. Chart 9 shows the outcome of complaints closed within the 2016/17 reporting period. 61 complaints were not upheld, 110 complaints were partially upheld and 34 complaints were fully upheld.

The SCFT investigator initially rates the outcome of each section, dependent on their findings and describes their rationale for the decision. This is reviewed/challenged by the complaints team and further reviewed/challenged by the Operational Manager (level depending on the complaint rating). The outcome therefore is not determined by one individual.

5.9 Comparisons 2015/16 to 2016/17 Chart 10: Outcome of complaints closed in 2016/17 Compared to 2015/16

Source: Datix Reporting System 1.4.17

Please Note: the figures have been based on the number of complaints closed as of 31st March each year and not the number of complaints received in the year.

5.10 The Differences

The table below shows the difference in number and percentage of the outcomes of

complaints over the past two years.

2015/16 2016/17 Movement From 2015/16

to 2016/17 No. % No %

Upheld 55 27.78% 34 16.59% - 11.19 %

Partially Upheld 90 45.46% 110 53.66% + 8.2 %

Not Upheld 53 26.76% 61 29.75% + 2.99 %

Totals 198 100% 205 100%

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5.11 Benchmarking

In September 2016 NHS Digital produced the National statistics on complaint data, which is submitted by all NHS Trusts quarterly through the KO41a (information for 2016/17 is not yet available). The information is reported in two categories:

Upheld/Partially Upheld complaints (although this category is broken down to differentiate between the two).

Complaints not upheld. When analysing SCFT data using the same categories, SCFT results are consistent with national data for Hospital and Community NHS Trusts and have a higher than national rate of Upheld and Partially Upheld outcomes. The table below defines the 2015/16 and 16/17 figures and percentages in the same

categories as NHS digital.

5.12 Possible Rationale for Differences in SCFT Outcomes

In 2016/17 the proportion of SCFT Upheld complaints dropped from the previous year by 11.19% and the partially upheld complaints increased by 8.2%. This change may be due to the increased use of the complaints toolkit during 2016/17. The toolkit breaks a complaint down into sections and each element is investigated and judged as to its outcome independently of the other elements. This is done to focus the investigation and ensure that every element of the complaint is responded to. Where there are several elements to a complaint and some elements are upheld and some not, the overall rating is partially upheld. Only complaints where every aspect is founded are deemed as upheld in totality. This may therefore explain the differences in figures from last year as operational staff are now required to provide an evidenced outcome and rationale for each aspect of a complaint.

5.13 Learning from Complaints

The Trust seeks to make improvements based on the identified learning from complaints, incidents, claims and PALS contacts. Quarterly reports to the Trust-wide Clinical Governance Group and Quality Committee include a section on learning and actions from complaints. This is included in the Quality Governance Newsletter which is disseminated across the organisation to share ways we can improve our services. The actions below are some examples of changes made or planned as a result of feedback through our complaints and PALS contacts: Table 4 – examples of lessons learn following complaints

Service / Team and Nature of Complaint/ concern

Action

Allegation of lack of communication leading to a patient being re-admitted to hospital.

The importance of documenting communication and actions and compliance with record keeping standards has been

National Data (2015/16)

SCFT 2015/16

SCFT 2016/17

Upheld/ Partially Upheld

64.9% 73.24% 70.25%

Not Upheld 35.1% 26.76% 29.75%


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Service / Team and Nature of Complaint/ concern

Action

reinforced to staff through team meetings.

Allegation of breach of patient confidentiality.

The importance of patient confidentiality and compliance with record keeping policy and standards has been reinforced to staff.

Lack of patient consent with full explanation of procedure.

Compliance with consent policy and practice reinforced with staff.

Wrong appointment information issued to patient.

Process changed to remove risk of different information being recorded on different systems, i.e. electronic registration system to be used and not parallel paper records. This will continue to be monitored.

Complainant unhappy with the wheelchair allocated to the patient.

Communication improvements between the team and service users.

Anxiety of a patient was raised during treatment from a dentist, due to lack of full attention whilst talking and topic of discussion during the appointment.

Team learning shared across clinicians at peer review around the importance of conversation topics being relevant to the patient when they are in our care.

Community nursing staff did not arrive as planned at patients home

Team learning shared and staff will be reminded to follow the protocol for deferred or cancelled visits and to let patients and their families know of any changes in their schedules. A commitment has been made to ensure clear and timely communication with patients

6. Parliamentary Health Service Ombudsman (PHSO)

Four cases have been referred to the PHSO to date in 2016/17 (two in August and two in December 2016), for which PHSO investigations remain in progress and outcome awaited. Two further cases were referred in March 2016, one of which is not being investigated by the PHSO and closed; the other remains under investigation. All cases relate to complaints made to the Trust, that were investigated, responded to and closed between 2013 and one from 2016. An overview of these cases are shown in table 5.

Table 5 - Overview of PHSO cases in 2016/17

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Source: Datix and Safeguard Database and complaint files kept.

7. Patient Advice and Liaison Service 7.1 Number of PALS enquires and themes

In 2016/17, 574 PALS queries were taken. Of these:

15 were raised by a patient’s friend or family member and the patient did not give consent to pursue the query.

39 were people providing comments (positive or negative) and feedback which were passed onto the appropriate service.

48 were people seeking information regarding health services, these queries pertain to 34 different service types across the Trust, with the highest number of information requests for community nursing (7), there were 4 requests for diabetes services and 3 requests for AAA screening.

2 resulted in resolution meetings between the enquirer and the relevant service.

102 were responded to by the PALS team in conjunction with the service involved.

329 were responded to locally by the relevant operational service.

21 were signposted to other NHS Trusts and external organisations.

The remaining 21 were still live at the point of the report writing.

7.2 Number of PALs Enquiries by Operational Areas.

Chart 11: PALS Enquiries by Operational Areas


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Source: Datix database 26/04/17

7.3 Categories of PALS enquired (top 6)

Chart 12: Top reasons for contacting PALS

Source: Datix database 26/04/17 Clinical provision, communication and appointments were the highest reason for PALS to be contacted through 2016/17.

7.4 Themes from PALS

The East Operational area received the highest number of PALS enquiries. 14 of these related to changes in the location of the diabetes services. This is consistent with the increase in complaints about the same services. The complaints followed a decision by the Clinical Commissioning Groups (CCGs) to reorganize the diabetes services and SCFT worked with the CCG’s to provide consistent information to patients who had cause to raise a concern. 22 PALS enquiries were in relation to Brighton community nursing teams – where home visits had been deferred. This issue is being closely monitored by operational staff and the number of contacts to PALS service has significant reduced.

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8. Friends and Family Test (FFT) SCFT currently uses a card based FFT in services. Patients are given a card to complete, either on discharge (in bedded units and minor injury units and urgent treatment centre) or periodically, for long term community patients. There is also an online option to complete the FFT, accessed through our Trust website. The FFT comprises of two questions

1. If a friend or family member needed similar care or treatment would you recommend the service to them? (This is rated from extremely likely to extremely unlikely).

2. Why have you given the rating you have? (This is a free text box). During 2016/17 the trust received 29,715 Friend and Family reviews. Of these:

96% of people said they were likely to recommend the service if a friend or family member needed similar treatment or care.

0.7% said they were unlikely or extremely unlikely to recommend the service to friends or family.

The remainder said they were neither likely or unlikely to recommend, gave no rating.

SCFT scored a star rating of 4.83 out of 5.

8.2 Examples of Positive/Negative Feedback from 2016/17

The Envoy messenger system provides themes of positive and negative comments. The image below is a screen shot of the Envoy report for the top 10 positive words and themes – (where less than 10 are provided 10 themes have not been identified).

Image – Screen Shot of Envoy Messenger Positive and Negative Comment Analysis.

Source: Screenshot, Envoy Messenger 04/05/2017

Where a person completes an FFT giving a negative rating, of ‘unlikely’ or ‘extremely unlikely’ to recommend, any positive comments written on the same card shows up as a negative theme as the data inputting process cannot differentiate between these incongruences. A sample of such comments is tabled below:

SAMPLE OF POSITIVE COMMENTS GIVEN AS A REASON FOR A NEGATIVE RATING

The good thing was that you try to make us comfortable in our own homes by proving different things to make our life more comfortable

Great service and within a reasonable time. Thank you!

They were really kind.


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Care was excellent - everything explained and understood. Talks more interesting and most helpful as not breathing properly is very frightening.

Caring reliability

I have always found politeness and very helpful. I like to know the facts of my health. Great staff.

All the nurses were kind and helpful.

The nurse was very obliging and helpful.

I'm very pleased with the service I received.

Quick and friendly staff were happy and helpful.

Excellent care and treatment.

Fast and friendly.

The frequency and rate of these discrepancies will be monitored and appropriate action taken in 2017/18 to review the FFT card design to ensure that the rating question is clear to its reader. Some FFT responses cite both positive and negative comments on the FFT Card. The overall rating determines where the comments are shown on the Envoy Messenger theme charts. For example where the word ‘good’ has been cited as a negative comment this relates to feedback where the experience overall was not rated as positive, although there was a balanced comment using the word ‘good’. Three examples of this are:

“The waiting time! The waiting time is far too long! The staff however, are doing a good job, considering the lack of staff.”

“Promptly seen by nurse, longer wait by doctor but care was good”

“Staff are very good. Probably the hospital needs improvement with the food” Staff attitude features as the highest positive theme for FFT feedback. HCC have noted the word ‘Friendly’ frequently appears in SCFT top comments and this has not been noted in such high volumes in the other 80 NHS Trusts that HCC works with. A sample of comments made is tabled below:

SAMPLE OF POSITIVE COMMENTS EXPLAINING POSITIVE RATINGS

Very friendly and helpful

Quick and friendly, nothing to improve.

The care was professional, the staff friendly and very helpful.

Staff are brilliant, child friendly and very helpful.

No improvements fantastic staff very kind and friendly

Quick friendly, kind.

Very quick, very friendly, very good care. The care my mum received was excellent thank you

Everyone at the surgery are very friendly and supportive with my needs. The genuinely care about my treatment and are attentive and kind, I have always had a bit of fear about my dental work, but I am always treated with compassion and respect.

Friendly and easy to talk to.

Friendly, great advice and helpful.

The theme screenshot from Envoy messenger cites staff attitude as the top negative theme. Having explored these comments, the vast majority of these are positive comments which have been attributed to a negative theme due to a poor overall rating. Waiting times is the top negative theme, with 31 negative comments attributed to 11 services within the trust. 11 of these comments were aimed at the Urgent Treatment Centre (UTC) in Crawley. Of these 11 comments, patients rated their experience as poor citing a 20 minutes to 4 hours waiting periods as negative. Staff and managers at the UTC are aware of this


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issue and attribute this to the disruption caused to treatment space during building works. This is expected to improve once the building works have been completed. Deferred community nursing visits and delayed arrival times of community practitioners were also cited as negative within the waiting time comments, although there is no identifiable theme or trend to these. There were 11 comments with negative ratings regarding staff shortages, these were across 11 different services, from community teams to community hospitals. The ward doctor is cited on 12 occasions under negative words and these relate to Minor Injuries units and the Urgent Treatment Centre. However all of these comments relate to the time taken to be seen by a doctor, the doctor being unable to specifically diagnose a condition and being referred back to a patient’s own General Practitioner, as opposed to negative comments about the individual doctors. Managers and nominated administrators have access to the envoy messenger system to view the results of the FFT about their services. A program of training for improved use of the system is taking place in Q1 of 2017/18. Service reports are produced by Healthcare Communications and these are sent to individual services to respond to and take appropriate action. The Patient and Carer Experience and Involvement Strategy has an aim to focus on closing the feedback cycle by capturing the actions taken and/or developments made by services as a result of FFT comments, which overall which is very positive feedback.

8.3 Risks and Challenges

FFT feedback provides valuable insight into how each service is perceived and experienced by their patients and service users. Feedback can be examined in order to identify areas for improvement and can also be a positive boost to staff morale. The Patient Experience Team has worked with clinical services to encourage use of FFT as an on-going learning tool and to make and report changes and developments resulting from patient feedback. This work is on-going. A recurring issue has been services submitting completed response cards to Healthcare Communications without identification codes. All cards must have the service/team name on them, together with their cost centre (as a double check). Without this identification, it is impossible to know where the response should be assigned. Whilst counted in the overall Trust totals, they are not attributed to the relevant service. The Patient Experience Team will be undertaking some focused work around FFT with services to ensure that cards routinely being provided to patients and staff are actively encouraging patients to complete these. A plan to improve Friends and Family response rates is included in the overarching Patient Experience plan (OPEP 2017/18).

8.4 Benefits and Developments

We are already working with High Weald and Lewes services in the East, who have been tasked by their commissioners to ask extra questions using the card based system. Using the electronic options to gather FFT data from our service users will make it easier for services to add any extra questions they feel would be useful. This can be done for a specific period of time, or on an on-going basis, making it much more flexible. The experience of Healthcare Communications is that response rates increase when using electronic methods for gathering service user feedback. In particular, younger service users


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are known to favour SMS texting. Displaying this information will also provide encouragement to other service users to participate.

8.5 FFT Developments

On 29/02/2016, SCFT signed a contract with Healthcare Communications (HCC) to provide the administrative and reporting of the SCFT FFT, via the HCC system Envoy Messenger. The contract was priced to include the use of SMS messaging, which has proved to increase response rates in NHS trusts significantly. The contract with HCC was defined in two phases.

Phase 1 – From commencement of contract date - Provide the level of existing service (provided by former FFT contractor Iwantgreatcare) of administrative services and reporting for the return of FFT cards.

Phase 2 –To provide a Short Messaging Service (SMS) and Interactive Voice Messaging (IVM) service for the FFT question, reporting on results as well as continuing to administer and report on the cards submitted by patients not choosing to use the SMS method of feedback.

Phase one of FFT was implemented in on 1st March 2016. It was anticipated that phase two would commence in the following in Quarter 2, 2016/17. There has been a delay in implementing phase two of the Friends and Family Test. We are currently in negotiation with the Informatics team and our Friends and Family provider HCC to realign their systems to ours so that we can commence text surveying and automated voice activated surveying. The initial work has now been completed and Area Directors have been asked to identify a pilot site. The Quality Governance Team will lead on a project team to implement phase two of FFT. The change in service area hierarchy and resource allocation has created a delay in this work which, when completed is expected to significantly increase the FFT response rates. A report describing our position has been presented to the Trust wide Clinical Governance Group.

9. Training Following feedback from our patient experience group and through our consultations for our patient experience developments, the Customer Care and Complaints training course has now been renamed ‘improving the patient experience’. Throughout 2017/18 this course will be facilitated at the annual statutory training day for all staff. To date 279 staff members have attended a bespoke ‘improving patient experience and complaints awareness’ training and a further 653 have completed this training as part of their annual statutory training day. Advanced training in investigation skills, designed to increase the skills and number of staff able to undertake complaints investigation was introduced in 2016/17. Demonstrative training on use of the Healthcare Communications Messenger system will be part of a rolling program throughout 2017/18 and be delivered by Healthcare Communications as well as the Quality Governance team.


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10. Assurance Patient experience reports will be presented for approval to the Patient Experience Group prior to be submitted to the Trust wide Clinical Governance Group and Quality Committee for assurance.

Report Title Patient Experience Group Trust Wide Clinical Governance Group

Quarter 1 2017/18 Patient Experience Report

July 2017 August 2017


October 2017 November 2017


January 2018 February 2018

Annual Patient Experience Report, including Quarter 42017/18

April 2017

May 2018

11. Conclusion The report provides an overview of the progress against the redevelopment of the patient experience activity of SCFT. Highlighting the various methods of collecting patient experience information, with examples of positive feedback received and the Trust’s response to areas of concern where improvement was required. There has been a significant reduction in the number of formal complaints and PALS enquiries received into the Trust. The Complaints team will continue to ensure the complaint’s process is visible within services for patient’s use. This will be aided by the implementation of the Healthwatch audit report which recommended changes to our public facing webpage and with the developments outlined in the Patient and Carer Experience and Involvement Strategy. Excellent progress has been made in reducing the total number of overdue complaints. Ongoing focus is required to ensure that this improvement is maintained and consistently met. Further focused work is required regarding implementation of real-time Friends and Family test surveys. Additionally focused work is underway to improve the response rates.

Documents

Patient Experience 08 Annual Report...Sussex Community NHS Foundation Trust – Annual Patient Experience Report 2016/17 Page 5 Source: SCFT Compliment Database (14th April 2017) Greeting