Improving Patient Experience

1. Improving Patient Experience Neil Churchill 25 June 2013

2. The Government expects to see the Board make significant progress by March 2015 in measuring and understandinghow people really feel about the care they receive and taking action to address poor performance

3. The NHS Patient Experience Framework (2012) NHS Quality Board (NQB) & Compassion in Practice (2013) emphasise the importance of: • Enabling access to care with attention to waiting times; • Involving patients in shared decision-making about their treatment and care; • Empowering patients to be partners in their own care; • Welcoming the involvement of family and friends; • Respecting patient centred values, preferences and expressed needs; • Coordinating care around the patient. • Information, communication and education; • Delivery of essential care with dignity, respect and compassion; • Managing expectations and providing emotional support and alleviation of fear and anxiety; • Ensuring continuity as regards information, especially over transition.

4. shared purpose Our • On some measures we are doing relatively well: NB Important work is still in progress regarding indicators which needs to be completed ensure firm foundations – is the balance correct?

5. Some key areas for improvement in cancer patient experience (based on the results of the 20101 and 2011/12 Cancer Patient Experience Surveys2) 1 https://www.gov.uk/government/uploads/system/uploads/attachment data/file/153436/dh 122520.pdf.pdf 2https://www.gov.uk/government/uploads/system/uploads/attachment data/file/126880/Cancer-Patient-Experience-Survey-National-Report-2011-12.pdf.pdf

6. Female, 91 Daniel, 14 year old

7. ‘Cardiologists seem unable to talk to other specialists involved with my care…. My most recent example is where one specialist seems to think that one of my conditions is probably due to something in the province of another specialist and has instructed me to ask this other specialist if this is the case “Yes or No”. I wanted to scream at him – “pick up your bloody phone and talk to him yourself, you are the experts”!’ Martyn Lewis I ♡ My NHS

8. At present: • Agenda is very measurement focused; • Need balance, with more emphasis on improvement; • Currently provider-led – need to equip commissioners; • Majority of insight still reactive – not part of way we do business; • Very limited focus on patient journeys and transitions in care. 95% of patient experience board reports result in no action being taken Robert et al What Matters to Patients 2011

9. Making the argument • Link between experience and health outcomes i.e. patients who have a better experience of care generally have better health outcomes • The relationship between staff and patients i.e. where staff are well cared for this has an impact on patient experience conversely if patients are having a poor experience, it has a negative impact on staff experience • The link between experience and cost of care i.e. poor experiences generally lead to higher costs as patients may have poorer outcomes, require longer stays or be admitted for further treatment • Experience – Outcomes - Productivity

10. Principles • See experience from the patient perspective – journeys of care, not just individual services; • Build on evidence base with clinical leadership; • Integrate patient experience throughout Domain strategy; • Pursue improvement through co-creation and experience-based design; • Address health inequalities in experience; • NHS England needs to model good practice.

11. 6 Areas for Action • Cohesiveness of approach across new system; • Patient leadership in delivering change; • Commissioning responsive health organisations; • Compassion in practice is not just for nurses; • Promoting rights & responsibilities; • Tackling high-priority issues: Outcome Framework & beyond.

12. Help shape our thinking and show us what works: neilchurchill@nhs.net @neilgchurchill