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Quality Issue Provider Action CCG Assurance

What Who When What Who When

Patient experience – PE Survey February 2017 – Key Messages

• Text messaging for inpatient (IP) surveys was piloted in April

2016.

• There have been 5,305 responses since April 2016

• This survey is a primary contributor to the public sector equality

duty assurance for the Trust.

• Equality data is being collected using the local monthly PE survey

and information looking at experience compared to protected

characteristic is available on our website.

(Source: Patient Experience Manager Buckinghamshire

Healthcare NHS Trust February2017)

Patient Experience – Local Survey February 2017

• In February 2017 there were 307 responses to the SMS IP survey

• 89% of patients surveyed said that the service was either good or excellent

• The rating for food has increased sharply as a result of the exclusion of the N/A responses from people for who food was not a part of the

experience.



Patient Experience-Friends and family Free Text – Feb 2017


Healthcare NHS Trust February 2017)

Patient Experience-Friends and family Performance – Aug- Feb 2017

(Source: Patient Experience Manager Buckinghamshire Healthcare

NHS Trust February 2017)

February 2017 - Results of proactive action for improved FFT Response

1. A&E response rate – 10%

2. IP response rate 23%

3. Maternity response rate 36%

Key Changes-

• PE manager now attends A&E governance Meeting, staff huddles, making FFT all inclusive for everybody.

• A&E Making use of volunteers A&E involving all grades of staff in the process



Patient Experience- IP Patient Survey Free Text –ve Feb 2017



Patient Experience- IP Patient Survey Free Text +ve Feb 2017



The tables above show thematic analysis of negative and positive free text received from the 307 IP surveys received in February 2017

The tables below show thematic analysis of negative and positive free text received from the FFT surveys received in February 2017



Patient Experience-PALS Themes 2016/17

October-December 2016/17 – PALS Top Issues

Analysis of the PALS data for February 2017 show a decrease in concerns raised in relation to delays and cancellations. This may reflect the decline

in winter pressures. There has been a slight increase in concerns raised about treatment and procedure across the Trust. The number of concerns

raised connected to behaviour and attitude of staff has decreased in February.

Learning and Actions to Address Key themes of PALS

The top 3 PALS concerns have remained the same in this reporting

period.

Delays/Cancellations

Information requests

Communication with relative or friend



Action Taken as a result of PALS Data – January/February 2017

Delays and Cancellations - Delays and cancellations have remained a recurring theme with the Trust exploring IT solutions to help mitigate

the causes of enquiries in this area. Furthermore, feedback relating to access is a core theme through complaints PALS, patient experience

data and friends and family. The access manager has explained that there are plans for modernisation of our Outpatient Department related

access processes. Progress is being made in the modernisation program proposals in relation to Electronic Referrals (ERS) however there

had been no funding made available to modernise Outpatients in the last 12 months. Plans are still on-going but nothing concrete is

established to date. The access manager has indicated that he does not think that modernisation will reduce clinic cancellations as this is an

operational issue.

Drive within primary care to increase GP referral rates via ERS - Yes, there is a target for Bucks CCGs to double their referral rate in

March 2017. We are working collaboratively with the CCGs and as part of that I can confirm that all routine services have always being

published to ERS and we have recently gone live with 2 two week wait services with more to follow.

Trust housekeeping exercise to ensure ERS is setup effectively - Ongoing and the project is due to be completed by the end of May

2017

Access- appointments & telephone access Electronic Outcome Form (ecO)- Electronic method of capturing clinician instructions relating to

an outpatient appointment. - Introduced to 80% of the Trust with an 70% completion rate currently. Successful 100% roll-out to all specialties

for the electronic outcome form. Current completion rate is approximately 80% of all appointments

Hybrid Mail – Hybrid mail is a secure and efficient mailing service that provides high quality added value, user friendly products and services

to enrich the experience of patients and provides a patient led process of communication.

Business case being updated; IT now in support of the proposal - Business case for hybrid mail has been resubmitted again with no decision

to date.

Firebreak Clinics – extra capacity clinics set up on a six to eight week basis to make sure all of our patients’ treatment plans are confined

within that time period. Each specialty to introduce ‘firebreak clinics’ to ensure that cancelled patients are not subject to excessive delays. No

firebreak clinics are set up as yet. - Ophthalmology Firebreak clinics to go live in Quarter 1 of 2017/18.

Behaviour and Attitude of staff

Behaviour & Attitude of staff and concerns highlighted about this matter have been rising since January 2016. The issue has also been

recorded by the PALS service in their role as single point of access, and has also featured in the free text feedback received relating to the

friends and family test. The cause for this is not confirmed but the incidents are often connected to telephone conversations or face to face

conversations about access to services or appointments. Actions taken so far include:

The PALS service conduct quarterly training sessions which include techniques related to managing difficult conversations.

The importance of staff attitude is further reinforced in the nursing preceptorship training

First impressions and communication is part of the patient experience presentation to the FY1&FY2 training and as part of new corporate

staff induction.

The importance of attitude and the perception of the patient is also being given in the HCA training given by the patient experience manager.

Source: Patient Experience Manager Buckinghamshire Healthcare NHS Trust February 2017



Patient experience-Complaints Performance

In February 2017 there were 35 formal complaints of which:

1. 24 were classified as 25 day complaints

2. 11 were classified as 40 day complaints (Jan 2017 -10)

Complaint Response Rates 25 day - The 25 day complaint

response rate for :

1. December 2016 the response rate was 88%.

2. January 2017 the response rate was 96%.

Complaint Response Rates 40 day- The complaints team track and

monitor 40 day complaints. These are complaints that are more

complex in nature and involve more than one division or organisation.

The forty day response rates where:

1. October 2016 - 50% (4 complaints)

2. November 2016 - 29% (14 complaints)

3. December 2016 - 63% (8 complaints)

Patient Experience-Complaints QIP (Quality Improvement Plan

2016/17)

1. 85% of complaints responded to within 25 working days

2. 50% reduction in reopened complaints 2014/15 against 2015/16

3. No complaints to take over 90 days to respond to



Complaints Process Changes – reporting update

An executive intervention has led to changes to the complaints process

and a summary of the results of the effects of the changes has been

reported to the executive management team.



Learning and Actions to Address Key themes of complaints

The top 3 complaints concerns in February 2017 reporting period.

• Communication Issues

• Behaviour & Attitude of staff – staff being described as curt or rude

• Treatment or procedure



Patient Experience-Learning & Improvement from Feedback Feb 2017

To help us learn from the way we handle complaints a complaints group that uses the Trust Chair, a NED and the complaints manager was set

up to ensure we learn from our complaints. A random selection of complaints are reviewed bi-monthly synchronised with the dates for the Trust

quality meeting. The complaint process and responses are reviewed for quality.

Key improvement messages February 2017 Lessons to be learned PE Survey

Word cloud for experience of our IP services for inpatients Word Cloud for experience of visiting our A&E February 2017

in February 2017. (1) Care (2) Friendly (3) Helpful Staff (1) Staff (2) Waiting (3) Care

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