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6b-PatientExperienceReportJuly-Sept08FINAL201108 Powered By Docstoc
					                   Patient Experience Quarterly Performance
                          1 July to 30 September 2008
                           Chief Executive Directorate
                                 November 2008

1.        Introduction

1.1       Changes in legislation to patient and public involvement for NHS Trusts
          were reported to the Board in March 2008. Relevant key points from the
          National Health Service Act 2006 and the Local Government and Public
          Involvement in Health Act 2007, are listed below for ease of reference.

1.2       These 2 important Acts replace the former duties under Section 11 of the
          Health and Social Care Act 2001. The renewed duties require NHS Trusts
          to make arrangements to involve and consult patients and the public in:

                 Planning services;
                 Developing and considering proposals for changes in the way
                  services are provided;
                 Decisions to be made that affect how services operate.

1.3       The National Health Service Act 2006 consolidated much of the current
          legislation concerning the health service and came into force on 1 March

1.4       Section 11 of the Health and Social Care Act 2001 is now section 242 of
          the consolidated NHS Act 2006. Section 242 applies in England to,
          Strategic Health Authorities (SHAs), Primary Care Trusts (PCTs), NHS
          trusts and NHS Foundation Trusts.

1.5       The Trust is committed to delivering services shaped around the needs of
          patients and carers and the above legislation provides clear guidance on
          how the Trust will work to achieve this aspiration.

1.6       The vision of Professor the Lord Darzi of Denham1 is to ensure an NHS
          that is fair, personal, effective and safe. Darzi‟s final report was published
          in June 20082.

    Vision set out in the Department of Health report ‘Our NHS, Our future: NHS next stage review
interim report: October 2007’
    Department of Health report ‘High Quality Care for All, NHS Next Stage Review Final Report
June 2008’

1.7    A further important publication entitled ‘Changing for the Better - DOH
       Guidance when Undertaking Major Changes to the NHS, June 2008’ 3 has
       been reviewed by the Directors. This report was as a result of Sir Ian
       Carruther‟s initial report on major service change published in February
       2007. This was clear that patients‟ clinical needs must come first in any

1.8    The Trust will fully adhere to the guidance when planning major service
       changes which require consultation with key stakeholders.

1.9    The performance framework for this work has been formalised and agreed
       with a revised Patient and Public Involvement and Community
       Engagement Strategy 2008 to 20104. The document describes how the
       Trust will involve and consult patients and the public in how services are
       planned and developed to provide person centred care.

2.     Purpose

2.1    The purpose of this performance report is to provide evidence, assurance
       and details of the plethora of methods employed within the Trust to
       capture patient and public feedback and how these views impact on
       service improvements. This is referred to as the „patient experience‟.

2.2    This valuable feedback illuminates the patient and carer experience of the
       ambulance service and has been gathered from the press and media
       office, Strategic internal and external communications, Website, Patient &
       Public Involvement (PPI), Equality and Diversity and Community
       Engagement work-streams, Appreciations, „Tell Us about It‟ feedback
       leaflets, Patient, Advice & Liaison Service (PALS) and the formal
       complaints procedures, including the latest early adopter pilot work led by
       the Department of Health called ‘Making Experiences Count’.5

3.     Performance

3.1    SWAST remains the lowest receiver of complaints and concerns for the
       whole of the NHS family in the South West and this is reflected nationally
       for ambulance services.

  Available from www.dh/gov.publications
  Strategy reviewed annually to comply with the NHSLA Clinical Negligence Scheme for Trusts
(CNST) requirements
  Reported to the Board in March 2007 available

4.    Patient Contacts

4.1   Table 1 shows the number of patient contacts compared to complaints,
      concerns and appreciations for A&E activity

      Table 1 - A&E

                  Month                        Contacts    Complaints        PALS
                  July                          75,623              23           16
                  August                        71,633              28           22
                  September                     57,047              35           26
                  Total                        204,303              86           64

      Table 2 - Urgent Care Service (UCS)

                 Month                    Contacts    Complaints PALS
                 July                          16,290          5    0
                 August                        19,048          9    2
                 September                     15,117          2    0
                 Total                         50,455         16    2

5.    Appreciations, PALS and Complaints

5.1   Table 3 provides a comparison for the % of appreciations, PALS and
       Table 3

                                 Percentage of contact with the Trust
                                        1 June - 30 Sept 2008


                 Appreciations                                          PALS Issues
                     62%                                                   15%

6.    Trends

6.1   The general findings and key trends are highlighted within section 4 of this

6.2   Appreciations

               272 appreciations;
               Majority of appreciations are for frontline operational staff who are
                congratulated for their superb contribution to continuing public
                confidence in the Trust;
               The Trust recognises that those staff who work behind the scenes
                are less likely to receive appreciation letters but publicly recognise
                and acknowledge in this report their equal contribution to upholding
                the strong reputation of the service;

6.3   PALS and complaints

6.3.1 Table 4 shows the categories for the total number and % of complaints
      and PALS finalised.

      Table 4

        Categories                       PALS Complaints Total                   %
        Access and Waiting                 16         23    39                   23
        Clinical Care                       7         37    44                   26
        Communication                      24         29    53                   32
        Security Issues and
        Driving Issues                      19               13    32            19
        Total                               66              102   168           100

6.4   The highest area of patient concern for this performance report is
      communication. The classification and associated statistics for each of
      these feedback areas comprise of:

               Attitude of staff (23);
               Information provided by Trust staff (16);
               Breakdown of Communication (12);
               Confidentiality (2);
               Respect and Dignity (0).

6.5    Top Impact Actions for patient experience feedback

6.6    A concern was received regarding an emergency call where a patient was
       experiencing considerable pain, whereby the call was triaged through the
       Trust‟s Advanced Medical Priority Dispatch System (AMPDS) in one of the
       Trust‟s Clinical Hubs (Control centres) and referred to NHS Direct.

       Impact Action: The Trust has highlighted the need for details of a
       patient's pain score to be included within the questioning prompted by
       AMPDS. A local protocol has been introduced by the Clinical Hubs which
       now includes this question. In addition senior managers have feed this
       back to the national working group and providers of the software system to
       influence other services nationally to adopt the same improvement.

6.7    A concern was received from a relative regarding communication
       procedures within the Urgent Care Service. The enquirer was unhappy
       that a duty doctor had tried to contact a relative by telephone and did not
       receive a reply so left a message and subsequently did not make a follow
       up call.

       Impact Action: The Trust has introduced a new procedure that provides
       clear guidance to healthcare professionals working for the Urgent Care
       Service on the communication procedure when a clinician is unable to
       contact a patient.

6.8    A complaint was received regarding the Trust‟s involvement in an
       emergency rescue of a patient.

       Impact Action: A multi-agency meeting is being convened to evaluate the
       management of this incident and to ensure lessons learned inform future
       joint working.

7.     Media and Reputation Management

7.1    Table 5 provides an activity summary for this quarter

Table 5

                              July 2008         August 2008     September 2008
Number of press cuttings            948                 442               1237
Number of media enquiries           304                 178                286

          The months of July and August show a dramatic decline in the number
           of cuttings received. This can be attributed to the „silly season‟ and
           high uptake of annual leave;
          The proportion of negative media coverage remains at approximately

         Geographical profiling shows a consistent rise in contact with and
          coverage in, media outlets nationally. The percentage of national
          coverage stands at 31%, which can be attributed to an increase in the
          publication of web-based articles;
         Newspapers continue to account for the majority of Trust coverage.

8.    Trust continues to scoop awards

8.1   An impressive total of 16 award nominations were submitted this quarter
      to organising bodies including; BUPA Foundation, HSJ, the Pride of Britain
      and Children of Courage. The awards showcased a variety of Trust
      initiatives, partnership working, excellent clinical practices, innovative
      projects and staff and patient bravery.

8.2   One short listed entry for the Pride of Britain awards secured coverage
      from numerous regional and national sources; Five year old Jakob from
      Frome, Somerset saved his mother‟s life when she suffered an epileptic
      fit. Trust staff who treated her were involved in the positive coverage.

8.3   The Ambulance Service Institute (ASI) has announced that this year‟s
      prestigious Special Service accolade is being awarded to a crew from
      Helston, who undertook a brave cliff rescue. They have been invited to the
      House of Commons to collect this prestigious award.

8.4   Further to the positive national coverage generated by an incident
      involving a crew from Plymouth, who saved the life of a patient trapped
      under a train, the Devon and Somerset Fire and Rescue Service awarded
      the crew an accolade for bravery.

9.    Compact – working in partnership

9.1   South West Regional Compact Partners, of which SWAST is an active
      member, has been presented with a national award. The group received
      the excellence Award for collaborative regional working at a ceremony in

9.2   The Compact is an agreement between organisations to promote better
      partnership working and improve outcomes for people and their

9.3   Compact membership has increased to include representation from NHS
      South West and the Commission for Equality and Human Rights and
      South West Ambulance Service NHS Trust‟s sign up to the compact has
      been viewed as a positive step to collaborative working.

9.4    The future of the Compact is currently out to consultation. The key issue is
       whether the Compact should remain a voluntary agreement between the
       Voluntary Councils of Services in England and government/public sector
       or whether it should be put onto a statutory basis; which means that sign
       up     to    the    Compact       will   be      enforceable     in     law.

9.5    Early indications are that members do not believe making the Compact
       into a set of statutory obligations would strengthen relationships. They
       believe that effective partnership working is better promoted through
       engagement – rather than being pressured to do so. The Compact has
       achieved much this year, including establishing a voluntary care sector
       health interest group at regional, sub-regional and local level.

10.    Strategic communications

10.1   Nick Pearson has joined the trust as assistant head of communications
       and PR. This has enabled Lynne Paramor to take up a new role as
       foundation trust lead and while she is in this new role, Nick will be
       managing the communications and patient experience team.

10.2   Nick is a member of the Chartered Institute of Public Relations and a
       former journalist on weekly, daily and regional titles. He joins the trust from
       Devon Primary Care Trust.

10.3   The communications & PR team will continues to take forward the overall
       Master Performance Framework which capture the evidence of achieving
       the corporate objectives of the trust.

10.4   Work has begun on a new corporate communications guide. This is
       intended to bring about uniformity in brand image. The new guide will
       include, for the first time, a document which aims to spread good practice
       in written communications and help to further improve public perception of
       the ambulance service.

10.5   Work has also begun to prepare marketing materials for the Foundation
       Trust programme and the upcoming patient transport tender process and
       plans are being progressed over a website/intranet redesign.

11.    Communicate 08

11.1   The trust‟s assistant head of communications & PR attended the national
       NHS communications conference, held in London, on November 5 and 6.

11.2   This was the first event of its kind and was attended by communications
       leads from across all NHS sectors, including the Director of
       Communications for the Strategic Health Authority, ambulance, primary
       care, acute and mental health trusts.

11.3   The conference was hosted by BBC Newsnight presenter Gavin Esler and
       leading communications professionals from both the public and private
       sectors gave lectures and held workshops about the importance of
       communications in the modern NHS.

11.4   The following provides a brief overview of key messages for trust boards.

David Nicholson, chief executive of the NHS, talked about the importance of
strategic communications to him personally. Unless communications were
managed at the highest level with good practitioners then the NHS would not be
not as effective as it could be. NHS organisations should harness the expertise
within their communications departments and work closely with them. He would
be making this clear to leading figures in the NHS, he added.

Colin Douglas, director of NHS communications, spoke of communicators being
key to the fundamental change in the service. The NHS should embrace strategic
communications and social marketing techniques but change could only be
achieved if NHS trust saw its true potential. There was a need to end the “press
release and leaflet” mentality in favour of targeted and strategically managed

Alistair Campbell, former press secretary to Tony Blair, spoke of the modern
world being defined by the pace of change. Big societal changes were
happening, characterised by the merging of citizen and consumer. People now
expected private levels of service from the public sector. There was a stronger
participative media and there had been a rise in the democratic corporation;
organisations that cannot operate in a vacuum. He also spoke of the importance
of linking organisational objectives to communications activity.

Professor Anne Gregory, leading communications academic, spoke of the
importance of the strategic management of communications. Department of
Health now realised the power of strategic communications and had
commissioned her to conduct a national research programme into excellence in
NHS communications.
This was described as “what does good communications look like” study and
amounts to a systems analysis approach to the issue.

Tom King, BAA director of communications and former advisor to the Labour
Government, talked about the power of communications in crisis management.
 Mr King had handled communications during the 7/7 London bombing, Omagh
and the Heathrow terminal 5 debacle. He offered valuable insights and practical
solutions for dealing with crises.

12.    Implications of the likely national direction of communications
       management on SWAST

12.1   The trust has a communications & PR department that is managed
       strategically and staffed by suitably qualified communications
       professionals. Strategic objectives are also linked to tactical
       communications activities.

12.2   Awareness of two-way communications, a central tenet of strategic
       communications management, is high and indeed, is practiced with focus
       groups and chat room use commonplace in both internal external trust

12.3   Communications practitioners are well qualified with graduate/post
       graduate qualifications and relevant and varied experience in the field of
       communication and marketing. There is a good knowledge of social
       marketing techniques within most of the team.

12.4   The location of the communications function within NHS organisations is
       key when delivering strategic management. In SWAST it is managed
       within the chief executive‟s department and there is a presence at board

12.5   Communications activities are conducted in a planned and systematic way
       where this is possible. Communications activities are also linked to
       corporate objectives which demonstrate a „golden thread‟.

12.6   The factors above indicate that the communications function at SWAST is
       already managed strategically and therefore in line with the wishes of the
       NHS CEO and NHS director of communications.

12.7   In this regard SWAST can be said to be ahead of national expectations.

13.    Proactive press

13.1   A total of 19 proactive press releases were disseminated to the Trust‟s
       portfolio of media contacts on a local, regional, and increasingly often,
       national basis. This is an increase on the last reporting period, when the
       figure stood at 13.

13.2   The topics of these releases vary greatly, many of which incorporate
       messages in support of the Trust‟s Public Health strategy; „Prevention is
       better than cure‟. Alcohol warnings, smoking cessation (focusing on the
       pictorial warnings now featuring on cigarette packets) and being „water
       wise‟ – a topic ideally suited to the summer months.

13.3   The Trust worked successfully in partnership with the Strategic Health
       Authority during the latest smoking cessation campaign which secured a
       great deal of coverage in the media.

13.4   Rural Health week was also supported, with an emphasis on improving
       emergency vehicle access to homes and premises, which are not clearly
       identifiable. National blood pressure week and a „Careless Calls Cost
       Lives‟ campaign also generated large amounts of positive coverage.
       Further, details of the Board Meetings and the AGM falling within this
       quarter were also released. The reappointment of two Board Non
       executive members also made the headlines locally and regionally.

       Responder recruitment, events, generosity from local Freemasons, and
       „Making your Experiences Count‟ are other areas, which were the subject
       of press releases during this reporting period.

14.    Reactive press

14.1   Throughout this quarter a total of six press statements were released.
       Three of these were distributed to multiple sources.

14.2    The majority of these statements were requested by Dorset media

14.3   One statement was proactively planned in advance of the Healthcare
       Commission‟s report concerning emergency and urgent care. The
       coverage for this was predominantly positive, although in Dorset there
       were a few negative angles taken.

14.4   The remaining statements were all prepared on a reactive basis to a
       variety of issues.

15.    Incidents

15.1   An incident involving a tour bus overturning made national news. A
       comprehensive statement concerning the Trust‟s involvement was issued
       within an hour of the call being received. Approximately 30 patients were
       treated and thankfully their injuries were not described as serious. Steve
       Smith, the Assistant Clinical Hub Manager (East) gave a number of

                                      - 10 -
       interviews shortly after leaving the scene and this was used widely by the
       Gcap Media group.

15.2   An incident involving the theft of an ECG machine from a Plymouth
       ambulance made headlines locally after a press release was distributed
       containing all the details.

15.3   A cave rescue in Dartmouth attracted the attention of many local and
       regional media sources.

15.4   After a light aircraft crashed in Exeter, many calls were taken from local
       and regionally based media. This story appeared on several online news
       sites nationally and attending officer Frank Mallet gave interviews to
       enquiring journalists.

16.    Campaigns

16.1   A „Careless Calls Cost Lives‟ campaign (re-branded from the previous
       „Inappropriate Calls‟ campaign) was run during the summer months
       Securing coverage from numerous sources incorporating both print and
       broadcast media. The press release contained the details of some
       surprising 999 calls which had never been released before. This will be re-
       released in the run-up to the festive season and it is hoped that it will
       receive interest on a national scale to equal the success of this campaign.

16.2   „Getting the Right Treatment‟ is another campaign that ran during this
       quarter. The detailed press release and accompanying leaflets were
       distributed to each media contact across the four counties and explain
       how, when and where to access the variety of health services on offer.
       Numerous articles from a variety of sources were reported across the four

16.3   „Know your numbers‟ week is an annual campaign run by the British Heart
       Foundation. The Trust supports this by issuing a press release which
       upholds the values and principles of its public health strategy. The release
       emphasises the need for regular blood pressure checks and highlights the
       life threatening illnesses associated with having untreated high blood
       pressure levels.

16.4   There is an ongoing campaign for community responder recruitment.
       During this reporting period a total of three press releases were distributed
       relating to the responder schemes.

                                       - 11 -
17.    Dissemination of media alerts – internal communications

17.1    Three media updates were distributed during this quarter; two in August
       and one in September. Positive feedback has been received about this
       method of communicating. It showcases the Trust‟s press office activity
       and keeps directors and senior managers abreast of media developments.

17.2   This method of communication is also used as an evidencing tool because
       all press office and other communications activities are showcased.
       Further, these information records are utilised as a referencing tool
       wherever practicable and assist in the preparation of the Trust‟s monthly
       media reporting and analysis.

18.    First Bike on Scene

18.1   The Commercial Training department offer a pioneering course to
       motorcyclists across the four counties. Entitled „First bike on scene‟ this
       one day course empowers participants with the knowledge of how to treat
       fellow motorcyclists should they be first on the scene of a collision.
       Despite previous press releases and articles being published about this
       potentially lifesaving scheme, it has been the subject of much praise from
       media sources this quarter.

18.2   A feature appeared on BBC Spotlight throughout all of its bulletins over
       the course of a day. Additionally, interviews were broadcast on BBC Radio
       Devon. A large number of calls from interested individuals and groups
       were received as a result. This saved the Trust thousands of pounds on
       advertising and continues to generate revenue from an increased
       participation rate.

19.    Broadcasting

19.1   This quarter has been very successful in terms of securing positive
       coverage via broadcasting. This encompasses radio and television
       interviews, and extends to activities including the production of podcasts
       and DVD‟s.

19.2   The Trust recently took delivery of its first corporate DVD. This innovative
       film was produced by London based company Ocicat and centres on
       vehicle safety. Predominantly aimed at front line staff, it is endorsed by
       VOSA (Vehicle Operating Standards Agency). The 15 minute piece was
       produced as a joint venture with the Fleet department, who earmarked the
       funds for this project. The Trust‟s Training department also played an
       integral role in the production of the film. It is expected to be rolled out to
       other ambulance trusts and form a key part of the Trust‟s core induction.
       This successful DVD has received some positive, constructive feedback.

                                        - 12 -
19.3   A South Devon based paramedic Haydn Glanville has been selected for a
       national, prime time television series similar in nature to that of „I‟m a
       celebrity, get me out of here‟. His destination is unknown and the Trust will
       be able to capitalise on this positively on his return.

19.4   Broadcast dates as yet are unknown but Haydn was given a brief and
       filming was undertaken of Trust vehicles and the air ambulance to be used
       as part of his introduction to the series. This is an excellent opportunity to
       positively build our brand nationally.

19.5   Following the distribution of a press release about Britain‟s longest serving
       paramedic John Spindler, who retired recently, his story appeared in the
       Sun, the Mirror, the Guardian, the Times, the Daily Express, Radio 4 and
       the Telegraph, as well as a live surprise feature on the first episode of the
       new series of Paul O‟Grady Show, aired on Monday 22 nd September. It
       was a great success and featured interviews with Ken Wenman and two
       other Trust personnel who had worked with him for a number of years.
       This is excellent in PR terms and provided another excellent opportunity to
       build the Trust‟s brand nationally in a positive capacity.

19.6   The official launch of the new Devon Air Ambulance was very successful,
       with a high media attendance rate. As a consequence, one of the Trust‟s
       aircrew secured a number of interviews through various broadcasting
       channels including radio and television (BBC Spotlight).

19.7   The Trust‟s Head of PR and Strategic Communications has secured a
       regular slot on BBC Radio Devon (Plymouth area) where she has the
       opportunity to discuss a topic of choice. This is an excellent opportunity to
       continue building the Trust‟s profile, and as far as is known, this is not
       practiced by any other NHS Trust Communications team in the South

19.8   The Trust is also a part of a Devon Communications group who have
       secured regular slots on BBC Radio Devon (Exeter) where different
       agencies host a representative to take part in the mid day live chat show
       about issues in their organisation. This is being managed by the
       Communication Director at the Peninsula Medical Schoole.

19.9   Other television appearances secured by the Trust include; a piece aired
       on BBC Spotlight highlighting the valuable work undertaken by Clinical
       Advisors operating within both Clinical Hubs, who ensure that patients
       receive the most suitable care pathway appropriated to their condition.
       Further, ahead of the introduction of pictorial warnings on cigarette
       packets, a feature appeared on ITV Westcountry, which included the
       health dangers associated with smoking. Following the press release that

                                        - 13 -
          was sent out regarding the access of healthcare over the bank holiday
          weekend, another feature appeared on BBC Spotlight, detailing the high
          number of calls expected by the Trust and how these would be dealt with.
          BBC Points West also ran a story about the rising costs of fuel, which has
          been one of the most topical subjects throughout this reporting period.

20.       Web

20.1      The Trust web site and staff intranet site are regularly updated with

20.2      There have been a total of 82,901 visits to the trust‟s website in the

20.3      Work is underway with commercial training to help promote courses
          through the internet.

20.4      A working group has been formed between communications and IT to look
          at redeveloping and modernising the existing internet/intranet sites in
          preparation for the Trust‟s Foundation Trust application.

20.5      Table 7 shows the 10 most popular web pages viewed by users.
Table 7

           Popular Pages                               Jul-08     Aug-08     Sept-08
           Individual Press Releases                    2,052      1,194       1,025
           Recruitment                                  1,098      1,055       1,224
           Careers                                      1,065      1,112       1,252
           Responder Group Pages                        1,044        765         791
           Careers & Vacancies                          1,023        980       1,092
           NHS Jobs                                       889        874         901
           Key Services                                   735        671         808
           Stations                                       688        693         828
           Responder Scheme                               631        579         531
           Contact Us                                     609        577         719

20.6      Table 8 provides an analysis of the top documents viewed. The Chief
          Executive‟s national urgent care booklet, written and produced on behalf
          of the 12 ambulance services in England, remains the most popular.

20.7      The booklet, aptly named the „Changing Face of Ambulance Services‟ is
          attracting interest from Commissioners on how the Trust is and can
          provide integrated health services within the health and social care

                                         - 14 -
       Table 8

        Popular Downloads                           Jul-08        Aug-08            Sept-08
        Changing Face of Ambulance                    278            281               287
        Annual Report 07/08                           180            153                 167
        LP036 Rib Injuries                            153            156                 211
        ECP guidelines                                149            123                 121
        LP029 Insect bites                            137            140                 107
        LP016 wound care minor burns                  111            117                 113
        Major incident plan                           104             84                 104
        LP056 Stitches/sutures aftercare              102            100                  97
        24/7 March edition                             98             71       (+June ed)214
        LP053 Dorset out of hours                      85             84                  83

20.8   The staff portal continues to be a popular tool to enable staff to work more
       flexibly. August and September saw usage increase to 719 and 716
       respectively, but October saw a marked increase with 837 people logging
       in to view Trust information.

21.    Marketing materials - leaflets

21.1   The Strategic Communication and PR team are in the process of
       redesigning the Trust‟s leaflets as and when reprinting is required.

21.2   Table 9 shows the number of Trust leaflets that have been distributed.
       This does not include the use of current stocks known to be on stations of
       which it is difficult to ascertain accurate statistical data but it provides
       further assurance of the numerous types of literature available to staff,
       patients and the public.
       Table 9

                                                        Jul    Aug         Sept
        Description                                                                 Total
                                                       2008   2008         2008
        Dorset Out of Hours Medical Service -
                                                      1,156   0            0        1,156
        Information for Patients
        Somerset Out of Hours Medical – Service
                                                       200    0        4,000        4,200
        Information for Patients

        PALS                                            0     0            50        50

                                           - 15 -
22.    Public access and information leaflets

22.1   Downloading pdf versions of leaflets from the web site is becoming the
       preferred route for accessing the Trust‟s Patient Advice Leaflets by
       members of the public, with a total of 9,130 downloads during the quarter.

22.2   Table 10 shows the following five clinical patient information leaflets were
       downloaded a total of 1,707 times.

       Table 10

                                                       Jul    Aug   Sept
        Patient Information Leaflet                                        Total
                                                      2008   2008   2008

        Rib Injury (LP036)                            153    156    121     421

        Insect Bites (LP029)                          137    140    107     384

        Wound Care / Minor Burns (LP016)              111    117    113     341

        Stitches/Sutures Aftercare (LP056)            102    100    97      299

        Dorset Out of Hours (LP053)                   85     84     83      252

22.3   The Strategic Communication and PR team has supplied SWAST Patient
       Information Leaflets to Scottish Ambulance Service as part of an income
       generation scheme.

22.4   Braille and large print versions of the recently published 2007/08 Annual
       Report are now available and an audio tape version is on order to
       increase the Trust‟s suite of accessible communication materials to ensure
       „hard to reach‟ groups can be kept fully informed.

23.    Questionnaires and Feedback

23.1   Throughout this reporting period analysis has been undertaken on the
       questionnaires gathered from the four NHS 60 celebratory events
       organised throughout the first week of July. The feedback received is
       largely positive and the questionnaires were well received. Personal data
       was also gathered during this process, which will help to inform the
       foundation trust membership recruitment.

23.2   A Communications stock take questionnaire was distributed with the June
       edition of Twentyfourseven. A total of 3000 questionnaires were sent out
       to each newsletter recipient, including Trust staff members. Participation
       has been strongly encouraged and requests for the completion and return
       of these has been posted in the Chief Executive‟s Bulletin. A number of

                                             - 16 -
       completed questionnaires have been returned but not a significantly large
       sample for purposes of analysis. This questionnaire was designed to
       gauge the effectiveness of the communication methods utilised by the
       Trust‟s PR and Communications team. The feedback will inform future
       communication tools and methods practiced by the Trust.

24.    Patient and Public Involvement (PPI) and event attendance

24.1   The Trust continues to receive a large number of requests and invitations
       from schools, colleges, groups and to numerous community events. With
       the recent emphasis on performance, the Trust has been unable to honour
       as many requests. This can also be attributed to the large staff annual
       leave uptake throughout the summer months. Further, the Trust relies
       solely on volunteers to support events of this nature as opposed to other
       services who employ dedicated personnel for carrying out community
       engagement objectives.

24.2   A total of 20 events were recorded on the PPI intranet diary for this
       reporting period. Although numerous requests are made by the team
       encouraging staff to populate the fields of the brief PPI form, which is held
       on the intranet, this process is not always carried out and therefore it is
       likely that this figure far exceeds 20. However, the majority of the
       approximated figure of 20 events were supported by Trust staff.

25.    The Trust’s multi-purpose PR and Education Unit

25.1   The utilisation of this innovative unit is becoming more frequent. The unit
       was used approximately 15 times and appeared at a variety of events
       including; the four NHS 60 health awareness events (one in each county).
       The PR unit is an integral part of the Pacesetters initiative currently
       operating in the North Devon area targeting farmers and led by a
       Barnstaple based ECP. On a fortnightly basis, health clinics are offered at
       farmers markets across the area. This initiative is extremely well received.

25.2   The North Devon Show, Blue Light Day in Dorset and dedicated health
       MOT event in Cornwall were other events supported by the PR unit during
       this quarter. One of the questions contained within the PPI questionnaire
       (see section 17) specifically refers to the introduction and usage of the PR
       unit and the overwhelming majority of respondents deemed it an excellent
       method of direct communication.

26.    Marketing Materials

                                       - 17 -
26.1   Following the successful securing of funds for a further order of marketing
       materials, these have been orders and the first items have been delivered
       to Trust Headquarters. The items include; water bottles, Frisbees,
       highlighters, bookmarks and stickers. Aimed at a variety of ages, these
       branded items also contain public heath messages and the website is also
       included in order to continue building the Trust‟s well renowned and
       respected brand.

26.2   These items have been well received by staff for taking into schools and to
       other events. The purpose of these materials also extends to act as an
       incentive for people to complete questionnaires. The British Heart
       Foundation also issue „Artie Beat‟ books, which are educational books for
       children aged 4-7. Similarly, the Trust has a supply of Mini-Medic‟ books,
       which are an educational resource provided at no cost.

27.    Equality and Diversity – targeting the ‘Hard to Reach’

27.1   The groundbreaking Pacesetter projects running across the four counties
       continue to develop positively. The health clinics for farmers (refer to 19.2)
       continue to be well supported and the launch of the migrant worker DVD
       and associated booklet in Cornwall are near completion, to be marked
       with an official launch.

27.2   The „Learn to Live‟ initiative, aimed at equipping young people with the
       important knowledge of safe driving practices, gathers momentum and
       has now been rolled out beyond Torquay, where it originated, to the
       Exeter area.

28.    Tell Us About It’ feedback leaflets

28.1   During the period 10 hard copy „Tell Us About It leaflets‟ were received by
       the Trust.

28.2   A proactive campaign was launched in August to continue to raise the
       profile of these patient feedback mechanisms for members of the public.

29.    Making Experiences Count (MEC)

29.1   The Trust has already put into place processes to shift towards this new
       approach reported to Trust Board in March 2008. and has re-categorised
       complaints and concerns received as Making Experiences Count within its
       DATIX software capture system.

29.2   As reported in the previous patient experience report the
       department has re-catergorised complaints and concerns received as

                                        - 18 -
           „Making Experiences Count‟ within its Datix software capture system. The
           statistics for complaints continue to rise from the previous quarter because
           the data was previously divided within Patient, Advice and Liaison
           concerns and formal complaints6, but are now combined.

 29.3      The PALS data capture now reflects minor issues such as requests for
           leaflets, signposting to other agencies, queries about the Trust for
           academic research purpose etc.

 29.4      Table 11 shows complaints finalised by service area.

 Table 11

     Complaints                                                                         Total
     A&E                                                                                  62
     Clinical Directorate                                                                  0
     Clinical Hubs (999 Controls)                                                          2
     Patient Transport Service (PTS)                                                      21
     Urgent Care Service                                                                  16
     Other NHS Trusts                                                                      1
     Total                                                                               102

 29.5      Table 12 shows PALS finalised by service area.

 Table 12

     PALS                                                                               Total
     A&E                                                                                  31
     Clinical                                                                               1
     Clinical Hubs (999 Controls)                                                           5
     Other NHS Trusts                                                                     11
     Patient Transport Service (PTS)                                                      14
     Urgent Care Service                                                                    2
     Minor Injury Units                                                                     1
     Support Functions                                                                      1
     Total                                                                                66

 30.       Complaints and PALS by Operational area

 30.1      Table 13 shows complaints and PALS by subject areas.

Table 13

  Healthcare Commission Spotlight on Complaints, a report on second-stage complaints about the
 NHS in England April 2008

                                             - 19 -
Subject area                                    PALS   Complaints      Total

West Division
(Cornwall/Isles Scilly & Devon)
East Devon OLM                                     1           6          7
North Devon OLM                                    2           4          6
South Devon OLM                                    2           7          9
West Devon OLM                                     0           7          7
East Cornwall OLM                                  2           3          5
West Cornwall OLM                                  0           2          2
Total                                              7          29         36

Subject area                                    PALS   Complaints      Total

East Division
(Dorset & Somerset)
South Somerset OLM                                3            5          8
West Somerset OLM                                 4            5          9
East Dorset OLM                                   2            1          3
West Dorset OLM                                   5            2          7
Central Dorset                                    5            3          8
Total                                            19           16         35

Clinical & Urgent Care Directorate
East Hub (999 control room)                       2            6          8
West Hub (999 control room)                       9           15         24
Dorset – UCS                                      1            9         10
Somerset – UCS                                    1            7          8
Clinical Department                               1            0          1
Minor Injury Unit                                 1            0          1
Total                                            15           37         52

Patient Transport Services
Plymouth and Cornwall Area                        0            4          4
Exeter Area                                       4            5          9
Somerset Area                                     6            3          9
Dorset Area                                       3            7         10
Total                                            13           19         32

Support Services
Human Resources                                   0            0          0
Other NHS Trusts                                  1            0          1
Total                                            11            1         12

Total Number of complaints, concerns and
issues                                            66         102        168

31.    Key Performance Indicators (KPIs) – NHS Complaint Legislation

                                       - 20 -
31.1      The Trust continues to be committed to investigating any complaint or
          concern as swiftly as possible to minimise any anxiety for patients and
          staff. Previously the Trust has been the only NHS Trust in the South
          West to have set a key performance indicator (KPI) for responding to
          PALS and monitoring of responding to concerns within 25 working days.

31.2      The statutory 25 working day complaint response target remains in place
          during the parallel running „Making Experiences Count‟ pilot. This
          provides compliance with the NHS Regulations for complaints handling.
          The deadline can be negotiated with a complainant for an extension
          compliance date for complex complaints.

31.3      Table 14 shows compliance figure of 98% has been achieved for this
          period for the combined 168 complaints and PALS.

Table 14

          Reporting Period       Numbers of         Numbers of          Numbers of       Percentage
                                  combined           combined            combined
                               complaints/PALS   complaints/PALS     complaints/PALS
                                   finalised      within timescale   outside timescale

 1 April – 30 June 2008                   168                 164                   4          98%

 Totals                                   168                 164                   4          98%

32.       Healthcare Commission

32.1      Nil requests for an independent review were received during this period.

32.2      During the period the Trust received the outcome of two independent
          reviews undertaken by the Healthcare Commission. Both of these
          complaints were received and responded to during the financial year
          2007/2008 before local resolution was implemented as the preferred
          method of managing complainants concerns.

32.3      Both complaints were upheld by the Healthcare Commission. The
          recommendations have been reviewed and action plans have been
          generated to address the recommendations. This work is currently

33.       Ombudsman

33.1      Nil for this period (Year to date – Nil)
34.       Outcomes

                                            - 21 -
34.1        Table 15 shows of the 153 combined complaints and PALS finalised
            during this period, 48 (32%) were not upheld. It further illustrates the
            outcomes by subject groups.

Table 15

                                                                                 External       Unknown       Total
                             Not                       Part      No Action       Action
 Subject Groups              Upheld        Upheld      Upheld    required
 A&E Activity                        25          7         11           39                  2             9           93
 Clinical                             0          0          0             1                 0             0           1
 Control                              2          1          0             4                 0             0           7
 Human Resources                      0          0          0             1                 0             0           1
 Urgent Care Service                  6          3          5             4                 0             0           18
 PTS                                  5          3          3           22                  2             0           35
 Minor Injury Unit                    0          0          0             1                 0             0           1
 Other NHS Trusts                     0          0          0             1             11                0           12
 Total                               38         14         19           73              15                9       168

34.2        Table 16 below shows the % of complaints and PALS that were upheld,
            not upheld, partially upheld, and those that required either no action or
            external action by another NHS Trust or organisation.

Table 16

                                Outcomes of Complaints/PALS
                                    1 July - 30 Sept 2008

                                            Unknow n
                         External Action                            Not Upheld
                               9%                                      23%

                No Action Required                                   Part Upheld
                       44%                                              11%

35.         Recommendation

                                                        - 22 -
35.1   The Board is asked to note the contents of this quarterly patient
       experience assurance report of the Trust‟s work to continually report and
       improve the patient experience and uphold the positive reputation it enjoys
       across the South West and beyond.

Lynne Paramor
Head of Strategic Communication & PR (Chief Executive Directorate)

                                      - 23 -

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