shetland nhs board · 2016. 6. 16. · clinical governance committee has oversight of the quality...

Board Paper 2016/27

Shetland NHS Board Meeting: Shetland NHS Board

Paper Title:

Quality Report – Update on Progress

Date: 13th June 2016

Author: Kathleen Carolan Job Title: Director of Nursing & Acute Services

Decision / Action required by meeting:

The Board is asked to note the progress made to date with the delivery of the action plan and other associated work which focuses on effectiveness, patient safety and service standards/care quality.

High Level Summary:

The report includes:

A summary of the work undertaken to date in response to the ‘quality ambitions’ described in the Strategy;

Our performance against a range of quality indicators (locally determined, national collaborative and national patient safety measures)

When available, feedback gathered from patients and carers – along with improvement plans

Overview of complaint management, themes and outcomes

Key Issues for attention of meeting:

Noting current performance as shown in the quality dashboard

Impact of item / issues on:

Patient Safety:

Yes – focus of the quality scorecard is on evidencing safe practice

Staffing/Workforce: Yes – focus of the review is on evidencing effective workforce planning to deliver care, professionalism and behaviours which support person centred care

Finance/Resource:

YES – in terms of the progress and slippage within work streams as well as corporate risk associated with service delivery and development

Shetland Partnership / Joint Working

Equality & Diversity:

Legal Issues:

Previously considered by:

Committee/Group:

Clinical Governance Committee has oversight of the quality scorecard performance and gathering feedback framework

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PROGRESS ON LOCAL QUALITY STRATEGY IMPLEMENTATION PROGRESS ON THE DEVELOPMENT OF A PATIENT EXPERIENCE

FRAMEWORK The Board supported a formal proposal to develop an approach (or framework) that would enable us to bring together the various systems that are in place to gather patient experiences and feedback so that we can demonstrate clearly how feedback is being used to improve patient care. Progress continues and since April 2016 the following actions have been taken:

The PPF hosted an open forum meeting in June 2016 with a focus on self directed support, patient travel and initiatives to support people who are returning home following admission to hospital (e.g. Take Home service provided by the RVS).

We continue to promote Patient Opinion, inpatient surveys, outpatient surveys and other ways of gathering feedback.

The Patient Focus Public Involvement (PFPI) Steering Group contributed to the content set out in the annual complaints report (also presented to the Board in June 2016)

NHS Shetland participated in the “What Matters to You?” national event in June 2016, with various activities around Shetland to promote the feedback mechanisms we have in place for Health and Social Care Services.

The SHC continues to support staff to gather feedback from a wide range of patients and service users. http://www.shb.scot.nhs.uk/board/pfpi/feedbackposters.asp

The first national survey of cancer patients in Scotland was launched on Wednesday 7th October 2015. The survey results which were published in June 2016 (see an abridged set of results in Appendix C) will help us to better understand people’s experience of cancer care in Scotland so that we can make sure that our cancer care meets the needs and expectations of patients. The survey was run in partnership with Macmillan Cancer Support and included respondents from Shetland. Due to the small number

http://www.shb.scot.nhs.uk/board/pfpi/feedbackposters.asp

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of respondents, data for the Island Boards has been aggregated and shared with Health Boards to inform local practice. We will discuss the results of the national survey and agree a local interpretation of the feedback through the Cancer Lead Team. The full report can be found at the following link: http://www.gov.scot/cancersurvey

The results of the national survey of patient’s experiences of

primary care services have been recently published. The results

are being reviewed locally (across Primary Care and at Health

Centre level). The results are largely positive, but some work will

be undertaken specifically to look at managing adverse events and

continuity of care (which we not rated as positively as in previous

survey responses). The survey does not gather information

relating to patient experiences where the practitioner was an

advanced nurse rather than a GP. Results for Shetland are shown

in Appendix D. The full results for the national reports can be found

at the following link:

http://www.hace15.quality-health.co.uk/index.php/reports/

http://www.gov.scot/cancersurvey

http://www.hace15.quality-health.co.uk/index.php/reports/

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FUTURE PLANS FOR THE DEVELOPMENT OF OUR QUALITY FRAMEWORK

The quality scorecard continues to evolve and include new measures for improvement. The quality scorecard can be found in Appendix B. Engagement with staff continues as part of the work to shape redesign plans for 2016-17, including input and advice from professional committees. Specific redesign programmes are now starting to take shape and Area Partnership Forum (APF) and Area Clinical Forum (ACF) are actively involved in commenting or communication plans, risk assessments and project outlines. This includes service redesign e.g. Public Health arrangements and medical imaging services redesign. Specific redesign projects are now starting to be developed and implemented and progress will be reported through the Board Efficiency and Redesign programme to the Strategy and Redesign Committee. The programme has been refreshed for 2016-17 and the focus has shifted to a number of key areas of service delivery – including hospital pathways, community based services and prescribing medicines. We are in the process of refining these plans in line with the joint strategic plans with a focus on increasing our use of telemedicine and reducing unnecessary patient travel. An Efficiency Board is now well established to support the redesign programmes across the organisation to ensure that there is sufficient capacity and pace to complete project scoping and implementation in 2016-17. Progress reports are received by the Strategy & Redesign Committee. We are in the second stage of implementing the ‘iMatter’ staff experience programme across the organisation, under the direction of the Area Partnership Forum (APF). The Acute and Specialist Services Directorate are in the process of implementing ‘imatters’ action plans with teams. The third phase of the programme is about to commence which includes Community based services/teams.

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POGRESS ON LOCAL QUALITY STRATEGY IMPLEMENTATION FOR INFORMATION AND NOTING

Local Engagement and Implementation of the Quality Strategy

Ambitions The Older Peoples Care in Acute Hospitals (OPAH) self assessment has been refreshed and was April 2016. Many of the quality measures associated with the monitoring of older peoples care are shown in the Quality Scorecard in Appendix B. In May 2016, we completed a new self assessment as part of the Healthcare Environment Inspectorate (HEI) programme which shows the governance arrangements in place for infection prevention in Shetland against the revised standards. Considerable work has also been undertaken to review the infection control manual and move our resources over to the national infection control procedures and website. A new Public Health rota has also been put in place to support the Public Health Consultants who are working in a regional network to provide public health cover for the Island Boards. Various members of the infection control team are contributing to this new model. NHS Shetland participated in the CEL 30 (2012) peer review of Systemic Anti-Cancer Therapy (SACT) standards in May 2016. This is a regional programme of external review to assess progress with the implementation of the standards, set out in the CEL. The peer review team (which included senior clinicians from across the region) commended NHS Shetland on the work that has been undertaken to work towards full compliance with CEL 30 (2012) which is reflected in the local report. The action plan arising from the peer review is being taken forward by the Cancer Lead Team.

A short life working group has been established to review medical staffing. A key component of this work is to identify ways of providing sustainable posts and rotas for junior doctors in training – we have advertised two posts for Clinical Development Fellows in conjunction with NHS Education for Scotland (NES). We are actively reviewing the current model to ensure that we provide the best possible opportunities for attracting doctors to our learning placements. NHS Shetland participated in a national event (and live Twitter chat) to contribute to the development of the ‘vision for nursing in Scotland’ at the end of April 2016. NHS Shetland will also be hosting a regional event

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to enable students and qualified nurses to participate in shaping the vision, particularly from a remote and rural perspective. The Nursing & Midwifery Council (NMC) launched its revalidation model in April 2016 – all nurses working for NHS Shetland, who were due to revalidate between April and June 2016 have completed the process successfully. Information resources and local training will continue to be provided throughout 2016-17 to ensure that appropriate support is in place for nurses revalidating for the first time.

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Appendix A Summary of complaints in 2016/17 and update on cases taken to the Scottish Public Services Ombudsman

A summary of formal complaint activity from 1 April 2016 to 9 June 2016 is set out below. Formal complaint activity in 2015/16 is provided for comparative purposes. Further detail, including the actions taken as a result of each formal complaint from 1 April 2016 to 9 June 2016 is provided. Details of all types of feedback and complaints and associated actions and learning for 2015/16 is included in the Annual Feedback and Complaints Report which is available on the Board’s website at http://www.shb.scot.nhs.uk/board/feedback.asp. From 1 April 2016 to 9 June 2016 the Board received a total of 15 formal complaints. These are now broken down into directorates rather than the previous distinction between hospital and community services. We have also handled 20 patient feedback contacts. Please note that the summary does not include independent contractor General Practices, who are responsible for their own local resolution of complaints following national guidance, except where we have acted as a facilitator in the complaint resolution. Complaints against other Health Boards or Special Health Boards, e.g. the Scottish Ambulance Service, are also excluded. The report also now includes a summary of the cases taken to the Scottish Public Services Ombudsman in 2015/16 and 2016/17 and the progress against any recommendations made.

2016/17 Quarter 1 (to date) Quarter 2 Quarter 3 Quarter 4 Total

1.4.16 – 09.06.16 01.07.16 – 30.09.16 01.10.16 – 31.12.16 01.01.17 – 31.03.17

Directorate of Nursing and Acute Services

4 4

Directorate of Community Health and Social Care

9 9

Acute & Community 1 1

Board HQ Services 1 1

Other 0 0

Withdrawn 0 0

Total 15 15

Outcome Upheld: 3 Partly upheld: 2 Not upheld: 3 Open: 7

http://www.shb.scot.nhs.uk/board/feedback.asp

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2015/16 Quarter 1 Quarter 2 Quarter 3 Quarter 4 Total

1.4.15 – 30.06.15 01.07.15 – 30.09.15 01.10.15 – 31.12.15 01.01.16 – 31.03.16

Hospital Services 10 2 4 7 23

Community Services 6 6 5 2 19

Hospital & Community 0 3 1 2 6

Board HQ Services 0 0 2 0 2

Other 0 0 0 0 0

Withdrawn 0 0 0 0 0

Total 16 11 12 11 50

Outcome Upheld: 7 Partly upheld: 7 Not upheld: 2

Upheld: 4 Partly upheld: 2 Not upheld: 5

Upheld: 7 Partly upheld: 4 Not upheld: 1

Upheld: 1 Partly upheld: 7 Not upheld: 2 Open: 1

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Complaints received 1 April 2016 to 9 June 2016 Summary Staff

Group(s) <= 20 wkg days

If not, why Outcome

Actions

1 Poor treatment and no follow up plan

CMHS N Slight delay in final sign off

Upheld Medical reasoning confirmed as appropriate, however

unmet need re psychological therapy support. Future

resources explained.

Recommendation of contact with CPN to further support

self management

2 Complaint handling Board HQ/ CMHS

Y Upheld Apology given and explanation of why a previous

complaint had not been handled satisfactorily.

Commitment given to address this as quickly as

possible and assurances sought from service about

ability to respond appropriately

3 Delay in receiving prescription medicines

LHC/ Pharmacy

Y Upheld Reasons for delay explained, however the prescription

was issued on the day as requested

Process audited to try and determine what had

happened to the original prescription

4 Physiotherapy referral Physio Y Not upheld Satisfied referral was triaged appropriately

5 Communication and diagnosis

CMHS N Unplanned staff absence

Open

6 Medication concern, communication and diagnosis

CMHS N Unplanned staff absence

Open

7 Staff attitude Consultant N Slight delay in final sign off

Partly upheld Meeting arranged between complainant and consultant,

facilitated by Medical Director. Unable to resolve

difference of opinion

Miscommunication regarding patient escort explained

and apology offered

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8 Delay in operation date GBH/GJNH Y Not upheld Slight delay owing to technical error at GJNH however

waiting time for operation within target

9 GP on call did not visit after advised they would by NHS24

OOH GP Y Partly upheld Apology offered that GP had spoken with relative rather

than patient (which would have been possible had they

made a home visit), however at the point the decision

was made there was no additional clinical information to

warrant a home visit (condition had been assessed the

previous day)

10 Poor care and failure to x-ray and diagnose fracture

LHC Y Not upheld Clinical advice and decision making found to be

reasonable over period in question

Treatment would not differ despite the later confirmation

of a fracture

11 Change to diagnosis, lack of support available

CMHS Open

12 Dissatisfaction with therapist

AHP Open

13 Junior doctor and consultant did not act on GP request

A&E Open

14 Poor attitude of staff during care

Ward 3 Open

15 Lack of support and failure to transition correctly between services

CAMHS / CMHS

Open

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Cases escalated to the Scottish Public Services Ombudsman from 1 April 2015 to 9 June 2016 Our complaint reference

Summary Outcome notification date

Outcome Recommendations (operational oversight by JGG)

Action owner

Completion/Evidence

2014/15_05 Poor dental treatment 26.10.15 Not upheld No recommendations

2014/15_26 Failure to diagnose a DVT Open

2014/15_43 Poor dental treatment 02.03.16 Not upheld 1. Board to introduce a process

for written consent for the

type of procedure, evidencing

discussion of risks

2. Board to give consideration to

producing an appropriate

local patient information

leaflet for the type of

procedure

Dental Director

Requested response to SPSO by 27.04.16 - COMPLETE Letter and evidence sent to SPSO on 27.04.16, including two existing patient information leaflets on having a tooth removed and post extraction care, along with three new pieces of documentation that have now been shared with dental staff:

1. Removal of wisdom

teeth – patient

information leaflet

2. Protocol for MOS

consent

3. MOS consent form

SPSO satisfied with actions taken

2015/16_15 Patient did not receive adequate physiotherapy treatment/advice

10.03.16 Not upheld 1. Physio to provide both verbal

and written advice re wound

care

2. Operation consent form to

include complex regional pain

syndrome as a risk of upper

limb surgery

Head of Physio Medical Director

Generalist physio skills locally which differ to specialist hand physios who will often have an extended role re wound care. Physio will however develop a general information sheet for care following the specific surgery Medical Director action to approach other Boards about the forms they use and adapt these for local use. Admin capacity to be determined, however this will be kept under

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Our complaint reference

Summary Outcome notification date

Outcome Recommendations (operational oversight by JGG)

Action owner

Completion/Evidence

review. Intention to streamline the approval process for procedure specific consent forms

2015/16_38 Failure to diagnose and treat in A&E

09.12.16 Not upheld No recommendations identified by SPSO beyond the learning points from the Board’s perspective

2015/16_03 Failure to follow child protection procedures

Open

2015/16_39 Poor clinical treatment and inappropriate discharge

Open

2015/16_45 Access to gynaecology appointment

03.06.16 Will not investigate

Appendix B NHS Shetland Quality Scorecard June 2016 (Board Report)

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CURRENT PREVIOUS END TARGET Comments

Source Description Report Period Perf Period Perf Traffic vs Last Traj. Date Value

T - Treatment

BSC16 Quarterly Hospital Standardised Mortality Ratios (HSMR) (count)

Q 2015

Oct-Dec 1.13

2015 Jul-Sep

0.77 R ↓ 1 2015-03 1 Provisional data. Small number variation. Rate well within expected levels.

T15a

All people newly diagnosed with dementia will have a minimum of a year's worth of post-diagnostic support coordinated by a link worker, including the building of a person-centred support plan (percentage)

M 2016 Mar

100 2015 Dec

100 G → 100 2016-04 100

ISD are having problems with how they record & measure our data. They are going to be making changes to the process in the near future. T15a is not currently being measured as a target at national level. We *offer* the link worker to everyone newly diagnosed & therefore we meet the target (understandably, not everyone wants to take up the offer). See T15b for details of our balancing measure.

T15b

Number of people with newly diagnosed dementia who take up the offer of post diagnostic support (ie have an active link worker) (percentage)

M 2016 Apr 45.3 2016 Jan

46.3 R ↓ 50 2016-04 50

58 of 123 cases. (Excludes those who have moved away, died or have no coding.) Continuing to promote the value of having this support to all patients at point of diagnosis, but it is down to individual choice as to whether they take up the offer.

P – Patient Experience Outcome Measures

CE01a % of patients who say they have had a positive care experience on Ward 3 (percentage)

M 2016 Apr 100 2016 Jan

97 G ↑ 90 2016-03 90

CE01b % of patients who say they have had a positive care experience on Ward 1 (percentage)

M 2016 Apr 100 2016 Jan

83 G ↑ 90 2016-03 90

CE02a % of people who say they got the outcome (or care support) they expected and needed on Ward 3 (percentage)

M 2016 Apr 100 2016 Jan

97 G ↑ 90 2016-03 90

CE02b % of people who say they got the outcome (or care support) they expected and needed on Ward 1 (percentage)

M 2016 Apr 100 2016 Jan

100 G → 90 2016-03 90

MD01a What matters to you - % people who say we took account of things important to them whilst they were in hospital (Ward 3) (%)

M 2016 Apr 100 2016 Jan

100 G → 90 2016-03 90


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MD01b

What matters to you - % of people who say we took account of the things that were important to them whilst they were in hospital (Ward 1) (percentage)

M 2016 Apr 100 2016 Jan

100 G → 90 2016-03 90

MD02a

What matters to you % of people who say we took account of the people who were important to them and how much they wanted to be involved in care/treatment (Ward 3) (percentage)

M 2016 Apr 100 2016 Jan

100 G → 90 2016-03 90

MD02b

What matters to you % of people who say we took account of the people who were important to them and how much they wanted to be involved in care/treatment (Ward 1) (percentage)

M 2016 Apr 100 2016 Jan

100 G → 90 2016-03 90

MD03a

What matters to you % of people who say that they have all the information they needed to help them make decisions about their care/treatment (Ward 3) (percentage)

M 2016 Apr 100 2016 Jan

97 G ↑ 90 2016-03 90

MD03b

What matters to you % of people who say that they have all the information they needed to help them make decisions about their care/treatment (Ward 1) (percentage)

M 2016 Apr 100 2016 Jan

83 G ↑ 90 2016-03 90

MD04a What matters to you % of people who say that staff took account of their personal needs and preferences (Ward 3) (percentage)

M 2016 Apr 100 2016 Jan

93 G ↑ 90 2016-03 90

MD04b What matters to you % of people who say that staff took account of their personal needs and preferences (Ward 1) (percentage)

M 2016 Apr 100 2016 Jan

83 G ↑ 90 2016-03 90

S - Service & Quality Improvement Programmes – Measurement & Performance

CAUTI - CN 01

% Compliance - Catheter Record in Care Plan (Community Nursing) (percentage)

M 2016 Feb

100 2015 Nov

100 G → 95 2015-12 95 9/9 records compliant Next audit November 2016.

CAUTI - CN 02

% Compliance - Urinary Catheter Insertion Checklist completed correctly (Community Nursing) (percentage)

M 2016 Feb

100 2015 Nov

100 G → 95 2015-12 95 Next audit November 2016.

CAUTI - CN 03

% Patients that had Catheter Care Leaflets available(Community Nursing) (percentage)

M 2016 Feb

100 2015 Nov


CAUTI - CN 04

CAUTI Rate per number of catheters inserted (Community Nursing) (percentage)

M 2016 Feb

0 2015 Nov


CAUTI - CN 05

Number of reported CAUTIs within 10 days of catheter insertion (Community Nursing) (count)

M 2016 Feb

0 2015 Nov



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CAUTI P1 - Ronas

Percentage compliance with Urinary Catheter Insertion bundle (Ronas) (percentage)

M 2016 Apr 100 2015 Dec

100 G → 95 2015-12 95

CAUTI P1 - W3

Percentage compliance with Urinary Catheter Insertion bundle (Ward 3) (percentage)

M 2016 Apr 100 2016 Mar

100 G → 95 2014-12 95

CAUTI P2 - Ronas

Percentage compliance with Urinary Catheter Maintenance Bundle (Ronas) (percentage)

M 2016 Apr 100 2016 Jan

100 G → 95 2015-12 95 April 2016 - 15/15 measures compliant (3 patients audited)

CAUTIO1 The number of new CAUTI developed in the last month (count)

M 2016 Apr 1 2016 Feb

0 R ↓ 0 2014-12 0 Patient developed an infection following treatment out with Shetland

CAUTIO2a CAUTI rate per catheter days (percentage) M 2016 Apr 1 2016 Feb

0 R ↓ 0 2014-12 0 1 CAUTI - total catheter days 129.

CAUTIP1 -W1 Percentage compliance with Urinary Catheter Insertion bundle (Ward 1) (percentage)

M 2016 Mar

100 2015 Dec

50 G ↑ 95 2014-12 95

No eligible patients on Ward 1 in April 2016 - catheters inserted elsewhere. 3/3 patients audited (March 2016).

CAUTIP2 - W1

Percentage compliance with Urinary Catheter Maintenance Bundle (Ward 1) (percentage)

M 2016 Apr 100 2016 Mar

100 G → 95 2014-12 95 April 2016 - 10/10 measures compliant (2 patients audited).

CCB1 Average length of stay for critical care patients discharged per month (days)

M 2016 Apr 4 2016 Jan

1.6 R ↓ 2 2014-12 2

CCO3 Days between a central line bloodstream infection (days)

M 2016 Apr 2811 2016 Jan

2721 G ↑ 300 2011-03 300

CCO5 Days between Staph. aureus Bacteraemias (ICU) (days)

M 2016 Apr 3586 2016 Jan

3496 G ↑ 300 2011-03 300

CCO9 Days between a C. Difficile associated disease occurence (days)

M 2016 Apr 3586 2016 Jan

3496 G ↑ 300 2011-03 300

CCP3 Compliance with central line insertion bundle. (percentage)

M 2016 Apr 100 2016 Jan

100 G → 95 2011-03 100

CCP5 Percentage achievement of multi-disciplinary rounds (MDR) (percentage)

M 2016 Apr 100 2016 Jan

100 G → 95 2011-03 95

CCP6 Percentage achievement of MDR and daily goals (percentage)

M 2016 Apr 100 2016 Jan

100 G → 95 2011-03 95

SSIS1 Percentage of cases where an infection is identified post C section (percentage)

Q 2016

Jan-Mar 1

2015 Oct-Dec

0 R ↑ 0 2015-04 0 8 procedures were carried out and one infection identified. Full root cause analysis undertaken.

SSIS2 Percentage of patients developing an infection post hip fracture (percentage)

Q 2016

Jan-Mar 0

2015 Oct-Dec

1 G ↓ 0 2015-04 0

SSP1 SEPSIS - Documented SIRS Score (percentage)

M 2016 Apr 100 2016 Feb

100 G → 95 2014-12 95

SSP5 SEPSIS - IV antibiotics < 1 hour (percentage) M 2016 Apr 100 2016 Feb

100 G → 95 2014-12 95


Page 4 of 10

SSP7 SEPSIS - Lactate measured < 1 hour (percentage)

M 2016 Apr 0 2016 Feb

33 R ↓ 95 2014-12 95 No lactate measured (0/1 patients) – but would not have changed management or outcome.

SSP9 SEPSIS Six performed < 1 hour (percentage) M 2016 Apr 0 2016 Feb

33 R ↓ 95 2014-12 95

5 out of 6 of the Sepsis 6 100% compliant. No lactate measured (0/1 patients) – but would not have changed management or outcome.

SSP10 SEPSIS - Antibiotic choice compliance (percentage)

M 2016 Apr 100 2016 Feb

100 G → 95 2014-12 95

GWP10 Percentage compliance with the PVC bundle (percentage)

M 2016 Apr 100 2016 Mar

100 G → 95 2011-03 95 Sample size = 5 Ward 3 patients.

POP1 Percent of eligible surgical patients receiving DVT prophylaxis (percentage)

M 2016 Mar

100 2016 Jan

100 G → 95 2011-03 95 9 patient notes audited in March 2016.

SI1 Hand Hygiene Audit Compliance (percentage) M 2016 Mar

98.8 2015 Dec

98.5 G ↑ 95 2011-03 95 Now collecting data on a quarterly basis due to continued high level of compliance.

SI2 Cleaning Specification Audit Compliance (percentage)

Q 2016

Jan-Mar 93.92

2015 Oct-Dec

93.73 G ↑ 90 2016-03 90

DP02 Number of Cardiac arrests per 1,000 discharges (rate)

M 2016 Mar

0 2016 Feb

0 G → 0 2014-12 0

GWO1 Crash call rate per 1000 discharges (number of crash calls/total number of deaths + live discharges x 1000) (rate)

M 2015 Mar

0 2016 Feb

0 G → 5.66 2011-03 0

LSP1 % of Patient Safety Conversations Completed (3 expected each quarter) (percentage)

Q 2016

Jan-Mar 67

2015 Oct-Dec

33 R ↑ 100 2016-03 100

2 out of 3 patient safety conversations took place in this quarter - Day Surgery in January, Orthotics in March. The conversation scheduled for February in Ronas Ward had to be postponed due to operational reasons. Patient safety conversations took place in April and May 2016.

SPSPF01b1 Number of falls recorded each month - Ward 1 (count)

M 2016 Apr 0 2016 Mar

0 G → 0 2014-12 0

SPSPF01b3 Number of falls recorded each month - Ward 3 (count)

M 2016 Apr 1 2016 Feb

2 R ↑ 0 2014-12 0 No avoidable harm identified as a result of patient falls in hospital during this audit cycle.

SPSPF01bR Number of falls recorded each month - Ronas (count)

M 2016 Apr 1 2016 Mar

0 R ↓ 0 2014-12 0 No avoidable harm identified as a result of patient falls in hospital during this audit cycle.

SPSPF02b1 Number of falls with harm - Ward 1 (count) M 2016 Apr 0 2016 Mar

0 G → 0 2014-12 0


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SPSPF02b3 Number of falls with harm - Ward 3 (count) M 2016 Apr 0 2016 Feb

0 G → 0 2014-12 0

SPSPF02bR Number of falls with harm - Ronas (count) M 2016 Apr 0 2016 Mar

0 G → 0 2014-12 0

SPSPPU1 Pressure ulcers - incident cases in last calendar month Ward 1 (count)

M 2016 Apr 0 2016 Mar

0 G → 0 2012-10 0

SPSPPU2 Pressure ulcer - prevalence cases on Ward 1 in the calendar month (count)

M 2016 Apr 1 2016 Mar

2 R ↑ 0 2012-10 0 Patient admitted from the community with a pressure ulcer.

SPSPPU3 Pressure ulcer - days between pressure ulcers developed on the ward. Ward 1 (count)

M 2016 Apr 662 2016 Mar

630 G ↑ 300 2016-03 365

SPSPPU4 Pressure ulcer - incident cases on Ward 3 during the calendar month. (count)

M 2016 Apr 0 2016 Feb

0 G → 0 2012-10 0

SPSPPU5 Pressure ulcers - prevalence cases on Ward 3 in the calendar month (count)

M 2016 Apr 0 2016 Feb

0 G → 0 2012-10 0

SPSPPU6 Pressure ulcers - days in between pressure ulcers on Ward 3 (count)

M 2016 Apr 388 2016 Feb

327 G ↑ 300 2016-03 365

SPSPPU7 Pressure ulcer - incident cases on Ronas during the calendar month. (percentage)

M 2016 Apr 0 2016 Mar

0 G → 0 2012-10 0

SPSPPU8 Pressure ulcers - prevalence cases on Ronas in the calendar month (count)

M 2016 Apr 0 2016 Mar

0 G → 0 2012-10 0

SPSPPU9 Pressure ulcers - days in between pressure ulcers on Ronas ward. (count)

M 2016 Apr 511 2016 Feb

481 G ↑ 300 2016-03 365

SPSI 02 % of patients discharged from acute care without any of the combined specified harms (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2015-12 95

MM-MD (W3) Medicines Management - Missed Doses (W3) (percentage)

M 2016 Apr 0.6 2016 Mar

0.3 G ↓ 1 2015-03 0

MMP1a Percent of patients with medication reconciliation performed on admission (percentage)

M 2016 Feb

75 2016 Jan

55 G ↑ 75 2016-12 75

MMP1b Percent of patients with medication reconciliation performed on discharge (percentage)

M 2016 Feb

50 2016 Jan

74 R ↓ 75 2016-12 75

Of the 16 eligible cases, 8 records were not completed appropriately – this will be picked up as part of the project junior doctors are undertaking to review medicines whilst patients are in hospital.

Patient Safety Programme – Maternity & Children Workstream


Page 6 of 10

SP1 % compliance with the newborn screening bundle (percentage)

M 2016 Feb

83 2015 Dec

20 R ↑ 100 2015-12 95 One blood sample taken was not sufficient for analysis.

HRMGP1a % compliance with gentamicin bundle (percentage)

M 2016 Feb

0 2015 Dec

0 G → 100 2015-12 100 No ill neonates.

ILP2i % compliance with peripheral vascular catheter (PVC) insertion bundle (percentage)

M 2016 Feb

0 2015 Dec

100 G → 100 2015-12 95 No ill neonates.

MB01 Maternity - % of normothermic newborn babies at the point of discharge from labour suite (percentage)

M 2016 Jan

100 2015 Dec

100 G → 95 2014-12 95

MO01 Rate of stillbirths (per 1,000 births) (rate) M 2016 Feb

0 2015 Dec

0 G → 4 2014-12 4

MO01b Days between stillbirths (count) M 2016 Feb

771 2015 Dec

742 G ↑ 300 2015-06 300

MO02 Rate of neonatal deaths (per 1,000 live births) (rate)

M 2016 Feb

0 2015 Dec

0 G → 2.21 2014-12 2.21

MO03 Rate of severe post-partum haemorrhages (rate)

M 2016 Feb

0 2015 Dec

0 G → 0 2014-12 0

MO04 % of non-medically indicated deliveries prior to 39 weeks gestation (percentage)

M 2016 Feb

0 2015 Dec

0 G → 0 2014-12 0

MP01 % of pregnant women offered CO monitoring at booking (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2014-12 95

MP02

% of pregnant women with a CO level > 4 ppm (or who say they are current or recent smokers) that are referred to smoking cessation services (percentage)

M 2016 Feb

100 2015 Dec

0 G → 95 2014-12 95 One patient.

MP03 % of pregnant women that continue to smoke who are provided with a tailored package of antenatal care (percentage)

M 2016 Feb

0 2015 Dec

0 G → 95 2015-03 95 No eligible patients admitted during this reference period.

MP04 % of birth plans signed and dated by the woman and midwife (percentage)

M 2016 Feb

67 2015 Dec

100 R ↓ 95 2014-12 95 Two birth plans not signed.

MP05 Number of safety walkrounds (Maternity) (count)

M 2016 Feb

4 2015 Dec

4 G → 4 2014-12 4

MP06 Maternity safety walk rounds - % of actionable items being completed each month (percentage)

M 2016 Feb

100 2015 Dec

100 G → 100 2014-12 100

MP08 Maternity - % compliance with daily safety brief bundle (percentage)

M 2016 Feb

97 2015 Dec

100 G ↓ 95 2014-12 95 One form not complete.

MP08a % compliance with daily safety brief (percentage)

M 2016 Feb

97 2015 Dec

100 G ↓ 95 2015-03 95


Page 7 of 10

MP09 Maternity - % compliance with surgical briefing (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2014-12 95

MP10 Maternity - % of exchanges that use a high quality SBAR (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2014-12 95

MP12 % compliance with team huddles (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2014-12 95

MP13 Maternity - % compliance with the MEWS bundle (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2014-12 95

MP14

Maternity - % of observations identified as at risk that have appropriate interventions undertaken in terms of their management as categorised by MEWS (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2014-12 95

MP15 Maternity - % compliance with the sepsis 6 bundle (percentage)

M 2016 Feb

0 2015 Dec

0 G → 95 2014-12 95 No eligible patients with sepsis admitted during this reference period.

MP16 Maternity - % compliance with the PPH prevention bundle (percentage)

M 2016 Feb

83 2015 Dec

80 R ↑ 95 2014-12 95 One form not complete.

MP17 % compliance with the PPH management bundle (percentage)

M 2016 Feb

0 2015 Dec

0 G → 95 2014-12 95 No eligible patients with PPH admitted during this reference period.

MP18 Maternity - % of women with a documented discussion regarding fetal movements (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2014-12 95

MP20 % compliance with VTE bundle (Maternity) (percentage)

M 2016 Feb

0 2015 Dec

20 R ↓ 95 2015-03 95 Antenatal form remains under discussion.

MP21 % of Maternity staff trained in SBAR (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2014-12 95

MP22 % of relevant Maternity staff trained to use CO monitors (percentage)

M 2016 Feb

100 2015 Dec

100 G → 95 2014-12 95

NO1 % of infants discharged to home or postnatal wards on breast milk (percentage)

M 2016 Feb

67 2015 Dec

60 R ↑ 75 2015-12 75 2/6 babies were not fed on breast milk.

UD01 % of infants receiving appropriate intervention(s) for deterioration (percentage)

M 2016 Feb

0 2015 Dec

100 G → 95 2015-12 95 No ill neonates.

UDP2 % of 'at risk' infants being cared for using appropriate pathway (percentage)

M 2016 Feb

100 2015 Dec

0 G → 95 2015-12 95


Page 8 of 10

Older Peoples Improvement Programme & Review of Care Standards in Hospital M 2014 Nov 67 2014 Oct 89 R ↓ 95 2014-12 95

OPAH DEL01-3

Delirium Screening Compliance - Ward 3 (percentage)

M 2016 Apr 100 2016 Mar

95 G ↑ 95 2014-12 95

OPAH DEL02-3

Delirium Bundle Compliance - Ward 3 (percentage)

M 2016 Apr 100 2016 Feb

100 G → 95 2014-12 95

OPAHDCP01

Record keeping - compliance with the completion of personalised care plans for dementia care for patients on Ronas Ward (percentage)

Q 2016

Apr-Jun 0

2016 Jan-Mar

0 G → 95 2015-04 95 No eligible patients to include in the audit.

OPAHDCP02

Record keeping - compliance with the completion of personalised care plans for dementia care for patients on Ward 3 (percentage)

Q 2016

Apr-Jun 100

2016 Jan-Mar

98 G ↑ 95 2015-04 95 5 notes reviewed in April 2016.

OPAHDCP03

Record keeping - compliance with the completion of personalised care plans for dementia care for patients on Ward 1 (percentage)

Q

2016

Apr-Jun

78 2016

Jan-Mar 89 R ↓ 95 2015-04 100

1 eligible patient in April - no Getting to Know Me forms in place.

OPAHDPD01 Record keeping - compliance with the completion of discharge planning documentation on Ronas Ward (percentage)

Q

2016

Apr-Jun

97 2016

Jan-Mar 92 G ↑ 95 2015-04 100

3 patient notes reviewed in April 2016.

OPAHDPD02 Record keeping - compliance with the completion of discharge planning documentation on Ward 3 (percentage)

Q 2016

Jan-Mar 100

2015 Oct-Dec

100 G → 95 2015-04 100 5 notes reviewed in April 2016.

OPAHDPD03 Record keeping - compliance with the completion of discharge planning documentation on Ward 1 (percentage)

Q 2014

Jul-Sep 100 G 95 2015-04 100 Ward 1 have not done this routinely.

OPAHFCP01

Record keeping - compliance with the completion of personalised care plans for falls management for patients on Ronas Ward (percentage)

Q

2016

Apr-Jun

91 2016

Jan-Mar 100 A ↓ 95 2015-04 100

3 patients notes reviewed in April 2016.

OPAHFCP02

Record keeping - compliance with the completion of personalised care plans for falls management for patients on Ward 3 (percentage)

Q 2016

Apr-Jun

100 2016

Jan-Mar 98 G ↑ 95 2015-04 95 5 patients reviewed in April 2016.

OPAHFCP03

Record keeping - compliance with the completion of personalised care plans for Falls management for patients on ward 1 (percentage)

Q 2015

Oct-Dec 83

2015 Jul-Sep

83 R → 95 2015-04 95 5 sets of notes audited (Dec 2015).

OPAHNCP1 Record keeping - compliance with completion of personalised care plans for nutritional care for patients on Ronas Ward (percentage)

Q

2016 Apr-Jun

100 2016

Jan-Mar 100 G → 95 2015-04 95 4 patients notes reviewed April 2016.


Page 9 of 10

OPAHNCP2

Record keeping - compliance with the completion of personalised care plans for nutritional care for patients on Ward 3 (percentage)

Q 2016

Jan-Mar 94

2015 Oct-Dec

95 A ↓ 95 2015-04 95 5 notes reviewed March 2016 (94%), 5 notes reviewed Jan 2016 (96%).

OPAHNCP3

Record keeping - compliance with the completion of personalised care plans for nutritional care for patients on Ward 1 (percentage)

Q 2016

Jan-Mar 98

2015 Oct-Dec

80 G ↑ 95 2015-04 95

OPAHPCP01

Record keeping - compliance with the completion of personalised care plans for pressure care for patients on Ronas Ward (percentage)

Q

2016

Apr-Jun

100 2016

Jan-Mar 100 G → 95 2015-04 95

3 patients notes reviewed in April 2016.

OPAHPCP02

Record keeping - compliance with the completion of personalised care plans for pressure care for patients on Ward 3 (percentage)

Q

2016

Apr-Jun

100 2016

Jan-Mar 97 G ↓ 95 2015-04 95 5 patients reviewed in April 2016.

OPAHPCP03

Record keeping - compliance with the completion of personalised care plans for pressure care for patients on Ward 1 (percentage)

Q 2016

Jan-Mar 93

2015 Oct-Dec

95 A ↓ 95 2015-04 95 5 sets of notes audited in April 2016.

SI7 A&E Food & Fluid Intake Recording Audit Compliance (percentage)

M 2016 Apr 98.9 2016 Feb

98.7 G ↑ 95 2011-03 95 620 out of 627.

SI15 Observational meal audit compliance - Ronas Ward (percentage)

Q 2015

Jul-Sep 96

2014 Jul-Sep

100 G ↓ 95 2014-04 100

The observational audit included 13 The meal time observed was a lunchtime in August 2015 The results have been fed back to the multi-disciplinary team - 12 criteria applied and only one was partially met (portion control was adequate but service did not include enough rice with the meal, which has been picked up by the Hotel Services Mgr). Next audit due Sept 16.

SI16 Observational meal audit compliance - Ward 1 (percentage)

Q 2015

Jul-Sep 100

2014 Jul-Sep

100 G → 95 2014-04 100

The observational audit included 13 criteria The meal time observed was a breakfast in August 2015 .The results have been fed back to the multi-disciplinary team - 11 criteria applied and all of them were met. Next audit due Sept 16.


Page 10 of 10

SI17 Observational meal audit compliance - ward 3 (percentage)

Q 2015

Jul-Sep 100

2014 Jul-Sep

91 G ↑ 95 2014-04 100

The observational audit included 13 criteria The meal time observed was a supper time in August 2015.The results have been fed back to the multi-disciplinary team - 13 criteria applied and they were all met. Next audit due Sept 16.

Appendix C – Scottish Cancer Patient Experience Survey 2015-16

NHSScotland

Question Response N %

Q1: Before you were told you needed to go to hospital about cancer, how many times did you see your GP (family doctor) about the health problem caused by cancer? (Board of residence at diagnosis)

None - I went straight to the hospital 427 9%

None - I went to hospital following a cancer screening appointment 685 15%

I saw my GP once 1,921 43%

I saw my GP twice 708 16%

I saw my GP 3 or 4 times 463 10%

I saw my GP 5 or more times 293 7%

Total 4,497 100%

Q2: How do you feel about the length of time you had to wait before your first appointment with a hospital doctor? (Board of residence at diagnosis)

Positive 3,856 82%

Neutral 549 12%

Negative 280 6%

Total 4,685 100%

Q3: How long was it from the time you first thought something might be wrong with you until you first saw a GP or other doctor? (Board of residence at diagnosis)

Less than 3 months 3,626 83%

3 - 6 months 500 11%

6 - 12 months 140 3%

More than 12 months 124 3%

Total 4,390 100%

Q4: Have you had diagnostic test(s) for cancer such as an endoscopy, biopsy, mammogram, or scan?

Yes 4,615 96%

No 187 4%

Total 4,802 100%

Q5: Beforehand, did you have all the information you needed about your test?

Positive 3,941 92%

Neutral 0 0%

Negative 353 8%

Total 4,294 100%

NHSScotland


Q6: Overall, how did you feel about the length of time you had to wait for your test to be done?

Positive 3,812 85%

Neutral 493 11%

Negative 188 4%

Total 4,493 100%

Q7: Were the results of the test explained in a way you could understand?

Positive 3,637 81%

Neutral 805 18%

Negative 76 2%

Total 4,518 100%

Q9: When you were first told that you had cancer, had you been told you could bring a family member or friend with you?

Positive 2,819 72%

Neutral 0 0%

Negative 1,076 28%

Total 3,895 100%

Q10: How do you feel about the way you were told you had cancer?

Positive 4,021 86%

Neutral 425 9%

Negative 229 5%

Total 4,675 100%

Q11: Did you understand the explanation of what was wrong with you?

Positive 3,603 75%

Neutral 1,084 23%

Negative 93 2%

Total 4,780 100%

Q12: When you were told you had cancer, were you given written information about the type of cancer you had?

Positive 2,310 60%

Neutral 0 0%

Negative 1,510 40%

Total 3,820 100%

NHSScotland


Q13: Before your cancer treatment started, were your treatment options explained to you?

Positive 3,457 86%

Neutral 483 12%

Negative 82 2%

Total 4,022 100%

Q14: Were the possible side effects of treatment(s) explained in a way you could understand?

Positive 3,103 71%

Neutral 1,056 24%

Negative 230 5%

Total 4,389 100%

Q15: Were you offered practical advice and support in dealing with the side effects of your treatment(s)?

Positive 2,814 64%

Neutral 1,151 26%

Negative 407 9%

Total 4,372 100%

Q16: Before you started your treatment(s), were you also told about any side effects of the treatment that could affect you in the future rather than straight away?

Positive 2,178 53%

Neutral 1,115 27%

Negative 786 19%

Total 4,079 100%

Q17: Were you involved as much as you wanted to be in decisions about your care and treatment?

Positive 3,554 78%

Neutral 820 18%

Negative 183 4%

Total 4,557 100%

Q18: Were you given the name of a Clinical Nurse Specialist who would support you through your treatment?

Positive 3,800 84%

Neutral 0 0%

Negative 725 16%

Total 4,525 100%

NHSScotland


Q19: How easy or difficult has it been for you to contact your Clinical Nurse Specialist?

Positive 3,030 90%

Neutral 186 6%

Negative 141 4%

Total 3,357 100%

Q20: When you have had important questions to ask your Clinical Nurse Specialist, how often have you got answers you could understand?

Positive 2,839 90%

Neutral 268 8%

Negative 61 2%

Total 3,168 100%

Health and Care Experience Survey 2015/16

Results for

May 2016, Official Statistics

NHS Shetland

Health and Care Experience Survey 2015/16

NHS Shetland

This report gives a summary of the results of the Health and Care Experience Survey 2015/16 for NHS Shetland.

The survey was sent to 5,081 people registered with GP practices in the area.

The survey asks about people’s experiences of accessing and using primary care services and was widened in 2013/14 to include aspects of

care, support and caring to support the principles underpinning the integration of health and care in Scotland outlined in the Public Bodies

(Joint Working) (Scotland) Act 2014.

A copy of the survey is available at:

www.gov.scot/Topics/Statistics/Browse/Health/GPPatientExperienceSurvey/HACE2015-16

1,069 patients of NHS Shetland sent in feedback on their experiences at the practice. Of the patients that answered questions about

themselves:

• 41% were male and 59% were female;

• 9% were aged 17-34, 18% were aged 35-49, 33% were aged 50-64 and 40% were 65 and over;

• 66% did not have any limiting illness or disability.

The survey was commissioned by the Scottish Government as part of the Scottish Care Experience Survey Programme, which aims to use

the public's experiences of health and care services to improve those services. The survey was managed by the Scottish Government in

partnership with Information Services Division (ISD) of NHS National Services Scotland. The survey was carried out by a patient survey

contractor, Quality Health Ltd.

The results of the survey will be used by GP practices, Health Boards, Health and Social Care Partnerships and the Scottish Government to

improve the quality of health and care services in Scotland.

National results for this survey and further details on the methods used to generate this report are available at:

www.gov.scot/Topics/Statistics/Browse/Health/GPPatientExperienceSurvey/HACE2015-16

Page 2

NHS Shetland

Health and Care Experience Survey 2015/16 - NHS Boards

Part of the Scottish Care Experience Survey Programme

http://www.gov.scot/Topics/Statistics/Browse/Health/GPPatientExperienceSurvey/HACE2015-16

http://www.gov.scot/Topics/Statistics/Browse/Health/GPPatientExperienceSurvey/HACE2015-16

Summary of Results

I am able to look after my own health 95% +1 *

Service users are supported to live as independently as possible 78% -6

Service users have a say in how their help, care or support is provided 80% +2

Service users' health and care services seem to be well coordinated 60% -15 S

Rating of overall help, care or support services 79% -2

Rating of overall care provided by GP practice 89% +2

The help, care or support improves service users' quality of life 84% -0

Carers feels supported to continue caring 54% +13 S

Service users feel safe 79% -5

This section provides the results for those questions which align to the Health and Social Care Indicators.

The difference between the percent positive score for the NHS Board and the Scottish average is shown in the final column. Differences which

are statistically significant are marked with an S. Where a comparison has not been tested due to small numbers, this is marked with an NT.

*Please note that measure "I am able to look after my own health" has not been subject to significance testing.

Page 3

NHS Shetland



Top Bottom 5 | Highest / Lowest Responses

Top 5 Responses (highest % positive scores) Bottom 5 Responses (highest % negative scores)

Question % positive Question % negative

Patients know enough about how and when to take

their medicines100% Overall rating of how mistakes are dealt with 62%

The receptionists are helpful 98%Caring has had a negative impact on carers' health and

wellbeing33%

It is explained to patients why they need a test 98%Carers have a say in the services provided for the

person they look after28%

Nurses listen to patients 98% Can usually see preferred doctor 25%

Patients have enough time with nurses 98%Able to book a doctors appointment 3 or more working

days in advance24%

Top Five and Bottom Five Results

The tables below show the top 5 responses (highest percent positive scores in green) and bottom 5 responses (highest percent negative

scores in red) for patients at this NHS Board.

Page 4

NHS Shetland



Notes on Interpretation

Very Positive Positive Neutral Negative

% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

Overall arrangements for getting to see a

doctor3000 85% 76% 73% -3% +1%

Please note: If an expected question does not appear within this section it is because it has been suppressed due to a low number of

responses.

Where a comparison has not been tested due to small numbers, this is marked with an NT.

The classification of answers as very positive, positive, neutral or negative for each question can be found in the technical report at:

www.gov.scot/stats/bulletins/01218

Later in this report we present results for questions that do not fit into the '% positive' format.

The “% Positive...” columns show the Board 2015/16 percent positive scores along with both 2013/14 & 2011/12 scores.

“Difference from Scotland” shows the difference between the Board percent positive score in 2015/16 and the Scottish average in the same

year, with a plus or minus sign depending on whether it is above or below the Scottish average.

“Change from 2013/14” shows the change in the percent positive score for the Board since the 2013/14 survey.

Differences which are statistically significant are marked with an S.

Results are shown as the percentage of patients who answered each question positively.

The bars illustrate the % positive as green (darker green being very positive and lighter green being positive), and the % negative as red.

Where answers are neither positive nor negative, the % is shown in yellow (see below).

Change

from

2013/14

Difference

from

Scotland

29% 44% 15% 12%

Page 5

NHS Shetland



http://www.gov.scot/stats/bulletins/01218

Your GP Practice: getting to see or speak to someone


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

It is easy to get through on the phone 952 82% 88% 91% +3% +8% S

Person answering the phone is helpful 951 95% 94% 96% +2% +2% S

Can see or speak to a doctor or nurse within 2

working days757 96% 89% 94% +4% S +9% S

Able to book a doctors appointment 3 or more

working days in advance761 62% 73% 76% +3% -0%

Can usually see preferred doctor 758 72% 75% 75% -0% -6% S

Overall arrangements for getting to see a doctor 951 69% 68% 68% -0% -4%

Overall arrangements for getting to see a nurse 884 85% 84% 92% +8% S +10% S

Your GP Practice: referrals


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

Arrangements for getting to see other health and

care services511 - 79% 78% -1% +1%

Number of

responses

Change

from

2013/14

Difference

from

Scotland

Number of

responses

Change

from

2013/14

Difference

from

Scotland

54% 36% 9%

76% 21%

74% 19%

76% 24%

75% 25%

37% 31% 16% 16%

55% 37% 8%

36% 42% 18%

Page 6

NHS Shetland



At your GP Practice


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

The receptionists are helpful 962 97% 94% 98% +4% S +5% S

Time waiting to be seen at GP practice 949 88% 75% 82% +8% S -4% S

At your GP Practice - doctors


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

Doctors listen to patients 868 94% 94% 94% +0% -1%

Patients feel that doctors have all the information

they need to treat them864 87% 86% 86% -0% -3%

Doctors take account of the things that matter to

patients860 - 87% 87% +0% +1%

Doctors talk in a way that helps patients to

understand their condition and treatment868 87% 90% 90% +0% +0%

Patients have confidence in doctors' ability to

treat them860 85% 86% 88% +2% -1%

Patients have enough time with doctors 864 88% 89% 91% +2% +2%

Number of

responses

Change

from

2013/14

Difference

from

Scotland

Number of

responses

Change

from

2013/14

Difference

from

Scotland

68% 30%

82% 18%

57% 37%

46% 40% 11%

50% 38% 9%

54% 36%

55% 34% 8%

54% 37%

Page 7

NHS Shetland



At your GP Practice - nurses


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

Nurses listen to patients 800 98% 98% 98% +0% +2% S

Patients feel that nurses have all the information

they need to treat them794 94% 95% 95% -0% +2% S

Nurses take account of the things that matter to

patients790 - 96% 92% -4% S +2%

Nurses talk in a way that helps patients to

understand their condition and treatment791 92% 96% 95% -1% +3% S

Patients have confidence in nurses' ability to treat

them792 95% 98% 95% -3% +1%

Patients have enough time with nurses 797 99% 96% 98% +1% +2% S

At your GP practice - care and treatment


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

Patients are involved as much as they want to be

in decisions about their care and treatment935 - 64% 65% +1% +3%

Number of

responses

Change

from

2013/14

Difference

from

Scotland

Number of

responses

Change

from

2013/14

Difference

from

Scotland

66% 32%

57% 38%

59% 33% 7%

63% 32%

64% 31%

64% 33%

65% 32%

Page 8

NHS Shetland



Tests arranged by your GP practice


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

It is explained to patients why they need a test 724 - 95% 98% +3% S +2% S

Patients are satisfied with the length of time they

wait for results715 - 81% 87% +6% S +2%

Patients are satisfied with the way they receive

results711 - 80% 79% -0% -1%

Test results are explained to patients in a way

they can understand714 - 81% 81% -0% -0%

Number of

responses

Change

from

2013/14

Difference

from

Scotland

60% 38%

47% 39% 9%

45% 35% 11% 10%

45% 36% 14%

Page 9

NHS Shetland



At your GP Practice - medicines


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

Patients find it easy enough for them to get their

medicines821 97% 93% 95% +2% -1%

Patients know enough about what their

medicines are for818 98% 98% 97% -0% +1%

Patients know enough about how and when to

take their medicines819 99% 100% 100% -0% +1% S

Patients know enough about side effects of

medicines815 83% 85% 85% +0% +3%

Patients know what to do if they have any

problems with their medicines816 91% 90% 92% +2% +3%

Patients take their prescription as they are

supposed to821 97% 99% 97% -1% -1%

At your GP practice - dealing with mistakes


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

Patients believe a mistake was made in their

treatment or care by their GP practice940 - 94% 95% +2% +2% S

Overall rating of how mistakes are dealt with 41 - 14% 38% +25% -8%

Number of

responses

Change

from

2013/14

Difference

from

Scotland

Number of

responses

Change

from

2013/14

Difference

from

Scotland

64% 32%

62% 35%

66% 33%

47% 39% 11%

52% 40%

68% 29%

95%

38% 62%

Page 10

NHS Shetland



At your GP practice - overall experience


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

Patients are treated with respect 959 94% 93% 94% +1% +3% S

Patients are treated with compassion and

understanding934 90% 86% 90% +4% +5% S

Rating of overall care provided by GP practice 961 84% 82% 89% +7% S +2%

Number of

responses

Change

from

2013/14

Difference

from

Scotland

62% 32%

57% 33% 9%

50% 38% 10%

Page 11

NHS Shetland



Out of hours healthcare


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

The time patients wait for out of hours services is

reasonable219 76% 71% 73% +2% -0%

Patients feel that people have all the information

they need to treat them216 77% 79% 81% +2% +3%

Patients feel that they are listened to 215 83% 87% 92% +6% +8% S

Things are explained to patients in a way they

can understand214 85% 88% 88% +0% +2%

Patients feel that they were treated by the right

people215 - - 86% - +5%

Patients feel they get the right treatment or

advice214 75% 82% 84% +2% +4%

Patients feel that people take account of the

things that matter to them214 - 80% 83% +3% +7% S

Rating of overall care provided out of hours 218 70% 76% 76% +0% +5%

Number of

responses

Change

from

2013/14

Difference

from

Scotland

33% 40% 9% 17%

35% 46% 11% 8%

43% 49%

43% 45% 8%

43% 43% 8%

43% 41% 11%

42% 41% 11%

33% 44% 15% 9%

Page 12

NHS Shetland



Care, support and help with everyday living


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

People take account of the things that matter to

service users79 - 84% 91% +6% +5%

Service users have a say in how their help, care

or support is provided75 - 80% 80% +0% +2%

Service users are aware of the help, care and

support options available75 - - 74% - -1%

Service users are treated with respect 77 - 93% 91% -1% +1%

Service users are treated with compassion and

understanding74 - 88% 86% -2% -1%

Service users' health and care services seem to

be well coordinated77 - 64% 60% -4% -15% S

Service users are supported to live as

independently as possible77 - 68% 78% +10% -6%

Service users feel safe 76 - 75% 79% +4% -5%

The help, care or support improves service users'

quality of life79 - 80% 84% +3% -0%

Rating of overall help, care or support services 88 - 81% 79% -2% -2%

Number of

responses

Change

from

2013/14

Difference

from

Scotland

41% 49%

31% 50% 11% 9%

25% 49% 18% 7%

44% 47%

42% 44% 8%

16% 44% 26% 14%

33% 50% 10% 7%

35% 44% 10% 11%

48% 30% 14% 8%

39% 41% 12% 9%

Page 13

NHS Shetland



Caring responsibilities


% Positive

2011/12

% Positive

2013/14

% Positive

2015/16

Carers have a good balance between caring and

other things in their life147 - 65% 65% -0% -4%

Caring has had a negative impact on carers'

health and wellbeing135 - 58% 45% -13% +4%

Carers have a say in the services provided for the

person they look after133 - 49% 50% +1% +0%

Local services are well coordinated for the people

carers look after134 - 52% 58% +6% +16% S

Carers feels supported to continue caring 133 - 41% 54% +13% +13% S

Number of

responses

Change

from

2013/14

Difference

from

Scotland

28% 37% 15% 20%

12% 32% 22% 33%

12% 38% 22% 28%

20% 38% 19% 23%

17% 37% 23% 23%

Page 14

NHS Shetland



2013/14 2015/16 ScotlandThe person I wanted to see was not available in the next 2 days 27 25 35

The times available in the next 2 days were not convenient for me 19 18 11

I was not offered a chance to see or speak to anyone within 2 working days 47 53 49

Another reason 8 4 6

Information Questions

This section shows results for questions that did not fit into the percentage positive format used elsewhere in the report. These tables show

the percentage of patients who responded to each answer option. Results for Scotland, and where possible, results from the previous survey

are included. If the question was new to this year’s survey, the absence of historic results will be indicated by a “-“.

Please note: If an expected question does not appear within this section it is because it has been suppressed due to low number of

responses.


Q6 - What was the main reason you waited longer than 2 working days?

Patients who have urgently needed to speak to a doctor or nurse from their GP practice in the last 12

months who waited more than 2 working days

Page 15

NHS Shetland



2013/14 2015/16 ScotlandYes, but I don’t mind 37 40 57

Yes, and I am not happy about it 18 9 19

No, other patients can’t overhear 33 35 17

Don’t know 11 16 8

At your GP Practice

Q12 - In the reception area, can other patients overhear what you say to the staff?

Patients who have contacted their GP practice in the last 12 months

Page 16

NHS Shetland



2013/14 2015/16 ScotlandTelephoned 111 for NHS 24 - 50 65

Went to Pharmacist / Chemist - 0 4

Went to Primary Care Emergency Centre - 3 2

Telephoned my own GP practice - 14 4

Telephoned 999 for emergency services - 3 6

Went to Hospital A&E / Casualty - 28 15

Other - 3 3

2013/14 2015/16 ScotlandGot phone advice only from NHS 24 - 11 16

Pharmacist / Chemist - 0 3

Primary Care Emergency Centre - 2 15

Own GP practice - 10 5

Home visit from a GP or Nurse - 16 9

Ambulance paramedics - 6 11

A&E / Casualty - 50 35

Social care services - 0 0

Other - 4 6

Patients who in the last 12 months have tried to get medical help, treatment or advice when their GP

Practice was closed

Q28 - Which service did you end up being treated or seen by?

Patients who in the last 12 months have tried to get medical help, treatment or advice when their GP

Practice was closed

Q27 - Thinking about the last time you tried to get help out of hours, which NHS service did you speak to or go to first?


Page 17

NHS Shetland



2013/14 2015/16 ScotlandI am happy with the opening hours of my GP practice 72 81 80

It is too difficult for me to get time away from work during my practice opening hours 17 10 11

The opening hours are not convenient for me for another reason 5 2 2

I am not sure when my GP practice is open 6 8 6

Q32 - What do you think about the opening hours of your GP practice?

All Patients

Page 18

NHS Shetland



2013/14 2015/16 ScotlandI was able to go back to most of my usual activities 52 40 43

There was no change in my ability to do my usual activities 19 21 23

I was less able to do my usual activities 14 19 19

It is too soon to say 16 21 15

2013/14 2015/16 ScotlandIt was better than before 55 54 51

It was about the same as before 32 32 35

It was worse than before 1 2 4


2013/14 2015/16 ScotlandI felt less depressed or anxious than before 51 46 53

I felt about the same as before 26 30 28

I felt more depressed or anxious than before 5 8 8


Patients who received treatment or advice because of something that was making them feel depressed

or anxious

Health and care effectiveness

Q39 - Thinking about the last time this happened, how would you describe the effect of the treatment on your ability to live your normal life?

Patients who received NHS treatment or advice because of something that was affecting their ability to

do their usual activities - to live their normal life

Q41 - Thinking about the last time this happened, how would you describe the effect of the treatment on your pain or discomfort?

Patients who received NHS treatment or advice because of something that was causing them pain or

discomfort

Q43 - Thinking about the last time this happened, how would you describe the effect of the treatment on how you felt?

Page 19

NHS Shetland



Variation in GP practice results within the NHS Board

n

n

|

S

NTIndicates that a significance test was not carried out because fewer than five respondents within this NHS Board selected a positive response or

because fewer than five respondents within this NHS Board selected a negative/neutral response.

Where a result does not appear in this section it has been suppressed due to the low number of valid responses (fewer than 20).

Indicates a statistically significant difference in the percent positive result between this NHS Board and NHS Scotland as a whole.

The tables/charts in this section show this NHS Board's percent positive results in relation to the range of percent positive results across GP Practices

within this NHS Board. The percent positive results for NHS Scotland are also shown.


Range of percent positive results across GP Practices within this NHS Board - ranges from lowest GP Practice to highest GP Practice.

The NHS Board's percent positive result.

NHS Scotland percent positive result.

Page 20

NHS Shetland




n |

91% 82% S

96% 94% S

94% 84% S

76% 76%

75% 81% S

68% 71%

92% 82% S

Can usually see preferred doctor

Overall arrangements for getting to see a doctor

Overall arrangements for getting to see a nurse

It is easy to get through on the phone

Person answering the phone is helpful

Can see or speak to a doctor or nurse within 2 working days

Able to book a doctors appointment 3 or more working days in advance

% Positive

NH

S

Bo

ard

NH

S

Sco

tlan

d

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 21

NHS Shetland




n |

78% 77%

At your GP Practice

n |

98% 94% S

82% 86% S

Arrangements for getting to see other health and care services

% Positive

NH

S

Bo

ard

NH

S

Sco

tlan

d

The receptionists are helpful

Time waiting to be seen at GP practice

% Positive

NH

S

Bo

ard

NH

S

Sco

tlan

d

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 22

NHS Shetland




n |

94% 95%

86% 89%

87% 87%

90% 90%

88% 90%

91% 88%

Doctors talk in a way that helps patients to understand their condition and

treatment

Patients have confidence in doctors' ability to treat them

Patients have enough time with doctors

% Positive

NH

S

Bo

ard

NH

S

Sco

tlan

d

Doctors listen to patients

Patients feel that doctors have all the information they need to treat them

Doctors take account of the things that matter to patients

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 23

NHS Shetland




n |

98% 95% S

95% 93% S

92% 90%

95% 91% S

95% 94%

98% 96% SPatients have enough time with nurses

% Positive

Nurses listen to patients

Patients feel that nurses have all the information they need to treat them

Nurses take account of the things that matter to patients

Nurses talk in a way that helps patients to understand their condition and

treatment

Patients have confidence in nurses' ability to treat them

NH

S

Bo

ard

NH

S

Sco

tlan

d

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 24

NHS Shetland




n |

65% 62%


n |

98% 96% S

87% 85%

79% 80%

81% 81%

It is explained to patients why they need a test

Patients are satisfied with the length of time they wait for results

Patients are satisfied with the way they receive results

Test results are explained to patients in a way they can understand

% Positive

NH

S

Bo

ard

NH

S

Sco

tlan

d

Patients are involved as much as they want to be in decisions about their

care and treatment

% Positive

NH

S

Bo

ard

NH

S

Sco

tlan

d

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 25

NHS Shetland




n |

95% 96%

97% 97%

100% 98% S

85% 82%

92% 89%

97% 98%Patients take their prescription as they are supposed to

NH

S

Sco

tlan

d

Patients find it easy enough for them to get their medicines

Patients know enough about what their medicines are for

Patients know enough about how and when to take their medicines

Patients know enough about side effects of medicines

% Positive

NH

S

Bo

ard

Patients know what to do if they have any problems with their medicines

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 26

NHS Shetland




n |

95% 93% S


n |

94% 92% S

90% 85% S

89% 87%Rating of overall care provided by GP practice

% Positive

NH

S

Bo

ard

NH

S

Sco

tlan

d

Patients believe a mistake was made in their treatment or care by their GP

practice

% Positive

NH

S

Bo

ard

NH

S

Sco

tlan

d

Patients are treated with respect

Patients are treated with compassion and understanding

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 27

NHS Shetland



Variation between NHS Boards

n

n

|

S

NTIndicates that a significance test was not carried out because fewer than five respondents within this NHS Board selected a positive response or

because fewer than five respondents within this NHS Board selected a negative/neutral response.

Where a result does not appear in this section it has been suppressed due to the low number of valid responses (fewer than 20).

Indicates a statistically significant difference in the percent positive result between this NHS Board and NHS Scotland as a whole.

The tables/charts in this section show this NHS Board's percent positive results in relation to the range of percent positive results across all NHS Boards in

Scotland. The percent positive results for NHS Scotland are also shown.


Range of percent positive results across all NHS Boards in Scotland - ranges from lowest NHS Board to highest NHS Board.

The NHS Board's percent positive result.

NHS Scotland percent positive result.

Page 28

NHS Shetland




n |

73% 74%

81% 78%

92% 84% S

88% 86%

86% 80%

84% 81%

83% 75% S

76% 71%

Patients feel that they were treated by the right people

Patients feel they get the right treatment or advice

Patients feel that people take account of the things that matter to them

Rating of overall care provided out of hours

The time patients wait for out of hours services is reasonable

Patients feel that people have all the information they need to treat them

Patients feel that they are listened to

Things are explained to patients in a way they can understand

% Positive

NH

S

Bo

ard

NH

S

Sco

tlan

d

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 29

NHS Shetland




n |

91% 85%

80% 79%

74% 76%

91% 90%

86% 87%

60% 75% S

78% 84%

79% 84%

84% 84%

79% 81%

Service users' health and care services seem to be well coordinated

Service users are supported to live as independently as possible

Service users feel safe

The help, care or support improves service users' quality of life

Rating of overall help, care or support services

NH

S

Sco

tlan

d

People take account of the things that matter to service users

Service users have a say in how their help, care or support is provided

Service users are aware of the help, care and support options available

Service users are treated with respect

% Positive

NH

S

Bo

ard

Service users are treated with compassion and understanding

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 30

NHS Shetland




n |

65% 68%

45% 40%

50% 50%

58% 42% S

54% 41% SCarers feels supported to continue caring

NH

S

Bo

ard

NH

S

Sco

tlan

d

Carers have a good balance between caring and other things in their life

Caring has had a negative impact on carers' health and wellbeing

Carers have a say in the services provided for the person they look after

Local services are well coordinated for the people carers look after

% Positive

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Page 31

NHS Shetland



n %

97 10.2

957 89.8

1054

n %

95 12.0

388 43.2

268 26.2

203 16.9

13 1.7

967

Once

2 - 4 times

5 - 10 times

More than 10 times

Can’t remember / don’t know

All patients

No

Yes

Q2 - Approximately how often have you contacted this GP practice in the last 12 months (either for yourself or someone you look after)?


Detailed Results for all Questions

This section shows a breakdown of responses for each question within the survey. The response categories that have been combined to

calculate the percent positive score are indicated with an asterisk.

Please note: If an expected question does not appear within this section it is because it has been suppressed due to low number of

responses.


Q1 - Have you contacted the GP practice named on the enclosed letter in the last 12 months?

Page 32

NHS Shetland



n %

* 682 54.4

* 231 36.2

39 9.4

Percent Positive - This Board 90.6 % 952

n %

* 819 75.6

* 121 20.7

9 2.9

2 0.8


n %

* 594 74.4

* 132 19.2

31 6.4


n %

8 24.8

7 17.8

16 53.2

2 4.2

33

The person I wanted to see was not available in the next 2 days

The times available in the next 2 days were not convenient for me

I was not offered a chance to see or speak to anyone within 2 working days

Another reason


I saw or spoke to a doctor or nurse on the same day

I saw or spoke to a doctor or nurse within 1 or 2 working days

I waited more than 2 working days to see or speak to a doctor or nurse

Q6 - What was the main reason you waited longer than 2 working days?

Patients who have urgently needed to speak to a doctor or nurse from their GP practice in the last 12 months who

waited more than 2 working days

Patients who have contacted their GP Practice by phone in the last 12 months

Very helpful

Fairly helpful

Not very helpful

Not at all helpful

Q5 - The last time you needed to see or speak to a doctor or nurse from your GP practice quite urgently, how long did you wait?

Q3 - Thinking of the last time you contacted this GP practice by phone, how easy was it for you to get through?


Very easy

Fairly easy

Not easy

Q4 - The last time you phoned the GP practice, how helpful was the person who answered?

Page 33

NHS Shetland



n %

* 665 76.4

96 23.6


n %

* 445 44.7

95 25.4

* 218 29.9


n %

* 543 36.9

* 273 30.7

85 16.4

38 12.1

12 3.8


n %

* 573 55.2

* 268 36.7

41 7.8

1 0.1

1 0.2


Good

Fair

Poor

Very poor

Fair

Poor

Very poor

Q9b - Overall, how would you rate the arrangements for getting to see a doctor and/or nurse in your GP practice? Getting to see a nurse


Excellent

No

I don’t have a doctor I prefer to see

Q9a - Overall, how would you rate the arrangements for getting to see a doctor and/or nurse in your GP practice? Getting to see a doctor


Excellent

Good


Yes

No

Q8 - When you arrange to see a doctor at your GP practice can you usually see the doctor you prefer?


Yes

Q7 - If you ask to make an appointment with a doctor 3 or more working days in advance, does your GP practice allow you to?

Page 34

NHS Shetland



n %

513 51.7

443 47.5

4 0.7

960

n %

* 227 36.3

* 193 42.2

69 17.6

15 2.7

7 1.2


Patients who had been referred to other health and care services by their GP practice in the last 12 months

Excellent

Good

Fair

Poor

Very poor


Yes

No, as it wasn't necessary

No, but I wanted to

Q11 - Thinking about the last time your GP practice referred you to other health or care services, how would you rate the arrangements for

getting to see other services?


Q10 - Has your GP practice referred you to see any other health or care services in the last 12 months?

Page 35

NHS Shetland



n %

344 39.7

75 9.3

403 35.0

139 16.0

961

n %

* 782 68.2

* 172 30.2

6 1.1

2 0.5


n %

* 860 82.4

89 17.6


Not very helpful

Not at all helpful

Q14 - How do you feel about how long you usually have to wait to be seen after you arrive at your GP practice?


It is reasonable

It is too long

Don’t know

Q13 - How helpful do you find the receptionists at your GP practice?


Very helpful

Fairly helpful

At your GP Practice

Q12 - In the reception area, can other patients overhear what you say to the staff?


Yes, but I don’t mind

Yes, and I am not happy about it

No, other patients can’t overhear

Page 36

NHS Shetland



n %

86 15.0

821 85.0

907

n %

* 543 57.5

* 289 36.9

27 4.3

6 1.0

3 0.3


n %

* 469 46.5

* 310 39.6

64 10.7

17 2.9

4 0.4


Disagree

Strongly disagree

Strongly disagree

Q15c - Thinking about the last time you saw a doctor at your GP practice, how much do you agree or disagree with each of the following? I

felt that the doctor had all the information needed to treat me

Patients who have seen a doctor at their GP Practice in the last 12 months

Strongly agree

Agree

Neither agree nor disagree

Q15b - Thinking about the last time you saw a doctor at your GP practice, how much do you agree or disagree with each of the following?

The doctor listened to me


Strongly agree

Agree


Disagree


Q15a - Have you seen a doctor from your GP practice in the last 12 months?


No

Yes

Page 37

NHS Shetland



n %

* 488 49.6

* 284 37.8

70 8.9

17 3.7

1 0.1


n %

* 521 54.3

* 281 36.0

47 5.8

15 3.4

4 0.4


Agree


Disagree

Strongly disagree


Disagree

Strongly disagree

Q15e - Thinking about the last time you saw a doctor at your GP practice, how much do you agree or disagree with each of the following?

The doctor talked in a way that helped me understand my condition and treatment


Strongly agree

Q15d - Thinking about the last time you saw a doctor at your GP practice, how much do you agree or disagree with each of the following?

The doctor took account of the things that matter to me


Strongly agree

Agree

Page 38

NHS Shetland



n %

* 522 54.6

* 263 33.6

51 8.0

15 2.9

9 0.9


n %

* 521 53.5

* 291 37.1

27 4.6

20 3.8

5 0.9



Strongly agree

Agree


Disagree

Strongly disagree

Strongly agree

Agree


Disagree

Strongly disagree

Q15g - Thinking about the last time you saw a doctor at your GP practice, how much do you agree or disagree with each of the following? I

had enough time with the doctor

Q15f - Thinking about the last time you saw a doctor at your GP practice, how much do you agree or disagree with each of the following? I

felt confident in the doctor’s ability to treat me


Page 39

NHS Shetland



n %

159 14.4

780 85.6

939

n %

* 571 66.1

* 216 31.7

12 2.0

1 0.1

0 0.0


n %

* 514 57.2

* 257 38.1

21 4.1

2 0.5

0 0.0


Disagree

Strongly disagree

Strongly disagree

Q16c - Thinking about the last time you saw a nurse at your GP practice, how much do you agree or disagree with each of the following? I

felt that the nurse had all the information needed to treat me

Patients who have seen a nurse at their GP Practice in the last 12 months

Strongly agree

Agree


Q16b - Thinking about the last time you saw a nurse at your GP practice, how much do you agree or disagree with each of the following?

The nurse listened to me


Strongly agree

Agree


Disagree


Q16a - Have you seen a nurse from your GP practice in the last 12 months?


No

Yes

Page 40

NHS Shetland



n %

* 521 58.7

* 229 33.3

35 7.2

5 0.8

0 0.0


n %

* 546 62.9

* 218 31.8

23 4.7

3 0.6

1 0.0


Agree


Disagree

Strongly disagree


Disagree

Strongly disagree

Q16e - Thinking about the last time you saw a nurse at your GP practice, how much do you agree or disagree with each of the following?

The nurse talked in a way that helped me understand my condition and treatment


Strongly agree

Q16d - Thinking about the last time you saw a nurse at your GP practice, how much do you agree or disagree with each of the following?

The nurse took account of the things that matter to me


Strongly agree

Agree

Page 41

NHS Shetland



n %

* 551 64.2

* 218 31.1

18 3.8

5 1.0

0 0.0


n %

* 564 64.5

* 221 33.1

8 1.8

4 0.6

0 0.0



Strongly agree

Agree


Disagree

Strongly disagree

Strongly agree

Agree


Disagree

Strongly disagree

Q16g - Thinking about the last time you saw a nurse at your GP practice, how much do you agree or disagree with each of the following? I

had enough time with the nurse

Q16f - Thinking about the last time you saw a nurse at your GP practice, how much do you agree or disagree with each of the following? I

felt confident in the nurse’s ability to treat me


Page 42

NHS Shetland



n %

* 671 64.9

244 31.5

20 3.5



Q17 - Are you involved as much as you want to be in decisions about your care and treatment?


Yes, definitely

Yes, to some extent

No, and I would like to be

Page 43

NHS Shetland



n %

230 25.3

714 74.7

944

n %

* 474 60.0

* 240 38.0

7 0.8

3 1.2

0 0.0


n %

* 385 47.4

* 242 39.3

59 9.1

25 3.3

4 0.8


Disagree

Strongly disagree

Strongly disagree

Q19b - Thinking about the last time you had a blood test, x-ray or any other test arranged by your GP practice, how much do you agree or

disagree with each of the following: I was satisfied with the length of time I waited for my test results

Patients who have had tests arranged by their GP practice in the past 12 months

Strongly agree

Agree


Q19a - Thinking about the last time you had a blood test, x-ray or any other test arranged by your GP practice, how much do you agree or

disagree with each of the following: It was explained to me why a test was needed


Strongly agree

Agree


Disagree


Q18 - In the last 12 months have you had any blood tests, x-rays or any other tests arranged by your GP practice?


No

Yes

Page 44

NHS Shetland



n %

* 377 44.6

* 222 34.8

62 10.7

39 7.8

11 2.1


n %

* 377 44.7

* 236 35.9

71 13.9

25 4.5

5 1.1


Agree


Disagree

Strongly disagree


Disagree

Strongly disagree

Q19d - Thinking about the last time you had a blood test, x-ray or any other test arranged by your GP practice, how much do you agree or

disagree with each of the following: The results of the test were explained to me in a way I could understand


Strongly agree

Q19c - Thinking about the last time you had a blood test, x-ray or any other test arranged by your GP practice, how much do you agree or

disagree with each of the following: I was satisfied with the way that I received the result


Strongly agree

Agree

Page 45

NHS Shetland



n %

136 14.8

817 85.2

953

n %

* 571 63.6

* 213 31.6

20 3.1

13 1.3

4 0.4


n %

* 555 62.3

* 244 35.0

15 2.4

4 0.2

0 0.0


Patients who were prescribed medicines in the last 12 months

Strongly agree

Agree


Disagree

Strongly disagree

Strongly agree

Agree


Disagree

Strongly disagree

Q21b - Thinking about the last time you were prescribed medicines, how much do you agree or disagree with each of the following: I knew

enough about what my medicines were for


No

Yes

Q21a - Thinking about the last time you were prescribed medicines, how much do you agree or disagree with each of the following: It was

easy enough for me to get my medicines



Q20 - Have you been prescribed medicines by your GP practice in the last 12 months?

Page 46

NHS Shetland



n %

* 590 66.2

* 223 33.3

3 0.3

1 0.0

2 0.1


n %

* 434 46.5

* 281 38.6

78 11.5

18 3.0

4 0.3


Disagree

Strongly disagree

Strongly disagree

Q21d - Thinking about the last time you were prescribed medicines, how much do you agree or disagree with each of the following: I knew

enough about possible side effects of my medicines


Strongly agree

Agree


Q21c - Thinking about the last time you were prescribed medicines, how much do you agree or disagree with each of the following: I knew

enough about how and when to take my medicines


Strongly agree

Agree


Disagree

Page 47

NHS Shetland



n %

* 486 51.7

* 279 40.1

41 6.1

9 2.0

1 0.1


n %

* 590 68.2

* 217 28.9

6 2.0

5 0.7

3 0.2


Agree


Disagree

Strongly disagree


Disagree

Strongly disagree

Q21f - Thinking about the last time you were prescribed medicines, how much do you agree or disagree with each of the following: I took my

prescription as I was supposed to


Strongly agree

Q21e - Thinking about the last time you were prescribed medicines, how much do you agree or disagree with each of the following: I would

know what to do if I had any problems with my medicines


Strongly agree

Agree

Page 48

NHS Shetland



n %

* 897 95.4

43 4.6


n %

* 20 38.2

21 61.8


No


No

Yes

Q23 - Were you satisfied with how it was dealt with overall?

Patients who believe their GP practice made a mistake in their treatment or care

Yes


Q22 - In the past year, do you believe a mistake was made in your treatment or care by your GP practice (including for example in test

results, medicines prescribed, diagnosis)?

Page 49

NHS Shetland



n %

* 685 62.1

* 240 32.1

27 4.8

6 0.5

1 0.4


n %

* 625 56.5

* 245 33.2

56 8.7

6 1.2

2 0.5


n %

* 631 50.5

* 266 38.5

54 9.7

8 0.9

2 0.5


Excellent

Good

Fair

Poor

Very poor

Agree


Disagree

Strongly disagree

Q25 - Overall, how would you rate the care provided by your GP practice?



Disagree

Strongly disagree

Q24b - How much do you agree or disagree with each of the following about how you are treated by the staff at your GP practice? I am

treated with compassion and understanding


Strongly agree


Q24a - How much do you agree or disagree with each of the following about how you are treated by the staff at your GP practice? I am

treated with respect


Strongly agree

Agree

Page 50

NHS Shetland



n %

219 22.8

830 77.2

1049

n %

96 49.5

1 0.1

2 2.6

58 14.3

6 3.0

46 27.7

7 2.8

216

Went to Hospital A&E / Casualty

Other

Patients who in the last 12 months have tried to get medical help, treatment or advice when their GP Practice was

closed

Telephoned 111 for NHS 24

Went to Pharmacist / Chemist

Went to Primary Care Emergency Centre

Telephoned my own GP practice

Telephoned 999 for emergency services

Q26 - In the last 12 months, have you tried to get medical help, treatment or advice, for yourself or someone you were looking after, when

your GP practice was closed (out of hours)?

All Patients

Yes

No

Q27 - Thinking about the last time you tried to get help out of hours, which NHS service did you speak to or go to first?


Page 51

NHS Shetland



n %

22 11.0

1 0.1

3 2.0

46 10.2

35 15.8

10 6.5

88 49.8

0 0.0

8 4.5

213

n %

159 76.3

29 14.9

4 3.3

9 5.5

201

A Nurse

A Pharmacist

Someone else

Social care services

Other

Q29 - Who ended up providing most of your treatment or care?


closed

A Doctor

Pharmacist / Chemist

Primary Care Emergency Centre

Own GP practice

Home visit from a GP or Nurse

Ambulance paramedics

A&E / Casualty

Q28 - Which service did you end up being treated or seen by?


closed

Got phone advice only from NHS 24

Page 52

NHS Shetland



n %

* 87 33.1

* 77 40.4

18 9.3

24 11.5

13 5.6


n %

* 88 34.9

* 92 45.6

19 11.4

13 6.5

4 1.6



closed

Strongly agree

Agree


Disagree

Strongly disagree

Strongly agree

Agree


Disagree

Strongly disagree

Q30b - Thinking of the service that you ended being treated or seen by, how much would you agree or disagree with the following about your

experience? I felt that the person had all the information needed to treat me

Q30a - Thinking of the service that you ended being treated or seen by, how much would you agree or disagree with the following about your

experience? The time I waited was reasonable


closed

Page 53

NHS Shetland



n %

* 104 42.9

* 91 49.2

10 3.5

5 2.6

5 1.8


n %

* 103 43.0

* 83 45.0

17 8.3

8 2.2

3 1.4


Disagree

Strongly disagree

Strongly disagree

Q30d - Thinking of the service that you ended being treated or seen by, how much would you agree or disagree with the following about your

experience? Things were explained to me in a way I could understand


closed

Strongly agree

Agree


Q30c - Thinking of the service that you ended being treated or seen by, how much would you agree or disagree with the following about your

experience? I felt I was listened to


closed

Strongly agree

Agree


Disagree

Page 54

NHS Shetland



n %

* 103 43.1

* 83 42.7

14 6.4

9 5.5

6 2.3


n %

* 104 43.3

* 78 41.1

21 11.0

4 2.0

7 2.5


Agree


Disagree

Strongly disagree


Disagree

Strongly disagree

Q30f - Thinking of the service that you ended being treated or seen by, how much would you agree or disagree with the following about your

experience? I felt that I got the right treatment or advice


closed

Strongly agree

Q30e - Thinking of the service that you ended being treated or seen by, how much would you agree or disagree with the following about your

experience? I felt that the person who treated me was the right person


closed

Strongly agree

Agree

Page 55

NHS Shetland



n %

* 103 42.1

* 77 40.5

20 11.0

5 2.4

9 4.1


n %

* 92 32.5

* 76 43.7

29 14.7

13 4.9

8 4.2


n %

874 80.7

72 10.2

14 1.5

39 7.6

999

Q32 - What do you think about the opening hours of your GP practice?

All Patients

I am happy with the opening hours of my GP practice

It is too difficult for me to get time away from work during my practice opening hours

The opening hours are not convenient for me for another reason

I am not sure when my GP practice is open


closed

Excellent

Good

Fair

Poor

Very poor

Strongly agree

Agree


Disagree

Strongly disagree

Q31 - Overall, how would you rate the care you experienced out of hours?

Q30g - Thinking of the service that you ended being treated or seen by, how much would you agree or disagree with the following about your

experience? I felt that people took account of the things that matter to me


closed

Page 56

NHS Shetland



n %

70 7.1

54 4.9

34 3.3

24 2.2

18 2.1

856 79.4

1069

n %

81 63.8

42 36.2

123

n %

58 72.4

7 10.8

3 5.0

4 3.0

7 8.7

79

I had a choice in how my care is arranged

I was not offered any choices

I had no choices due to medical reasons

I did not want a choice in how my care was arranged

Can’t remember / don’t know

People who have received help or support with everyday living in the past 12 months

Yes

No

Q35 - Which of the following applies to you and how your social care is arranged?

People who have received help or support with everyday living in the past 12 months

Yes, help for me for activities outside my home

Yes, help to look after someone else

No, not had any help but I feel that I needed it

No, not had any help

Q34 - Did you get help from services provided by, for example, the Council, NHS, voluntary organisations, or private agencies – including

services you paid for?


Q33 - In the last 12 months have you had help or support with everyday living?

All Patients

Yes, help for me with personal and/or household tasks

Yes, help for me with adaptations and/or equipment for my home

Page 57

NHS Shetland



n %

* 33 41.4

* 37 49.3

6 5.8

2 2.3

1 1.2


n %

* 24 30.9

* 34 49.6

10 10.7

5 6.7

2 2.2


n %

* 25 25.0

* 35 49.3

9 18.4

4 4.1

2 3.1



Disagree

Strongly disagree

Disagree

Strongly disagree

Q36c - How much do you agree or disagree with the following about your care, support and help services - excluding the care and help you

get from friends and family - over the past 12 months? I was aware of the help, care and support options available to me

People who have received formal help and care services in the past 12 months

Strongly agree

Agree

Strongly disagree

Q36b - How much do you agree or disagree with the following about your care, support and help services - excluding the care and help you

get from friends and family - over the past 12 months? I had a say in how my help, care or support was provided


Strongly agree

Agree


Q36a - How much do you agree or disagree with the following about your care, support and help services - excluding the care and help you

get from friends and family - over the past 12 months? People took account of the things that matter to me


Strongly agree

Agree


Disagree

Page 58

NHS Shetland



n %

* 35 44.4

* 36 46.9

3 4.7

3 4.0

0 0.0


n %

* 33 42.2

* 32 44.1

5 5.8

3 6.0

1 1.8


n %

* 20 16.1

* 34 43.9

15 25.9

6 8.9

2 5.1



Strongly agree

Agree


Disagree

Strongly disagree

Strongly agree

Agree


Disagree

Strongly disagree

Q36f - How much do you agree or disagree with the following about your care, support and help services - excluding the care and help you

get from friends and family - over the past 12 months? My health, support and care services seemed to be well coordinated

Agree


Disagree

Strongly disagree

Q36e - How much do you agree or disagree with the following about your care, support and help services - excluding the care and help you

get from friends and family - over the past 12 months? I was treated with compassion and understanding


Q36d - How much do you agree or disagree with the following about your care, support and help services - excluding the care and help you

get from friends and family - over the past 12 months? I was treated with respect


Strongly agree

Page 59

NHS Shetland



n %

* 38 48.2

* 24 29.6

10 14.5

3 4.9

2 2.8


n %

* 33 38.6

* 29 40.7

9 11.6

2 2.2

3 6.9


n %

* 30 33.4

* 38 50.1

7 9.6

2 4.0

2 2.8



Disagree

Strongly disagree

Disagree

Strongly disagree

Q36i - How much do you agree or disagree with the following about your care, support and help services - excluding the care and help you

get from friends and family - over the past 12 months? The help, care or support improved or maintained my quality of life


Strongly agree

Agree

Strongly disagree

Q36h - How much do you agree or disagree with the following about your care, support and help services - excluding the care and help you

get from friends and family - over the past 12 months? I felt safe


Strongly agree

Agree


Q36g - How much do you agree or disagree with the following about your care, support and help services - excluding the care and help you

get from friends and family - over the past 12 months? I was supported to live as independently as possible


Strongly agree

Agree


Disagree

Page 60

NHS Shetland



n %

* 33 34.8

* 36 43.9

10 10.4

7 9.4

2 1.5


Good

Fair

Poor

Very poor

Q37 - Overall, how would you rate your help, care or support services – excluding the care and help you get from friends and family?


Excellent

Page 61

NHS Shetland



n %

266 27.7

761 72.3

1027

n %

119 39.9

52 20.8

48 18.6

44 20.8

263

n %

505 49.9

507 50.1

1012

All Patients

Yes

No

I was able to go back to most of my usual activities

There was no change in my ability to do my usual activities

I was less able to do my usual activities

It is too soon to say

Q40 - In the last 12 months, have you received NHS treatment or advice because of something that was causing you pain or discomfort?

All Patients

Yes

No

Q39 - Thinking about the last time this happened, how would you describe the effect of the treatment on your ability to live your normal life?

Patients who received NHS treatment or advice because of something that was affecting their ability to do their usual

activities - to live their normal life

Health and care effectiveness

Q38 - In the last 12 months, have you received NHS treatment or advice because of something that was affecting your ability to live your

normal life?

Page 62

NHS Shetland



n %

296 54.3

143 31.9

10 2.1

48 11.7

497

n %

144 14.4

840 85.6

984

n %

80 46.2

37 30.0

10 8.3

17 15.5

144

I felt less depressed or anxious than before

I felt about the same as before

I felt more depressed or anxious than before


All Patients

Yes

No

Q43 - Thinking about the last time this happened, how would you describe the effect of the treatment on how you felt?

Patients who received treatment or advice because of something that was making them feel depressed or anxious

It was better than before

It was about the same as before

It was worse than before


Q42 - In the last 12 months, have you received NHS treatment or advice because of something that was making you feel depressed or

anxious?

Q41 - Thinking about the last time this happened, how would you describe the effect of the treatment on your pain or discomfort?

Patients who received NHS treatment or advice because of something that was causing them pain or discomfort

Page 63

NHS Shetland



n %

866 85.8

55 5.0

39 4.2

4 0.3

5 0.6

45 4.1

1014

n %

* 48 27.9

* 53 37.0

24 15.3

17 15.2

5 4.7


Agree


Disagree

Strongly disagree

Yes, 35 - 49 hours a week

Yes, 50 or more hours a week

Q45a - How much do you agree or disagree with the following about how you feel as a carer most of the time? I have a good balance

between caring and other things in my life

People who act as carers

Strongly agree

Q44 - Do you look after, or give any regular help or support to family members, friends, neighbours or others because of either long-term

physical / mental ill-health / disability or problems related to old age?

All patients

No

Yes, up to 4 hours a week




Page 64

NHS Shetland



n %

12 8.0

32 24.9

30 22.5

* 39 32.2

* 22 12.4


n %

* 22 11.7

* 42 38.4

41 22.1

16 18.4

12 9.3


n %

* 27 19.9

* 49 37.9

36 19.3

14 18.3

8 4.6


Strongly disagree

Q45d - How much do you agree or disagree with the following about how you feel as a carer most of the time? Local services are well

coordinated for the person(s) I look after


Strongly agree

Agree


Disagree


Strongly agree

Agree


Disagree

Strongly disagree

Strongly agree

Agree


Disagree

Strongly disagree

Q45c - How much do you agree or disagree with the following about how you feel as a carer most of the time? I have a say in services

provided for the person(s) I look after

Q45b - How much do you agree or disagree with the following about how you feel as a carer most of the time? Caring has had a negative

impact on my health and wellbeing


Page 65

NHS Shetland



n %

* 28 16.9

* 39 37.3

39 22.8

22 19.1

5 3.8


Disagree

Strongly disagree

Q45e - How much do you agree or disagree with the following about how you feel as a carer most of the time? I feel supported to continue

caring


Strongly agree

Agree


Page 66

NHS Shetland



n %

439 41.2

612 58.8

1051

n %

93 9.0

176 18.2

335 33.0

432 39.8

1036

n %

671 65.0

338 29.6

43 5.4

1052

n %

121 11.2

256 22.8

667 66.0

1044

Yes, limited a little

No

Fair

Bad

Q50 - Are your day-to-day activities limited because of a health problem or disability which has lasted, or is expected to last, at least 12

months?

All patients

Yes, limited a lot

50-64

65+

Q48 - How would you rate your health in general?

All patients

Good

Female

Q47 - What was your age on your last birthday?

All patients

17-34

35-49

Demographics

Q46 - Are you male or female?

All patients

Male

Page 67

NHS Shetland



n %

606 57.5

390 37.3

47 4.5

9 0.8

1052

n %

519 49.3

364 35.0

146 12.4

21 3.0

4 0.3

1054

Very Good

Good

Alright / neither good or bad

Bad

Very bad

Quite well

Not very well

Not at all well

Q52 - Thinking about the good and bad things that make up your quality of life, how would you rate your quality of life as a whole?

All patients

Q51 - In general, how well do you feel that you are able to look after your own health?

All patients

Very well

Page 68

NHS Shetland



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NHS Shetland



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shetland nhs board · 2016. 6. 16. · clinical governance committee has oversight of the quality...

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