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East Cheshire NHS Trust
Patient Experience Strategy
October 2014 – October 2017
Policy Title:
Patient Experience Strategy 2014-2017
Executive Summary:
The aim of this strategy is to ensure that all patients, their families,
carers and visitors have a positive experience in our care, ensuring their
physical and emotional needs and expectations are met or exceeded.
An organisational approach called ‘Patients First’ will be implemented
to drive cultural change in order to deliver a consistently positive patient
experience and a fair and equal service for all. This is beneficial for our
patients and their carers, and also for the Trust in attracting market
share and contracts.
This document sets out our strategy for the next three years. It identifies
how the trust will continue to work towards improving the patient
experience and involving service users in developing, improving and
celebrating our services. The action plan will be reviewed annually.
Supersedes:
Patient experience was covered by the Communications and
Engagement Strategy 2013 – 2016
Description of
New strategy
Amendment(s):
This policy will impact on:
This is a Trust wide strategy and impacts on all areas.
Financial Implications:
 Purchase of two 3G Ipads in order to carry out real time patient experience monitoring in trust
community locations.
 Costs associated with SMS text messaging in connection with roll out of Friends and Family Test.
 May need more resource if tenders contain requirement for extensive patient experience
work, but this should be built into the bid.
Policy Area:
Governance
Document Reference:
Version Number:
V1
Effective Date:
October 2014
Issued By:
Author:
(Full Job title )
Director of Corporate
Affairs & Governance
Lyn Bailey
Equality & Patient
Experience Manager
Review Date:
October 2017
Impact Assessment
Date:
October 2014
APPROVAL RECORD
Consultation: Heads of Service &
Equality Impact Assessment
Circulated
October 2014
Committee approval
October 2014
Group
Safety Quality & Standards
Committee
Received for information:
Page | 2
All staff
November 2014
Table of Contents
1.
Introduction
Page 4
2.
Why Improve Patient Experience
Page 4
3.
Patients First Approach
Page 5
4.
Aims
Page 5
5.
Strategic Context
Page 6
6.
Current Patient Experience Activities
Page 6
7.
Overview of Patient Experience Objectives
Page 7
8.
Action Plan (See Appendix 3)
Page 8
9.
Accountabilities
Page 8-9
Appendix 1
Appendix 2
Appendix 3
Appendix 4
Appendix 5
Activities Underway Under the ‘Patients First’ Approach
Different Methodologies for Patient Experience
Action Plan
List of key policies and other documents informing the strategy
Equality Analysis Template
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1.
Introduction
The Department of Health defines patient experience as,
“Getting good treatment in a comfortable, caring and safe environment, delivered in a calm
and reassuring way; having information to make choices, to feel confident and feel in control;
being talked to and listened to as an equal and being treated with honesty, respect and
dignity” (DoH, 2009)
Improving patients’ experience is central to High Quality Care for All: NHS next stage
review (Department of Health 2008a), and the reason it is important is referred to in
the preface to the draft NHS constitution, which sets out certain NHS values including
respect and dignity, compassion, and working together for patients: [The NHS] “touches our
lives at times of most basic human need, when care and compassion are what matter most.”
(Department of Health 2008b)
In 2012, NICE (National Institute for Clinical Excellence) released patient experience
guidance and a standard, enabling trusts to self- assess and work towards improving against
a range of patient experience measures. Follow this link to view the standard:
http://www.nice.org.uk/guidance/QS15
The aim of this strategy is to ensure that all patients, their families, carers and visitors have a
positive experience in our care, ensuring their physical and emotional needs and
expectations are met or exceeded. This approach will be called ‘Patients First’ and will be
achieved by working in partnership to shape and develop our services with a fundamental
goal of delivering a consistently positive experience.
This document sets out our strategy for the next three years. It identifies how the Trust
will continue to work towards improving the patient experience and involving service
users in developing, improving and celebrating our services.
2.
Why Improve Patient Experience
Goodrich and Cornwall (2008) set out the case for why it is necessary to have a clear
strategy for improving patient experience, both in terms of clinical outcomes and the success
of the organisation:
Improving patient experience makes good sense for patients because:




The reduction of anxiety and fear can speed the healing process and shorten
patient’s length of stay
The provision of information reduces post-operative complications
Good communication/information enables people to (self) manage their illnesses
more effectively
Effective communication improves treatment and medications compliance.
Improving patient experience makes good business sense because:

Patients are increasingly using the internet to rate their experience, affecting
organisational reputations
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
The NHS choice programme empowers patients to choose services perceived to
provide the best care and treatment.
More recently it has become apparent that readily available patient experience evidence can
support the tendering process leading to increased market share. In addition, the Care
Quality Commission has a clear focus on the experience of patients who have used or are
currently using our services.
3.
Patients First Approach
There are four components of the patient experience ‘Patients First’ approach. These are
 Treating patients with dignity, respect, care and compassion
 Listening to and involving patients
 Keeping patients informed
 Caring
‘Patients First’ will be used to support staff in thinking about the many and varied elements
which patients tell us make a good patient experience. Good practice and lessons learned
will be shared across the trust under this banner to spread good practice and learning. See
appendix 1 to view areas that the trust is already focussing on under these four headings.
4.
Aims
The aims of the patient experience strategy are as follows:

To be the healthcare provider of choice by ensuring that all patients, carers and
visitors consistently receive a service that meets what we would accept for ourselves,
our family and friends.
 To make the trust values and behaviours integral to the working life of all staff, to
help us to inspire, develop and support every staff member to live the values for
every patient, every colleague, every day.
 To embed patient experience as a key focus of the culture of the organisation by,
making sure we use this rich information to feed into service planning and
development
 To introduce the concept of ‘Patients First’
 To have up to date patient experience evidence always available in service areas
 To raise the profile of patient experience both internally and externally.
The trust is committed to ensuring that our services are developed and improved as a direct
result of patients’ and carers’ experience and involvement, and that the patient is always our
priority. Excellent patient experience is supported by the Trust’s strategic objectives.
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5.
Strategic Context
The Trust’s Quality Strategy 2012-2015 supports quality improvements in patient care and
experience and describes giving equal importance to the whole experience of care provided
by the Trust. It also states that an attitude and culture should be developed within our entire
organisation whereby everyone is constantly striving for excellence and continual quality
improvement in all that they do. Follow this link to view the quality strategy: Quality Strategy
The Trust’s Clinical Strategy 2012-2015 refers to giving ‘the best care in the right place for
the healthcare needs of patients’ and that any changes will support improvements in both
patient care and experience. Follow this link to view the clinical strategy: Clinical Strategy
The Trust is currently developing a volunteer strategy. Having over 350 committed
volunteers across community and acute areas enhances the patient experience in so many
ways - from helping someone to eat their meal, to holding a patient’s hand in theatre to
sitting and spending time with someone. The volunteer strategy aims to increase the
numbers of volunteers with a key aim of enhancing the patient experience.
6.
Current Patient Experience Activities
The Trust has already established several mechanisms to capture patient feedback and improve
the patient experience including:
 Use of Patient Stories – These will continue to be delivered to the monthly trust board
and Safety, Quality and Standards Committee
 Board Assurance Walkabouts using the principles of the 15 steps – This enables Board
Members to seek patient, staff and carer feedback for themselves
 Implementation of the Friends and Family Test across the organisation
 Participation in the national patient survey programme
 Local patient feedback plan, incorporating peer review, accreditations, and a range of
methodologies including interviews, focus groups and real time surveys. See appendix 2
for information about different methodologies
 Review of the complaints / concerns process to ensure that a more proactive approach
is taken to facilitate early resolution of concerns
 Implementation of the Patient Advice and Liaison Service outreach programme
 Dedicated engagement with local groups and organisations, to work across equality
protected characteristics
 Patient reference groups in a number of areas
 Experience based design initiatives
 Engagement with Healthwatch
 Quarterly patient experience Key Performance indicators on dignity and respect and
involvement in care
 Quarterly patient experience reports.
See appendix 1 to view how the range of activities fit under the ‘Patients First’ approach.
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7.
Patient Experience Objectives Overview
The main areas of focus are in creating an organisation wide commitment to patient
experience from trust board down through all levels of the organisation. This means that
patient experience will continue to feature in all key committees and will also become a
standing item at team level meetings. The focus will be on what service improvements occur
as a result of the feedback, how patients and carers rate these changes and how they can
be sustained. Any training programmes introduced into the trust must evidence patient
experience throughout.
Organisational culture change will be achieved by embedding the values and behaviours
developed with staff and patients and which form part of the appraisal process. The NICE
patient experience standard will also be promoted across the trust and used as part of the
appraisal process.
There is already a wide range of patient feedback mechanisms in the trust. This will be
further developed to include more real time feedback, more use of social media, listening
days where patients and carers will be able to informally chat with senior leaders in the trust
about their experiences, roll out of Friends and Family Test and identification of trust wide
themes to enable service improvement.
Data analysis will be developed to enable triangulation of data across a number of areas to
identify key hot spots for action.
All proposals to the board will have a quality and an equality impact assessment and
evidence that findings are considered. Proposals will be rejected if these assessments and
evidence that the findings have been considered are not in place.
Improvements will be made in the cascading of patient experience performance across the
trust down through wards and departments, to include good practise information.
A key requirement of this strategy is that all staff commit to carrying out required actions by
agreed deadlines, eg action plan submissions and that they are held to account by heads of
service. Action plans based on patient feedback must have:
• actions that are SMART (Specific, Measurable, Achievable, Realistic and Time bound)
• actions that focus on improving the way services are delivered in order to improve patient
experience for the greatest number of patients.
It is important that teams check patient experience following interventions to ensure that
improvements are sustained.
Performance monitoring of service lines will include performance monitoring on patient
experience which will form a key part of any presentation to the Board or Safety, Quality and
Standards Committee or Sub Committee.
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8.
Action Plan – See Appendix 3
The action plan at appendix 3 is for the first year and there will be an annual review
thereafter. Some of the key areas already listed for year two are:
 Supporting the use of the NICE patient experience standard in appraisal
 Further work on ensuring that patient experience remains as a standing item on all
trust meeting agendas
 Rolling out the national Friends and family Test as per national requirements
 Developing feedback forms in other languages
 Introducing patient experience listening days
 Introducing the concept of involving a range of stakeholders in producing action
plans following patient experience exercises
 Triangulating themes across patient experience measures, patient safety and patient
outcomes data.
The action plan will be reviewed and reported on in the trust patient experience report which
is submitted on a quarterly basis to the Quality Forum.
9.
Accountabilities
It is the responsibility of all Staff to be receptive to all forms of patient experience feedback,
and recognise that such information is an essential element of clinical governance and
service improvement.
The Trust Board will ensure there is a culture of learning from patient feedback throughout
the organisation. The Safety Quality and Standards Committee has delegated authority from
the Board for receiving information on patient experience, including assurance in relation to
key performance indicators.
The Chief Executive is the Accountable Officer for ensuring that patient experience within
East Cheshire NHS Trust is managed effectively and has delegated this responsibility to the
Director of Corporate Affairs and Governance.
The Director of Corporate Affairs and Governance as the nominated lead director will
ensure that there are robust systems in place to gather and analyse patient experience
feedback and that action is taken in light of any issues identified. The Director of Corporate
Affairs and Governance is responsible for reporting information on patient experience to the
Trust Safety Quality and Standards Committee, and the Board.
All Executive Directors will support the implementation of the patient experience policy and
ensure their staff abide by best practice through listening, responding and learning from
patient experience feedback and issues raised from this.
The Medical Director will drive improvement in patient experience through clinical
leadership and the effective governance of medical staff.
Non-Executive Directors will ensure that patient experience is high on the agenda of any
committees or projects they are involved in.
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The Director of Nursing, Performance and Quality is responsible for Quality and the
development and implementation of the Quality Strategy which includes patient experience
as a key area. They will ensure action plans to improve patient experience, highlighted
through patient experience surveys and information sources are delivered.
The Deputy Director of Corporate Affairs and Governance has overall line management
responsibility for the patient experience function and will implement the patient experience
policy, with staff within the Directorate. The Deputy Director will provide reports on the
performance indicators relating to this policy to the Trust Safety Quality and Standards
Committee and working in collaboration with relevant senior managers will ensure any
improvement plans are developed and implemented. The Deputy Director will monitor the
implementation of the agreed action plan to support the patient experience strategy and has
management responsibility for the Equality and Patient Experience Manager.
The Equality and Patient Experience Manager will provide expertise and support to
service areas in respect of patient experience, this will include undertaking patient
experience surveys, ensuring the website is updated and identify and share any best
practice across the organisation. The Equality and Patient Experience Manager
will ensure that expertise and training on patient experience methodology is provided across
the organisation and develop procedures to ensure that patient experience staff and staff
across the trust involved in patient experience work are clear regarding their roles and
responsibilities. The Manager is responsible for escalating concerns identified via patient
experience work.
The Patient Experience Officer will assist the Equality and Patient Experience manager in
ensuring the smooth running of the national and local survey programme, carrying out
quantitative and qualitative analysis and working with service areas to support timely action
planning to achieve service improvements. The Patient Experience Officer is also
responsible for the compilation of reports following patient experience projects.
Heads of Service, Matrons and Clinical Teams will ensure they embed the Trust’s values
and behaviours and continue to improve patient experience which will support patient good
clinical outcomes for patients. Additionally Heads of Service will assume overall
responsibility for the management of patient experience work within their service areas. This
will include identification of areas to be surveyed, a co-ordinated approach to any projects
established and a timely response to issues raised, including action planning and follow up.
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APPENDIX 1 – Activities Underway Under the ‘Patients First’ Approach.
Dignity, respect, care
and compassion
Excellent customer
care
Values based
recruitment and
appraisal
Focus on privacy and
continue to implement
single sex
accommodation
guidance
Reasonable
adjustments for all
patients who need
them – use of patient
passports and
reasonable adjustment
symbols on white
boards and bed spaces
Continue with the Open
to Autism project and
learning disabilities
work
Continuing mental
capacity act training
Listening and
involving
Working to ensure
patients feel involved
in decisions about
their care and
treatment
Rolling out the
Friends and Family
test and working to
capture themes
Using the experience
based design
approach in service
planning
Keeping patients
informed
Implementation of a
patient information
toolkit to support staff
to produce patient
information
Accreditation under
the national Patient
Information Standard
Caring
Communications
training for all clinical
staff
Raising the profile of
the importance of
spiritual care for
patients
Full programme of
national and local
surveys
Reviewing the
possibility of recording
complaints meetings
Continue to implement
the end of life strategy
Triangulation of
patient feedback to
identify themes
Update of trust
website
Daily and weekly audits
of care on wards
Engagement with
local groups across
the range of equality
protected
characteristics
Talking to patients
and carers at visiting
times
Maintain/improve
scores in national
patient surveys
Maintain excellent
scores in PLACE
assessment (Patient
lead assessments of
the care environment)
Making improvements
to food on hospital
wards
Real time surveys in
acute and community
settings
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APPENDIX 2 – Different Methodologies for Patient Experience
Different methodologies for patient experience feedback exercises
Method
Paper based survey
Web, on-line surveys
Advantages
 Suited to quantitative 'tick box'
questions
 Gives you quantitative data to
analyse - good for benchmarking
 Can take less time for
respondents to complete
 Respondents familiar with filling
in paper based questionnaires




Touchscreen surveys

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Suggestion boxes


Focus groups



Depth telephone
interviews
Face to face interviews
Suited to quantitative 'tick box'
questions
Gives you quantitative data to
analyse - good for benchmarking
Can take less time for
respondents to complete
Less time consuming than postal
surveys
Can give instant feedback
Quick and easy for respondents
to fill in
Suited to quantitative 'tick box'
questions
Easy to set up
Anyone can complete a feedback
card
Enables you to gather
information from numerous
respondents simultaneously
Allows in depth questioning
Can unearth issues you may not
previously have thought of



Allows in depth questioning
Can give you the full story
Patient quotes can be powerful in
analysis



Allows in-depth questioning
Can give you the full story
Patient quotes can be powerful in
analysis
Can see body language

Disadvantages
 May not get as many
responses as you need
 Can be time consuming if
sending in post
 Questions could be
misinterpreted
 May leave you with
unanswered questions i.e. the
reasons behind the results
 Not all respondents may have
Internet access
 Respondents may not be
familiar with completing online questionnaires
 May not get as many
responses as you need
 May leave you with
unanswered questions i.e. the
reasons behind the results
 Lack of devices on which to
carry out surveys
 Some people can find it hard
to read screens
 Screens can get dirty infection control issues
 Low response rate
 May not get specific feedback


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



Can be difficult to set up
Can be time consuming to
arrange
Can be difficult to compare
and analyse information
Group can be dominated by
one or two members
Can be time consuming
Can be difficult to arrange
interview time
Can be difficult to compare
and analyse information
Cannot see body language
Can be time consuming
Can be difficult to arrange
interview time
Can be difficult to compare
and analyse information
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Observational research
Allows you to see things through the
patients' eyes
Allows you to get a feel for things at a
grass roots level
People may feel uneasy being
observed
Can be easy to misinterpret what is
seen
Patient stories
Can be powerful and moving
Patients may not want to be filmed
Can be time consuming
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APPENDIX 3 – Action Plan
Objective
Senior leaders have a
significant focus on
patients and their
experience of care
The organisational
culture is patientfocussed and values
behaviours which
enhance the experience
of patients
There are multiple
routes for patients to
provide feedback,
including those with
diverse needs
Year 1 action
- Patient Stories to be a standing item on all high
level committees
Lead
Director of Nursing, Performance & Quality
Deadline
Dec 15
- Any leadership programmes to include sessions
on patient experience eg leadership programme,
team leaders programme
Organisational Development Manager
Mar 15
-Ensure patient experience development
framework is used with senior leaders.
-Values and behaviours being embedded across
the organisation tested out via appraisal
-Review and update patient experience section of
website quarterly
-Publicise NICE patient experience standard
Director of Corporate Affairs & Governance
Mar 15
Clinical Directors & Heads of Service
March 15
Equality & Patient Experience Manager
Dec 14 & Mar 15
Equality & Patient Experience Manager
Dec 14
-Patient Stories to be a standing item on key trust
meetings agendas eg service line SQS
- ensure IT enables for real time patient
experience monitoring in community settings
-Develop audit tool to collect views of patients
with communication needs
-Identify trust wide themes from Friends and
family test
Heads of Service
Dec 14
Deputy Director of Corporate Affairs and
Governance
Equality & Patient Experience Manager &
Patient Experience Officer
Equality & Patient Experience Manager &
Patient Experience Officer
Mar 15
-Develop renewed plan of focus groups to include
dementia carers and patient reference group
- Reintroduce mystery shopper programme
Equality & Patient Experience Manager
Dec 14
-Run social media survey for feedback from
patients with autism.
Equality & Patient Experience Manager &
Patient Experience Officer
Equality & Patient Experience Manager
Dec 14
Dec 14
Nov 14
Feb 15
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Objective
There is a systematic
and consistent approach
to analysing patient
feedback, and
considering it alongside
patient safety and
outcomes data
Year 1 action
-Triangulate themes across the range of patient
experience measures
-Identify themes from hard to reach groups
-Programme of visits to local groups and
organisations
-Quality Health to cross map results of staff and
patient national surveys
Lead
Equality & Patient Experience Manager
Deadline
Mar 15
Patient Experience Officer
Equality & Patient Experience Manager
Mar 15
Nov 14
Equality & Patient Experience Manager
Mar 15
The Trust actively and
routinely seeks out
patient feedback to
underpin quality and
service improvement
work
- All proposals to the board will have a quality and
an equality impact assessment and evidence that
findings are considered.
-All areas undertaking Friends and Family Test to
identify monthly themes to enable trust wide
themes to be identified.
Clinical Directors and Heads of Service
Mar 15
Matrons
Dec 14
The Trust regularly
reports and publishes its
patient experience data
and involves front line
staff and stakeholders in
producing improvement
plans.
-Quarterly patient experience reports to go to all
service areas
-All survey leads to produce action plans and
follow up reports involving staff in their area by
agreed deadlines
Equality & Patient Experience Manager
Dec 14
-Identify ways of sharing best practise
Survey leads/ Patient Experience Manager
As per deadlines
Deputy Director of Corporate Affairs and
Governance
Dec 14
Mar 15
-Trust wide collation and sharing of good news
(compliments data)
Complaints Manager
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APPENDIX 4 – List of key policies and other documents informing
the strategy
Trust Development authority – Patient experience development framework
TDA-Patient-Experie
nce-Development-Framework.xlsx
NHS Five year Forward View (October 2014)
http://www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf
Equity and excellence: Liberating the NHS (2010)
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalass
et/dh_117794.pdf
NICE Clinical Guideline 138 Patient Experience in Adult NHS Services (February 2012)
http://www.nice.org.uk/nicemedia/live/13668/58283/58283.pdf
High quality care for all (Darzi; DoH2008)
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh
_085828.pdf
The Kings Fund Point of Care Programme reports:

Seeing the Person in the patient (Kings Fund 2009)
http://www.kingsfund.org.uk/publications/the_point_of_care.html

Making shared decision-making a reality: No decision about me without me. (Kings Fund
2011)
http://www.kingsfund.org.uk/publications/nhs_decisionmaking.html

Patient Choice: How patients choose and providers respond (Kings Fund 2010)
http://www.kingsfund.org.uk/publications/patient_choice.html

Patient Preferences Matter: Stop the silent misdiagnosis (Kings Fund 2012)
http://www.kingsfund.org.uk/publications/patients_preferences.html

Continuity of Care for Older Hospital patients (Kings Fund 2012)
http://www.kingsfund.org.uk/publications/continuity_of_care.html
NHS Equality Delivery System
http://healthandcare.dh.gov.uk/equality-delivery-system/
DoH Framework for Patient Experience (2012)
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh
_132788.pdf
Friends and Family Test. DOH (2012)
https://www.wp.dh.gov.uk/publications/files/2012/10/NHS-Friends-and-Family-Test-ImplementationGuidance-v2.pdf
NHS Mandate (2012)
https://www.wp.dh.gov.uk/publications/files/2012/11/mandate.pdf
NHS constitution
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalass
et/dh_113645.pdf
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