1. Council of Governors Meeting December 2013 Beverley Geary Director of Nursing

2. Introduction Changes to the team Nursing strategy and priorities The response to Francis report Cancer Survey result Questions

3. Patient Experience Patient Safety Measuring the impact Staff Experience New team –new strategy

4. Full review of service Complaints management Patient engagement Learning & sharing Governor involvement Patient Experience

5. Staff Experience AKUH Acuity & Dependency Documentation review IMW Introduction of new roles

6. Bring back Matron!

7. Matron focus areas Quality of Care IP&C Patient Experience Professional Standards Environment Accountability

8. Senior Nurse Agenda = Patient Care Agenda Matrons Lead Nurse’s role Safeguarding Adults Patient safety Ward Sister - key Professional standards & accountability

9. Francis: The final report of the Mid Staffordshire NHS Foundation Trust Public Inquiry

10. Francis: Key Recommendations fundamental change in culture is needed which puts patients and their safety first: Every single person and organisation in the NHS needs to reflect on what needs to be done differently in future and how they can contribute to a safer, committed, compassionate and caring service Patients need to be the first and foremost consideration of the system and all those who work in it

11. Francis – key recommendations ' A structure of fundamental standards and measures of compliance Openness, transparency and candour is required throughout the system, underpinned by statute Improved support for compassionate, caring and committed nursing Stronger patient centred healthcare leadership Accurate, useful and relevant information to allow effective comparison of performance by patients and the public.

12. Patients First and Foremost – The Government Response Preventing Problems Detecting Problems Quickly Taking Action Promptly Ensuring Robust Accountability Ensuring Staff are Trained and Motivated

13. Patients First and Foremost The York Response…

14. Preventing problems Task and Finish Group developed to establish action required to Francis Review of key risk management processes Review of SI process locally Further development of compliance review systems Changes to senior nursing structure IMW programme (nursing leadership) Senior Nurse walkabouts & peer review planned Policy development and review processes' to be revised Refinement of audit processes Introduction of new roles to support clinical teams

15. Detecting problems quickly EWTT under development for ward level assurance PURP-weekly monitoring & monthly meetings with Chief Nurse and clinical team Dashboard developed to look at early detection of organisational risk Refinement of NCI’s Embedded Safety Thermometer Weekly review of complaints (CEO, CN) Review of mechanisms for learning from SI’s and complaints FFT – patient feedback in Real Time Review of PPI/ Communication strategy

16. Taking Actions Promptly Weekly review of incidents, trends and themes Local resolution training commenced Board level review of triggers Intervention and management of robust action plans at senior level if required further work on organisational approach to learning and review of Serious incidents begun Senior Nurse walkabout and peer review planned (triangulated with internal and external compliance visits)

17. Ensuring Accountability SI review group and sharing at Executive Board level of all SI’s Strong risk management system in place, review currently being undertaken Review of Being Open policy & audit of implementation Monthly quality and safety report to board (being revised to ensure robust and relevant data is being captured) Public Board meetings introduced Changes in Nursing management structure to ensure clear lines of accountability

18. Ensuring staff training and motivation Patient stories included regularly in Board and Senior meetings Action plan in response to Staff Survey – monitored at Board Level It’s My Ward programme & promotion of engagement of clinical staff Robust training programme available for all staff at all level's Exploration of how we can feedback to staff more quickly, incidents, complaints etc. New Nursing strategy with focus on safety, patient experience, staff experience and improving clinical outcomes'

19. November 2013 After Francis: making a difference Introduction of inspector of hospitals 1st wave of new inspections' New CQC ratings Consultation on standards' Nursing leadership programmes Changes to pre-reg. education

20. The work continues…

21. National Cancer Patient Experience Survey 2012-13

22. 3 rd Annual Survey – Department of Health All Trusts – 155 Adult patients (16+) Patients discharged between 1 st Sept – 30 th November 715 responses 69% (64% national) response rate 111 pages of qualitative feedback

23. Key Findings: 62 questions asked: 24 – top 20% of Trusts 3 – bottom 20% of Trusts 35 – remaining 60% of Trusts 91% of patients rated their care as excellent or very good

24. Key Positive Findings 91% - given easy to understand written information about their test 87% - staff explained completely what would be done during the test* 86% - staff gave complete explanation of test * 94% - CNS definitely listened carefully 93% - CNS gave understandable answers to important questions 95% - patients reported that staff told them who to contact if worried post discharge

25. Key areas for improvement 80% - always given enough privacy when discussing condition/treatment 79% - patient had seen information about cancer research in hospital 25% - patient reporting that they had been asked to take part in cancer research

26. Questions?

27. Thank-you beverley.geary@york,nhs.uk 01904 725087