PEN Awards Webinar series 4 of 6

#PENNA2015 #PatExp
What’s working well
in patient
experience?
PEN Awards Webinar Series
29th September, 12 - 1pm
6th October, 12 - 1pm
3rd November, 12 - 1pm
#PENNA2015 #PatExp

patientexperiencenetwork.org
#PENNA2015 #PatExp
RUTH EVANS
Managing Director
Patient Experience Network
WELCOME
What’s working well in patient
experience?
PEN Awards Webinar Series

#PENNA2015 #PatExp
Webinar content – 20th October 2015
Welcome and introduction
• Ruth Evans - PEN Launch of the Winning Principles and overarching
Framework
• Georgina Craig - ELC - Commissioning for Patient Experience
• Amy Maclean - Birmingham Womens’ NHS Foundation Trust - Patient
Connect App + Feedback at Birmingham Women’s Hospital
• Jennie Negus - United Lincolnshire Hospitals NHS Trust - See it my way;
transforming complaints and concerns at United Lincolnshire Hospitals
NHS Trust
• Heather Ramessur-Marsden - Public Health Wales - In it Together:
Transgender Awareness Project
Questions

#PENNA2015 #PatExp
Welcome to the UK’s leading awards event that recognises
Patient Experience excellence
Wednesday 11 March 2015
PEN National Awards 2014
Re:thinking the experience
LET’S CELEBRATE A YEAR OF SUCCESS

#PENNA2015 #PatExp
Intention and Outlook
• Passion and determination
• The most successful initiatives are driven by an individual or team with a
firm belief in what they are doing, and the need to invest time and
money to make it happen and bring about change.
• Broadening perspectives
• A key milestone for success is supporting and educating fellow
professionals to look beyond their own situations and embrace and
adapt work going on elsewhere.
• Keeping it simple
• Making initiatives easy for people to understand and adopt is crucial.
Clear communication, posting results and evidencing improvements
encourages engagement and continuation with projects.

#PENNA2015 #PatExp
Organisational Support
• Culture
• Creating a culture where everyone is engaged in patient experience and
understands the role they have to play in improving it is vital to success.
All successful initiatives are delivered by teams, not individuals.
• Management
• Senior level support is often key to the success of a project. The best
results are seen where improving patient experience is encouraged and
prioritised by management.
• Leadership
• Clinical and senior management leadership, particularly in the form of
empowering staff to identify, develop and implement changes is key to
sustainable improvement.

#PENNA2015 #PatExp
Evidence & Impact
• Financial impact
• It is clear that positive patient experience pays dividends, and our most
successful entries demonstrate how time and financial investment in
well thought out projects can yield an excellent return.
• Building professional relationships
• Working in partnership with teams within and outside your
organisation, as well as with volunteers and other groups is key to
ensuring ongoing success in spreading and embedding positive practice.
• Spread and sustainability
• Evidencing sustainability and transferability are key to success.
Demonstrating how initiatives have been or could be adapted provides
an opportunity to share and embed successful practices.

#PENNA2015 #PatExp
Questions?
#PENNA2015 #PatExp

Commissioning for Patient
Experience
Celebrating Success
Georgina Craig - ELC
@GCAssoc @ELCworks
-

Slough’s journey towards
person centred commissioning

Slough Clinical Commissioning Group
Georgina Craig
National Director
ELC Programme

12Slough Clinical Commissioning Group
TWO PARTNERS

Do we understand the emotional currency of
health?

“
I really like my GP.
We have a very good
relationship. But often I don’t
understand a word (s)he says
to me”
What we did together
• Understood how to improve
maternity work
• Co-designed a Prime Minister
Challenge Fund bid
• Undertook co-design work to
support redesign of primary
care

What we achieved: maternity
• Involved over 250 women, partners and
front line teams in mapping improvement
• Changed the outcomes included in
contracts to be more family centred
• Piloted a narrative based discharge process
(APP)
• Uncovered new insights to inform clinical
practice

What we achieved: PMCF
•Changed the PMCF proposal – less emphasis on access;
more emphasis on improving the quality of the GP -
patient conversation
•Won £2.9 million and national recognition =
the only bid that had involved the community in
co-designing PMCF solutions
•Built alliances between practices and PPGs
•Explored how frequent attenders impact on general
practice
•Piloted Group Consultations and a Simple Words
Reflective Practice Programme as well as 7 other
initiatives co-designed with local people

What we achieved: primary care
• Co-designed primary care strategy with
local people
• Talked to over 550 people in one day in the
16 practices in Slough
• Worked with PPG to do this work
• Made sense of their feedback, which
reinforced the importance of the PMCF
work and identified significant issues
around making appointments as well as
access issues

Get in touch to learn more
Georgina Craig The ELC Programme
georgina&@gcraigassociates.co.uk
Tel: 07879 480005
@ELCworks @GCAssoc
Jacky Walters, Slough CCG
jackywalters@nhs.net

Patient Connect App + Feedback
at Birmingham Women’s Hospital
Celebrating Success
Amy Maclean - Birmingham Womens’ NHS
Foundation Trust
@amymaclean @WomenBirmingham
-

VITA Inspiration
from the USA
17 hospitals
1 Patient Experience Conference
20 days

• Philosophies
• Care
• Service Transformation
• The Environment
• The Building
• Communication
• Technology
• Organisational Structure/Governance
• Just plain good ideas…
• What does this mean for us?

Philosophies
• Strong CEO Messaging and utilisation of ‘burning platforms’
• Family and Patient Centred Care and Patients First
• Financial incentive for Patient Experience (HCAHPS)
• Bringing in incentives for low scores on avoidable events
• Messaging to patients of expectations we have
• Hospitality principles
• Accountability counts
• Holding staff to account for poor attitudes: sarcasm, curtness and
complaining.
• Flowchart of satisfaction
• Immediate debrief following something not going right:
• What did we do well? What could we do better?
• Onstage/offstage

Philosophies
• Financial incentive for Patient Experience (HCAHPS)
• Bringing in incentives for low scores on avoidable events
• Hospitality principles
• Accountability counts
• Holding staff to account for poor attitudes: sarcasm, curtness and
complaining.
• Flowchart of satisfaction
• Immediate debrief following something not going right:
• What did we do well? What could we do better?
• On-stage/Off-stage

CARE
• Rounding is grounding
• Ward-based classes, videos as a norm
• Post-discharge phone calls
• TVs have a relaxation channel
• Weekly classes on pain management and relaxation
• Daily classes for in patients on bf, 1st aid, paediatrics and going home
• Wireless telemytry (NYP) more for being modern than for keeping a woman active, but it
does allow showers in early labour.
• Circumcision stations
• Breastfeeding support—lactation centre
• Sleeping spaces for parents/visitors
• 24 hour care of patients/visitors—legally enforced but guidance on reduced time allowed
• Quiet time campaign
• Peer support

• Bolster your hellos/goodbyes of your entire service and of
each individual service—impact for greatest number of
people
• Front of house volunteers
• Improving receptions in outpatient clinics and
welcomes to wards
• Improving discharge processes
• Escort with a volunteer

CARE
• Post-discharge phone calls
• TVs have a relaxation channel
• Weekly classes on pain management and relaxation
• Breastfeeding support—lactation centre
• Sleeping spaces for parents/visitors
• 24 hour care of patients/visitors—legally enforced but guidance on reduced time allowed
• Quiet time campaign
• Peer support

Service Transformation
• Families as care team members
• Hospitality as central (LIJMC 2 hour training)
• Reduction in c-sections by a medic league table
• The power of forensic data on patients for feedback
• Department of Service Excellence or Family and Patient Centred Care
• Display of new build and mock up rooms
• Use the phone!
• Targets for acceptable wait times rather than what it was and bringing it down.
• Deploy volunteers for busy nursing/midwife times and ask key questions that distract
• Room service vs tray service
• Private services (Global service CC)

Service Transformation
• Families as care team members
• Hospitality as central (LIJMC 2 hour training)
• Reduction in c-sections by a medic league table
• The power of forensic data on patients for feedback
• Department of Service Excellence or Family and Patient Centred Care
• Use the phone!
• Targets for acceptable wait times rather than what it was and bringing it down.
• Deploy volunteers for busy nursing/midwife times and ask key questions that distract

The Environment
• Birth rooms
• Healthcare design conference (HCD)—November 2015
• TVs w scrolling education
• Uncluttered: Corridors, hall storage
• Entry ways
• Family spaces
• Nourishment stations
• Onstage/offstage
• Spa-like features
• Teaching stations
• Family waiting zones: computers, coffee, tables for games
• Multiple blinds

The Building
• Winston Churchill:
We shape our buildlngs, and afterwards
our buildings shape us.
• Patient at the centre of design (Wilson)
• Reading the principles of Patient centred Care

The Building
• Spaces (p36 of Joint Commission)
• Single rooms
• Protected rest time
• Infection control prevention
• Room signage for risk
• Medics lounge
• Breakout spaces for patients/classes
• Desks in hallways
• NICU support of breastfeeding/videos in
each room/kit
• Breastfeeding centre and shop
• Master planning strategies
• Loose fit design
• Adaptable flexibility
• Convertible flexibility
• Sustainability
• Way finding
• Robust utilities
• Plug and play infrastructure
• Connectivity of staff to patients
• Open access for re-stocking from hallway
• Blanket warmer in LDRs
• Great seating in ward areas
• Sliding doors between rooms

The Building
• Spaces (p36 of Joint Commission)
• Single rooms
• Protected rest time
• Infection control prevention
• Master planning strategies
• Loose fit design
• Adaptable flexibility
• Convertible flexibility
• Sustainability
• Way finding
• Robust utilities
• Plug and play infrastructure
• Connectivity of staff to patients

Communication
• Discharge lounge near front entrance to wait for cars to come around.
• Whiteboards which create conversations
• Intention—see housekeeping signage
• Gift shop repeated items in display cases remind patients in other parts of the
hospital what’s on offer.
• History of hospital

Communication
• Whiteboards which create conversations
• Intention—see housekeeping signage
• Gift shop repeated items in display cases remind patients in other parts of the
hospital what’s on offer.

Technology
• Hugs and Kisses tagging system shows where the mother and baby are in hospital and
ensures they are paired together.
• Voicera
• Wireless in every new build
• Room availability screen
• Lights (Steris)
• TV units—a whiteboard surround or two TVs stacked
•
Education videos on hand for every area of health
• Tablets for rounding

Technology
• Wireless in every new build
• TV units—a whiteboard surround or two TVs stacked
•
Education videos on hand for every area of health
• Tablets for rounding

Organisational Structure/Governance
• Collaborative Care Councils
• Family and Patient Advisory Councils
• Medical PE Steering Groups
• Staff-Led PE Committee
• Committees as exponents of a staff committee:
• Facility Appearance
• SWOT Team
• Green Team
• Reward and Recognition Committee
• Service Excellence training

Other great ideas…
• Staff recognition—TV in lobby
• Team Lavender
• No Pass Zones
• Red wagons
• Twilight Service
• Quiet at night
• Patient Peer Support (p2p) or Caregiver to caregiver (c2c)
• Discharge Before Noon
• Caring Canines
• Canine Greeters
• Infant massage classes
• Education for parents on what all the tubes are
• Doggie Discharge
• Funding idea with the Council
• Valet parking

Other great ideas…
• Team Lavender
• No Pass Zones
• Patient Peer Support (p2p) or Caregiver to caregiver (c2c)
• Discharge Before Noon (DBN)
• Caring Canines
• Canine Greeters
• Doggie Discharge
• Funding idea with the Council

So what now?
Ideas we are working on at BWH
• No Pass Zones
• Family and Patient Advisory Council
• Medic-Led Patient Experience Steering Group
• Staff-led Patient Experience Committee
• Improved data so we know and define more clearly what
good looks like!

Staff Engagement & Patient Experience Trust
Governance Alignment
Passionate
about our
People Working
Group
People Committee
Staff Led Patient
Experience
Committee
(Patient facing staff
representation: porters, FoH,
catering, HCA’s, MSW’s)
Family & Patient
Advisory Council
Patient Outcomes
Committee
Medical Patient
Experience
Steering Group
Equality &
Diversity Steering
Group
Access to Charitable Funds
Trust Board

Thank you for your attention.
This powerpoint is available for you to share and
please feel free to get in touch if you’d like more
details on any aspect.
Questions?

See it my way; transforming complaints and
concerns at United Lincolnshire Hospitals
NHS Trust
Celebrating Success
Jennie Negus - United Lincolnshire Hospitals
NHS Trust
@ULHTNews @NegusJennie

‘See it My Way’
transforming complaints and concerns
at
Jennie Negus. Deputy Chief Nurse

The 2013 ULHT Keogh ULHT review
report stated:
The complaints process is confusing
and not fit for purpose: The Director
of Nursing and the Company
Secretary should review the handling
of complaints and the processes
whereby complaints can be
systematically fed back and used by
staff teams to improve service
delivery. This should include creating
a PALs function.

Afraid to make
a complaint
No
accountability
Patronising,
arrogant
Frustration with
process
Lengthy,
bureaucratic
No confidence
in process
Poor
communication
Response
didn’t answer
issues
Defensive
Want to avoid
happening
again
We asked our
patients through
a listening event,
surveys and
workshops.

No site support
No sharing or
learning
Red tape,
admin hold ups
Wrong people
involved
No ownership
Logistics with
medical staff
No
accountability
Staff don’t
answer the
questions
Defensive
Process doesn’t
work
We then asked
our staff at
workshops,
engagement
workshops

the same……..
the same……..

What our patients told us What our staff told us
Afraid of making a complaint. No sharing or learning process.
Nobody owns the complaint. No site complaints area.
No accountability. Lack of site presence.
Patronising and arrogant. Red tape; admin holdups.
Frustration with process. Varying engagement.
Lengthy and bureaucratic. Wrong people involved.
Don’t seem to learn from complaint Logistics with medical notes.
Poor communication. Chronology; doesn’t answer
issues
Long winded process. Not clear who does what.
Response didn’t answer issues. Should be meeting pts first.
No confidence in process. Shop floor staff training needed.
Didn’t know where to go for help. Should be PALS route first.
Defensive. Clear ownership needed.
Want to avoid happening again. Clear accountability needed.
What national research & reports
tell us is required
Complaints system that is easy to
navigate.
Easy to understand process.
Freedom from fear of complaining.
Non-judgmental.
Tailored response
Sensitive individual response.
Acknowledge emotional trauma.
Timely, prompt and clear process.
Resolve quickly; proportionate.
Seamless across services and
agencies.
Support through the complaints
process.
Want to make a difference.
Openness and accountability.

See it My Way

Putting things
right
• Training at all levels;
starting with the Trust
Board
• Empowering staff to act
on concerns
• Duty of Candour
• Openness &
transparency
• Data and reports to
focus improvements
and actions
• Listening into action
developing PALS
champions
Access
• Introduced site
based PALS teams
• Introduced site
based complaints
teams
• Patient reps from
initial listening
event involved in all
recruitment
• Web, twitter,
Facebook, e-mail,
phone, letter, face
to face

Process
• Ownership at site and service
level.
• Initial call by deputy director,
clinical director or head of
nursing (= Senior Site Lead
SSL)
• SSL identifies case manager
and retains oversight and
responsibility.
• Consultants now acting as
case managers investigating
and drafting responses.
• Site complaints teams
support and facilitate; they
lead rather than ‘do’.
Response
• Designed new
documentation: an
investigation grid and
executive response
template.
• Case manager
responsible for
ensuring all issues
responded to and
drafting response.
• SSL assures response
before sending for exec
sign off.

A clear, open and
transparent approach
to ensure all points are
addressed and are
factual against each
concern.
Complainants can see
that every point has
been considered and
that there is clear
alignment of learning
against issues raised.
Forces a response to each point (which
patients told us they wanted), doesn't
require creative writing skills to
incorporate the findings into a
narrative. When sent to staff the points
they are responsible for will be
highlighted.
Complainants can see that every point
has been considered and that there is
clear alignment of learning against
issues raised.
Demands
ownership of each
issue and associated
remedial action or
learning.
The learning column
can be lifted directly
into DATIX and a
running log for sites
and services to
track learning and
progress.
This is then merged and a copy is sent to the complainant with their response letter.

Learning
• Regular reports and data to
teams, sites, business units
and Trust Board.
• Patient stories to Trust Board.
• Designed a complaints
‘change register’ to track and
sign off actions and changes
agreed with clear cascade
process. PALS version in
development.
• Plan to write to complainants
once actions completed.
• Surveying of complainants.
• Quarterly peer review panel
with patient reps,
Healthwatch and POhWER.
Reports:
• Trend analysis
• Subject, sub subject, staff group,
location detail
• Performance metrics on numbers
received, subjects, responsiveness.
• Performance metrics on clearing
backlog.
• Dashboard at site and business unit level
Circulated to:
• Sites and services
• Patient Experience Committee
• Quality Governance Committee
• Trust Board
Assurance

We are not an outlier in terms of numbers
of complaints; we were however in terms
of unresolved…..this quickly turned
around when we implemented the new
process.

Backlog of historical complaints
There was a significant and shameful number of complaints still in the
system some going back a considerable time; we owed it to our patients to
resolve these despite the challenge of time elapsed.

PEER
REVIEW
PANEL
Co-designed with our
patients
Committee
representation

Principles:
• Getting it right
• Being patient focused and empathetic
• Being open and accountable
• Acting fairly and proportionately
• Putting things right
• Seeking continuous improvement
Putting things
right
Access Process Response Learning

“I felt the complaint was handled
well and taken seriously; a
satisfactory resolution”
“The deputy director phone call
reassured me that my complaint was
being taken seriously”
We designed and
introduced this at a
time of huge
pressure, huge
resistance, intense
scrutiny & low
morale…….
And we did this by
ensuring ownership
& accountability.

In it Together: Transgender Awareness
Project
Celebrating Success
Heather Ramessur-Marsden - Public Health
Wales
@PublicHealthW
-

Insert name of presentation on Master Slide
In it together
Transgender Awareness
Project
Jenny-Anne Bishop, Unique Transgender Network
Lewis Rimmer, FTM Wales
Heather Ramessur-Marsden, Screening Engagement Team

Who are we?
Public Health Wales
Breast Test
Wales
Cervical
Screening
Wales
Antenatal
Screening
New Born
Hearing
Screening
Screening Division

Screening Engagement Team
• Partnership Working
• Public Engagement
• Service Improvement
• Public Information
Development
• Education /Training

What is Screening?
• Screening aims to detect cancer, abnormal
changes or a condition at an early stage
• Screening tests are offered to people without
any symptoms of disease
• Finding cancer or a condition early can give
you a better chance of successful treatment
• Screening can save lives!

NHS screening in Wales
Women aged 50-70 are invited for a breast
X-ray every
three years. Women over the age of 70 can
ask for a screening appointment.
Women from the age of 25 are invited for
screening every three years. Women aged
50-64 are invited every five years.
Men and women aged 60-74 are invited to
take part every two years.
Men aged 65 are invited for a one-off
ultrasound screening test.

Informed Choice
UK National Screening Committee
“ The public should be given a realistic view of
the merits and flaws of screening so that they
can make an informed choice and decline an
invitation if they wish”.

In it together
• Public Health Wales, Screening Division has been working
in partnership with the transgender community in Wales
to improve service provision and access to NHS screening
programmes.

In the beginning
• Our journey together began in December 2012
• Transgender in Wales contacted the Screening
Engagement Team to discuss how if at all, we could
work together to improve screening services for
Transgender service users
• Transgender Awareness Wales was invited to the
Screening Engagement Team meeting - this was a
shared learning experience for all
• Members from Female To Male (FTM) Wales, Unique
Transgender Network and the Centre for Equality and
Human Rights(CEHR) have been involved throughout
the project

In it together
• A number of issues for affecting Transgender
service users were highlighted.
These included:
• Communication
• Education aimed at staff, public and
professionals
• No Trans specific public information
• Poor engagement between Trans service users
and screening

Working Together
• Following the initial meeting, an action plan
was jointly written to take forward key areas
of work. These included -
• Training/Education
• Trans specific public information development
• Active public engagement
• Communication

Getting Transgender on
the agenda
• Making this project an organisational priority
involved a lot of:
• Patience
• Dedication and Commitment
• Transgender Education
• Involved multiple meetings
• Obtaining organisational commitment and
funding

Training
• Representatives from Transgender Awareness Wales
have since met with Heads of Programmes to raise
awareness of Transgender issues
• Equality and Diversity training (mandatory for all staff)
currently being reviewed
• Members from the trans community have delivered
training to some screening front line staff as part of
their CPD
• We are continuing to deliver training to other screening
staff groups

Public Information
As part of the project we have developed:
• Transgender specific screening leaflet and
Information Cards
• Web based ‘Frequently Asked Questions’
• Short educational films
• Transgender specific information on
programme websites
• Trans specific information reviewed by
transgender service users
http://www.screeningforlife.wales.nhs.uk/transgender-stories

Engagement
The Screening Engagement Team have:
• Attended the Sparkles event in Swansea
• Presented the project to LGBT Network in South Wales
• Presented this work at the national Welsh Public Health
Conference
• Used this work to illustrate good practice as part of the
Participation Cymru ‘hard to reach’ community
engagement course
We are continuing to:
• Improve links with the transgender organisations

Project Launch
This work was
officially launched on
the 8th October by
the Welsh Deputy
Health Minister,
Vaughan Gethin AM

Where next?
• Evaluate the leaflet with the Trans community
• Work with Trans groups to deliver community
based education
• Look at digital technologies to ensure we are
consistently inclusive
• Work together in the ‘long term’ and not the
short
• To share good practice with other organisations

Is there a Magic Bullet?
• Hard work and commitment
• Small steps
• Achievable goals
• Realistic expectation
• Working together
• Recognising that we are not all the
same
• Facing the challenges together

For further information
Heather Ramessur:Lead Screening Engagement Specialist
Heather.ramessur-marsden@wales.nhs.uk
For further information:
www.screeningforlife.wales.nhs.uk
Lewis Rimmer: FTM Wales
http://www.ftmwales.co.uk/
Jenny-Anne Bishop: Unique Transgender Network
http://www.uniquetg.org.uk/

#PENNA2015 #PatExp
Thank you
#PENNA2015 #PatExp

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PEN Awards Webinar series 4 of 6