National Inpatient Survey Webinar 2014 August 21 st 2014

Agenda and timings o Survey development [10 min] o Data protection and section 251 requirements [10 min] o Practicalities of Administration [15 min] o Potential Errors [5min] o Provisional Timetable [5min] o Questions and Answers [10 min]

Survey development: Questionnaire changes since 2013 Two questions carried in the 2013 inpatient questionnaire have been removed for the 2014 survey: o Did you receive copies of letters sent between hospital doctors and your family doctor (GP)? o Were the letters written in a way that you could understand? Two new questions added covering relational aspects of care: o 33. Did you have confidence in the decisions made about your condition or treatment? o 67. During your time in hospital did you feel well looked after by hospital staff? Question bank: there will be no question bank for the 2014 survey.

Survey Development: Cognitive testing Ten interviews were completed in Oxford with individuals who had been an inpatient in an NHS hospital in the last 6 months. The testing considered the cognitive process of responding in terms of the model described by Tourangeau (1984) seeking to establish consistency in: o Comprehension o Retrieval o Evaluation o Response

What’s new? CQC Flyer New this year to the Inpatient survey is the CQC flyer to include in mailings, for contractors these will be sent to you directly and for in house trusts they will go to the trust. The CQC flyer explains who CQC are and how the survey data will be used by them. Sample declaration form The sample declaration form is a new addition for the 2014 Inpatient survey. These documents are to be sent to your approved contractor before you are able to submit your sample. Once your approved contractor has checked your sample, both the sample declaration form and the anonymised sample file will be submitted to the Co-ordination Centre by your approved contractor. Samples files will not be accepted without the signed sample declaration form. The Co-ordination Centre will use these documents to help check your sample file. Free text comments A change to this year’s survey is that free text comments do not need to be anonymised, as a statement has been added to the questionnaire stating that any information provided in the free text box will be shared. This will enable results to be looked at in full by trusts, the CQC and researchers.

Adherence to guidance o Please note that Section 251 approval which has been sought for this project to provide a legal basis for trusts using a contractor to provide names and addresses to them. Although in-house trusts are not undertaking this, we expect them to follow the standard practices and procedures in the interest of protecting patient confidentiality and maintaining high standards. o It is not permitted to offer financial inducements or lottery prizes to respondents. o Similarly, we do not recommend translation of questionnaires into other languages within the national survey. The terms of the ethical approval do not permit these types of alteration. Furthermore, such alterations might mean that the comparability of the survey would be compromised, and such results may not be acceptable for computation of the relevant measures within the Care Quality Commission assessments for that trust. o If trusts want to make any adjustments to the method or materials set out in this guidance, they will need to seek local research ethics approval, and check with the Co-ordination Centre that the proposed alteration would not compromise comparability.

Approval under section 251 of the NHS Act 2006 o Approval for the NHS Adult Inpatient Survey 2014 was sought this year under Section 251 of the NHS Act o This approval allows the common law duty of confidentiality to be put aside in order to enable the processing of patient identifiable information without consent. The survey methodology was reviewed by the Health Research Authority (HRA), and the Confidentiality Advisory Group (CAG) of the Health Research Authority (previously NIGB) has granted a recommendation of support. o Please note that any deviation from the methodology outlined in the guidance manual may render the approval invalid and would lead to action being taken against an NHS trust.

Data protection and Section 251 requirements o Separate mailing and sample files from trusts to contractors. o Sample declaration form and process. o Dissent posters. o Recording dissent and removing patients.

Data protection and Section 251 requirements: separate mailing and sample files o This is a non-negotiable requirement of the survey’s Section 251 approval. o It must be followed by every trust to contractors. o Failure to comply will result in this being counted as a breach. o CQC and CAG will be notified of any breaches: follow up action taken as necessary

Data protection and Section 251 requirements: separate mailing and sample files o Mailing file contains: – Unique identifier (patient record number) – First name – Surname – Address fields – Full postcode

Data protection and Section 251 requirements: separate mailing and sample files o Sample file contains: – Unique identifier (patient record number) – Year of birth – Gender – Ethnic group – Date of admission – Date of discharge – Length of stay – Route of admission – Main specialty (of consultant) code on discharge – NHS site code of admission – NHS site code of discharge – CCG o Sent to contractors with AES-256 Encryption

Data protection and Section 251 requirements: sample declaration form & process o Similar to the declaration introduced for the national A&E Survey o Must be completed by the NHS trust: signed by the person preparing the sample file AND by the Caldicott Guardian. o Must be ed to your survey contractor or Co- ordination Centre if in house BEFORE the sample file is sent. o The survey contractor or Co-ordination Centre must confirm receipt of the form and give permission for the sample file to be sent.

Administration of the survey o Approved contractors and conducting surveys in-house. o Survey guidance. o Fieldwork time keeping. o Updating the Co-ordination Centre. o DBS checks. o Freetext comments.

Survey publicity o It is important that the national surveys are publicised and responses encouraged so that as many patients’ voices are heard as possible. o Updated templates provided in the guidance. o Use of publicity in addition to posters such as: Twitter and social media, local media and newspapers – increasing visibility of the survey.

Potential errors o Questionnaire format and re-typing questionnaires. o Sampling: Inclusion of ineligible patients (based on route of admission information) e.g:  Incorrectly excluded by specialty code.  Sampled by consecutive admission.  Screened single night stays.  Incorrectly excluded by age.  Inclusion of private patients.  Inclusion of patients both admitted and discharged from a community hospital.

Provisional timetable o Patient samples to be drawn and submitted for DBS checks – 8th September – 26 th September o Questionnaire mail out begins – 15 th September o Fieldwork – 15 th September 2014 – 16 th January o Final data due to Co-ordination centre – 23 rd January o Weekly monitoring starts – 9 th October o Reporting (April)

Q&A

Thanks for joining us o A copy of the slides and the recording will be uploaded on NHS surveys. Contact details: Telephone number: