1. Blood Supply – Blood Donation Operations and Nursing Improving Donor Experience Board Presentation March 2014 Jane Pearson

2. Blood Supply – Blood Donation Operations and Nursing Complaints - National Donor Complaints per million Donations vs. Target (4,500) YTD Teams above target There are 41 teams above 4,500 YTD West 6181, East 5457, North 4566 EastHorsham13466 WestExeter10282 WestCity9990 NorthMitcham9965 WestH G 19736 EastPortsmouth9007 EastTeeside8609 East Kings Norton 8573 WestWorcester8466 EastIpswich7844 Mobile teams: North: 2567 / 562150 West: 2858 / 462400 East: 3354 / 614580 Donor centres: YTD 506 whole blood donors / 143506 YTD 56 platelet donors Numbers of donors complaining YTD / No of donations

3. Blood Supply – Blood Donation Operations and Nursing Slot availability, Not seen at time and turned away are the highest causes of complaints. All five categories have deteriorated with particular focus on turned away and slot availability. The implication is that opportunity to walk-in is the major driver of complaints increase. Top 5 Complaint Categories KEY December-12 December-13 YOY Change

4. Blood Supply – Blood Donation Operations and Nursing Team Level Diagnostics Two Steps to Diagnostics: 1.What is the problem? (Hypothesis) 2.Why does the problem exist? (Root Cause Analysis - holistic and whole team and donor engagement) This simple approach will ensure that even incoming managers with little to no experience of managing session environments (e.g. external appointments) will be able to easily understand issues and action plan appropriately.

5. Blood Supply – Blood Donation Operations and Nursing What is the problem (Hypothesis)? Session Capacity Clinical Is waiting time satisfaction <56%? Do donor satisfaction comments support hypothesis? HypothesisQuestions Is peak queuing time above 40 mins? Validation Observe session flow and speak to donors on session. Is there a trend of staff attitude complaints? Customer Service Are deferrals and/or FVPs above the national average? Observe clinical practice and speak to donors on session. The majority of donor complaints can be separated into one of the above 3 categories. An initial hypothesis about the main cause of complaints on any team can be confirmed and validated using the above approach. 1 1 2 2 3 3 Do donor satisfaction comments support hypothesis? Is needle satisfaction lower than national average? Do donor satisfaction comments support hypothesis? Observe staff-donor interactions and speak to donors on session.

6. Blood Supply – Blood Donation Operations and Nursing Worcester example – Hypothesis Session Capacity Is waiting time satisfaction <56%? Do donor satisfaction comments support hypothesis? HypothesisQuestions Is peak queuing time above 40 mins? Validation Observe session flow and speak to donors on session. Yes – waiting time satisfaction is the lowest in the country at 30.4% YTD. Yes – the majority of donor comments relate to long waiting times. Yes – peak queuing times are regularly above 40 mins. Area Manager session visit observed waiting times on under attended session (confirmed by donor feedback). The expected problem on Worcester team was Session Capacity contributing to high waiting times and turned away donors. This hypothesis was proven and validated by the steps above. Team and review of data indicated that most issues were related to donor waiting times and donors turned away.

7. Blood Supply – Blood Donation Operations and Nursing Worcester example – Root Cause Session Capacity Interrogate TPBs: Is target reflective of capacity? Is the balance of attendance even? Was donor attendance above 130% of grids? Is the throughput/ 20 mins reflective of number of beds? Is there an effective ramp up? Are beds kept full? No Establish: Were too many donors called up? Were the appointment grids reflective of donor attendance? Was there excessive marketing? Pre Session On Session Yes Planning Marketing Establish: Were there venue issues? Was staffing reduced on the day? Are the team working at a slow pace? Yes Manager Team

8. Blood Supply – Blood Donation Operations and Nursing Why does the problem exist (root cause)? Customer Service Investigate issues: Do complainants identify one individual? If donor does not know name, does review of DHC indicate individual? Do complainants indicate multiple individuals? Is there a poor team attitude to customer service? Yes Establish: Does investigation of circumstances indicate individual is at fault? Does investigation of circumstances indicate donor complaints were actually for a different reason? Individual Team Yes Individual Establish: Are team at fault? Were cause of complaints a different reason? Yes Team 2 2 Restart process at different category

9. Blood Supply – Blood Donation Operations and Nursing Worcester example – Action Planning Root CauseActionsDeadlines The team will be taken off road for dedicated development day to increase understanding, set performance expectations, ensure understanding of operating model/task timings and Customer Service Improvement (CSI). Donors will be updated every 15 minutes on anticipated wait times. Complaints, Compliments and Comments to be fed back to the team regularly. Daily performance observations and feedback/coaching by managers and OTP experts on sessions. Supervisors and Nurses will visit and learn from a high performing team. Waiting time satisfaction and peak queue times will be displayed prominently on each session, with clear targets for improvement in each measure (targets to be agreed with Senior Sister). PDPR objectives will encompass session flow management, with clear standardised targets and objectives. The capability policy will be invoked if staff are unable to manage session flow effectively after training. Performance against targets and management observations will inform a decision to invoke this policy. Mar-14... Mar-14 Mar-14. Apr-14. May-14. Jun-14 The team does not effectively manage the flow of the session, meaning that donors are often seen beyond their appointment time and walk ins are turned away.

10. Blood Supply – Blood Donation Operations and Nursing Action Planning OptionsPlanningMarketingManagerTeamIndividual Reduce calls ups. Reshape appointment grids. Move session times to fit donor attendance patterns. Reduce local marketing initiatives. Change marketing messages – encourage more appointment donors. Change NCC message to donors, “If you turn up, you will be seen”. Ensure NCC and Nurses are working to same guidelines (e.g. calendar month vs. days). Venue issues resolved, or new venues found. Communicate likely staff reductions to Planning well in advance of sessions. Feedback compliments and best practice to team staff. Ensure team ramp up session effectively and flex to maximise throughput. Review A/L management, Union Duties and all absence impact. Appropriate dedicated development time Controlled acceptance of return of staff on restricted duties.. Display waiting time expectations on session. Tie customer service levels into PDPR objectives. Team members to observe the process with donor’s eyes (15 Steps). Update on waiting time every 15 minutes. Disciplinary policy invoked in all proven staff attitude cases. Capability policy invoked for staff who cannot achieve required throughput.

11. Blood Supply – Blood Donation Operations and Nursing What is CSI? DEVELOPMENT OF PERSONNEL Develop Achieving Excelling Principles, Values and Core BehavioursChange Culture, Change behaviour Peer to Peer Training Managers Commitment Ongoing tools Customer Service Model Recruit the Right People Assessment Centre Feedback on the floor and in PDPR Visibility & Participation Keeping it ‘alive’ everyday Observation of Team & Individual Role Model, Coach & Give Feedback DVD & Discussion PDPR Tool Scripted Phraseology Information Guide Character Profiles Our CS Approach Nomination cards Local ownership local solutions

12. Blood Supply – Blood Donation Operations and Nursing CSI Team Roll Out – National Kings Norton Sutton Coldfield Teesside Newcastle Lincoln Hither Green Brighton Mitcham 1 st Wave Start: late Jan 14 2 nd Wave Start: late March 14 Exeter Portsmouth Worcester Gloucester DC Liverpool Northwich Wrexham Leicester Horsham Harlow 2 City 3 rd Wave Start: late May 14 Cornwall Southampton Solihull Southampton DC Cumbria Hull Caernarfon Ipswich London Middlesex Maidstone 4 th Wave Start: late July 14 Bristol DC Oxford DC Bristol North/South Bath Lancaster Nottingham Stoke Leeds/Bradford York Norwich Ashford Tooting DC Gloucester Manchester E & W Sheffield N & S Epsom WEDC Trial Phase Completed Roll out of each phase will take a total of 12 months

13. Blood Supply – Blood Donation Operations and Nursing Planned Initiatives (1) Initiative SummaryTeamDate Clinical leadership autonomy trial (no Hemocues, CST etc.) Text Messaging Service trial (session running late) trial Brighton/HorshamMarch 14 Kings NortonMarch 14 Stop call up text messagesNationalComplete Appointment and walk in only session trialsCambridge/HuntingdonMarch 14 Introduction of script for WelcomersOxford/NewcastleTBC Venue assessment change to enable venue WiFi if possibleNationalTBC Continuous session trial (bleed throughs)CumbriaMarch 14 1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 “Sandwich” grids – appts at start and end, walk ins in middleOxfordMay 14 10 PDPR Reviewer training for Senior Sisters / Charge NursesNationalTBC PDPR objectives linked to Customer Service standardsNationalApril 2014 11 12 Session Management training for Sisters and DCSsNationalApril 2014 Introduction of volunteer queue management trainingNationalTBC

14. Blood Supply – Blood Donation Operations and Nursing “Sandwich” Grids DNA DEF 14:00 14:05 14:10 14:15 14:20 14:25 14:30 14:35 14:40 14:45 14:50 10 x walk ins 14:55 15:00 Idea originates from staff and designed by staff on teams for roll out based on local knowledge. Evidence based on walk in, appointment attendance, deferral rates and times of walk ins per team. Pilot teams to design management at reception, including visual indicators. Appointment donors will be seen on or closer to appointment time and walk in donors can be more accurate donation time. Better staff experience – including more controlled session flow and fewer overruns.

15. Blood Supply – Blood Donation Operations and Nursing Initiative Summary Target the dissatisfied donors with a recovery programme letter Undertake a portal promotion to those individuals who have walked-in over the last 12 months and to whom we have an email address – 170,000 5 5 6 6 7 7 8 8 Change the text reminder system and only text non-appointment call up at certain times of the year and for certain blood group Roll-out the portal Planned Initiatives (2) 9 9 Implement compliment and complaint of the month to illustrate and showcase positive behaviours Date May 14 Ongoing March 14 10 Work with Customer Service team and Comms team to improve standard responses Ongoing 11 Refresh the previous approach to seeking donor feedback via various donor engagement forums – proposal to SMT. April 14