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

2. Why is insight into patient experience important? “ 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” A systematic review of evidence on the links between patient experience and clinical safety and effectiveness British Medical Journal

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

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

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

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

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

10. © Ipsos MORI Paste co- brand logo here Sometimes an overall measure can mask poor experience 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 “… 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…

11. 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.”

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

14. UNCLASSIFIED Means nothing if nothing is done

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

16. The priorities for patients with breast and lung cancer were different Lung cancerBreast cancer Communication of diagnosisFunctioning of day surgery unit Information about treatmentAppointments system and conduct of OP clinics Continuity and coordination of careCommunication Information about symptoms

17. 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.

18. 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.

19. Friends and Family Test Overview Simple test based on Net Promoter Score methodology ‘How likely are you to recommend our to friends and family if they needed similar care or treatment?’ 1Extremely Likely 2Likely 3Neither Likely nor Unlikely 4Unlikely 5Extremely Unlikely 6Don’t know

20. Friend and Family Test - outcomes 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 Environmental issues Mid Staffs NHS Foundation Trust Sandwell and West Birmingham Hospitals NHS Trust

21. 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 Medication issues The Royal Wolverhampton NHS Trust Friend and Family Test - outcomes

22. 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 Nutrition and Hydration

23. 23 Building on success and promoting what works Improving understanding of malnutrition and dehydration Involving all staff and building collaboration between teams Embedding responsiveness to patient voices Making every contact with patients and carers count Strengthening commissioning Building on Compassion in Practice to connect values with behaviours and make nutritional care an agenda that resonates within and beyond nursing

24. ‘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

25. 17 April 2013 Derbyshire Healthcare NHS Foundation Trust Opening Ceremony @GrangerKate

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

28. 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.

29. PLACE assessments

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