The National Cancer Patient Experience Programme 2010 National Survey

1. National Cancer and Picker National Inpatient Surveys 2010 and internal patient experience questionnaires. Results summary and action plan Amanda Parker – Director of Nursing and Quality

2. The National Cancer Patient Experience Programme 2010 National Survey

3. The survey sampled 109,477 patients from 158 acute hospitals who were treated between January and March 2010. Of the 95 eligible QVH patients, 62 returned their questionnaire giving a response rate of 67% which is equal to the national average. Results were broken down by tumour group with the majority of QVH patients questioned being either head and neck or skin cancer patients. National Cancer Survey

4. Patients were asked questions about their care and treatment from pre- admission to discharge. 51 questions were applicable to QVH patients and when compared to the other trusts the results are as follows: 25 questions were in the highest scoring 20% of Trusts (of which 6 were top scores) 9 questions were in the lowest scoring 20% of Trusts 20 questions were in the remaining 60% of Trusts20 Patients were given to opportunity to state what they felt was good about their care, what could be improved and any other comments. 37 comments were received of which 70% were positive aspects of their care and 30% were suggestions for improvement. QVH results

5. High scores: Given easy to understand information about tests - 94% Clinical Nurse Specialist (CNS) listened carefully – 95% Patients had confidence and trust in doctors - 100% Ward nurses gave understandable answers – 88% Told patient who to contact if worried - 96% Staff did everything they could to control pain – 95% Always treated with dignity and respect by staff – 96% Overall, given the right information about condition or treatment - 91% What we are doing well

6. Lower scores: Pt thought they were seen as soon as necessary – 71% Side effects explained – 62% Written information about side effects – 58% Patients given written information about operation – 54% Staff gave enough emotional support (outpatient/day case) – 66% What could be improved

7. National Inpatient Survey 2010

8. Picker Inpatient Survey • Survey required by the Care Quality Commission (CQC) - carried out for QVH by the Picker Institute • The Picker Institute surveyed 75 other NHS Trusts, thus enabling us to benchmark against them • The survey is based on a sample of 850 consecutively discharged inpatients who attended the Trust in June, July or August 2010. • 393 questionnaires were returned completed • Response rate 47% compared to 52% for our 2009 survey.

9. Scoring The Picker Institute uses the concept of ‘problem scores’ as a summary measure. Problem scores are based on a combination of the less satisfactory answers e.g. ‘No’ or ‘not usually’ This score is given as a percentage % Low scores = Better performance

10. QVH highlights • Of the 88 questions asked: • 70 scored significantly better than other trusts in Picker survey (there were no scores significantly worse than average) • 25 were ‘top’ scores • 33 questions were given a problem score of under 10% • 6 questions were significantly better than last year

11. Rating of care was good/excellent 96%. Doctors and nurses worked well together 95%. Always had confidence and trust in doctors 91%. Room or ward was very/fairly clean 98%. Toilets and bathrooms were very/fairly clean 97%. Hand-wash gels visible and available for patients and visitors to use 90%. Always enough privacy when being examined or treated 95%. Risks and benefits of surgery clearly explained 86%. High patient experience scores

12. QVH Average Information on ward routines 35% 58% Hospital food was fair or poor 29% 42% Opportunity to talk to doctor 26% 47% Doctors knew enough 4% 11% Nurses gave clear answers 15% 33% Nurses talked in front of patients as if they weren’t there 7% 21% Wanted to be more involved in decisions 27% 46% Not told who to contact if worried 6% 21% Significantly better than average

13. Widespread national publicity about commissioning reforms Ambitious savings targets for PCTs / GPs Looking to reduce spend in hospitals Low Priority Procedures Loss of “corporate memory” Example of how QVH compares to other trusts (in Picker survey)

14. Improvements since last year • 2009 2010 • Admission process not at all or fairly organised 23% 15% • Shared sleeping area with opposite sex 7% 3% • Patients in more than one ward, sharing sleeping • area with opposite sex 14% 4% • patients using bath or shower area who shared it • with opposite sex 15% 9% • Not always enough privacy when being examined • or treated 6% 3% • Discharge: was delayed 22% 16% • Results show significant improvement in mixed sex accommodation and privacy and dignity, reflecting the work put in over the past year.

15. Higher problem scores Whilst in some questions we are better than other trusts these scores show there is still room for improvement. Last year the trust adopted a policy to routinely copy patients into letters to their GP and we would expect the 2011 survey score to reflect this.

16. Where do we go from here?

17. Key staff will be involved in making improvements Actions will be incorporated into the Patient Experience Action Plan Action planning

18. Improving the written information available to patients about their condition or treatment (particularly for cancer patients) Written information about side-effects for cancer patients Improve discharge information for cancer patients Emotional support for cancer outpatients or day cases Ensuring inpatients are asked to give views on quality of care Improve information and communication for patients whose discharge is delayed for 1 hour or longer Continue to ensure copies of letters are sent to patients Key action points from both surveys

19. Capturing the QVH patient experience

20. In-patients are encouraged to complete Inpatient Experience Questionnaire before leaving the hospital. The QVH governors are attending clinics on a regular basis to ask patients to complete an Outpatient Questionnaire. Comment cards and boxes are available across the site for patients and visitors to leave their feedback. Patient Feedback Posters are on display around the site encouraging feedback and advising patients of the various ways they can tell us about their experiences. How we try to capture the patient experience

21. Ward exit responses Quality of Care

22. Ward exit responses Would recommend QVHto friends and family?

23. Negative comments Would have liked my consultant to have visited… As usual parking very difficult, in spite of disabled badge Fantastic hospital and care. However, very rushed when discharged by Dr and staff in that team - very disappointed by this - ward staff tried to rectify this for me! Good Backup! Lack of mushy food post jaw surgery. If I can change one thing it would be the waiting time for the operation. Patients could be shown around to explain where to go i.e. bathroom, toilet, dayroom etc. My only complaint is that at times the ward is very noisy and it is hard to sleep

24. Positive comments Having been in hospital several times during recent years I was stunned by the cleanliness, general courtesies and environment in general. If I am unfortunate to be an inpatient again then let it be here! I received outstanding care from everyone at QVH. They made a difficult experience a whole lot easier to undergo - thank you. Everyone was polite and helpful at all times, no matter what their role was Staff were very friendly and helpful. Always responded quickly to bell calls and always arrived smiling made the experience a lot less painful. Everybody from the cleaners to the top surgeon were extremely polite, well trained and of a very caring nature. I felt comfortable with at all times and aware of my condition and dangers involved during the procedures - well done everybody. (plastic surgery) Best Hotel I Have Ever Been In.

25. QVH is committed to improving the patient experience and we have been introducing a variety of methods for patients and visitors to give us their feedback about our services and their overall experience. Data is recorded and analysed on a monthly basis and brought together in a Patient Experience Report presented to the trust management teams and wider public audience, through the Board of Governors and Public Engagement Committee. 2010 saw the first edition of a QVH Patient Experience Action Plan this document has identified and brought together key issues for our patients. The Action Plan comprises of issues raised through a variety of sources: National surveys, Internal inpatient and outpatient questionnaires, Comment Cards, NHS Choices, PALS and Complaints data and feedback from governors, staff and volunteers. Bringing it all together

26. Any Questions?