25th June 2014
Best Practice Principles in presenting
Cancer Patient Experience Survey Data
for Improvement
Catherine Thompson
Head of Patient Experience, Acute
Care, NHS England
Welcome and Introduction
to the day
www.england.nhs.uk
Learning for
Change
Best practice principles
in presenting Cancer
Patient Experience
Survey data for
im...
www.england.nhs.uk
• Explore how CPES results can be best presented to:
• Meet the needs of patients.
• Meet the needs of ...
www.england.nhs.uk
• Shared with Quality Health (current CPES provider),
CPEAG
• Develop a Quality Improvement Resource th...
www.england.nhs.uk
• If you would like to participate in a follow up telephone
interview to share innovative practice in u...
Dan Wellings
Head of Insight and Feedback
NHS England
@danwellings
An update from NHS England Patients
and Information Dir...
Building choice of high quality support for commissioners
FFT and beyond – Insight and
Feedback in the NHS
Dan Wellings
He...
Our vision for insight & feedback
“Our ambition is for the NHS to become a world class
customer service. Above all this me...
Insight in practice…
• Using qualitative and
quantitative data to inform what
we do
• Using whatever data sources
we have ...
Why is it important?
“The confidence that individuals have in
their beliefs depends mostly on the
quality of the story the...
The Insight
Strategy
Insight &
Feedback
Less descriptive
LessgeneralisableMoregeneralisable
More descriptive
In depth interviews
Experience Bas...
Objective of Insight Strategy
To establish a clear strategic vision for how the different
elements of insight & feedback c...
FFT and other data
– Review raised a question mark over perceived purpose
– It has different characteristics from other su...
Means nothing if nothing is done
dan.wellings@nhs.net
Thank you
The CPES – how can
patients and public use it to
drive change?
• Bonnie Green
• Service User and Carer
• June 2014
What I’m covering
– Why am I here
– Working with Macmillan
– Working with my local commissioner
– Working with my local pr...
My story
My husband’s story
Why am I here
Working with Macmillan
• Worked with
Macmillan last
summer to produce
a guide to create
more patient/public
awareness of t...
• To support people affected by cancer to navigate the National Cancer Patient
Experience Survey (CPES)
• To outline the k...
What we considered important to
highlight:
– Explaining what
the CPES is
– What the data
indicates
– How it can be
used
– ...
Who was involved
How has the guide been distributed
• Copies sent to 80 cancer patient representatives on
Healthwatch
• Disseminated via Ma...
How have I utilised the CPES
results locally
1. My local CCG
2. My local provider
Questions and Discussion
Dr Sean Duffy, National Clinical
Director, Cancer
NHS England
An overview from NHS England
Activity 1.
Turning insight into improvements
and solutions
www.england.nhs.uk
Model for
Improvement
Ben Page, Chief Executive
Ipsos MORI
@benatipsosmori
Data and what works well
Bringing data to life, tailoring CPES
data to the right audience
Activity 2
Gill Starkey
Northumbria NHS Trust
Case Study
Northumbria Healthcare NHS
Foundation Trust Experience
One of the largest geographical trusts in
England.
Provides acute and community health services
and adult social care to a...
Director of Patient Experience
Patient Experience Team
Executive management team support
Ensure patients & families are al...
Quality Council
Shared Purpose
Patient Perspective
2 minutes of your time
Friends and family
Inpatients – best in North Ea...
Cancer patient experience
In top 10 for first 3 surveys :-
What happens with results?
CNS meeting
Lead Clinicians / MDT’s
...
Strong membership :-
Communication
Peer review
Lung cancer project
Orthotics
Publicity – business cards
Detailed analysis ...
Mainly from patient comments
Communication :- Sage and Thyme
Advanced Communications
Written assessment / care plan
Financ...
24 hour chemotherapy helpline
CNS’s at ODU report
Acute Oncology service
Survivorship programmes
Clinical Psychology
Teamw...
Staying in top 10!!
Environment
Capacity
Cumbria
New Emergency Care Hospital
Challenges ahead
Thank you for
listening– any
questions?
Julie Wells
Director
Transforming Health Ltd
&
Kristin Gustafsen
Programme Manager
Imperial College Healthcare NHS Trust
T...
Macmillan Values Based
Standard®
What we have achieved and learnt
to date
Julie Wells
Macmillan Values-Based
Standard™
• Naming – “I am the expert on me”.
• Private communication – “My business is my business...
Trumps!
The relational
aspects of care
trump the
functional ones
How we work…….
What is really going on here?Discover
• Use survey data, annual and real time
• Work with staff – identify ...
Triangulation
Key achievements to date
• Our Collaborative Phase 1 and 2
• Involvement of front-line staff
• Involvement of patients
• T...
The Learn Zone
http://learnzone.macmillan.org.uk
Imperial`s
“Way Forward “
by Kristin Gustafsen
Aim
• Background
• Demo of presenting results
• Innovation challenges
• Next step
Background
• Pilot started Oct 2012
• 4 areas
• Data collection
• Privacy and ward round focus
• Restructure in organisati...
Discovery and Data Collection
• 1st and 2nd wave areas
• Ward visits
• Build relationships and promote projects
• Data col...
The Evidence
• National Cancer Survey
• In-Patient feedback survey
• Patient feedback interviews and discussions
• Staff f...
Staff survey results
RAG: Red/Amber/Green
Do you feel that there is good team work in this unit? STF032 88.75
Are you prou...
Do you think hospital staff did everything they could to
help control your pain?
Did you feel the staff treated you as an ...
PERSy Example – Showing Improvement
Did staff pay attention to your levels of general comfort? (E.g. Did
you have enough p...
Way Forward Events;
Who, when, where?
Themes
Information and feedback
• Patients said; they feel informed about their treatment plan and care,
although 3/10 sai...
Co-Design
Innovation challenges
• Engagement
• Quick Wins
• Longer term solutions
• Patient involvement
• Project leads
• Resources
...
Our Next Step
Q&A
How best to present data
Activity 3
NHS Improving Quality Update
Purpose of NHS IQ
Improving health outcomes across England by providing
improvement and change expertise
• Scanning the ho...
Improvement programmes
Next Steps
1. Deliver regional learning events in 2014 in partnership with NHS
England and Macmillan “Using CPES for commi...
3. Commission qualitative research into the
conditions for best practice/improvement, by
visiting and discussing key chara...
Reflections on the day and next
steps
@NHSIQ
enquiries@nhsiq.nhs.uk
www.nhsiq.nhs.uk
Improving health outcomes across England
by providing improvement and chang...
CPES event June 2014
CPES event June 2014
CPES event June 2014
CPES event June 2014
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CPES event June 2014

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A national learning event took place in June 2014, to explore how best to present data from the Cancer Patient Experience Survey (CPES) in order to drive improvement.

Outcomes from the event will help to shape the future presentation of CPES data, so that it is more accessible and easier for professionals and the public to use and interpret.

The event was held by NHS Improving Quality's Experience of Care team, in partnership with Macmillan Cancer Support, and NHS England's Insight team, to bring together cancer managers, lead nurses and lead clinicians. They heard from speakers including patient Bonnie Green, Ben Page, chief executive of Ipsos Mori, and Sean Duffy, National Clinical Director for cancer. Delegates also undertook group activity looking at the barriers that exist in translating data into improvement, and tailoring data for the right audiences.

The event forms part of NHS Improving Quality's wider work with NHS England looking at how the NHS is using the CPES data to reduce variation in the cancer patient experience. CPES, part of the national survey programme commissioned by NHS England, generates data and insight into the experiences of cancer patients.

- See more at: http://www.nhsiq.nhs.uk/news-events/news/using-insight-data-to-improve-patient-experience.aspx#sthash.Yh1yiQ6y.dpuf

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CPES event June 2014

  1. 1. 25th June 2014 Best Practice Principles in presenting Cancer Patient Experience Survey Data for Improvement
  2. 2. Catherine Thompson Head of Patient Experience, Acute Care, NHS England Welcome and Introduction to the day
  3. 3. www.england.nhs.uk Learning for Change Best practice principles in presenting Cancer Patient Experience Survey data for improvement 25 June 2014
  4. 4. www.england.nhs.uk • Explore how CPES results can be best presented to: • Meet the needs of patients. • Meet the needs of trust leaders, clinicians and patient experience teams • Drive improvements in services. • Increase understanding of how Trusts use and cascade CPES data. • NOT to change the questions or methodology of CPES To inform and develop CPES reporting
  5. 5. www.england.nhs.uk • Shared with Quality Health (current CPES provider), CPEAG • Develop a Quality Improvement Resource that will help people to put the CPES data to greatest use • Your contributions are essential to the process. The outputs from today
  6. 6. www.england.nhs.uk • If you would like to participate in a follow up telephone interview to share innovative practice in using the CPES data make contact with a member of NHS Improving Quality • Live Tweet the event using #Insight2Improve Throughout the day
  7. 7. Dan Wellings Head of Insight and Feedback NHS England @danwellings An update from NHS England Patients and Information Directorate
  8. 8. Building choice of high quality support for commissioners FFT and beyond – Insight and Feedback in the NHS Dan Wellings Head of Insight and Feedback – NHS England
  9. 9. Our vision for insight & feedback “Our ambition is for the NHS to become a world class customer service. Above all this means always listening to what our patients & service users tell us. By routinely gathering people’s comments, feedback, complaints & suggestions, we can construct a rich database of information & evidence that will enable us to commission the services people want. This is what we mean by insight” Transforming participation in health & care Sept 2013
  10. 10. Insight in practice… • Using qualitative and quantitative data to inform what we do • Using whatever data sources we have - not just surveys but a whole range of market and social research techniques • Always asking the question, what don’t we know? • As much an art as science • Answering the question, “So what?” “The most important single change in the NHS in response to this report would be for it to become, more than ever before, a system devoted to continual learning and improvement of patient care, top to bottom and end to end” A promise to learn – a commitment to act The Berwick Report
  11. 11. Why is it important? “The confidence that individuals have in their beliefs depends mostly on the quality of the story they can tell about what they see, even if they see little. We often fail to allow for the possibility that evidence that should be critical to our judgement is missing – what we see is all there is” Daniel Kahneman Thinking, Fast and Slow
  12. 12. The Insight Strategy
  13. 13. Insight & Feedback Less descriptive LessgeneralisableMoregeneralisable More descriptive In depth interviews Experience Based Co-Design Focus groups & patient forums NHS Trusts CCGs Healthwatch Patient organisations Surveys GP Patient Survey Bereaved Voices Cancer Patient Experience Survey NHS Staff Survey PROMs Online reviews & ratings NHS Choices Patient Opinion IWantGreatCare Care Connect Patient stories HealthTalkOnline Patient Voices Feedback tools (kiosks, SMS, apps) Examples include: Hospedia Synapta Feedback apps Social media listening Salesforce Polecat Healthberry Public Meetings NHS Trusts CCGs Matrix of insight methods from Measuring patient experience: evidence scan Health Foundation, June 2013 Friends & Family Test Complaints
  14. 14. Objective of Insight Strategy To establish a clear strategic vision for how the different elements of insight & feedback can complement each other most effectively, to be greater than the sum of their individual parts in giving us a clear picture about what patients and the public think of their NHS services
  15. 15. FFT and other data – Review raised a question mark over perceived purpose – It has different characteristics from other surveys 15 FFT • Real-time • Ward-level • Effective for service improvement • Can be used as early-warning system • Not representative National surveys • Robust, comparable data at Trust level • Data on a range of issues • Suitable for relative scores • Not meaningful to front-line staff • Has not historically changed behaviours • FFT and the national survey programme offer complementary sources of Insight • FFT is a formative measure: it provides data to improve services • National surveys are summative measures: they provide an accurate picture of relative performance
  16. 16. Means nothing if nothing is done
  17. 17. dan.wellings@nhs.net Thank you
  18. 18. The CPES – how can patients and public use it to drive change? • Bonnie Green • Service User and Carer • June 2014
  19. 19. What I’m covering – Why am I here – Working with Macmillan – Working with my local commissioner – Working with my local provider
  20. 20. My story My husband’s story Why am I here
  21. 21. Working with Macmillan • Worked with Macmillan last summer to produce a guide to create more patient/public awareness of the CPES and how the data can be utilised to improve the patient experience http://be.macmillan.org.uk/be/p-21015-driving- change-in-local-cancer-care.aspx
  22. 22. • To support people affected by cancer to navigate the National Cancer Patient Experience Survey (CPES) • To outline the key themes covered in the CPES that patients have said are important to them • To enable them to find CPES data they feel is most relevant • To empower them to use relevant CPES data, e.g. local or tumour specific and use it in their roles as patient/carer representatives in a range of settings such as CCGs, Healthwatch, hospital groups/committees, to influence service improvement Aims and objectives of the guide:
  23. 23. What we considered important to highlight: – Explaining what the CPES is – What the data indicates – How it can be used – That it represents the experiences of 70,000 cancer patients
  24. 24. Who was involved
  25. 25. How has the guide been distributed • Copies sent to 80 cancer patient representatives on Healthwatch • Disseminated via Macmillan’s Service Development Team to PPI leads in SCNs, CCGs and Health & Wellbeing Boards • Handed out at events e.g. Macmillan Parliamentary Question Time, Pan London Cancer User Partnership • Over 200 copies ordered from be.macmillan What’s still to do • Refreshed distribution in September alongside CPES, e.g. circulation to all Healthwatches, Macmillan information centres, Macmillan involvement coordinators
  26. 26. How have I utilised the CPES results locally 1. My local CCG 2. My local provider
  27. 27. Questions and Discussion
  28. 28. Dr Sean Duffy, National Clinical Director, Cancer NHS England An overview from NHS England
  29. 29. Activity 1. Turning insight into improvements and solutions
  30. 30. www.england.nhs.uk Model for Improvement
  31. 31. Ben Page, Chief Executive Ipsos MORI @benatipsosmori Data and what works well
  32. 32. Bringing data to life, tailoring CPES data to the right audience Activity 2
  33. 33. Gill Starkey Northumbria NHS Trust Case Study
  34. 34. Northumbria Healthcare NHS Foundation Trust Experience
  35. 35. One of the largest geographical trusts in England. Provides acute and community health services and adult social care to a population of over half a million people in the North East. The trust has nine hospitals (three general hospitals plus six community hospitals) and employs about 10,000 staff. Northumbria Healthcare NHS Foundation Trust
  36. 36. Director of Patient Experience Patient Experience Team Executive management team support Ensure patients & families are always included Transparency Quality Council The Northumbria Way
  37. 37. Quality Council Shared Purpose Patient Perspective 2 minutes of your time Friends and family Inpatients – best in North East region and within top 20%. Outpatient survey 2011/12 – 5th best in the country. King’s Fund 2013 - study identifying Northumbria as one of 30 Trusts who provide consistently good patient experience in acute, outpatient and A&E. Quarterly monitoring of A&E across 3 sites – within top 20%. General patient experience
  38. 38. Cancer patient experience In top 10 for first 3 surveys :- What happens with results? CNS meeting Lead Clinicians / MDT’s Cancer locality group Trust board Safety and quality panel Patient/ Carers
  39. 39. Strong membership :- Communication Peer review Lung cancer project Orthotics Publicity – business cards Detailed analysis of CPES Patient / Carer User Group
  40. 40. Mainly from patient comments Communication :- Sage and Thyme Advanced Communications Written assessment / care plan Financial support Detailed lung patient survey Research Actions
  41. 41. 24 hour chemotherapy helpline CNS’s at ODU report Acute Oncology service Survivorship programmes Clinical Psychology Teamwork Primary Care links PATIENT/ CARERS Good practice
  42. 42. Staying in top 10!! Environment Capacity Cumbria New Emergency Care Hospital Challenges ahead
  43. 43. Thank you for listening– any questions?
  44. 44. Julie Wells Director Transforming Health Ltd & Kristin Gustafsen Programme Manager Imperial College Healthcare NHS Trust The Macmillan Values Based Standard
  45. 45. Macmillan Values Based Standard® What we have achieved and learnt to date Julie Wells
  46. 46. Macmillan Values-Based Standard™ • Naming – “I am the expert on me”. • Private communication – “My business is my business”. • Communicating with more sensitivity – “ I’m more than my condition” • Clinical treatment and decision-making – “I’d like to understand what will happen to me”. • Acknowledge me if I’m in urgent need of support – “I’d like not to be ignored”. • Control over my personal space and environment – “I’d like to feel comfortable”. • Managing on my own – “I don’t want to feel alone in this”. • Getting care right – “My concerns can be acted upon”.
  47. 47. Trumps! The relational aspects of care trump the functional ones
  48. 48. How we work……. What is really going on here?Discover • Use survey data, annual and real time • Work with staff – identify system failures • Interview patients, run focus groups • Observation • Identify front line improvement teams/leads What interventions might help?Innovate • Staff and patients co-design interventions • Agree measurement systems • Small tests of change, evaluate and refine • Diffused leadership and permissions to respond to individual need • Workplace reflection, learning and support Measure, sustain and spread improvementImprove • Develop measurement systems that ensure on-going improvement • Continually involve patients and staff in understanding ‘how we are doing’ • Embed workplace reflection • Develop a plan for spreading good practice, including corporate processes such as , recruitment, induction and appraisal • Feedback results – Ward to Board
  49. 49. Triangulation
  50. 50. Key achievements to date • Our Collaborative Phase 1 and 2 • Involvement of front-line staff • Involvement of patients • The power of data • Spread • National interest • The Learn Zone
  51. 51. The Learn Zone http://learnzone.macmillan.org.uk
  52. 52. Imperial`s “Way Forward “ by Kristin Gustafsen
  53. 53. Aim • Background • Demo of presenting results • Innovation challenges • Next step
  54. 54. Background • Pilot started Oct 2012 • 4 areas • Data collection • Privacy and ward round focus • Restructure in organisation • Programme manager November 2013 • 11 areas
  55. 55. Discovery and Data Collection • 1st and 2nd wave areas • Ward visits • Build relationships and promote projects • Data collection • Patient focus • Staff focus
  56. 56. The Evidence • National Cancer Survey • In-Patient feedback survey • Patient feedback interviews and discussions • Staff feedback survey • Staff feedback interviews and group sessions
  57. 57. Staff survey results RAG: Red/Amber/Green Do you feel that there is good team work in this unit? STF032 88.75 Are you proud of the quality of care that you and the team deliver within this unit? STF040 92.50 Do you encourage patients to raise their concerns? STF033 95.00 Are you able to provide confidentiality and privacy when this is needed, to discuss a mobile patient's condition or treatment in this unit? STF029 94.29 When you have concerns do you feel they are actioned by the person you raised it with? STF041 63.75 At work, do you feel your opinions seem to count within the team on this unit? STF039 61.25 Does your manager or a senior member of staff at work, seem to care about you as a person? STF037 62.50 Do you feel your role is valued within the organisation? STF020 45.00 Does your manager or team leader encourage your development? STF038 45.00 In this last year, have you had opportunities at work to learn and develop within your role? STF042 43.75 Do you receive recognition or praise for doing good work, from your manager or a senior member of staff at least weekly? STF036 53.75 At work, do you feel you have the opportunity to deliver the best service you can every day? STF001 62.50
  58. 58. Do you think hospital staff did everything they could to help control your pain? Did you feel the staff treated you as an individual person? Were you happy with how staff spoke to you during your stay? High Performing Questions
  59. 59. PERSy Example – Showing Improvement Did staff pay attention to your levels of general comfort? (E.g. Did you have enough pillows?)
  60. 60. Way Forward Events; Who, when, where?
  61. 61. Themes Information and feedback • Patients said; they feel informed about their treatment plan and care, although 3/10 said they had not received written information • 3/10 felt that the ward welcome could be improved and they had experienced being left waiting without being informed about what was going on, making them very anxious. • Staff said; they do not always get feedback, and that there is a lack of positive feedback and praise from senior leaders and managers. The ward manager do give staff praise sometimes.
  62. 62. Co-Design
  63. 63. Innovation challenges • Engagement • Quick Wins • Longer term solutions • Patient involvement • Project leads • Resources • Measures
  64. 64. Our Next Step
  65. 65. Q&A
  66. 66. How best to present data Activity 3
  67. 67. NHS Improving Quality Update
  68. 68. Purpose of NHS IQ Improving health outcomes across England by providing improvement and change expertise • Scanning the horizon, ensuring our work is cutting edge to help grow improvement science, knowledge and skills across the health and care system • Develop and implement improvement programmes and building improvement capability and capacity within the NHS • Support improvement across the wider NHS
  69. 69. Improvement programmes
  70. 70. Next Steps 1. Deliver regional learning events in 2014 in partnership with NHS England and Macmillan “Using CPES for commissioning for continual quality improvement”. 2. NHSIQ will develop a quality improvement programme aligned to the CPES, using recognised Quality Improvement methodologies based upon the Model for Improvement Framework. NHS IQ will evaluate the knowledge and insight accumulated from the collaborative programme and the validity of adapting and replicating the approach in other Patient Experience priority areas.
  71. 71. 3. Commission qualitative research into the conditions for best practice/improvement, by visiting and discussing key characteristics of a purposive sample of top performing and “most improved” Trusts . 4. Develop a peer support and review model whereby high performing and most improved Trusts would “buddy” with low performing partner. 5. Publish tools and resources for professionals using recognised Quality Improvement techniques for improved patient experience and engagement
  72. 72. Reflections on the day and next steps
  73. 73. @NHSIQ enquiries@nhsiq.nhs.uk www.nhsiq.nhs.uk Improving health outcomes across England by providing improvement and change expertise.

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