1. Denise Llewellyn Executive Director of Nursing Aneurin Bevan Health Board “Look Closer See Me” Dignity in Care

3. Growing concern reported about care provided to (older and vulnerable) people in NHS settings: - Patients Association & Community Health Council NHS Complaints Ombudsman in England Care Quality Commission/Health Inspectorate Wales Comments from the nursing profession – RCN/NMC Increasing media, public and political concern and comment Awaiting Francis review Background…

4. Fundamental change is needed. Patients need to know what quality care is, and staff need to be supported by systems and resources to empower them to meet patient’s expectations. Poor practice should not be tolerated. The attitudes, behaviour and emotional intelligence of staff on the wards are crucial. We need strong, positive leadership at all levels and a system which builds in dignity and respect as the cornerstone of high quality care’’ What the Commissioner said…

5. High on the agenda Board commitment Staff commitment Seeing results, feeling results with evidence of improvement ABHB Patient Experience Framework (2011) Dignity in Care in ABHB

6. Key Areas being addressed Leadership Culture Safe Dignified Care Workforce Listening to the Patients Voice

8. The ‘Fundamentals of Care’ (2003) ( FOC) is a Welsh Assembly Government initiative which aims to improve the quality of aspects of health and social care for adults. The standards are monitored annually by the Welsh Assembly Government, with quarterly internal reports on progress to the Nurse Director. The FoC initiative grew out of concerns regarding the following: Inconsistency in standards across services and areas Common themes in complaints and compliments Increasing expectation of the service user Lack of clarity for service users Increasing focus on regulation and performance Ward Sister empowerment and ownership

9. Standard Operational Score % compliance User Experience % score 2009201120092011 1Communication & Information75859396 2&5Respecting People & Relationship70808894 3Ensuring Safety88909395 4Promoting independence83829194 6Sleep, rest and activity78838791 7Ensuring comfort, alleviating pain79839496 8Personal Hygiene and appearance70769195 9Eating & Drinking838990 94 10Oral Health and hygiene62 707487 11Toilet needs8793 95 12Preventing pressure ulcers82878291 Overall Average Score78 83 8994 The table below shows % compliance with the 12 Fundamentals of Care Standards from 2009 2011

10. “Transforming Care” (NLIAH 2009) is the vehicle to improving the patients’ experience of care To increase the time nurses spend in direct care to 70% (average is 35%!) To increase patient satisfaction to at least 95%. To increase staff satisfaction to at least 95%. To reduce adverse events by 50% AN AMBITIOUS CHALLENGE!

11. “Transforming Care” Dignity Outcomes Knowing How We Are Doing is critical….. St Woolos Hospital in Newport – 10 months without a Hospital Acquired Pressure Ulcer County Hospital in Torfaen – 3 months without a Hospital Acquired Pressure Ulcer Direct Patient Care Time has increased from 48% to 56% in Ebbw Ward, YAB Ward B3, RGH have had 365 days without a Medication mis-administration Incident Ward C4 West, RGH have had 235 days without a case of MRSA Ward 4/1, NHH have had 71 days without a V&A Incident

15. WAY FORWARD Patient Stories Patient & Family Centred Care Programme (Kings Fund & IHI) Patient experience Improvement Work (Kafka Brigade UK)

16. “Look Closer See Me”