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Neil Churchill

Neil Churchill. Director of Patient Experience - ( Domain 4 Lead). Measuring, Understanding and Acting on Patient Experience Insight.

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Neil Churchill

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  1. Neil Churchill Director of Patient Experience - (Domain 4 Lead) Measuring, Understanding and Acting on Patient Experience Insight

  2. “The data presented display that patient experience is positively associated with clinical effectiveness and patient safety, and support the case for the inclusion of patient experience as one of the central pillars of quality in healthcare” Why is insight into patient experience important? A systematic review of evidence on the links between patient experience and clinical safety and effectiveness British Medical Journal

  3. Q Overall, how would you describe your experience of your GP surgery? What does a “very good” experience mean? Very good Fairly good Neither Poor Source: GP Patient Survey 2012-2013 All respondents who answered the question (948,758)

  4. How do we take our love of doctors into account? Q. “For each, would you tell me whether you generally trust them to tell the truth or not?” Base: 1,026 United Kingdom adults aged 15+, 10-16 June 2011Source: Ipsos MORI/BMA

  5. Net satisfaction with the running of the NHS To what extent do we need to tackle “gratitude bias”? Data: BSA 1983-2010. Each data point represents >100 respondents

  6. Proportion of UK population from each generational grouping So what impact will the changing demographic have on satisfaction? 2010: All adults aged over 66 2010: All adults aged between 45 and 65 2010: All adults aged between 44 and 31 1983: All adults aged under 39 2010: All adults aged under 31 Source: Eurostat

  7. How was your experience? (1)Adult Inpatient Survey 2012 18% rated their overall experience lower than 7/10 I had a very good experience I had a very poor experience Source: CQC/Picker Institute Base: 61399 (all respondents). Fieldwork: Sept 2012 – Jan 2013

  8. How was your experience? (2)Adult Inpatient Survey 2012 BUT 62% reported at least one aspect of poor care 18% 62% Experienced some form of poor care Poor overall experience Overall experience measures good for tracking satisfaction but not for rooting out problems? Source: CQC/Picker Institute Base: 61399 (all respondents). Fieldwork: Sept 2012 – Jan 2013

  9. On third day she asked for a bedpan Nurse told her it wasn’t worth running back and forth, told her to do it in the bed Nurse complained to her in the morning that she was soaking wet Sometimes an overall measure can mask poor experience “… in [the hospital] they treated me well” “Oh yes I found it satisfactory” Female, white, 65+, in hospital for several months Her report… Her experience…

  10. CASE STUDY “I went to the dentist, reported to the receptionist and the receptionist forgot about me. I’m not used to my sight loss and lost my orientation and couldn't bring myself to ask anyone for help and just felt too nervous to shout out or anything. I ended up sitting there for hours and it was an extremely frightening experience.”

  11. Patient experience is closely linked to patient involvement and engagement Being involved is part of having a good experience Individual Experience Involvement Involving patients is one means to understanding and improving experiences Individual and collective

  12. UNCLASSIFIED Means nothing if nothing is done

  13. http://www.kingsfund.org.uk/projects/ebcd/experience-based-co-design-descriptionhttp://www.kingsfund.org.uk/projects/ebcd/experience-based-co-design-description www.institute.nhs.uk/theguide

  14. The priorities for patients with breast and lung cancer were different

  15. Everyone Counts: Planning for Patients 2014/15 to 2018/19 • Plans are expected to demonstrate measurable improvement in patient experience as well as continued investment in generating feedback; • enhance feedback and insight from vulnerable patient groups; • measure and improve the experience of carers; • easier access to proven techniques and support for their implementation; • strengthen forms of staff engagement which can support improvements in patient experience through better staff experience; • learn from complaints and improve the experience of making a complaint.

  16. Putting Patients First: NHS England business plan 2014/2015 • NHS England’s Commitments to Carers published April 2014 • Introduction of Staff FFT April 2014 and support to engage staff on patient experience; • All NHS services provide real-time feedback through FFT by March 2015; • Insight strategy 2014; • Plans for ‘Always Events’ and a system-wide approach to improving patient experience by Sept 2014; • Patient Rights programme November 2014 and strategy to embed NHS Constitution; • Patient Centred Outcome Measures (PCOMs) by March 2015; • Accessible Information Standard and extension of PLACE to cover disability issues by March 2015; • Strategy for nutrition and hydration by March 2015 • Support for patient leaders.

  17. Friends and Family Test Overview ‘How likely are you to recommend our <ward / A&E department> to friends and family if they needed similar care or treatment?’ Simple test based on Net Promoter Score methodology Extremely Likely Likely Neither Likely nor Unlikely Unlikely Extremely Unlikely Don’t know

  18. Friend and Family Test - outcomes Environmental issues Mid Staffs NHS Foundation Trust Sandwell and West Birmingham Hospitals NHS Trust • Soft closing bins have been purchased for inpatient areas as a response to patients feeding back that noisy bins kept them awake at night • Comments regarding disturbed nights led to Introducing the ‘Quiet Protocol’ to help patients sleep well at night

  19. Friend and Family Test - outcomes Medication issues The Royal Wolverhampton NHS Trust The Royal Wolverhampton NHS Trust • After negative feedback, the Trust has introduced medication cards for patients who are off the ward during drug rounds to alert them that their medication is waiting to be dispensed • "Was in pain on previous admission, felt ignored by staff" – comment led to self-medication programme - patients manage their own analgesic medication when they are in pain

  20. Nutrition and Hydration • 3 million people in the UK are malnourished or at risk of...Of those: • A third are over the age of 65 - more than 1 million older people are malnourished • 93% are in the community, 5% in care homes, 2% in hospital • Public Sector expenditure is estimated to be billions of pounds a year. • NICE identifies better nutritional care as the sixth largest potential source of cost savings to the NHS

  21. Nutrition and Hydration

  22. ‘If you’d asked me the most important quality of a doctor, I would have said competence. When I became a patient I soon realised how important compassionate attributes in the people looking after me were’ Kate Granger

  23. 17 April 2013 Derbyshire Healthcare NHS Foundation Trust Opening Ceremony @GrangerKate

  24. Ensuring we listen and act on feedback from vulnerable patients

  25. Accessible Information Standard • There is a formal process to develop an Information Standard. • We are asking people for their views to inform the details of the standard, which we will start to write in spring 2014. • There will be a formal consultation on the draft standard in summer 2014. • We are expecting to have a final version of the standard approved in autumn 2014 – organisations will then have up to 12 months to comply.

  26. PLACE assessments

  27. Point of Care 2014 Staff Satisfaction = Improved Patient Satisfaction and Care

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