THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
Board Paper - Cover Sheet
Meeting Title
Trust Board
Report Title
Patient Experience
Lead Director
Nursing & Patient Services Director
Date
May 2016
Agenda Item
A5(v)
Report Author Helen Lamont, Nursing and Patient Services Director
Andy Pike, Head of Patient Experience
Frances Blackburn, Deputy Nursing and Patient Services
Director, Freeman
Classification NHS Unclassified
Purpose (Tick
one only)
Approval
Links to
Strategic
Objectives
 To put patients and carers at the centre of all we do and to
provide care of the highest standard in terms of both safety
and quality.
 To continue to be recognised as a first-class teaching hospital,
counted amongst the top 10 in the country, which promotes a
culture of excellence, in all that it does.
Links to CQC
Domains/
Fundamental
Standard(s)
Identified
Risk? (If yes,
risk
reference)
Resource
Implications
Legal
implications
and equality
and diversity
assessment
Benefit to
patients and
the public
Regulation 9, 10, 16.
CQC Domains responsive to people’s needs, well led and
effective.
Report
History
Monthly report on published complaints data. Also, has recently
been developed as a more comprehensive patient experience
paper bringing together a range of issues all of which relate to
the patient experience.
To read, discuss and approve this paper.
Next steps
Discussion
For Information

No.
No additional resource implication.
This paper does not highlight any specific equality and diversity
implications. Work is ongoing to analyse data in relation to
protected characteristics where this is available.
Provides assurance that the Trust has robust and transparent
systems for collecting and acting upon patient feedback from
across the Trust.
Demonstrates culture of continuous improvement.
Agenda item A5(v)
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
PATIENT EXPERIENCE MONTHLY REPORT – MAY 2016
EXECUTIVE SUMMARY
This monthly paper presents key Patient Experience data to the Board including:
 The Complaints Management Dashboard as presented to the Complaints
Panel in May 2016
 The Friends and Family data for February 2015.
In terms of this month’s report, key points to note are:
 Highlights of Friends and Family performance with local and national
comparisons. Challenges remain with low engagement in key areas such as
Accident and Emergency but overall patient feedback remains largely
positive.
 Details of the Trust’s performance in relation to Complaints Management. A
review of year on year volumes, changes to the quality assurance processes,
Directorate level analysis and key areas for future focus and development.
 Update on the Trust’s work in better supporting and engaging carers in the
provision of the best possible healthcare for patients
 Highlights of the key work streams resulting from the National In-Patient
Survey workshop
 Update on the Disabled Go project with surveying work due to commence in
June and a go-live date set for September 2016.
 Details of the ‘OK to Ask’ research campaign with a number of patient
engagement events planned
 An update on on-going telehealth projects using Florence texting technology
to enhance patient care and details of positive patient feedback.
RECOMMENDATION
To (i) receive the briefing and (ii) support the work outlined.
Helen Lamont
Nursing and Patient Services Director
Frances Blackburn
Deputy Nursing and Patient Service Director Freeman
Andy Pike
Head of Patient Experience
18th May 2016
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
PATIENT EXPERIENCE MONTHLY REPORT – MAY 2016
1.
INTRODUCTION
This monthly report on Patient Experience highlights the current data, key
developments, risks and actions arising from this area of work.
2.
FRIENDS AND FAMILY TEST (FFT) AND REAL TIME PATIENT FEEDBACK (RTPF)
RESULTS
Highlights of Friends & Family data for February 2015:
Summary for February 2016 (with comparison to January 2016):
Area
Inpatients
Emergency Dept
Maternity (birth)
Community
Outpatients
Recommendation rate (%)
97
91
97
99
93
Comparison to Previous
Month (%)
-1
-4
-/+
-/+
+1
Inpatients
 Newcastle Hospitals is joint top (with 4 other Trusts) in relation to percentage
recommendation when compared with other similar sized Trusts nationally. The
Trust is joint second within the local region with a rate of 97% (Sunderland were
top with 98%) along with four other Trusts (Northumbria, South Tees,
Gateshead and North Cumbria). The response rate has decreased from 19% in
January to 14.2% in February.
 The report shows that 97% of patients would recommend the hospital and 1%
of patients are not likely to recommend the hospital.
Emergency Department
 The percentage of responses has increased slightly from 2.0% in January to
2.2% in February (this equates to 315 from an eligible population of
14,412). Based on the response rates, the Trust is bottom within the national
comparator group and second bottom locally along with North Cumbria who
achieved 2.0%.
 91% of patients in February would recommend the Trust Emergency
Department. This places the Trust in a mid-range position when compared to
other local and national Trusts.
Maternity
 For question 1 – antenatal community, the Trust received only 4 responses so
the recommendation rate is not published. An excellent response rate of 56%
(291 responses) was achieved for question 2 (place to give birth) and 270
responses to question 3 (postnatal care in hospital). This led to a
1

recommendation score of 99% and 97% respectively. Only seven responses
were received for Question 4 (postnatal community) which resulted in a 100%
recommendation rate.
The response rates for all Trusts vary considerably between the questions.
Community
 Responses have gone down this month from 91 in January to 64 in February.
 97% of patients who completed the FFT question said that they would
recommend the Trust.
Outpatients
 Using a combination of kiosks and postcards, 573 responses were recorded
which gave the Trust a 93% recommendation rate. The highest
recommendation rate in the local area was again from City Hospitals
Sunderland at 97%. The highest number of responses was achieved by North
Tees with 2,070 responses.
Full details of the results are available via the following link:
http://www.england.nhs.uk/ourwork/pe/fft/friends-and-family-test-data/
The new supplier of the on-line and postcard FFT solution, Quality Health, has been
working on the survey links and the change over to the electronic solution on all kiosks
took place on 1 April 2016. There are some small issues to be resolved in the way
that the online survey appears on the kiosks and Quality Health are working with the
Trust’s IT department to address these issues.
Outpatient staff have been informed on the changeover via the Outpatient User Group
and Outpatient Nurses Forum. Initial feedback from the Sisters in Outpatient
Departments is that the survey is quicker to use. In an effort to increase engagement ,
the members of the Outpatient Nurses Forum have agreed to:
 encourage staff to engage with patients to complete the survey
 consider the use of volunteers within outpatient areas to assist patients (a
volunteer profile has been developed for this purpose)
 obtain feedback on their performance and provide the results on a regular basis
via the Forum meetings.
An infographic has been developed to show the Trust performance at a glance. The
latest results are currently displayed on the ‘You said, we did…. boards at the main
entrances and the graphic has been used within the latest edition of the Take 2
minutes newsletter. ’ (Appendix 1)
3.
COMPLAINTS’ MANAGEMENT
Appendix 2 shows the May 2016 Complaints Management Dashboard.
The Trust received 576 formal complaints in the year up to the end of February 2016.
The projection based on this figure shows the Trust will receive 14% fewer formal
complaints in 2015/16 when compared to the previous year. Having made substantial
efforts to advertise the complaints process and ensure that the system is as straight
forward as possible in the past 6 months, the Board should be assured that this is not
a reflection of any user accessibility issue.
2
During February 43 formal complaints were received. The Directorate of Medicine
generated the largest volume with 8 complaints (19%), followed by Neurosciences with
6 (14%). The most prevalent theme in these complaints was ‘Clinical Issues’ (53%),
followed by ‘Attitude of Staff’ (16%) and ‘Appointment / Delays / Cancellations OP’
(12%).
The Trust’s performance in relation to complaints versus activity remains an
improvement on last year. The year to date ratio by February 2016 was 1 complaint
per 2,978 patient contacts compared with 1: 2,530 for the same period last 2014/15.
Neurosciences continue to have the poorest ratio with 1: 1,237 and Cancer Services
have the highest ratio with 1: 7,950.
Several changes have been made to the complaints processes and quality assurance
mechanisms in recent months. The main aim of these developments has been to
enhance the quality and timeliness of responses from Directorates. At the end of
February 107 of 576 (19%) complaint response timescales had needed to be renegotiated with complainants. This is a key focus in future and will be reported to the
Board regularly to assess the impact of changes in reducing this number. 36% of
these re-negotiations relate to General Medicine complaints.
The level of outstanding concern responses (where the complainant is dissatisfied with
the response provided) will also be actively monitored and reported. By the end of
February 44 (8%) of complaint responses were returned by the complainant.
4.
DEVELOPMENTS
i)
Working with carers
The Newcastle upon Tyne NHS Hospitals Foundation Trust is committed to
promoting a carer‐friendly culture and ensuring that carers are recognised as
important partners in the care of patients. Acknowledging carers and other family
members, and the important role they play in providing care, helps staff to provide
the best care for patients. The Care Act 2014 introduced new duties to health and
social care providers. Duties relevant to health services include:



Helping to prevent people developing care and support needs
Providing information and advice
Involving carers in discharge plans
Carers feedback in 2015 identified that they were not always recognised, felt
excluded from care on occasions, and were given inconsistent and sometimes
conflicting information regarding their involvement during admission and especially
in regard to discharge.
The Trust has worked in partnership with Newcastle City Council, Newcastle
Carers and Barnardos Young Carers to develop a number of Trust commitments
and a package of interventions to improve the experiences carers have whilst
supporting Trust In-patients. These include:
 guidance for staff
 a poster to welcome carers
 a pack to inform them of what they can expect and to direct them to
additional support in the community
3


flexible visiting
practical support around food and rest.
In addition, the Trust has signed up to John’s Campaign. This campaign is focused
on ensuring that carers of people with dementia are able to support their loved
ones at whatever time is most helpful to the patient and practicable for the carer.
As well as enabling the Trust to meet statutory obligations, the need to recognise
and support the Carers is fundamental to putting patients at the heart of all that we
do, providing personalised healthcare and responding to feedback which tells us
we can improve the experience of both carers and patients.
ii) National Patient Survey
Further to the results of the 2015 National Inpatient Survey being received, a
workshop style event was held with staff and stakeholders within the Trust to
share the findings, examine trends and themes, and agree priorities for further
action. This event took place on Monday 18th April with presentations from the
Picker Institute Europe and a patient representative from our Community Advisory
Panel and the Head of Patient Experience.
Representatives attended from a range of staff and stakeholders including
Nursing, Medical staff, Directorate Management teams, Directors and Heads of
Departments. Patient representatives from the Community Advisory Panel,
Healthwatch Newcastle and Governors were also in attendance. The final session
of the workshop aimed at identifying potential areas for action to improve the
patient experience.
A paper was presented to the Patient Experience Steering Group which outlined
the action areas; these are detailed in full in Appendix 3. Key areas included in the
action plan include:
 The quality of written patient information
 Meeting patients’ nutritional needs
 Discharge planning and involvement
 Waiting times for surgical procedures
iii) DisabledGo
As reported last month, the Trust is working in partnership with DisabledGo to
create a new resource which will offer a detailed access guide to disabled patients
and visitors accessing Trust premises. Newcastle Hospitals will be the first Trust in
the North east to provide such information to members of the public.
The DisabledGo surveying team will start the surveying work, which is expected to
take around six weeks, on 6th June 2016 with a view to launching the access
guides online from September 2016. A session was held on 5th May to introduce
key staff and service users to the project and an induction session will be held for
the surveying team to ensure that the requirements for security, infection control
and privacy and dignity are adhered to.
4
iv) Okay to Ask
Each year, the International Clinical Trials' Day is celebrated around the world on
or near the 20th May in order to celebrate the day that James Lind started his
famous trial on the 20th May 1747 (www.jameslindlibrary.org). The main objective
of the day/week is to make the International Clinical Trials' Day a focal point for
international communication events, meetings, debates, and celebrations of
clinical research. The event is supported by NIHR with an 'It's OK to Ask' research
awareness campaign. (www.crn.nihr.ac.uk/blog/news/ok-to-ask-about-clinicalresearch.
The Research and Development Department at the Newcastle Upon Tyne
Hospitals formed a task and finish group to plan and deliver the national
campaign. This year several events are being planned across the Trust across the
week beginning 16th May.
Summary of Events:
 Patient and Public Event - Monday 16th May 2015 at the Freeman Hospital
(Theme – bio bank and tissue donation).
 “Ok to Ask” public involvement event at the Dental Clinical Research
Facility
 Clinical Research Facility Open Day
 Raising awareness of research with non – research Musculoskeletal staff
 ‘Ok to Ask’ campaign within Northern Centre for Cancer Care (SBRU)
 Open Day at the Clinical Ageing Research Unit (CARU)
 Ok to Ask campaign across wards in Great North Children’s Hospital
(GNCH)
 Displays/Stalls across entrance of base sites and out-patient departments
Patient Quote from last year’s event:
“We really enjoyed yesterday. It was lovely to meet all your colleagues & find out
how everything works. I must admit my original thoughts of clinical research were
laboratories with white coated personnel rather than the patient facing side.”
(Sjogrens Patient)
v) Telehealth Project: Florence
The Telehealth team are continuing to undertake an on-going assessment of the
use of Florence, a text messaging service, with Gestational Diabetes patients. As
previously reported, the texting system is used to avoid the patients having to
make regular visits to the Trust whilst allowing the clinical team to monitor their
condition. Automatic flags are raised for any issues of concern.
40 patients have completed satisfaction questionnaires and the full detail is shown
in Appendix 4. Some highlights include:



100% Strongly Agreed that the system was safe and saved time
100% either Agree or Strongly Agreed that the system helped them
manage their health better
100% Strongly Agreed that the system provided enough support, control
and information
5
Freetext comments have included:
‘Florence helped me monitor my diabetes and keep a record of BG readings. Also
vitally saving time and made it easier than ringing twice each day’
An initial 4 week trial in the use of Florence has been launched in Day Case
Surgery with 3 patients. 2 patients rated their satisfaction with the system at 5/5
and 1 at 4/5.
‘I felt I was one text away from everyone I needed.’
Florence is also being trialed currently in Immunology (for patients on a 24 week
Allergy Monitoring pathway) and Epilepsy (medication reminders). These trials are
on-going and outcomes will be reported in future updates.
5.
RISKS AND MITIGATION
In May 2016, the key risks to the Trust’s Patient Experience arrangements are:

6.
The Trust has an obligation to provide a freetext comment section on all
electronic Friends and Family questionnaires. Since the launch of electronic
FFT questionnaires on outpatient kiosks, this has not been possible due to
technical difficulties. Patients have been offered a selection of the most
common responses to questions but there is currently no virtual keyboard
option to allow freetext. IT are working with Quality Health to resolve this issue
as a matter of urgency.
SUMMARY
The Trust continues to receive positive feedback from patients via the Friends and
Family test responses; however, engagement remains a challenge particularly in key
areas. All Trust kiosks have now had the Friends and Family questionnaire
downloaded and feedback from staff in outpatient areas is positive, highlighting that
the questionnaire is quicker to complete. There remain some technical difficulties
which the Trust’s IT team are working to remedy.
The overall number of formal complaints the Trust has received this year remains
below the previous year in spite of efforts to make the process as accessible and
widely publicized as possible. Changes to the quality assurance process are expected
to improve the ratio of returned complaints and reduce the need for Resolution
Meetings in the future which will be closely monitored.
The Trust’s work to enhance the role of carers progresses at a significant pace, as
does the Disabled Go project which will provide the most detailed access guide
information to patients and visitors of any Trust in the North East from September
2016. Several Telehealth pilots using Florence texting technology are on-going with
very positive feedback and comments from patients and a number of work streams
have been initiated as a result of patient feedback in the National Patient Survey.
6
7.
CONCLUSION
The Trust continues to collect, analyse and report patient experience feedback. Work
is now becoming well established to emphasise a ‘You Said We Did’ approach to
demonstrate learning and practice development arising from feedback received.
This report highlights key results, actions and issues from May 2016.
8.
RECOMMENDATION
To (i) receive the briefing and (ii) support the work outlined.
Helen Lamont
Nursing and Patient Services Director
Frances Blackburn
Deputy Director of Nursing and Patient Services, Freeman
Andy Pike
Head of Patient Experience
18th May 2016
7
Appendix 1: Friends & Family Infographic – February data
8
Appendix 2: Complaints Panel Dashboard March 2016
9
Appendix 3: National Patients Survey
A paper was presented to the Patient Experience Steering Group which outlined the
following areas for action
Issue
Information given
to patients
Information on how
to raise concerns
Written information
provided at
discharge
Discharge
Planning and
involvement
Quality of food
Proposed Actions
Review and refresh the Coming to Hospitals
information booklets
- Is this the correct format?
- Is it given at the right time for patients?
- Does it include our learning from the
Thinksafe pilot and place a focus on patient
safety?
- Does it cover the needs of patients admitted
as emergencies
New poster now available in all wards and
departments.
Re-iterate to patients on admission that we want
their feedback
Audit and review current use of the Discharge Wallet
Ensure information given at discharge complements
the information provided before and during the
patient’s stay
Consider how to personalise the information
provided to patients following their stay e.g. following
minor surgery, following surgery under general
anaesthetic etc to ensure individual needs are met
Review findings and historical performance with
Discharge Review Group to ensure
Catering managers to obtain site specific results and
comments.
Food tasting panels continue with service user
involvement
Meeting patients
nutritional needs
MUST assessment must always be done and
reviewed – all appropriate actions taken
Communication
with patients
Embed ‘Hello my name is’ into everyday practice of
all
Revisit Patient Experience DVD to decide next steps
Waiting times for
surgical
procedures
Understand the impact on patient and on waiting
times if patients asked to attend on staggered basis
rather than early morning.
10
Lead/s
Caroline McGarry
/
Sally Ridley
Patient Relations
Nursing teams
Discharge
Review group
(Paula Watson)
Caroline McGarry
Sally Ridley
Caroline McGarry
Sally Ridley
Discharge
Review Group
(June)
Geoff Moyle (FH)
and Wayne Reed
(RVI). Report to
Nutritional
Steering Group
Matrons with
support of
Nutritional
Steering group
Patient Services
HR/Training
Department
Theatre User
Group
Appendix 4: Florence Telehealth project
11
12