Patient Experience Report
Quarter 4: 1st January2013–31stMarch2013
Executive Summary
Introduction
Thisreport provides a summary of patient experiences withinDerbyshire Community Health ServicesNHS Trust (DCHS), good or bad.
Feedback received from patients and carers provides a wide range of information from
different sources including:
- Compliments
- Patient Questionnaires
- Comment Cards
- Websites: Patient Opinion and NHS choices
- Complaints
- Derbyshire LINk (Now Healthwatch Derbyshire)
- Friends and Family Test – Net promoter
Using all methods available to us, provides DCHS with feedback from all
services so that efforts can be prioritised to focuson the actions necessary to improve when
required and sustain quality.
Executive Summary cont’d….
Compliments / 2012/2013 / 2011/2012Quarter one / 1778 / 1538
Quarter two / 1784 / 1804
Quarter three / 1939 / 1380
Quarter four / 2528 / 1250
Complaints / 2012/2013 / 2011/2012
Quarter one / 60 / 57
Quarter two / 72 / 55
Quarter three / 61 / 49
Quarter four / 59 / 63
This quarter highlights are as follows
Executive Summary cont’d…
Executive Summary cont’d….
Patient Questionnaires
The patient questionnaires wererolled out to Integrated Community Based Services (community services) during October 2012 and were completed in February 2013.
Comment Cards
Since September 2012, the comment cards have been distributed to all service areas and include day case activity in LCRODD.
Contents
1. Feedback OverviewUpdates from quarter 3 / 7-12
Compliments / 13
Complaints / 14
Patient Opinion and NHSChoices / 15-16
2. Statutory reporting
Complaints – keythemes / 17-19
Outcomes / 20
Parliamentary HealthService Ombudsman(PHSO) / 21
MPLetters / 21
Friends and Family Test Question / 22-23
3 Patient Experience
Patient Questionnaire / 24-29
4 Patient and Public Involvement / 30-36
5 Themed Feedback
Privacy andDignity / 37
Nutrition / 38
Carers / 39
Healthcare for All / 40
EMIAS update, Picker Review, Francis Report / 41
6 Priorities for Quarter 1 for the Patient Experience Team / 42
Updatesfrom Quarter Three
What could we do better?
The perception from patients that some of the wards are not staffed sufficiently remains a recurrent theme. Services managers regularly review staffing levels and the skill mix on the wards in line with the patient dependency/ occupancy levels. They acknowledge that the ward staff are always busy and patients may perceive a short of staff.
Complaints status in Qtr 3
Of the 49 complaints investigated in quarter 3:
53% were upheld
33% partially upheld,
and 14% were not upheld
In four cases,the complainant requested further local investigation or information. Another case was closed following financial redress when a patient arrived for an appointment because they had not been informed that the clinic had been cancelled.
Outcomesof Level 3 complaints
18 complaints were rated at level three, examples being:
LCRODD complaint themes within Quarter 4 period 2012/13
The graph below outlines the complaint trends over the last year:
As shown the most common cause for complaints were staff attitudes, communication and appointment, in particular issues around waiting times. The quarter 2 and 3 action plan had a number of actions to address these. As shown in the above graph and improvement from December onwards across all of these domains.
The numbers of complaints relating to aspects of clinical care remains constantly around the 3/4 a month. This is to be a focus going forwards into 2013/14 year with actions to ensure that patients are receiving high quality and effective care.
Action Plan for LCRODD most frequent complaint themes within Quarter 4 period 2012/13
Description/Theme / Lead / Action / Timescale/Further Actions- All aspects of clinical care
AT / To ensure that if a patient raises a concern around clinical treatment that we ensure investigation and full feedback provided to the patient.
To ensure that patient are provided with time and opportunity to discuss their concerns with a clinician.
This area of complaints is difficult to manage given the subjective nature. / Monitor and review Qtr 1
- Communication & staff attitudes
It is worth noting that the overall 2012/13 complaint rate is approximately 1 in 2,600 patient contacts and of these there has been no level 4 complaints, and 72% of all complaints have been level 2 or level 1 complaints.
Compliments
Complaints - DCHS
This graph highlights a 50% increase in the number of complaints/concerns received regarding the Contraception and Sexual Health servicein DCHS. Further investigation found that this was due to 11 complaints about long waiting times at the drop in clinic. A letter of apology, advising that the service would be looking at this internally, was sent out to each complainant. As a result,they all did not wish to take their complaint further. There were no specific service trends identified under the “Others/ MP/ NSL” category. A decrease in Leicester Outpatients complaints was observed between quarter 3 and 4.
Patient Opinion and NHS Choices
Patient Opinion is a non-profit social enterprise based in Sheffield, which uses the web to carry the voices of users and carers into the heart of the health services. The aim is to make it quick, easy and safe for patients and carers to give feedback about their health care, and for health service providers and commissioners to respond and use the feedback for service improvements.NHS Choices is part of the Department of Health. Thecomments posted on NHS Choices are automatically recorded on the Patient Opinion website therefore both services have been reported together.
The following graphs and tables show all feedback this quarter. The compliments are added to the compliment database and the head of services are notified of the concerns and complaints.
/ January / February / March
Compliments / 0 / 1 / 5
Complaints / 0 / 1 / 0
An example of a patient’s post (compliment)an example of a response post by DCHS staff
Complaints
Level 1 / Level 2 / Level 3 / Level 4 / TotalComplaints / Misc
enquiries
Resolved by end of next working day / None or minimal impact to the provision of healthcare / Potential to impact on service provision/ delivery / Significant issues of standards causing lasting detriment
Qtr Four / DCHS / 34 / 29 / 19 / 48 / 65
MP letters / 0
Leicestershire and Rutland / 6 / 6 / 6 / 12 / 13
Totals / 40 / 35 / 25 / 60 / 78
Of the78miscellaneous enquiries, received 9 were regarding lack of staff communication with patients.
Contextual Overview of K041(a)
- The Department of Health requires information to monitor the number of written Hospital and Community Health Service (HCHS) complaints received by the NHS each year. The information allows analysis of complaints by subject.
- The information obtained from the K041(a) collection monitors written hospital and community health service complaints (by service area and type) received by the NHS each year. It also supports the commitment given in Equity and Excellence to improve the patient experience by listening to the public voice
The Complaints Team categorises each concern/complaint using the K041a national codes. Within Derbyshire, the top five categories with the greatest frequency are:
Qtr 1 2012 / Qtr 2 2012 / Qtr 3 2012 / Qtr 4 2013Appointments, delay/cancellations (out-patients) / 21 / 21 / 23 / 7
All aspects of clinical treatment / 22 / 33 / 36 / 26
Communication / 16 / 21 / 29 / 5
Attitude of staff / 12 / 9 / 10 / 6
Premises / 6 / 6 / 1 / 3
Within Leicestershire, the top five categories with the greatest frequency are-
Qtr 1 2012 / Qtr 2 2012 / Qtr 3 2012 / Qtr 4 2013Appointments, delay/cancellations (out-patients) / 12 / 7 / 8 / 3
All aspects of clinical treatment / 7 / 7 / 5 / 7
Communication / 2 / 3 / 4 / 5
Attitude of staff / 1 / 1 / 2 / 3
Premises / 0 / 0 / 0 / 0
It appears from the above tables that concerns and complaints received regarding communicationhad decreased this quarter in Derbyshire and remained consistent in Leicestershire. Complaints have been received regularly for all aspects of clinical treatment, further analysis revealed that this was across 12 sites and not related to one specific service.
The graph above illustrates the top eight themes and trends. The incidence of complaints receivedabout“all aspects of clinical care”in quarter four remains high, a large contributory factor to this was the 11 level 1 complaints relating to the Sexual Health Service at Long Eaton Health Centre in which patients commented on the long waiting times before an appointment. These complaints were resolved by the end of the next working day and all complainants received a letter of apology, advising that service will be looking at this internally as to what caused the delay and what actions could be implemented to avoid repetition of this incident. There has also been a consistent increase in the number
of complaints relating to “attitude” in which no site trends were identified.
Outcomes
Quarter 4 Friends and Family Test Results- Inpatient Wards Jan- March 2013
Hospital / Speciality / Friends and Family Test Scores / Discharges / Returns / Return rate % / CommentsJanuary / February / March
Ash Green, Hillside Ward / 100 / - / - / 8 / 2 / 25
Babington, Baron Ward / 75 / 20 / 75 / 65 / 21 / 32 / excellent food
Babington, Chevin Ward / 100 / - / - / -
Bolsover, Welbeck Ward / 100 / 87.8 / 67 / 127 / 54 / 43 / Answer call bells quicker
Cavendish, Fenton Ward / 80 / 95.2 / 100 / 70 / 56 / 80 / Staff work very hard, Perceived shortage of staff
Cavendish, Spencer Ward / - / 66.7 / - / 23 / 3 / 13
Clay Cross, Alton Ward / 100 / 92.3 / 100 / 46 / 21 / 46
Clay Cross, Fernilea / - / - / - / - / 5 / -
Heanor, Hanbury Ward / 80 / 66.7 / 100 / 58 / 20 / 34
Heanor, Coppice Ward / - / - / -
Ilkeston, Hopewell / 60 / 70.6 / 71 / 87 / 36 / 41 / friendly staff
Newholme, Rowsley Ward / - / 81.8 / 100 / 70 / 28 / 11 / Helpful staff
Newholme, Riverside Ward / - / - / - / 11 / nil / 45
Ripley, Butterley Ward / 100 / 100 / 100 / 87 / 39 / 51 / staff helpful, excellent and informative physio
St Oswald’s, Okeover Ward / 100 / 100 / 43 / 70 / 36 / 14 / friendly staff, physio excellent
Walton, Derwent Ward / - / 71.4 / - / 102 / 14 / 14
Walton, Melbourne Ward / - / - / - / 22 / 7 / 32
Walton, Linacre Ward / 100 / - / - / 23 / 2 / 9
Walton, Lea Hurst / 100 / - / - / - / 6 / -
Whitworth, Oker Ward / 100 / 40 / 100 / 53 / 20 / 38 / Excellent meals
Patient Feedback Friends and Family Test Score Breakdown Report
Leicester Planned Care Services January- March 2013
January- March 2013 / January / February / MarchHospital / Friends and Family Test Score
Market Harborough / 100 / 100 / 100
Hinckley and District Hospital / 100 / 100 / 100
Loughborough Hospital / 100 / 100 / 96.8
Melton Mowbray Hospital / 100 / 91.6 / 100
No comments were collected with the Friends and Family Test scores obtained from Leicester Planned Care Services.
Patient Experience Questionnaire … Health, Wellbeing and Inclusion
Focus in quarter 3 and 4 was on Health and Wellbeingand Inclusion ICBS serviceswithin DCHS.
The following presents an overview of the patient feedback captured in the questionnaires from Health and Wellbeing and Inclusion services from Health Psychology, Tier 3, Dental, Contraception and Sexual Health , Fresh Start (City), Sexual Health Promotion, Tobacco Control, Waist Wise, Health Visitors, School Nurses and Speech and Language Therapy. Patients had the opportunity to add any additional comments if they gave a rating of 8or below indicating a negative response to any of the questions. The Friends and Family Test question was also included at the end of the questionnaire. Not all patients responded to each question, therefore these omissions were taken into account in the analysis of each question. Questions which had a categorical response (e.g. Yes/No) show the results in percentages of patients whilst questions which had a scoring response show the results as an average score value.
The questions cover the categories Communication, Privacy and Dignity and Cleanliness.
Communication
98% of patients (who responded to the question) reported that the member of staff treating them introduced themselves when they first arrived at their appointment.
Patients gave an average score of 9.7/10 when asked how polite staff were to them.
Patients gave an average score of 9.5/10 when asked how well they would rate the staff at involving them in decisions about their treatment.
Patients gave an average score of 9.6/10 when asked how good the member of staff was at keeping them informed about what was happening during their treatment.
Patients gave an average score of 9.5/10 when asked how easily they felt they could raise any concerns regarding their treatment/care with the service if they needed to.
Privacy and Dignity
Patients gave an average score of 9.6/10 when asked whether they felt they were given enough privacy when being treated/ cared for.
Patients gave an average score of 9.6/10 when asked if something sensitive needed to be discussed, how privately this was done.
Patients gave an average score of 9.7/10 when asked if they felt they were treated with respect.
Cleanliness
Patients gave an average score of 9.6/10 when asked how clean the area was that they attended.
Overall
Patients gave a Friends and Family Test Scoreof 93, when asked how likely it was that they would recommend the service to friends and family.
These are aggregated results and all services received individual reports to discuss with their staff and develop action plans in areas where there could be improvement.
ICBS (Domiciliary Services)
The following presents an overview of the patient feedback captured in the questionnaires from ICBSDomiciliary Services from Community Matrons, Community Nursing, Community Therapy Teams, District Nursing, Respiratory Nurses and Unique Care. Patients had the opportunity to add any additional comments if they gave a rating of 8or below indicating a negative response to any of the questions. The Friends and Family Test question was also included at the end of the questionnaire. Not all patients responded to each question, therefore these omissions were taken into account in the analysis of each question. Questions which had a categorical response (e.g. Yes/No) show the results in percentages of patients whilst questions which had a scoring response show the results as an average score value.
The questions cover the categories Communication and Privacy and Dignity.
Communication
99% of patients (who responded to the question) reported that the member of staff treating them introduced themselves when they were first seen.
Patients gave an average score of 9.8/10 when asked how polite staff were to them.
Patients gave an average score of 9.6/10 when asked how well they would rate the staff at involving them in decisions about their treatment.
Patients gave an average score of 9.5/10 when asked how good the member of staff was at keeping them informed about what was happening during their treatment.
Patients gave an average score of 9.6/10 when asked how easily they felt they could raise any concerns regarding their treatment/care with the service if they needed to.
Privacy and Dignity
Patients gave an average score of 9.7/10 when asked whether they felt they were given enough privacy when being treated/ cared for.
Patients gave an average score of 9.8/10 when asked if they felt they were treated with respect in their own home.
Overall
Patients gave a Friends and Family Test Scoreof 89, when asked how likely it was that they would recommend the service to friends and family.
These are aggregated results and all services received individual reports to discuss with their staff and develop action plans in areas where there could be improvement.
ICBS (Outpatient Services)
The following presents an overview of the patient feedback captured in the questionnaires from ICBSOutpatient Services from.Day Services, Diabetes Specialist Nurses, Minor Injuries Units, Neuro OT and Neuro Physio. Patients had the opportunity to add any additional comments if they gave a rating of 8or below indicating a negative response to any of the questions. The Friends and Family Test question was also included at the end of the questionnaire. Not all patients responded to each question, therefore these omissions were taken into account in the analysis of each question. Questions which had a categorical response (e.g. Yes/No) show the results in percentages of patients whilst questions which had a scoring response show the results as an average score value.
The questions cover the categories Communication, Privacy and Dignity and Cleanliness.
Communication
91% of patients (who responded to the question) reported that the member of staff treating them introduced themselves when they were first seen.
Patients gave an average score of 9.7/10 when asked how polite staff were to them.
Patients gave an average score of 9.4/10 when asked how well they would rate the staff at involving them in decisions about their treatment.
Patients gave an average score of 10/10 when asked how good the member of staff was at keeping them informed about what was happening during their treatment.
Patients gave an average score of 9.5/10 when asked how easily they felt they could raise any concerns regarding their treatment/care with the service if they needed to.
Privacy and Dignity
Patients gave an average score of 9.5 /10 when asked whether they felt they were given enough privacy when being treated/ cared for.
Patients gave an average score of 9.5/10 when asked if something sensitive needed to be discussed, how privately this was done.
Patients gave an average score of 9.7/10 when asked if they felt they were treated with respect.