Embed Size (px)
Citation preview
1
Your Healthcare, Your WayPatient and Public Empowerment Strategy 2014-17
Ensuring that patient experience is
person centred and high quality, all of the time.
2
Foreword from Paul Kearney on behalf of the Bristol Community Health Board
2
When attending a recent national NHS conference, I was struck by some of the stories of poor experiences patients had received within the broader healthcare environment. Many of these experiences were poor because patients and carers were not given the opportunity to be fully involved in decisions about their care and treatment, or to be involved in the way the services are designed and run. Healthcare services are for patients and should be developed with patients.
We have over 30,000 patient contacts every month from the greater Bristol area. Add to that our engagement with families , carers and supporting voluntary agencies we are probably talking to 10% of the City’s population in any given month. This presents a unique opportunity to involve this group of citizens in shaping, advising and supporting the development of community based health services in the future. As the challenges facing the NHS increase due to an aging population, pressure on resources and increased demands on available services, it has never been more critical to gain the input of people who use our services.
As part of Bristol Community Health’s on-going commitment to achieve the highest standards of patient care and service improvement, significant extra effort is being invested into our relationship and communication with patients ,carers and the wider public. My colleagues and I representing the Board of Bristol Community Health and its staff, are determined to reach out as widely as possible to ensure we listen , learn and act to develop the way we provide health services to our patients and carers. ‘Your Healthcare, Your Way’ is Bristol Community Health’s Patient and Public Empowerment Strategy that sets out how we will do this.
“It is great to see a social enterprise committing to a person centred approach in the delivery of high quality community care. Bristol Community Health’s recently released Patient and Public Empowerment Strategy represents a clear commitment to putting the needs of their care users at the heart of both the structure and the delivery of their care services. Bristol’s ‘Your Healthcare, Your Way’ event, coupled with subsequent rounds of engagement and feedback from the public and care users has ensured this strategy truly represents what matters to those using Bristol Community Health’s care services. We also welcome their commitment to collect regular feedback focusing on theexperiences of care users and to use this intelligence to improve care quality”
Dr Andrew McCulloch, CEO Picker Institute Europe
3
1. Executive Summary.........................................................................4-5 2. Introduction .....................................................................................63. Context............................................................................................7 4. Scope...............................................................................................85. Our Objectives:................................................................................9-25
1. Place what is important to patients at the centre of every decision. 2. Make it simple for patients and carers to share their experiences. 3. Make it simple to inform patients and carers how their feedback is leading to improved services . 4. Work together with patients, carers and the wider public to develop services around their needs. 5. Work alongside volunteers to strengthen the care we provide and our bonds with the community. 6. Working collaboratively with the voluntary and community sector to improve outcomes for patients and carers.
Appendix – Action Plan...................................................................26-34
Contents
3
4
‘Your Healthcare, Your Way’ is Bristol Community Health’s Patient
and Public Empowerment Strategy 2014-2017. There are six key objectives
within this strategy that will contribute to a substantial shift from patients and
carers being passive recipients of care, to active participants in developing, shaping and
influencing community healthcare at an individual, service and strategic level across Bristol. These
objectives are described below. Please refer to the action plan which is included as the appendix to this strategy for
timescales for delivery and how progress will be measured.
1. Place what’s important to patients at the centre of every decision.In order to achieve this, we will:
• Always discuss the options for treatment choices with patients and empower patients to make decisions.
• Help patients understand their long term conditions and know what they can do to maintain optimal health.
• Provide decision support to ensure all patients are happy about the decisions thay make about their care.
• Enable patients to proactively plan for future care needs.
2. Make it simple for patients and carers to share their experiences.In order to achieve this, we will:
• Introduce an approach that will allow patients and carers to provide feedback across all services in as close to real-time as possible.
• Introduce a new role for volunteers in supporting patients and carers to provide feedback to Bristol Community Health.
• Promote Healthwatch as an independent organisation that patients, carers and the public can access to give their views on Bristol Community Health services.
• Gather patient and carer stories, using these experiences to improve Bristol Community Health services and influence the work of other health and social care partners.
• Ensure our complaints, concerns, compliments and comments process is accessible and simple for all.
1. Executive Summary
4
5
3. Make it simple to inform patients and carers how their feedback is leading to improved services.In order to achieve this, we will:
• Publish how patient, carer and public feedback has improved services. • Introduce transparent and open publishing of feedback.• Demonstrate what we have learned from feedback received via complaints, comments, compliments
and concerns.• Provide an annual patient experience report pulling together all of the Patient and Public
Engagement activity over the year.
4. Work together with patients, carers and the wider public to develop services around their needs.In order to achieve this, we will:
• Support people who use services to become Patient Leaders. • Create a vibrant and active ‘Participation Community’. • Embed a rolling programme of service focus groups to ensure that patients and carers have the
opportunity to shape Bristol Community Health services.• Develop approaches to involve patients and carers in deciding on strategic priorities and budget
setting.
5. Work alongside volunteers to strengthen the care we provide and our bonds with the community.In order to achieve this, we will:
• Harness volunteers’ ability to support and communicate with patients and carers.• Work with external partners in our development of volunteering roles.• Provide all service managers with the support they need to develop volunteering in their services.• Ensure that we support all our volunteers to make progress towards their goals.• Make our volunteering opportunities available to the full range of Bristol’s people.
6. Work collaboratively with the voluntary and community sector to improve outcomes for patients and carers.In order to achieve this, we will:
• Continue to embed our community outreach work programme aimed at providing health and wellbeing, promotion, advice and signposting to seldom heard communities.
• Actively pursue joint healthcare projects with local voluntary and community sector organisations to deliver innovative and flexible community healthcare services.
• Create a community health and wellbeing forum with the local voluntary and community sector.
5
6
Bristol Community Health believes that the best healthcare services are those
designed with patients and carers playing a fundamental role at an individual, service
and strategic level:
“This means seeing patients and carers not only as a source of need, but also assets for direct care
of themselves and others, providers of information and motivation for their community, and change
makers within health services themselves.” (see footnote)
The benefits of empowering patients and carers to play their part in shaping local services are well documented, both in terms
of improving the quality of services but also in ensuring services are as efficient and effective as possible.
Achieving consistently excellent patient experience is crucial to Bristol Community Health’s vision for Person Centred Patient Care. ‘Your Healthcare, Your Way’ is Bristol Community Health’s Patient and Public Empowerment Strategy for 2014-2017. This strategy sets out:• the approaches that will support and empower patients to be fully involved in decisions about their
care and treatment; we call this shared decision making• the approach that will shift the role of patients and carers as passive recipients of care to active
participants in shaping priorities in local community healthcare services• how Bristol Community Health will work with and support volunteers to offer practical and emotional
support for patients and carers as well as provide a meaningful and rewarding experience for volunteers
• how Bristol Community Health will work with the Voluntary and Community Sector (VCS) to join up services and improve health and wellbeing outcomes for Bristol.
Informing the Strategy
On Monday 16 June, a community engagement event was held in Bristol by Bristol Community Health, called ‘Your Healthcare, Your Way’. Over 70 delegates were in attendance, ranging from patients and carers through to representatives of the VCS.
The purpose of the day was to ask patients, carers and the VCS to feed in to this strategy and address how Bristol Community Health can involve key stakeholders at service and board level in new, exciting and innovative ways. Engaging with patients and carers in this way, right at the start of developing a new approach, was constructive, insightful and most importantly has significantly influenced the objectives of this strategy. Bristol Community Health would like to thank all of those who attended on the day for their energy, enthusiasm and ideas.
Outline of Strategy
The key objectives of this Patient and Public Empowerment strategy are described in section 5. An action plan to implement this strategy is included as Appendix A that includes, for each objective, the key milestones, timescales for delivery and how Bristol Community Health will measure progress.
2. Introduction
6 ‘Patient Empowerment: for better quality, more sustainable health services globally’, All Parliamentary Group, May 2014.
7
Ensuring patients have a positive experience of care is one of the measures identified in the NHS Operating
Framework, as well as a key component of the NHS Constitution. It also comes under ‘Making their Day’, one of
Bristol Community Health’s four strategic themes. Listening to, learning from and actively involving patients and the public is integral
to ensuring quality and safety in healthcare services. In the context of the Berwick, Darzi and Francis reports, patient and public engagement is a
deliberate exercise in critical, self-reflection. Bristol Community Health will ensure the patient and carer voice is heard, and crucially, acted upon, so that we can review and improve services to best effect and biggest impact.
Quality in healthcare services as defined in the Bristol Community Health Quality Account covers three core areas; clinical effectiveness, patient safety and patient experience.
The focus of this strategy is on how Bristol Community Health will ensure that patient experience is person centred and high quality, all of the time. Excellent patient experience means patients and carers feeling empowered and influential in shaping community healthcare services at an individual, service and strategic level across the city.
Context
7
We
will
ens
ure
that
pat
ient
ex
perie
nce
is p
erso
n ce
ntre
d an
d hi
gh q
ualit
y, a
ll of
the
time.
3. Context
Patient experience
Clinical effectivenessSafety
8
This strategy covers our approach to: • shared decision making;• how we gather, report on and make best use of patient and carer feedback;• meaningful involvement of patients and carers in developing services and shaping our priorities;• volunteering, and;• working with the voluntary and community sector.
The strategy covers all services that Bristol Community Health are commissioned to provide. It also covers all patients and carers who have been in contact with Bristol Community Health services or may be in contact with them in the future.
8
Scope
4. Scope
8
The strategy covers all patients and carers who have been in contact with Bristol Community Health services.
9
5. Our Objectives
Our approach:Our clinicians provide expertise in clinical
effectiveness; the probable advantages and benefits of treatments and the potential disadvantages. The
other expert is the patient. The patient is the expert on themselves, their social circumstances, their personal attitude
to illness and risk, their values and preferences.
Bristol Community Health’s aim is to work in equal partnership with patients to ensure that shared decisions are made about healthcare choices based on
what is most important to the patient.
Shared decision making is a specific approach to healthcare in which patients are encouraged to participate in selecting appropriate treatments or management options. Not being properly told about their illness and the options for treatment is the most common cause of patient dissatisfaction. Most patients want more information and a greater say in decisions about how they will be treated.
In 2011, The Kings Fund, an independent health think-tank in the UK, stated that ‘there is compelling evidence that patients who are active participants in managing their health and health care have better outcomes than patients who are passive recipients of care.’
Bristol Community Health are already collecting feedback to assess the impact our support is having on patients. We assess what is important to our patients and work as a team to address these priorities. Through patient satisfaction survey and telephone interviews, we are able to interact with patients and ask them what we did well and what we could improve on with rgeards to working in partnership with them. Please see objective 2 for more detail.
1 Place what’s important to patients at the centre of every decision.
9
9
10
1.1 Always discuss the options for treatment choices with patients and empower patients to make decisions.
Bristol Community Health will ensure that patients are able to provide informed consent in all decisions about their healthcare and management of their health problem. Bristol Community Health clinicians will:• discuss with patients the advantages and disadvantages of all appropriate treatment choices. • Bristol Community Health will take the time to inform patients of their choices and listen to their
wishes and preferences in relation to treatment and management options, in any situation when there is more than one reasonable choice of treatment and no one option is clearly the best for everyone.
1.2 Help patients understand their long term conditions and know what they can do to maintain optimal health.
Bristol Community Health will always encourage patients to be active participants in their healthcare management, based on what’s most important to the patient in relation to their life, their values and their personal health goals. This will include:• always explaining the nature of their health problem and what can be done about it and why;• helping patients to understand their health problem better, including what they can do to both
support treatment and seek to maintain good long term health;• empower patients to successfully self-manage long term conditions for longer periods whilst
providing appropriate self-management support whenever it is needed;• providing or signposting to health education classes and groups that have been shown to help
patients to understand, maintain and improve their health by increasing their knowledge (as best as research suggests). For example, by running education and exercise groups for people with chronic lung disease or chronic low back pain.
1.3 Provide decision support to ensure all patients are happy about the decisions they make about their care.
Decisions about healthcare happen whenever a patient undergoes a screening or diagnostic test, undergoes a medical or surgical procedure, takes part in a self-management education programme or psychological intervention, takes or changes medication, or attempts a lifestyle change.
Bristol Community Health will strive to provide patients with written information on treatment choices wherever possible. This will include:• discussing the likely success rates, and potential advantages and disadvantages of different
treatment choices, including any risks involved and how common they are. • providing these ‘decision aids’ wherever there is good quality research to support them, for example,
when considering a total knee replacement, or what choices and actions patients can take to respond effectively to exacerbations of long term conditions.
• reviewing the waiting times and outcomes of the different choices patients make in Bristol to help update and inform the choices available to patients.
10
by June 2015
by Dec 2015
by March 2015
11
1.4 Enable patients to proactively plan for future care needs.
Bristol Community Health will help patients to plan ahead for important future healthcare management decisions likely to affect them:• when there are choices that are in the patient’s best interests to potentially consider for the future,
we will help patients think about what’s most important to them and when might be the right time for each individual patient to consider a change in management approach. For example changing from management of osteoarthritis with exercise, advice and pain medication, to thinking about having knee replacement surgery; or changing from walking independently to using a walking aid to improve pain and mobility and reduce the risk of falls;
• provide a written ‘My Personal Care Plan’ for community nursing patients, to provide information and help patients think about how they may want to approach their future health management, including their wishes around end of life care.
9
11
We will encourage patients to be active participants in their healthcare
by Jan 2015
12
Our approach:Gathering and acting on patient and carer feedback has never been more important. In recent years, it has been well documented in a series of high profile reports that the approach of the NHS (and NHS funded organisations) in listening to, and crucially acting on patient and carer feedback has been poor. The following quotes from Keogh and Berwick reports in to the quality of NHS services highlight the significant shift that must be made:
“Real-time patient feedback and comment must become a normal part of provider organisations’ customer service and reach well beyond the Friends and Family Test.” Keogh, July 2013.
“Patient feedback is instrumental to the measurement, maintenance and monitoring of safety. Feedback should be collected as far as possible in real time and be responded to as quickly as possible.” Berwick, August 2013.
An approach that gathers and reports on real-time patient experience insight will bring significant benefit to patients and carers. Improving the ability to use feedback of patient experience to develop services will increase patient and carer satisfaction, make services as accessible as they can be and always deliver person centred patient care.
Bristol Community Health will adopt an approach that allows patients and carers to share their experience in a way that suits them, and at a time that suits them. The approach will be accessible for the diverse population who come in contact with and use Bristol Community Health services. This might be about the reading age of the language used, or the format of questionnaires, for example audio or braille for those with a sensory impairment. It may be about translating information in to the range of languages spoken in Bristol or it may be about using the very best easy-read approaches to ensure the experiences of people with learning difficulties can be understood.
9
We will support patients and carers to share their experience in a way that suits them, and at a time that suits them.
12
2 Make it simple for patients and carers to share their experiences.
13
Bristol Community Health recognises that there must be a variety of methods available for patients and carers to share their experiences. These methods need to be diverse and make the best use of technology to ensure that patient experience can be gathered in a timely way. Patient and carer feedback information needs to feed in to Bristol Community Health at a service and board level efficiently and in a timely way to drive the highest quality services.
The range of services provided by Bristol Community Health are unique in terms of size and profile. Some services are clinic-based, whilst others see patients in their own homes and the demographic profile of patients also changes between our services. This means that the approach must be flexible and tailored. The objectives below outline how we will deliver on this agenda.
2.1 Introduce an approach that will allow patients and carers to provide feedback across all of our services in as close to real-time as possible.
Bristol Community Health will secure a patient feedback solution that will provide patients and carers with the opportunity to give feedback in a variety of ways. The solution will deliver:• real-time listening of patient experience with timely and efficient reporting of feedback to service
managers and the Bristol Community Health board, enabling them to improve services based on the needs of patients and carers;
• integration of the Friends and Family Test question “How likely are you to recommend this service to your friends and family if they needed similar care or treatment?”;
• tailored questionnaires designed to understand the experience of patients and carers across each of our services including clinic-based services such as physiotherapy, community nursing in patients’ homes, healthcare in prison services and services for children and young people;
• opportunities to provide feedback across a variety of methods including online, via mobile working tablets used by many of our healthcare professionals, dedicated secure tablets in our prison services and via paper questionnaires;
• fully accessible questionnaires in a range of languages, easy-read versions for people with learning disabilities, appropriate formats, such as audio for people with a sensory impairment, and in age appropriate formats to ensure that children can provide feedback on services.
13
Real
-tim
e lis
teni
ng
by March 2015
14
Bristol Community Health will always explain why feedback is gathered and what is done with the information in our patient information and communication. Stringent data confidentiality guidelines will be adhered to. Named feedback will only be published where Bristol Community Health is given permission to do so.
2.2 Introduce a new role for volunteers in supporting patients and carers to provide feedback to Bristol Community Health.
Through our dialogue with patients and carers, for example at the ‘Your Healthcare, Your Way’ community engagement event in June 2014, Bristol Community Health heard that for some, providing feedback via a telephone call or a face to face meeting is preferable and in some cases more appropriate than via an online or paper survey.
In light of this, Bristol Community Health will introduce a volunteer role to support patients and carers to provide feedback on their experiences of services. The role will work across a range of services, particularly focusing on services where gathering patient and carer feedback may require a different, approach. Examples of where this may be the case include our Prison Services, Learning Disabilities Service and End of Life Care.
Staff across Bristol Community Health services will have a key role to play in identifying patients and carers who wish to provide feedback either by telephone or face to face and will be able to refer patients and carers to the volunteer role to arrange a telephone call or meeting. It is also anticipated that the volunteer role will outreach to individuals and communities who have been less likely to provide feedback on our services and equalities monitoring information will be used to target this work.
The volunteer role will use, as far as possible, the service specific surveys developed with the real-time patient feedback solution (see objective 2.1) to ensure consistency in the approach to gathering feedback.
2.3 Promote Healthwatch as an independent organisation that patients, carers and the public can access to give their views on Bristol Community Health services.
Healthwatch Bristol is the local independent consumer champion for health and social care services. Healthwatch encourages feedback from patients, carers and the public and use this information to influence the work of commissioners, service providers and a strategic level via Bristol’s Health and Wellbeing Board. Healthwatch also works across the communities in Bristol with an aim to reduce health inequalities and ensure equal access, treatment and outcomes for all.
We recognise that for some patients and carers, sharing their feedback directly with us is not appropriate for a variety of reasons. Therefore we will build a strong partnership with Healthwatch Bristol and work together on the following areas:• promotion of Healthwatch Bristol across all Bristol Community Health services in the form of leaflets
and posters to ensure that patients and carers are aware of Healthwatch Bristol as an independent consumer champion;
• establish a mechanism to allow for regular sharing of key themes from patient experience feedback gathered by both Bristol Community Health and Healthwatch Bristol, ensuring that both organisations make best use of feedback to improve services in the local area.
1.
14
from June 2015
from June 2015
15
2.4 Gather patient and carer stories, using these experiences to improve Bristol Community Health services and influence the work of other health and social care partners.
Gathering, understanding and making best use of patient and carer experience requires a variety of approaches. Objective 2.1 in this strategy will provide patients and carers the opportunity to provide feedback in a variety of ways and in close to real-time, however, by collecting patient stories Bristol Community Health will build on this survey information by allowing patients to give qualitative insights to feed in to service improvement work.
Patient stories can provide rich insight in to the experience of patients in terms of access, treatment and outcomes across a range of services. By gathering patient stories, Bristol Community Health can better understand what the barriers and priorities are for patients, often involving community services, primary care and hospital services.
Bristol Community Health will introduce ways for patients and carers to share their stories in the form of 1:1 interviews and during focus groups to:• examine the patient journey;• understand the patient experience at both a service and Bristol Community Health board level;• monitor service improvements.
Bristol Community Health are also registered on Patient Opinion (www.patientopinion.org.uk), a social enterprise at the forefront of gathering patient stories to affect improvements in healthcare services. Bristol Community Health will promote Patient Opinion through services and in patient information leaflets to encourage patients and carers to share their experience of services and use these stories to drive a culture of service improvement across the organisation.
2.5 Ensure our complaints, concerns, compliments and comments process is accessible and simple for all.
Bristol Community Health will ensure that the process for feedback in the form of complaints, comments, concerns and compliments is clear, simple and accessible. Bristol Community Health will ensure that all members of our community have equal access to the complaints service and use equalities monitoring information to focus work on those communities who are under-represented in raising complaints, con-cerns and comments.
In order to achieve this, Bristol Community Health will ensure that information around how to complain is clearly visible on Bristol Community Health website and in literature, for example in posters and leaflets that are clearly visible in appropriate public areas.
Bristol Community Health will continue to work to ensure that all staff are competent to deal with com-plaints and concerns with specific customer care training for all staff.
Bristol Community Health will work with the Healthlinks Team to ensure those whose first language is not English are aware of the complaints process and know how to make a complaint.
Bristol Community Health will also develop a ‘Listen’ service for vulnerable people and hard to reach groups, for example for people with Learning Difficulties and patients in HMP prison services. The ‘Listen’ service will provide outreach to individuals and groups, allowing patients and carers to share concerns and comments regarding Bristol Community Health services. Bristol Community Health will make best use of existing forums and groups within prison services to ensure the approach does not duplicate existing ways for individuals in prison to share their concerns.
1215
from April 2015
from March 2016
16
Make it simple to inform patients and carers how their feedback is leading to improved services
Our approachProviding the right opportunities at the right time for patients and carers to provide feedback on Bristol Community Health services is essential in ensuring that services are person centred. It is also essential that patients and carers are able to see how their feedback is leading to improvements in services, both for themselves but also the wider community who make use of Bristol Community Health services:
“Patients, carers and members of the public… should be confident that their feedback is being listened to and see how this is impacting on their own care and the care of others.” Keogh, July 2013.
Bristol Community Health will adopt an open and transparent culture of patient and carer feedback where both positive and negative feedback on services is routinely published and crucially, information on how Bristol Community Health is using this feedback to work with patients and carers to deliver better health and wellbeing outcomes for Bristol’s population.
Bristol Community Health will use a variety of approaches described below to ensure that patients and carers are regularly informed of how their feedback and involvement is effecting change. Bristol Community Health will make best use of the communication methods available to provide updates to the community of Bristol on service improvements via the Bristol Community Health community newspaper, the Bristol Community Health website and local radio stations.
3.1 Publish how patient, carer and public feedback has improved services.
A ‘You Said, We Did’ section will be established on the Bristol Community Health website so that patients and carers can easily see the range of comments received on each service and what actions have been taken to improve patient experience based on these comments.
Bristol Community Health will publish service-specific case studies each year describing:• a summary of feedback received on the service in the past 12 months;• what patients and carers said during focus groups and through patient stories;• how patients and carers have been involved in developing services;• what people who use the service now say about the service as a result of actions taken to improve
patient experience.
3.2 Introduce transparent and open publishing of feedback.
Bristol Community Health would like to promote a culture of openness and transparency in terms of patient experience. The majority of feedback received is extremely positive, although there are always cases where there is room for improvement. Bristol Community Health believes that by publishing feedback, both positive and negative, in a way that is accessible to the communities across Bristol, a culture of listening and crucially acting on feedback will be embedded to improve the experience of patients and carers both now and in the future.
A simple and accessible approach will be developed, integrated in to the Bristol Community Health website and via other sources such as our community newspaper that will allow patients, carers and the wider public to see the feedback received across the range of services. Bristol Community Health believes this approach will empower patients and carers to regularly provide feedback, which in turn, will lead to improvements in patient experience. All feedback published will be anonymous unless we have been given permission to publish the name of the patient or carer.
16
3
from April 2015
from Oct 2015
17
3.3 Demonstrate what we have learned from feedback received via complaints, comments, compliments and concerns.
Bristol Community Health will put in processes that monitor learning from complaints, comments, compliments and concerns and report regularly to interested parties, including providing feedback to complainants when learning is implemented across the organisation. Service managers and the Bristol Community Health board will regularly review the learning from complaints. Bristol Community Health will communicate regularly on feedback and learning from complaints on the website.
Bristol Community Health will also ensure that all complainants receive a service evaluation with their final response to their complaint along with an equality and diversity monitoring form to help ensure that all sections of our community receive equal access.
3.4 Provide an annual patient experience report pulling together all of the patient and public empowerment activity over the year.
Bristol Community Health will produce an annual patient experience report, published in May of each year. We will aim for this report to provide a balanced veiw of patient experience, giving voice to individuals and communities that represent the diverse population of Bristol. Each year, we will provide an accessible summary of the following areas:• key themes from patient and carer feedback received throughout the year, summarised by service
area;• performance against the Friends and Family Test, where possible benchmarked with other similar
community healthcare organisations;• a section on patient and carer participation and engagement in Bristol Community Health services
including focus groups on services and work to support patient leaders / expert patients (see objective 4) including a year-end ‘You Said, We Did’ summary;
• a section that describes our collaboration with the local voluntary and community sector in Bristol and how this partnership working is improving health and wellbeing outcomes for Bristol;
• an update on the action plan attached as Appendix 1 to this strategy.
17
from Feb 2015
from May 2015
1818
Work together with patients, carers and the public to develop services around their needs
Our approachHistorically, Patient and Public Involvement (PPI) activities across the NHS have focused on listening and consulting with patient and carer groups. Bristol Community Health is committed to both of these areas but believes that patients and carers should be empowered as partners in planning their own care and furthermore, working in an active and open partnership with services to improve patient experience, both for themselves and the wider community.
Objectives 2 and 3 of this strategy have focused on how patients and carers can provide feedback on their experiences and how we will communicate back on the steps we are taking to improve services. This objective explains how Bristol Community Health will move from patients and carers being passive recipients of care to active participants at all levels of the organisation.
Bristol Community Health will introduce a variety of approaches, developed with patients and carers, to move towards a co-production model of community healthcare. Our approaches will include patient leadership from service to board level, a rolling programme of focus groups across the range of Bristol Community Health services, and opportunities for patients and carers to shape priorities at a strategic level.There are some areas of service development which are outside of the direct control of Bristol Community Health. Where patients and carers highlight suggestions for improvement that fall under these areas, we will work with our commissioners to ensure that no voice is lost.
4
We will introduce a variety of approaches, developed with patients and carers, to move towards a co-production model of community healthcare.
19
4.1 Support people who use services to become Patient Leaders.
Patient Leaders are patients, service users and carers who work with others at a strategic level to influence change in healthcare. Patient Leaders are not only involved in service improvement work, but in subsequent strategic level decision making across healthcare organisations (see footnote).
Bristol Community Health’s vision is for patients to feel part of their local healthcare community, feeling empowered with learning and support from Bristol Community Health that meets their practical, emotional and psychological needs. Bristol Community Health will support Patient Leaders so that they feel they have the knowledge, skills and confidence to build dialogue with other patients and community groups, create trusting relationships, enhance accountability and ultimately improve services and outcomes for themselves and the wider community.
Bristol Community Health will introduce a Patient Leadership programme during 2014/15 and 2015/16 that will create opportunities for patients and carers to be involved in community healthcare at a strategic level across the range of Bristol Community Health services, right through to the Bristol Community Health board. We will support Patient Leaders with a package of learning and development suited to their needs so that the following roles can be fulfilled:• community enablers – e.g. Health Champions with particular interests and researchers in to the
needs of the diverse communities across Bristol;• improvement champions – e.g. Providing scrutiny on service improvement activity, encouraging
other patients and carers to provide feedback on their experiences and working in partnership with services on key policy changes;
• patient entrepreneurs – e.g. Jointly leading on developing new services and initiatives across community health services;
• informal / formal representatives – e.g. Patient leaders on service level management teams and strategic management meetings;
• peer to peer support – e.g. providing an advocate role in the local community, becoming a coach / mentor for other patients who may have similar healthcare needs and experiences;
• patient representatives in recruitment – e.g. patient and carers involved in the recruitment of key healthcare staff across the organisation from service to board level;
• patient trainers and educators – Patients and carers involved in delivering parts of our training and education programmes for health care professionals – ‘what does the patient experience feels like’.
Bristol Community Health recognise that the work involved in reaching this objective is significant, but we also recognise that in order to achieve the best possible outcomes with patients and carers, a fundamental shift must be made in the relationship with patients from recipients of services to partners in care, both at an individual and strategic level. A detailed programme in relation to Patient Leadership will be published in early 2015.
4.2 Create a vibrant and active ‘Participation Community’.
A ‘Participation Community’ will be created allowing patients and carers to register their interest in being involved in Bristol Community Health in areas such as patient leadership and service specific focus groups. Registration to the Participation Community will be possible in the following ways:
• The Bristol Community Health website will allow patients and carers to register their areas of interest which may be about services such as podiatry, physiotherapy or community nursing;
‘Bring it on – 40 ways to support Patient Leadership’, Centre for Patient Leadership & NHS Midlands and East, 2014.
19
from Spring 2015
from Spring 2015
20
• Forthosewithoutaccesstotheinternet,BristolCommunityHealthwillprovideregistrationforms on patient information leaflets so that the opportunities to be involved in community healthcare in Bristol are accessible to everyone. • BristolCommunityHealthwillalsoworkwithlocalvoluntarysectororganisationstoreachseldom heard groups to promote opportunities for collaborative working with patients and carers.
Patients and carers who register with the Participation Community will receive regular communication on opportunities to be involved and how their input is leading to improved services (see objective 2). Bristol Community Health will work to ensure the Participation Community is interactive, for example exploring ways to provide the latest information, advice and tools to promote healthy living, decision aids to support shared decision making and, in the future, making it possible for patients to access their care plans online.
The Participation Community will support patients and carers in the following ways:• create a forum for patients and carers who are involved in Bristol Community Health services to
come together and share their experiences, best practice and challenges with one another;• identify what type of support patients and carers may need to further develop their knowledge, skills
and confidence in being involved in Bristol Community Health services;• using the above, establish a learning and development programme for patient and carer
participants which may include areas such as equality and diversity training;• generate ideas for further opportunities for patient and carer involvement in services;• celebrate success by recognising best-practice examples of patient and carer involvement.
The Participation Community will be invited to meet each year with specific meetings to identify learning and development needs and regular communication via an online forum on the Bristol Community Health website, newsletters and emails.
4.3 Embed a rolling programme of service focus groups to ensure that patients and carers have the opportunity to shape Bristol Community Health services.
Over the past 2 years, Bristol Community Health has run a number of successful focus groups with patients and carers with the aim of improving patient experience. Although these focus groups have been effective, the structure, frequency and promotion of them has been sporadic resulting in missed opportunities to involve a wider group of patients and carers in service improvement work.
We wi
1520
We will allowpatients and carers to register their interest in being involved in Bristol Community Health.
from June 2015
21
Bristol Community Health will create a 2-year rolling programme of focus groups covering all appropriate services. These focus groups will encourage participants to share their thoughts, attitudes and ideas on a range of topics about the service in question. They will be used to gain a deeper understanding of patient experience with an aim to drive service improvement.
Patients and carers who have registered on the Participation Community will be contacted to register their interest in being involved in a focus group. Services will also contact a random sample of current and discharged patients to ensure that a wide audience is reached.
Bristol Community Health will always aim to choose venues for focus groups that are accessible, clarify the aims and objectives of the group and send out a letter or email explaining the purpose of the group and what is expected of participants. Typically, focus groups will last between 1 and 2 hours and compromise of between 6 and 12 people. We will always aim to hold focus groups at a time and day that suits the majority of participants and there may be occasions where we hold two focus groups, one during the day and one during the evening.
Bristol Community Health will aim to align this approach within existing groups and forums within prison services to ensure the approach does not duplicate existing methods of engagement and involvement.
The outcome of the focus group work and actions taken will be communicated as per objective 3 of this strategy.
4.4 Develop approaches to involve patients and carers in deciding on strategic priorities and budget setting.
Providing a range of opportunities for patients and carers to shape local community healthcare services is a priority for Bristol Community Health. This will be taken further developing approaches to involve patients and carers in deciding on strategic priorities and budget setting. This approach will bring community healthcare decision making to a local level so that the Bristol public can influence how they would like to see their services develop in the future.
This objective will:
• build on existing work to involve members of the public and the voluntary and community sector • in setting priorities in the annual Bristol Community Health Quality Account ensuring engagement is
inclusive, meaningful and reaches Bristol’s diverse communities;• seek views on Bristol Community Health reinvestment plans, involving patients and carers in
helping to shape budget setting each year;• seek the views of patients and carers on service development priorities each year (such as those
received from Commissioners) to ensure that service development plans deliver Person Centred Patient Care.
1621
from Feb 2015
22
Work alongside volunteers to strengthen the care we provide and our bonds with the community.
Our approachIn its 2013 report, ‘Volunteering in Health and Social Care’, The King’s Fund wrote that volunteers ‘play an important role in improving people’s experience of care, building stronger relationships between services and communities, supporting integrated care, improving public health and reducing health inequalities.’ The challenge for Bristol Community Health is to enable volunteers to play this essential role to the full.
The most direct way Bristol Community Health will do this is by developing roles that harness the specific ability of volunteers to open channels of care and communication with patients. In developing these roles, Bristol Community Health will ensure that it is working in collaboration with external partners, especially in the voluntary and community sector. Bristol Community Health will also give co-ordinated support to service managers to identify and develop volunteering roles that can enhance their work.
Volunteers are unpaid, but Bristol Community Health does not view their work as free. Bristol Community Health will ensure that service managers have the support they need to manage volunteers well, and will support volunteers to make progress towards their goals, whether that is recovery, career progression or social contact. At the same time, Bristol Community Health will conduct the necessary outreach work to ensure that volunteering opportunities are made available to a full range of people across Bristol.
Bristol Community Health will ensure that roles are developed for volunteers that make use of their unique ability to communicate with patients and carers, and to provide them with emotional and practical support. These roles will include:• a Care Plan Volunteer, to support patients in developing their own care plans;• volunteer Researchers, to work with Health Champions in identifying the barriers that prevent some
people from getting in contact with health services;• a Feedback Volunteer role to elicit high-quality feedback from patients and carers in sensitive areas
such as end of life care (see objective 2.2).
5.2 Work with external partners in our development of volunteering roles.
Bristol Community Health will strive to draw on the expertise and experience of the voluntary and community sector in developing volunteering roles that complement rather than duplicate existing services. As part of this objective Bristol Community Health will:• attend citywide and regional volunteering and networking meetings to seek out opportunities to
collaborate;• take advantage of patient and public empowerment engagement events to share knowledge with
voluntary and community sector organisations;• seek to co-develop volunteering roles with external voluntary sector organisations.
1722
5
from Spring 2015
5.1 Harness volunteers’ ability to support and communicate with patients and carers.
from Dec 2014
23
5.3 Provide all service managers with the support they need to develop volunteering in their services.
Bristol Community Health will provide service managers with the support and information they need to fully involve volunteers in their services. As part of this objective Bristol Community Health will:• develop briefings for managers and recruitment staff to illustrate how volunteers can help enhance
services;• run a short series of workshops in different localities around Bristol to support managers to develop
volunteering roles;• work with Human Resources to streamline and integrate volunteering into their existing systems.
5.4 Ensure that we support all our volunteers to make progress towards their goals.
In return for the valuable work done by volunteers, Bristol Community Health will commit to supporting volunteers to attain their goals, whether recovery, social contact or building professional experience. To do this Bristol Community Health will:• make training available to volunteers;• interview volunteers upon recruitment, and six-monthly thereafter, to check that they are making
progress towards their goals.
5.5 Make our volunteering opportunities available to the full range of Bristol’s people.
Bristol Community Health will ensure that its volunteering opportunities are available to a full and diverse spectrum of Bristol’s people. To ensure this Bristol Community Health will:• research and develop specific channels for marketing our roles to the full range of people in Bristol,
especially currently underrepresented groups, including over-fifties and people with disabilities;• ensure equality and diversity training is available for all Bristol Community Health volunteers.
18
9
23
We will commit to supporting volunteers to attain their goals.
by March 2016
from March 2015
from March 2015
24
Work collaboratively with the voluntary and community sector to improve outcomes for patients and carers.
Our approachWorking collaboratively with the voluntary and community sector is a key priority for Bristol Community Health. Many services are provided in conjunction with VCS organisations and these partnerships deliver joined up care to improve outcomes for people across Bristol.
Bristol Community Health values the unique role the voluntary and community sector has in improving health and wellbeing outcomes and reaching out to communities across Bristol. The approach going forward will be to identify opportunities to strengthen these partnerships and to take a lead role in promoting joint working with voluntary and community sector organisations relating to community healthcare provision. Bristol Community Health are also committed to harnessing the unique role that voluntary and community sector organisations play across Bristol to provide health promotion and advice in community meeting spaces and to those who may not be aware of or have not accessed Bristol Community Health services. This objective should be read in conjunction with the Bristol Community Health Community Pledge strategy.
6.1 Continue to embed our community outreach work programme aimed at providing health and wellbeing promotion, advice and signposting to seldom heard communities.
During 2013/14, Bristol Community Health established a community outreach work programme with the aim of taking key Bristol Community Health services out to communities, supported by the local voluntary and community sector. The main aims of this programme are to:• provide health and wellbeing promotion and advice to communities across Bristol;• reach out to seldom heard communities by taking services to community organisations and meeting
spaces;• improve patient and carer experience of Bristol Community Health services in terms of access and
outcomes;• promote partnership working between Bristol Community Health and the local voluntary and
community sector.
Services such as Podiatry and the Diabetes and Nutrition Service (DANS) have already met with local community groups such as Dhek Bhal (a voluntary organisation supporting the South Asian community in Bristol). The feedback from members of these groups has been very positive.
Bristol Community Health will continue to embed the community outreach programme, ensuring links are established with key voluntary and community sector organisations to reach the diverse communities across Bristol. Bristol Community Health will ask members of these organisations about the areas of community healthcare they are particularly interested in to target this work. Where there is higher prevalence of a particular health condition amongst the community (e.g. diabetes in the South Asian community), appropriate services will be asked to outreach to these communities. Bristol Community Health will use this information to develop a timetable of community outreach work, linking services with local community groups to raise awareness of services and offer health promotion and advice with an aim of improving health and wellbeing across the city.
1924
6
Ongoing
25
This programme of work will provide an opportunity to understand any barriers communities may face in accessing community healthcare services and will also provide a forum to discuss patient and carer experience of services linked to theme 1 of this strategy.
6.2 Actively pursue joint healthcare projects with local voluntary and community sector organisations to deliver innovative and flexible community healthcare services.
Bristol Community Health is proud of its track record of strong partnership with local voluntary and community sector organisations. Joint working with organisations such at Diabetes UK, British Heart Foundation, British Lung Foundation, Macmillan and British Red Cross has resulted in better health outcomes for patients and carers.
Bristol Community Health will continue to work closely with local voluntary and community sector organisations, and in particular explore opportunities for partnership working, to meet gaps in services or to further develop and improve existing services. Bristol Community Health will explore opportunities to attract funding jointly with voluntary and community sector organisations to deliver flexible and innovative community healthcare services that will benefit patients, carers and the wider community.
6.3 Create a community health and wellbeing forum with the local voluntary and community sector.
As the local provider of community healthcare services, Bristol Community Health would like to take a leading role in promoting joint working with voluntary and community sector organisations to deliver improved health and wellbeing outcomes for individuals and communities across Bristol.
Bristol Community Health will establish a community healthcare forum with voluntary and community sector organisations with the aim of achieving the following:• actively participate in sharing new ideas;• act as a hub for sharing best-practice;• explore partnership opportunities, which may include integration of healthcare delivered in the
community and in acute hospitals;• invite patients and carers to share their experiences of community healthcare services and use these
experiences to shape future work;• invite key speakers such as commissioners, regulators and the local authority to update the forum
on key priorities for Bristol and provide the opportunity to discuss how best to achieve these together.
Bristol Community Health will aim to meet with communitiesin Bristol, ensuring that the forum is accessible to as many organisations as possible.
2025
We will explore
opportunities for
partnership working.
Ongoing
by April 2016
26
6. Appendix
Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
1. To
pla
ce
wha
t’s
impo
rtant
to
patie
nts
at
the
cent
re
of e
very
de
cisi
on
1.1 To
alw
ays
disc
uss
the
optio
ns fo
r tre
atm
ent c
hoic
es
with
pat
ient
s an
d em
pow
er p
atie
nts
to
mak
e de
cisi
ons.
•Sh
are
PPE
stra
tegy
with
clin
icia
ns.
•En
sure
a m
embe
r of e
ach
serv
ice
lead
s on
pat
ient
info
rmat
ion.
•
Obt
ain
patie
nt fe
edba
ck o
n in
form
atio
n av
aila
ble
and
adap
t as
requ
ired.
Janu
ary
15
Janu
ary
15
Janu
ary
15
•Pa
tient
info
rmat
ion
lead
in e
ach
team
est
ablis
hed.
•
Patie
nt fe
edba
ck r
ecei
ved
rega
rdin
g pa
tient
info
rmat
ion.
1.2 To
hel
p pa
tient
s to
un
ders
tand
thei
r lon
g te
rm c
ondi
tions
and
kn
ow w
hat t
hey
can
do to
mai
ntai
n op
timal
he
alth
.
•Cl
inic
ians
to d
iscu
ss h
ealth
care
adv
ice
with
pat
ient
s.
•Pa
tient
infro
mat
ion
to b
e m
ade
avai
labl
e fo
r com
mon
con
ditio
ns, e
xerc
ise
and
activ
ity, a
nd c
omm
unity
gro
ups.
Ong
oing
Dec
15
Avai
labi
lity
of p
atie
nt in
form
atio
n co
verin
g a
wid
e ar
ea o
f hea
lthca
re.
1.3 To
pro
vide
dec
isio
n su
ppor
t to
ensu
re a
ll pa
tient
s ar
e ha
ppy
abou
t the
dec
isio
ns
thay
mak
e ab
out t
heir
care
.
•D
ecis
ion
supp
ort a
ids
to b
e pr
ovid
ed fo
r:1.
Self-
man
agem
ent o
f exa
cerb
atio
n of
ch
roni
c lu
ng d
isea
se (C
OPD
Ser
vice
)2.
Kn
ee re
plac
emen
ts (M
ATS)
3.
Shou
lder
pai
n (M
ATS)
Mar
ch 15
Mar
ch 15
Mar
ch 15
•D
ecis
ion
supp
ort a
ids
in p
lace
an
d be
ing
succ
essf
ully
use
d by
se
rvic
es.
•Q
ualit
y of
pat
ient
feed
back
on
deci
sion
sup
port
aid
s pr
ovid
ed.
1.4 To
ena
ble
patie
nts
to p
roac
tivel
y pl
an fo
r fu
ture
car
e ne
eds.
•Vo
lunt
eers
to g
athe
r pat
ient
feed
back
on
the
use
of M
y Pe
rson
al C
are
Plan
in
Com
mun
ity N
ursi
ng•
Com
mun
icat
e st
rate
gy s
tate
men
t to
Clin
icia
ns
•D
evel
opm
ent a
nd s
uppo
rted
upta
ke o
f th
e us
e of
My
Pers
onal
Car
e Pl
ans
for
empo
wer
ing
patie
nt d
ecis
ions
rega
rdin
g fu
ture
hea
lth n
eeds
Oct
ober
14
Janu
ary
15
Dec
embe
r 14
•G
ood
upta
ke a
nd u
se o
f My
Pers
onal
Car
e Pl
an•
Qua
lity
of p
atie
nt fe
edba
ck o
n M
y Pe
rson
al C
are
Plan
s
26
27
Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
2- M
ake
it si
mpl
e fo
r pa
tient
s an
d ca
rers
to
shar
e th
eir
expe
rienc
es
2.1 I
ntro
duce
a re
al-
time
patie
nt e
xper
ienc
e fe
edba
ck s
olut
ion
•Se
cure
feed
back
sol
utio
n•
Impl
emen
tatio
n ph
ase
•Fu
ll ro
ll-ou
t to
all s
ervi
ces
July
201
4A
ugus
t - D
ecem
ber 2
014
Mar
ch 2
015
•Ye
ar o
n ye
ar in
crea
se in
feed
back
re
ceiv
ed a
cros
s al
l ser
vice
s•
Impr
oved
pat
ient
sat
isfa
ctio
n•
Feed
back
rece
ived
refle
cts
the
serv
ice
dem
ogra
phic
•
Full
roll-
out o
f the
NH
S Fr
iend
s an
d Fa
mily
Test
acr
oss
all
serv
ices
by
Dec
embe
r 201
42.
2 In
trodu
ce a
new
ro
le fo
r vol
unte
ers
in
supp
ortin
g pa
tient
s an
d ca
rers
to p
rovi
de
feed
back
to B
risto
l Co
mm
unity
Hea
lth
Plea
se re
fer t
o 5.
1Pl
ease
refe
r to
5.1
Plea
se re
fer t
o 5.
1
2.3
Prom
ote
Hea
lthw
atch
as
an
inde
pend
ent
orga
nisa
tion
that
pa
tient
s, c
arer
s an
d th
e pu
blic
can
acc
ess
•Pi
lot H
ealth
wat
ch
prom
otio
n in
ser
vice
s•
Eval
uate
and
roll-
out t
o ot
her s
ervi
ces
•Es
tabl
ish
mec
hani
sm fo
r sh
arin
g pa
tient
exp
erie
nce
them
es b
etw
een
Hea
lthw
atch
and
Bris
tol
Com
mun
ity H
ealth
Janu
ary
2015
May
201
5
June
201
5
•H
ealth
wat
ch m
ater
ials
ava
ilabl
e ac
ross
Bris
tol C
omm
unity
Hea
lth
serv
ices
•Q
uarte
rly re
porti
ng o
f pat
ient
ex
perie
nce
them
es in
pla
ce
betw
een
Hea
lthw
atch
and
Bris
tol
Com
mun
ity H
ealth
2.4
Gat
her a
nd u
se
patie
nt a
nd c
arer
sto
ries
to im
prov
e pa
tient
ex
perie
nce
•Pr
omot
e Pa
tient
Opi
nion
vi
a pa
tient
info
rmat
ion
leaf
lets
and
Bris
tol
Com
mun
ity H
ealth
web
site
•Es
tabl
ish
a pr
ogra
mm
e of
wor
k to
gat
her p
atie
nt
stor
ies
via
1:1 in
terv
iew
s an
d fo
cus
grou
ps•
Repo
rt on
pat
ient
sto
ries
and
key
lear
ning
poi
nts
/ ac
tions
to s
ervi
ce le
ads
and
Bris
tol C
omm
unity
H
ealth
boa
rd a
nd p
ublic
.
Mar
ch 2
015
Janu
ary
2015
Apr
il 20
15 o
nwar
ds
27
28Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
2.5
Ensu
re o
ur
com
plai
nts,
con
cern
s,
com
plim
ents
and
co
mm
ents
pro
cess
is
acce
ssib
le a
nd s
impl
e fo
r all
•En
sure
that
info
rmat
ion
arou
nd
how
to c
ompl
ain
is c
lear
ly v
isib
le
on th
e Br
isto
l Com
mun
ity H
ealth
w
ebsi
te a
nd th
at li
tera
ture
(e.g
. po
ster
s /
leaf
lets
) are
cle
arly
vi
sibl
e in
all
publ
ic a
reas
•En
sure
that
all
staf
f are
co
mpe
tent
to d
eal w
ith
com
plai
nts
and
conc
erns
(s
peci
fic c
usto
mer
car
e tra
inin
g fo
r all
staf
f). P
atie
nt S
ervi
ces
Man
ager
will
focu
s on
one
se
rvic
e lin
e pe
r qua
rter.
Co
mpl
aint
s In
vest
igat
ion
Skill
s tra
inin
g w
ill a
lso
be o
ffere
d.•
Dev
elop
men
t of
a “L
ISTE
N”
Serv
ice
for v
ulne
rabl
e /
hard
to
reac
h gr
oups
e.g
. LD
and
pris
ons
Mar
ch 2
015
Sept
embe
r 201
5
Mar
ch 2
016
•Co
nfid
ent,
prof
essi
onal
, kn
owle
dgea
ble,
com
mitt
ed
and
happ
y st
aff w
ho v
alue
an
d en
cour
age
feed
back
fro
m p
atie
nts
and
the
publ
ic•
Cust
omer
Car
e pr
oces
ses
are
open
, tra
nspa
rent
, ef
fect
ive,
qua
lity
assu
red
and
the
“loop
clo
sed”
•In
itial
incr
ease
in re
porti
ng
of th
e “4
C’s”
Com
plai
nts,
Co
ncer
ns, C
omm
ents
an
d Co
mpl
imen
ts –
un
ders
tand
ing
that
this
is
nat
ural
whe
n pu
blic
ity
incr
ease
s
3 - M
ake
it si
mpl
e to
info
rm p
atie
nts
and
care
rs h
ow
thei
r fee
dbac
k is
lead
ing
to
impr
oved
ser
vice
s
3.1 P
ublis
h ho
w p
atie
nt,
care
r and
pub
lic
feed
back
has
impr
oved
se
rvic
es
•Yo
u Sa
id, W
e D
id s
ectio
n on
Br
isto
l Com
mun
ity H
ealth
w
ebsi
te•
Case
stu
dies
pub
lishe
d on
PPI
w
ork
Febr
uary
201
5
Apr
il 20
15 o
nwar
ds
•In
crea
se in
par
ticip
atio
n in
Br
isto
l Com
mun
ity H
ealth
se
rvic
es b
y pa
tient
s an
d ca
rers
•Im
prov
ed p
atie
nt
expe
rienc
e
3.2
Intro
duce
tran
spar
ent
and
open
pub
lishi
ng o
f fe
edba
ck
•D
evel
op a
ppro
ach
to p
ublis
hing
fe
edba
ck (l
inke
d to
1.1.)
•
Publ
ish
feed
back
rout
inel
y on
Bris
tol C
omm
unity
Hea
lth
web
site
July
- Se
ptem
ber 2
015
Oct
ober
201
5 on
war
ds
•Su
rvey
of s
take
hold
ers
to
asce
rtain
whe
ther
they
feel
Br
isto
l Com
mun
ity H
ealth
is
tran
spar
ent i
n pu
blis
hing
fe
edba
ck•
Incr
ease
in fe
edba
ck b
y pa
tient
s an
d ca
rers
•Im
prov
ed p
atie
nt
expe
rienc
e
28
29Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
3.3
Dem
onst
rate
wha
t w
e ha
ve le
arne
d fro
m
feed
back
rece
ived
via
co
mpl
aint
s, c
omm
ents
, co
mpl
imen
ts a
nd
conc
erns
•Pr
oces
s in
pla
ce th
at
mon
itors
lear
ning
fro
m 4
C’s.
•Co
mm
unic
atio
n pl
an d
evel
oped
to
feed
back
lear
ning
fro
m c
ompl
aint
s.
.Com
plai
nant
s re
ceiv
ing
serv
ice
eval
uatio
n w
ith
equa
litie
s m
onito
ring
form
.
Febr
uary
201
5
Sept
embe
r 201
4
•Le
arni
ng fr
om c
ompl
aint
s em
bedd
ed a
cros
s or
gani
satio
n•
Impr
ovem
ent i
n pa
tient
ex
perie
nce
3.4
Prov
ide
an a
nnua
l pa
tient
exp
erie
nce
repo
rt pu
lling
toge
ther
all
of
the
Patie
nt a
nd P
ublic
En
gage
men
t act
ivity
ove
r th
e ye
ar
Publ
ish
first
ann
ual
patie
nt e
xper
ienc
e re
port
May
201
5•
Publ
ishe
d re
port
•In
crea
se in
feed
back
by
patie
nts
and
care
rs•
Hig
h pr
opor
tion
of p
atie
nts
and
care
rs fe
el th
ey a
re /
hav
e be
en g
iven
the
oppo
rtuni
ty to
be
invo
lved
in B
risto
l Com
mun
ity
Hea
lth s
ervi
ces
4- W
ork
toge
ther
w
ith p
atie
nts,
car
ers
and
the
wid
er p
ublic
to
dev
elop
ser
vice
s ar
ound
thei
r nee
ds
4.1 S
uppo
rt pe
ople
who
us
e se
rvic
es to
bec
ome
Patie
nt L
eade
rs
•D
evel
op p
atie
nt
lead
ersh
ip p
ilot
•Im
plem
ent p
ilot
•Ev
alua
tion
of p
ilot
•Ro
ll ou
t of p
rogr
amm
e
Febr
uary
201
4
Mar
ch –
Jul
y 20
15A
ugus
t 201
5Se
ptem
ber 2
015
onw
ards
•Pa
tient
lead
ers
feel
em
pow
ered
to
influ
ence
cha
nge
at a
stra
tegi
c le
vel
•Im
prov
emen
t cha
mpi
ons
recr
uite
d. P
atie
nt re
pres
enta
tives
at
ser
vice
/ m
anag
emen
t m
eetin
gs•
Patie
nt re
pres
enta
tives
em
bedd
ed
in re
crui
tmen
t pro
cess
for s
enio
r po
sitio
ns w
ithin
Bris
tol C
omm
unity
H
ealth
Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
2.5
Ensu
re o
ur
com
plai
nts,
con
cern
s,
com
plim
ents
and
co
mm
ents
pro
cess
is
acce
ssib
le a
nd s
impl
e fo
r all
•En
sure
that
info
rmat
ion
arou
nd
how
to c
ompl
ain
is c
lear
ly v
isib
le
on th
e Br
isto
l Com
mun
ity H
ealth
w
ebsi
te a
nd th
at li
tera
ture
(e.g
. po
ster
s /
leaf
lets
) are
cle
arly
vi
sibl
e in
all
publ
ic a
reas
•En
sure
that
all
staf
f are
co
mpe
tent
to d
eal w
ith
com
plai
nts
and
conc
erns
(s
peci
fic c
usto
mer
car
e tra
inin
g fo
r all
staf
f). P
atie
nt S
ervi
ces
Man
ager
will
focu
s on
one
se
rvic
e lin
e pe
r qua
rter.
Co
mpl
aint
s In
vest
igat
ion
Skill
s tra
inin
g w
ill a
lso
be o
ffere
d.•
Dev
elop
men
t of
a “L
ISTE
N”
Serv
ice
for v
ulne
rabl
e /
hard
to
reac
h gr
oups
e.g
. LD
and
pris
ons
Mar
ch 2
015
Sept
embe
r 201
5
Mar
ch 2
016
•Co
nfid
ent,
prof
essi
onal
, kn
owle
dgea
ble,
com
mitt
ed
and
happ
y st
aff w
ho v
alue
an
d en
cour
age
feed
back
fro
m p
atie
nts
and
the
publ
ic•
Cust
omer
Car
e pr
oces
ses
are
open
, tra
nspa
rent
, ef
fect
ive,
qua
lity
assu
red
and
the
“loop
clo
sed”
•In
itial
incr
ease
in re
porti
ng
of th
e “4
C’s”
Com
plai
nts,
Co
ncer
ns, C
omm
ents
an
d Co
mpl
imen
ts –
un
ders
tand
ing
that
this
is
nat
ural
whe
n pu
blic
ity
incr
ease
s
3 - M
ake
it si
mpl
e to
info
rm p
atie
nts
and
care
rs h
ow
thei
r fee
dbac
k is
lead
ing
to
impr
oved
ser
vice
s
3.1 P
ublis
h ho
w p
atie
nt,
care
r and
pub
lic
feed
back
has
impr
oved
se
rvic
es
•Yo
u Sa
id, W
e D
id s
ectio
n on
Br
isto
l Com
mun
ity H
ealth
w
ebsi
te•
Case
stu
dies
pub
lishe
d on
PPI
w
ork
Febr
uary
201
5
Apr
il 20
15 o
nwar
ds
•In
crea
se in
par
ticip
atio
n in
Br
isto
l Com
mun
ity H
ealth
se
rvic
es b
y pa
tient
s an
d ca
rers
•Im
prov
ed p
atie
nt
expe
rienc
e
3.2
Intro
duce
tran
spar
ent
and
open
pub
lishi
ng o
f fe
edba
ck
•D
evel
op a
ppro
ach
to p
ublis
hing
fe
edba
ck (l
inke
d to
1.1.)
•
Publ
ish
feed
back
rout
inel
y on
Bris
tol C
omm
unity
Hea
lth
web
site
July
- Se
ptem
ber 2
015
Oct
ober
201
5 on
war
ds
•Su
rvey
of s
take
hold
ers
to
asce
rtain
whe
ther
they
feel
Br
isto
l Com
mun
ity H
ealth
is
tran
spar
ent i
n pu
blis
hing
fe
edba
ck•
Incr
ease
in fe
edba
ck b
y pa
tient
s an
d ca
rers
•Im
prov
ed p
atie
nt
expe
rienc
e
29
30Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
4.2
Crea
te a
vib
rant
an
d ac
tive
‘Par
ticip
atio
n Co
mm
unity
’
•D
efin
e sc
ope
of
parti
cipa
tion
com
mun
ity•
Impl
emen
t in
sect
ion
of
new
Bris
tol C
omm
unity
H
ealth
web
site
•Es
tabl
ish
outli
ne p
lan
for
parti
cipa
tion
com
mun
ity
foru
m
•Id
entif
y in
itial
lear
ning
an
d de
velo
pmen
t nee
ds
of p
atie
nts
and
care
rs•
Esta
blis
h le
arni
ng a
nd
deve
lopm
ent p
rogr
amm
e fo
r pat
ient
s an
d ca
rers
•Fi
rst m
eetin
g of
pa
rtici
patio
n co
mm
unity
Nov
embe
r 201
4
Janu
ary
2015
Apr
il 20
15
Febr
uary
- Ju
ly 2
015
Sept
embe
r 201
5
Oct
ober
201
5
•In
crea
se in
num
ber o
f pat
ient
s an
d ca
rers
regi
ster
ed in
par
ticip
atio
n co
mm
unity
•H
igh
prop
ortio
n of
pat
ient
s an
d ca
rers
feel
they
are
/ h
ave
been
gi
ven
the
oppo
rtuni
ty to
be
invo
lved
in
Bris
tol C
omm
unity
Hea
lth s
ervi
ces
•Pa
tient
s an
d ca
rers
repo
rt th
ey fe
el
supp
orte
d by
a tr
aini
ng p
rogr
amm
e pr
ovid
ed b
y Br
isto
l Com
mun
ity
Hea
lth th
at m
eets
thei
r nee
ds•
Best
-pra
ctic
e ex
ampl
es o
f pat
ient
an
d ca
rer i
nvol
vem
ent s
hare
d •
Initi
al m
eetin
g of
par
ticip
atio
n co
mm
unity
hel
d
4.3
Embe
d a
rolli
ng
prog
ram
me
of s
ervi
ce
focu
s gr
oups
to e
nsur
e th
at p
atie
nts
and
care
rs
have
the
oppo
rtuni
ty to
sh
ape
Bris
tol C
omm
unity
H
ealth
ser
vice
s
•Cr
eate
rolli
ng p
rogr
amm
e of
focu
s gr
oups
with
tim
etab
le a
gree
d ac
ross
se
rvic
es•
Crea
te a
focu
s gr
oup
tool
kit f
or s
ervi
ce
man
ager
s /
team
lead
ers
•Im
plem
enta
tion
Apr
il 20
15
May
201
5
June
201
5 on
war
ds
•Fo
cus
grou
ps h
eld
acro
ss a
ll ap
prop
riate
Bris
tol C
omm
unity
H
ealth
ser
vice
s w
ithin
2 y
ears
•H
igh
prop
ortio
n of
pat
ient
s an
d ca
rers
feel
they
are
/ h
ave
been
gi
ven
the
oppo
rtuni
ty to
be
invo
lved
in
Bris
tol C
omm
unity
Hea
lth s
ervi
ces
•Im
prov
ed p
atie
nt e
xper
ienc
e
4.4
Dev
elop
app
roac
hes
for i
nvol
vem
ent i
n st
rate
gic
prio
ritie
s.
•Q
ualit
y A
ccou
nt
enga
gem
ent.
•Re
inve
stm
ent
enga
gem
ent
•Se
rvic
e de
velo
pmen
t pr
iorit
ies
enga
gem
ent
Janu
ary
- Mar
ch
each
yea
r (fro
m
2015
)Ja
nuar
y - M
arch
ea
ch y
ear (
from
20
16)
Janu
ary
- Mar
ch
each
yea
r (fro
m
2016
)
•H
igh
prop
ortio
n of
pat
ient
s an
d ca
rers
feel
they
are
/ h
ave
been
gi
ven
the
oppo
rtuni
ty to
be
invo
lved
in
Bris
tol C
omm
unity
Hea
lth s
ervi
ces
•Im
prov
e pa
tient
exp
erie
nce
30
We
will
cre
ate
a vi
bran
t and
act
ive
‘Par
ticip
atio
n Co
mm
unity
’.
3131A
rea
Obj
ectiv
e Ta
skD
ueM
easu
res
of S
ucce
ss
5 –
Wor
k al
ongs
ide
volu
ntee
rs to
st
reng
then
the
care
w
e pr
ovid
e an
d ou
r bo
nds
to w
ith th
e co
mm
unity
5.1 H
arne
ss v
olun
teer
’s ab
ility
to s
uppo
rt an
d co
mm
unic
ate
with
pa
tient
s an
d ca
rers
•D
evel
op ro
le to
su
ppor
t pat
ient
s to
de
velo
p th
eir c
are
plan
s•
Dev
elop
role
to
rese
arch
the
barr
iers
fo
r pat
ient
s in
kn
owin
g ho
w to
co
ntac
t the
ir se
rvic
e•
Dev
elop
role
to
elic
it fe
edba
ck fr
om
patie
nts
and
care
rs
(ref 2
.2)
Apr
il 20
15
Aug
ust 2
015
June
201
5
•N
umbe
r of r
oles
dev
elop
ed
•N
umbe
r of v
olun
teer
s in
thes
e ro
les
•N
umbe
r of p
atie
nts
com
mun
icat
ed w
ith a
nd
supp
orte
d•
Qua
litat
ive
feed
back
fro
m
patie
nts
on th
e ex
tent
to w
hich
th
ey fe
el c
omm
unic
ated
with
and
su
ppor
ted
•Im
prov
ed p
ropo
rtion
of p
atie
nts
who
kno
w h
ow to
con
tact
thei
r se
rvic
e•
Equa
litie
s da
ta o
n pa
tient
fe
edba
ck s
how
s im
prov
emen
t fro
m s
eldo
m h
eard
gro
ups
5.2
Wor
k w
ith e
xter
nal
partn
ers
to e
nsur
e w
e ar
e co
llabo
ratin
g ef
fect
ivel
y w
ith th
e VC
S
•A
ttend
city
wid
e an
d re
gion
al v
olun
teer
ing
and
netw
orki
ng
mee
tings
•Ta
ke a
dvan
tage
of P
PE
enga
gem
ent e
vent
s to
sha
re k
now
ledg
e w
ith V
olun
tary
and
Co
mm
unity
Sec
tor
orga
nisa
tions
•Se
ek to
co-
deve
lop
volu
ntee
ring
role
s w
ith
exte
rnal
Vol
unta
ry
Sect
or O
rgan
isat
ions
Aim
to a
ttend
at l
east
one
m
eetin
g a
mon
th
On-
goin
g
At l
east
one
role
co-
owne
d ro
le d
evel
oped
by
Febr
uary
20
16
•N
umbe
r and
ext
ent o
f pro
activ
e pa
rtner
ship
s•
Qua
litat
ive
feed
back
from
pa
rtner
s an
d ot
her V
olun
tary
Se
ctor
org
anis
atio
ns o
n th
e ex
tent
to w
hich
they
feel
Bris
tol
Com
mun
ity H
ealth
is c
olla
bora
ting
in it
s vo
lunt
eerin
g w
ork
32Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
5.3
Prov
ide
all s
ervi
ce
man
ager
s w
ith th
e su
ppor
t the
y ne
ed to
de
velo
p vo
lunt
eerin
g
•D
evel
op b
riefin
gs
for m
anag
ers,
m
ade
avai
labl
e to
Re
crui
tmen
t Adv
iser
s,
to il
lust
rate
how
vo
lunt
eers
can
hel
p en
hanc
e se
rvic
es•
Run
a sh
ort s
erie
s of
w
orks
hops
in d
iffer
ent
loca
litie
s ar
ound
Br
isto
l to
supp
ort
man
ager
s to
dev
elop
vo
lunt
eerin
g ro
les
•W
ork
with
Hum
an
Reso
urce
s to
st
ream
line
and
inte
grat
e vo
lunt
eerin
g in
to th
eir e
xist
ing
syst
ems
Brie
fing
issu
ed to
HR
advi
sers
by
Janu
ary
2014
One
wor
ksho
p he
ld b
y D
ecem
ber 2
015
The
seco
nd h
eld
by M
arch
20
16
By S
epte
mbe
r 201
5
•N
umbe
r of n
ew s
ervi
ces
that
take
on
vol
unte
ers
•N
umbe
r of v
olun
teer
s re
crui
ted
to
thes
e ro
les
•Q
ualit
ativ
e fe
edba
ck fr
om
man
ager
s on
the
exte
nt to
whi
ch
they
feel
sup
porte
d in
set
ting
up
volu
ntee
ring
role
s
5.4
Ensu
re th
at w
e su
ppor
t all
our v
olun
teer
s to
mak
e pr
ogre
ss
tow
ards
thei
r goa
ls
•M
ake
all t
rain
ing
avai
labl
e to
vol
unte
ers
thro
ugh
the
Bris
tol
Com
mun
ity H
ealth
tra
inin
g sy
stem
(MLE
)•
Set u
p an
d m
aint
ain
a re
gula
r sur
vey
of a
ll vo
lunt
eers
to c
heck
th
at th
ey a
re m
akin
g pr
ogre
ss to
war
ds
thei
r goa
ls
All
volu
ntee
rs o
n M
LE
syst
em b
y Se
ptem
ber 2
014
All
volu
ntee
rs s
urve
yed
by
Mar
ch 2
015
and
half-
year
ly
ther
eafte
r
•Q
ualit
ativ
e fe
edba
ck fr
om
volu
ntee
rs o
n th
e ex
tent
to w
hich
th
ey fe
el s
uppo
rted
in m
ovin
g to
war
ds th
eir g
oals
•D
estin
atio
n of
vol
unte
ers
afte
r th
ey le
ave
Bris
tol C
omm
unity
H
ealth
3
32
33Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
5.3
Prov
ide
all s
ervi
ce
man
ager
s w
ith th
e su
ppor
t the
y ne
ed to
de
velo
p vo
lunt
eerin
g
•D
evel
op b
riefin
gs
for m
anag
ers,
m
ade
avai
labl
e to
Re
crui
tmen
t Adv
iser
s,
to il
lust
rate
how
vo
lunt
eers
can
hel
p en
hanc
e se
rvic
es•
Run
a sh
ort s
erie
s of
w
orks
hops
in d
iffer
ent
loca
litie
s ar
ound
Br
isto
l to
supp
ort
man
ager
s to
dev
elop
vo
lunt
eerin
g ro
les
•W
ork
with
Hum
an
Reso
urce
s to
st
ream
line
and
inte
grat
e vo
lunt
eerin
g in
to th
eir e
xist
ing
syst
ems
Brie
fing
issu
ed to
HR
advi
sers
by
Janu
ary
2014
One
wor
ksho
p he
ld b
y D
ecem
ber 2
015
The
seco
nd h
eld
by M
arch
20
16
By S
epte
mbe
r 201
5
•N
umbe
r of n
ew s
ervi
ces
that
take
on
vol
unte
ers
•N
umbe
r of v
olun
teer
s re
crui
ted
to
thes
e ro
les
•Q
ualit
ativ
e fe
edba
ck fr
om
man
ager
s on
the
exte
nt to
whi
ch
they
feel
sup
porte
d in
set
ting
up
volu
ntee
ring
role
s
5.4
Ensu
re th
at w
e su
ppor
t all
our v
olun
teer
s to
mak
e pr
ogre
ss
tow
ards
thei
r goa
ls
•M
ake
all t
rain
ing
avai
labl
e to
vol
unte
ers
thro
ugh
the
Bris
tol
Com
mun
ity H
ealth
tra
inin
g sy
stem
(MLE
)•
Set u
p an
d m
aint
ain
a re
gula
r sur
vey
of a
ll vo
lunt
eers
to c
heck
th
at th
ey a
re m
akin
g pr
ogre
ss to
war
ds
thei
r goa
ls
All
volu
ntee
rs o
n M
LE
syst
em b
y Se
ptem
ber 2
014
All
volu
ntee
rs s
urve
yed
by
Mar
ch 2
015
and
half-
year
ly
ther
eafte
r
•Q
ualit
ativ
e fe
edba
ck fr
om
volu
ntee
rs o
n th
e ex
tent
to w
hich
th
ey fe
el s
uppo
rted
in m
ovin
g to
war
ds th
eir g
oals
•D
estin
atio
n of
vol
unte
ers
afte
r th
ey le
ave
Bris
tol C
omm
unity
H
ealth
Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
5.5
Mak
e ou
r vol
unte
erin
g op
portu
nitie
s av
aila
ble
to
the
full
rang
e of
Bris
tol’s
pe
ople
•Re
sear
ch a
nd d
evel
op
spec
ific
chan
nels
for
mar
ketin
g ou
r rol
es to
th
e fu
ll ra
nge
of p
eopl
e in
Br
isto
l, es
peci
ally
cur
rent
ly
unde
rrep
rese
nted
gro
ups:
1. ov
er fi
fties
2.
pe
ople
with
dis
abili
ties
•Se
t up
equa
lity
train
ing
for a
ll Br
isto
l Com
mun
ity
Hea
lth v
olun
teer
s
Com
mun
icat
ion
stra
tegy
for r
each
ing
thes
e tw
o gr
oups
de
velo
ped
by
Nov
embe
r 201
4
All
exis
ting
volu
ntee
rs
to h
ave
gone
on
train
ing
by M
arch
20
15
•Ex
tent
to w
hich
Bris
tol C
omm
unity
H
ealth
’s ra
nge
of v
olun
teer
s m
atch
es th
e di
vers
ity o
f Bris
tol
•N
umbe
r of p
atie
nts,
ex-
patie
nts
and
thos
e w
ith d
isab
ilitie
s vo
lunt
eerin
g fo
r Bris
tol
Com
mun
ity H
ealth
6 - W
ork
colla
bora
tivel
y w
ith th
e VC
S
6.1 C
ontin
ue to
em
bed
our
com
mun
ity o
utre
ach
wor
k pr
ogra
mm
e
6.2
Act
ivel
y pu
rsue
join
t he
alth
care
pro
ject
s w
ith lo
cal v
olun
tary
an
d co
mm
unity
sec
tor
orga
nisa
tions
•Im
plem
ent 2
014/
15
com
mun
ity o
utre
ach
wor
k pr
ogra
mm
e •
Eval
uate
key
lear
ning
poi
nts
•D
evel
op 2
015/
16
com
mun
ity o
utre
ach
wor
k pr
ogra
mm
e •
Impl
emen
tatio
n
•Id
entif
y po
tent
ial
partn
ersh
ip a
rran
gem
ents
w
ith V
CS o
rgan
isat
ions
•Id
entif
y fu
ndin
g op
portu
nitie
s fro
m
natio
nal /
loca
l hea
lth
impr
ovem
ent o
rgan
isat
ions
/
com
mis
sion
ers
On-
goin
g
Mar
ch 2
015
Febr
uary
201
5
Apr
il 20
15 –
Mar
ch
2016
Ong
oing
•Po
sitiv
e fe
edba
ck fr
om in
divi
dual
s /
com
mun
ities
who
are
par
t of
pro
gram
me
in te
rms
of
awar
enes
s of
Bris
tol C
omm
unity
H
ealth
ser
vice
s /
who
to c
onta
ct•
Posi
tive
feed
back
from
VCS
org
s w
ho a
re p
art o
f pro
gram
me
•In
crea
sed
colla
bora
tion
betw
een
Bris
tol C
omm
unity
Hea
lth a
nd
VCS
33
3434
Are
aO
bjec
tive
Task
Due
Mea
sure
s of
Suc
cess
6.3
Crea
te a
com
mun
ity
heal
thca
re m
eetin
g fo
rum
with
the
loca
l vo
lunt
ary
and
com
mun
ity
sect
or
•Cr
eate
pro
posa
l do
cum
ent o
f co
mm
unity
hea
lthca
re
mee
ting
foru
m•
Shar
e pr
opos
al w
ith
VCS
/ VO
SCU
R to
test
•
Plan
/ h
old
first
m
eetin
g of
foru
m
Oct
ober
201
5
Dec
embe
r 201
5
Apr
il 20
16
•N
ew p
artn
ersh
ip o
ppor
tuni
ties
iden
tifie
d•
Best
-pra
ctic
e sh
ared
bet
wee
n VC
S /
Bris
tol C
omm
unity
Hea
lth w
hich
be
nefit
s pa
tient
s an
d ca
rers
Wor
k to
geth
er w
ith
patie
nts,
car
ers
and
the
wid
er p
ublic
to
deve
lop
serv
ices
aro
und
thei
r nee
ds.
