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					                                                                                      Agenda Item No.


                                                                                               5
                                                                                      PALS (WHHT)
                                PALS Themes April – June 2007
                                        Quarter One

Introduction

During the period April ’07 to June ’07 a number of themes have been identified across the Trust
from contact with PALS by analysis of data held on the Datix Risk Management Database. The
top six themes across all divisions are illustrated in the table below.

                                                               Communication /
                 160                                           Info to Patients

                 140                                           Appointment -
                                                               OPD
                 120
                                                               Clinical Treatment
                 100

                  80                                           Appointments -
                                                               IPD
                  60
                                                               Admission /
                  40                                           Discharge /
                                                               Transfer
                  20                                           Staff Attitude


                    0
                                                               Other
                                  Categories


A total of 142 concerns were raised throughout the Quarter, consistent to previous Quarters:

                                                       concerns           themes
                                                        raised             raised
               Quarter 3 - Oct 05 - Dec 05               172                298
               Quarter 4 - Jan 06 - March 06             161                304
               Quarter 1 - April 06 - June 06            132                306
               Quarter 2 - July 06 - Sept 06             136                296
               Quarter 3 - Oct 06 - Dec 06               126                245
               Quarter 4 - Jan 07 - March 07             148                327
               Quarter 1 – April 07 – June 07            142                340




                                                                                                 1
Acute Medical Care Division

                            Breakdown of themes within 6 main specialities:

                                          CARD     COTE    EMERC     GAST       GENM   RHEU    Total
Admissions/Discharge/Transfer                2       1                           2               5
Patients Privacy/Dignity                                                         1               1
Appointments - Delayed/Cancelled - OPD       4                        2          1         4     11
Staff Attitude                               1       1       2        1          3               8
Clinical Treatment                           4       2       1        3          3               13
Communication/Information to Patients        7       3       3        4          6         4     27

Within Medicine, 32 concerns have been received. Out of the 79 themes identified within this
Division 37% of these 79 themes relate to communication and information to patients. Cardiology –
concerns raised include queries over clinical treatment, cancellation of outpatient appointments,
staff attitude and chasing up GP letters.

                       Breakdown of Departments – Acute Medical Care Division

                                                  Concerns            Concerns
                           Department               raised             received
                                                 this Quarter        last Quarter
                       Care of the Elderly             3                  14
                       General Medicine                8                   2
                          Cardiology                   7                   1
                        Emergency Care                 3                   5
                       Gastroenterology                5                   4
                         Rheumatology                  4                   1

Issues also continue to be raised in relation to clinical treatment, and as mirrored within the formal
complaints process it seems that the Trust is not always providing clear or adequate explanations
of care and treatment, leading to a lack of understanding.

Clinical Support Division

                            Breakdown of themes within 4 main specialities:

                                                    PATH    PHYSIO        RAD        SURAP     Total
Appointments - Delayed/Cancelled - OPD                           1          2          2        5
Appointments - Delayed/Cancelled - IPD                                      1                   1
Staff Attitude                                                              1                   1
Clinical Treatment                                                          1                   1
Communication/Information to Patients                1           1          3          2        7



Clinical Support Division received a total of 12 concerns for the last quarter. Within Radiology
Services concerns have been raised regarding waiting time for MRI and CT scans. In part patients
not being aware of the waiting time for such procedure may cause this.




                                                                                                       2
Facilities and Estates

1 complaint received within this Division relating to cleaning which was raised and resolved by the
Medirest Deputy Service Manager.

Surgery & Anaesthesia

                           Breakdown of themes within 8 main specialities:

                                         BREAST ENT GSUR GYNAES OPTH PAIN TRAU UROL Total
Admissions/Discharge/Transfer              1      2        4           3     1    8    2    21
Appointments - Delayed/Cancelled - OPD     7     11            2       1     6    2    1    30
Appointments - Delayed/Cancelled - IPD            1        5           2          11   7    26
Staff Attitude                                    1            1                  1         3
Clinical Treatment                                3        2           2          8    2    17
Communication/Information to Patients      7     14        7   3       7     6    19   10   73
Complaints Handling                        1                                      2         3



Surgery & Anaesthesia Division has received a slight decrease of complaints from the last Quarter
from 42% for Quarter 3 and 69% for Quarter 4 down to 58% for this Quarter. Furthermore, Trauma
and Orthopaedic services remain consistant, as they represent 23% of concerns raised within this
Division. 83 out of the 206 themes relate to communication to patient and 35 relate to the
cancellation and delay of Outpatient appointments. Concerns within this area include cancellation
and waiting times for Orthopaedic surgery, delays and cancellations in outpatient appointment, and
information not being explained or given in relation to clinical treatment. Issues in relation
cancellation of Orthopaedic surgery have been escalated to Admissions, Service, Divisional and
Operational Manager.

                         Breakdown of Departments - Surgery & Anaesthesia

                                                Concerns            Concerns
                          Department              raised             received
                                               this Quarter        last Quarter
                         Trauma and
                         Orthopaedic                  19               23
                       Breast Services                 7               7
                        Ear, Nose and
                            Throat                    14               13
                       General Surgery                 7               11
                       Ophthalmology                   7               11
                           Urology                    10               10




                                                                                                  3
Women and Children Services

                           Breakdown of themes within 4 main specialities:

                                             CHILDN    FERTIL     GYN        MIDWIF       Total
Admissions/Discharge/Transfer                  2                                            2
Personal Records                                         1         1                        2
Appointments - Delayed/Cancelled - OPD                   1         1            1           3
Appointments - Delayed/Cancelled - IPD         1                   1                        2
Staff Attitude                                 1                                            1
Clinical Treatment                                       1         1            1           3
Communication/Information to Patients          2         2         4            4           12

Within this Division twelve complaints were received. 4 complaints were within Gynae relating to
communication and clinical treatment whilst a patient was an inpatient, delay in Outpatient
appointment and request for information. 3 concerns were raised regarding the suspension of ante
natal classes and this was escalated to Acting Head of Nursing for Midwifery. 2 complaints
received within Children Services raised and resolved by the Modern Matron.

Information provided by:

Hamed Zarin
Patient Advice and Liaison Service

9th August 2007

                                PALS Themes July – September 2007
                                          Quarter Two

Introduction

During the period July ’07 to September ’07 a number of themes have been identified across the Trust from
contact with PALS by analysis of data held on the Datix Risk Management Database. The top nine themes
across all divisions are illustrated in the table below.

   250                                                                 Communication / Info to
                                                                       Patients
                                                                       Appointment - OPD

   200
                                                                       Clinical Treatment

                                                                       Appointments - IPD
   150
                                                                       Admission / Discharge /
                                                                       Transfer
                                                                       Staff Attitude
   100
                                                                       Communications


    50                                                                 Personal records

                                                                       Info / Advice to patients relative

     0                                                                 Others
                                Categories


                                                                                                            4
During this Quarter the highest number of complaints (215) were dealt with solely by one
PALS Officer, despite decreased volunteer admin support for this Quarter:

                                                         Concerns          Themes
                                                          raised            raised
               Quarter 3 - Oct 05 - Dec 05                 172               298
               Quarter 4 - Jan 06 - March 06               161               304
               Quarter 1 - April 06 - June 06              132               306
               Quarter 2 - July 06 - Sept 06               136               296
               Quarter 3 - Oct 06 - Dec 06                 126               245
               Quarter 4 - Jan 07 - March 07               148               327
               Quarter 1 – April 07 – June 07              142               340
               Quarter 2 – July 07 – Sept 07               215               517

Acute Medical Care Division

                           Breakdown of themes within 6 main specialities:

                                           CARDIO   COTE   EMERG     ENDO    GENM    NEURO    Total
Admissions/Discharge/Transfer                2               1                 4       1        8
Communications                               1       1       1         1               1        5
Patients Privacy/Dignity                             3                         2                5
Appointments - Delayed/Cancelled - OPD       5       1                 3                1      10
Information/Advice to Patient's Relative     1       1        1                1        1       5
Staff Attitude                               1       1        1                1        1       5
Clinical Treatment                           2       4        1        1       5        2      15
Communication/Information to Patients        8       5        2        3       7        2      27


Within Medicine, 46 concerns have been received. Out of the 115 themes identified within this
Division 30% of these 115 themes relate to communication and information to patients

Within Cardiology concerns raised included deceased patient’s relative requesting meeting with
consultant to seek information relating to treatment and diagnosis, delay in appointment for ECG,
delay and cancellation of Outpatient appointments patients chasing up GP letters following
Outpatient appointment.

In Care of the Elderly, concerns raised included delay and cancellation of Outpatient appointments,
deceased patient’s relatives requesting meeting with consultant to seek information relating to
treatment and diagnosis, Health and Safety incident on Ward involving patient, Infection Control
and Nursing care issues, concerns regarding patient becoming malnutrition and also being put in a
mixed ward, lack of Nursing care and cleanliness.

Concerns within Endocrinology include delay and cancellation of Outpatient appointments and
chasing up results following diagnostic testing.

Within General Medicine, concerns included delay in seeing Medical team follow adverse reaction
to antibiotics, family requesting meeting with Medical team to seek more information regarding
patient’s care and treatment and delay in receiving medication following discharge.




                                                                                                 5
                      Breakdown of Departments – Acute Medical Care Division

                                                 Concerns              Concerns
                         Department               received             received
                                                Last Quarter          This Quarter
                        Care of the
                           Elderly                     3                       19
                          General
                         Medicine                      8                       27
                        Cardiology                     7                       22
                      Emergency Care                   3                       9
                      Gastroenterology                 5                       8
                       Rheumatology                    4                       6

Clinical Support Division

                            Breakdown of themes within 5 main specialities:

                                                                                                    SURG
                                                PHARM       PHLEB     PHYSIO         RADIO           APL     Total
Clinical Treatment                                1           1                                       1        3
Staff Attitude                                                                           2            1        3
Communication/Information to Patients             1           1            2             6            3       13
Appointments - Delayed/Cancelled - OPD                        1            2             3            2        8


Clinical Support Division received a total of 13 concerns and 32 themes identified for the last
quarter. Within Radiology Services concerns raised related to MRI scans; include patient chasing
up scan relating to a ENT tumour investigation, chasing up scan results and report, and
appointment for scan.

Within Surgical Appliances, concerns raised included cancellation and delay of Outpatient
appointments and delay in receiving surgical appliance.

Facilities and Estates

8 complaints were received within this Division relating to broken vending machines at Hemel
Hempstead General Hospital outside CCU, domestic cleaning at Hemel Hempstead General
Hospital, cleaning on the Wards at Watford General Hospital, and car parking exemptions.

Surgery & Anaesthesia

                            Breakdown of themes within 8 main specialities:
                                                                       GEN
                                         TRAUMA       AUDIO   ENT     SURG      OPHTH        ORAL    UROL   VASC     Total
Aids/Appliances/Equipment                               3                                     2                       5
Admissions/Discharge/Transfer              10                     1    6            2         1       4      2        26
Personal Records                           2                           1            1         1                       5
Policy/Commercial – Trust                  1                                        2                 1      1        5
Communications                             2                                                  2                       4
Appointments - Delayed/Cancelled - OPD     8            4         5    2            6         4       5      1        35
Appointments - Delayed/Cancelled - IPD     24                     1    5            6         1       9      2        48
Staff Attitude                             2            1              2            1                 3               9
Clinical Treatment                         10                     1    4                      1       5      2        23
Communication/Information to Patients      44           6         7    12           15        8       20     2       114

                                                                                                                 6
Surgery & Anaesthesia Division has received a slight increase of complaints from the last Quarter
from 42% for Quarter 3 and 69% for Quarter 4 and 58% for Quarter 1 to 59% for Quarter 2.
Furthermore, Trauma and Orthopaedic services had an increase of complaints, from 23% for the
previous Quarter to 36% for this Quarter.

Within Trauma and Orthopaedic, majority of concerns raised related to cancellation and delay of
surgery, partially down to the “teething problems” with the centralisation of elective surgery at St
Albans City Hospital, patients being unsuitable for surgery at St Albans City Hospital and no bed
availability for patients scheduled at Watford General Hospital. Other concerns raised within this
speciality included enquiries regarding waiting time for surgery, patients unhappy to travel to St
Albans City Hospital, planning of caudal epidurals, cancellation and delay of Outpatient
appointments and lack of confidence in Orthopaedic consultant. These concerns were escalated to
Admissions, Service, Divisional and Operational Manager.

Audiology concerns related to waiting time for hearing aids. ENT concerns include cancellation of
surgery and delay and cancellation of Outpatient appointments. Within General Surgery, concerns
include cancellation of surgery, information relating to waiting times, concerns following discharge
and patient requesting to see consultant to seek information regarding treatment and diagnosis.
Ophthalmology identified concerns relating to cancellation and delay of surgery and Outpatient
appointments. Urology services experienced similar problems during the cancellation as
cystoscopies were cancelled due to insufficient staffing levels.

                       Breakdown of Departments - Surgery & Anaesthesia

                                               Concerns            Concerns
                       Department               received           received
                                              Last Quarter        This Quarter
                       Trauma and
                       Orthopaedic                 19                  46
                    Breast Services                7                   4
                  Ear, Nose and Throat             14                  7
                    General Surgery                7                   13
                     Ophthalmology                 7                   15
                         Urology                   10                  21

Women and Children Services

                         Breakdown of themes within 4 main specialities:

                                          ANCAR GYNAE CHILD FERT Total
 Admissions/Discharge/Transfer                    1     1         2
 Patients Privacy/Dignity                         1               1
 Personal Records                                 1           1   2
 Appointments - Delayed/Cancelled
 - OPD                                                  1                   2       3
 Appointments - Delayed/Cancelled
 - IPD                                                  2                           2
 Staff Attitude                                         1                           1
 Clinical Treatment                          1          3          1        3       8
 Communication/Information to
 Patients                                               8          1                9
 Failure to Follow Procedure                                       2                2
 Policy/Commercial - Trust                   1                                      1
                                                                                                  7
Within this Division 16 complaints were received. 8 complaints were within Gynae relating to
cancellation of surgery, awaiting diagnostic scan following Outpatient appointment, lack of
treatment, care, privacy and dignity during Outpatient appointment, 2 concerns were raised
regarding the suspension of ante natal classes and this was escalated to Acting Head of Nursing
for Midwifery and progression has been made in their reintroduction. 2 complaints received within
Children Services raised included waiting time for medication and lack of communication between
Pharmacy, and treatment of child in Children Emergency Department, which resolved by the
Modern Matron. Fertility services had 3 complaints, included concerns regarding delay of treatment
and cancellation of Outpatient appointments, chasing up referral for fertility treatment and request
for notes and photographs relating to treatment.

Information provided by:

Hamed Zarin
Patient Advice and Liaison Service

4th November 2007

                                 Comment Card Report for Quarter 2

                                        July to September 2007

Introduction

For Quarter 1, PALS collected 100 comment cards across the 3 sites. 104 main themes were
identified from these comment cards spread across the divisions.

                                  Themes breakdown for each Division

                             Division                  Q4        Q1        Q2
                    Acute Medical Care                 22        115       58
                    Clinical Support                    2         38        7
                    Corporate Nursing                                       3
                    Facilities, CP & Estates            20       24        18
                    Patient Access                       2        2
                    Surgery & Anaesthesia               14       31        14
                    Women and Children Services          3        7         4




                                                                                                  8
Summary

Acute Medical Care Division received 58 comment cards, from which 45 of these were from A & E.
A dominant theme was relating to positive comments within this Division, noticeably 15 within A &
E. Waiting times in A & E and high heat levels were other issues identified.

                   Division     Department        Themes Identified      Number
                   AMCD
                                A&E            Positive comments             15
                                               Heating                       6
                                               Waiting times                 12
                                               Cleaning                      2
                                               Negative comments             7
                                               No water                      2
                                               Reception                     1
                                RAU            Positive comments             1
                                ECG            Seating                       1
                                               Staff no ID badge             1
                                Aldenham Ward Positive comments              1
                                               Discharge                     1
                                GUM            Positive comments             3
                                St Peters Ward Positive comments             1
                                Cardiology     Positive comments             1
                                Croxley Ward Staff compliment                1
                                               Negative comments             1


14 comment cards were received relating to Surgery and Anaesthesia. Issues identified were
within Cleves Ward, Pain Clinic, Fracture Clinic, Langley Ward, Ridge Ward, Theatres and
Ophthalmology. Concerns raised include high heating levels, positives comments and waiting
times.

                 Division    Department          Themes Identified         Number
                 Surgery &
                 Anaesthesia
                             Cleves Ward     Positive comments                  1
                             Pain Clinic     Heating                            1
                             Fracture Clinic Heating                            2
                                             Positive comments                  1
                                             Negative comments                  1
                                             Waiting Times                      2
                               Langley Ward Visiting times                      2
                               Ridge Ward    Positive comments                  1
                               Theatre       Information to relatives           1
                               Ophthalmology Closed                             1
                                             Low staffing levels                1

Within Facilities, Capital Planning and Estates, 15 comment cards were received. 18 themes
identified including car parking being too expensive for short stays, high heating levels, better
signage on site and vending machines at Hemel Hempstead General Hospital not working.



                                                                                                    9
                  Division     Department         Themes Identified Number
                  Facilities,
                  Capital
                  Planning and
                  Estates
                                                  Cleaning of toilets         2
                                                  Car Parking                 4
                                                  Lighting                    2
                                                  Heating                     3
                                                  Vending Machines            3
                                                  Cleaning                    1
                                                  Phone box too high          1
                                                  Signage                     2

Women and Children Services received 4 comment cards, these included compliments to Children
Emergency Department, Starfish Ward and Delivery Suite.

Clinical Support services received 7 comment cards, themes identified included waiting times
relating to waiting times in the Blood Clinic and Pharmacy and compliments for Radiology services.

Information provided:

Hamed Zarin

Patient Advice and Liaison Service
4th November 2007

                        PALS Themes October 2007 – December 2007
                                     Quarter Three

Introduction

During the period October ’07 to December ’07 a number of themes have been identified across
the Trust from contact with PALS by analysis of data held on the Datix Risk Management
Database. The top six themes across all divisions are illustrated in the table below.

                 250
                                                             Communication/Info
                                                             to Patients
                 200                                         Clinical Treatment

                                                             Appointment - OPD
                 150
                                                             Admission /
                                                             Discharge / Transfer
                 100                                         Appointments - IPD

                                                             Staff Attitude
                  50
                                                             Others

                   0
                                     Categories


                                                                                                10
Continuation from the previous Quarter, PALS had (210) complaints solely dealt by one
PALS Officer, despite decreased volunteer admin support due to sickness and
bereavement:

                                                      Concerns           Themes
                                                       raised             raised
              Quarter 3 - Oct 05 - Dec 05               172                298
              Quarter 4 - Jan 06 - March 06             161                304
              Quarter 1 - April 06 - June 06            132                306
              Quarter 2 - July 06 - Sept 06             136                296
              Quarter 3 - Oct 06 - Dec 06               126                245
              Quarter 4 - Jan 07 - March 07             148                327
              Quarter 1 – April 07 – June 07            142                340
              Quarter 2 - July 07 – Sept 07             215                517
              Quarter 3 – Oct 07 – Dec 07               210                560




Acute Medical Care Division

                         Breakdown of themes within 7 main specialities:

                                      CARD COTE DERM EMERC GAST GENM RHEU
Admissions/Discharge/Transfer           4   2          1          2    1
Patients Privacy/Dignity                    3                     1
Communications                          2   1          1    1
Appointments - Delayed/Cancelled - OPD 7    2     1         2     1    4
Staff Attitude                              3     1    1    1
Clinical Treatment                      2   5     1    2          3
Communication/Information to Patients  12   9     2    5    4     5    6


Within Medicine, 50 concerns have been received. Out of the 121 themes identified within this
Division 30% of these 115 themes relate to communication and information to patients

Within Cardiology concerns raised included cancellation of inpatient procedure and outpatient
appointments, and patient chasing up results following tests,

In Care of the Elderly, concerns raised included delay and cancellation of Outpatient appointments,
deceased patient’s relatives requesting meeting with consultant to seek information relating to
treatment and diagnosis, family concerned about treatment received from team and request for
second opinion from medical team, concerns relating to discharge, issues relating to privacy and
dignity and lost property.

Concerns within Emergency Care include procedure in handing in sample out of hours,
communication of patient transfer and staff attitude from Nursing staff in A & E.




                                                                                                11
                    Breakdown of Departments – Acute Medical Care Division

                                            Concerns             Concerns
                         Department          received            received
                                           Last Quarter         This Quarter
                      Care of the                                    10
                         Elderly                 19
                        General                                       6
                       Medicine                  27
                      Cardiology                 22                  13
                    Emergency Care                9                  5
                    Gastroenterology              8                  4
                     Rheumatology                 6                  6

Clinical Support Division

                          Breakdown of themes within 4 main specialities:

                                               PATH PHYSIO RAD SURAP
        Appointments - Delayed/Cancelled - OPD        1     3    2
        Communication/Information to Patients    1    3     4    3

Clinical Support Division received a total of 12 concerns and 25 themes identified for the last
quarter. Within Radiology Services concerns raised related to patient chasing up copy of x-ray, and
appointment for scan.

Within Surgical Appliances, concerns raised included cancellation and delay of Outpatient
appointment and delay in receiving surgical appliance.

Facilities and Estates

5 complaints were received within this Division relating to state of car park in Watford General
Hospital, patient transport arriving late, state of building in St Albans City Hospital, standard of
cleaning and reimbursement of travelling costs.

Surgery & Anaesthesia

                          Breakdown of themes within 7 main specialities:

                                       ENT GSUR OPTH OROM TRAU UROL VASC
Admissions/Discharge/Transfer           2   11   2     1   30    4    4
Appointments - Delayed/Cancelled - OPD 2     2   8     6    5    2    1
Appointments - Delayed/Cancelled - IPD  2    8   2     1   28    4    3
Staff Attitude                          0    1   0     0    9    1    0
Clinical Treatment                      1    8   3     2   34    6    4
Communication/Information to Patients   4   20   11    7   43    9    5

Surgery & Anaesthesia Division have received 112 concerns (53%) in comparison to 127 concerns
raised in the last Quarter.

Within Trauma and Orthopaedic, majority of concerns raised related to cancellation and delay of
surgery. This is a continuation of problems which occurred in the last Quarter with the
centralisation of elective surgery at St Albans City Hospital, planning of surgery and patients being
unsuitable for surgery at St Albans City Hospital and no bed availability for patients scheduled at
Watford General Hospital. This has resulted in an accumulation of patients waiting for surgery.
                                                                                                  12
Other concerns raised within this speciality included enquiries regarding waiting time for surgery,
patients unhappy to travel to St Albans City Hospital and planning of caudal epidurals. These
concerns were escalated to Admissions, Service, Divisional and Operational Manager.

ENT concerns related to cancellation and delay of Outpatient appointments and in patient surgery.
Within General Surgery, concerns include cancellation of surgery, information relating to waiting
times, concerns following discharge and patient requesting to see consultant to seek information
regarding treatment and diagnosis. Ophthalmology identified concerns relating to cancellation and
delay of surgery and Outpatient appointments, no notes being available for appointment and
patient claiming travelling expenses following cancelled appointment. Oral Maxio Facial had
concerns relating to cancellation of procedures due to no Nursing staff being available.

                       Breakdown of Departments - Surgery & Anaesthesia

                                                Concerns           Concerns
                       Department                received          received
                                               Last Quarter       This Quarter
                       Trauma and
                       Orthopaedic                  46                 45
                    Breast Services                 4                  2
                  Ear, Nose and Throat              7                  4
                    General Surgery                 13                 20
                     Ophthalmology                  15                 11
                   Oral Maxio Facial                                   7
                         Urology                    21                 9

Women and Children Services

                           Breakdown of themes within 3 main specialities:

                                                  CHILDN FERTIL GYN
           Appointments - Delayed/Cancelled - OPD    1     3     1
           Appointments - Delayed/Cancelled - IPD    0     0     3
           Communication/Information to Patients     3     5     6

Within this Division 16 complaints were received. Within Gynaecology concerns related to patient
chasing up ultrasound report, cancellation of surgery, clincial treatment at Emergency Gynae
department and cancellation and delay of Outpatient appointment. Within Infertility services
concerns include cancellation of Outpatient appointment and patient chasing up results for private
treatment. Children Services had concerns relating to cancellation of appointment, chasing up
results and parent concerns relating to having hot drinks on the Ward.

Information provided by:

Hamed Zarin
Patient Advice and Liaison Service

19th February 2008




                                                                                                 13
                               Comment Card Report for Quarter 3

                                      October to December 2007
Introduction

For Quarter 1, PALS collected 110 comment cards across the 3 sites. 105 main themes were
identified from these comment cards spread across the divisions.

                                Themes breakdown for each Division

                           Division               Q4      Q1         Q2         Q3
             Acute Medical Care                   22      115        58         32
             Clinical Support                      2       38         7         25
             Corporate Nursing                                        3
             Facilities, CP & Estates             20       24        18         26
             Patient Access                        2        2                    1
             Surgery & Anaesthesia                14       31         14        19
             Women and Children Services           3        7          4         2
Summary

Acute Medical Care Division received 32 comment cards, from which 28 of these were from A & E.
A dominant theme was A & E waiting times in A & E and staff attitude and these were raised with A
& E Manager and Modern Matron.

                    Division   Department         Themes Identified    Number
                    AMCD
                               A&E                Positive comments         4
                                                  Heating                   3
                                                  Waiting times            11
                                                  Negative comments         3
                                                  Staff Attitude            7
                               MIU (SACH)         Waiting times             1
                               Dermatology        Reception                 1
                               GUM                Positive comments         2
19 comment cards were received relating to Surgery and Anaesthesia. Main themes identified
including waiting times in the Fracture Clinic and cancellation of Orthopaedic surgery.

        Division       Department               Themes Identified               Number
        Surgery &
        Anaesthesia
                       Trauma and Orthopaedic Cancellation of surgery                3
                       Wards                  Signage                                2
                       Pre-Op Assessment      Information to patients                1
                                              Waiting Times                          1
                       Fracture Clinic        Staff Attitude                         1
                                              Waiting Times                          6
                       Langley Ward           Positive comments                      2
                       Ophthalmology          Appointments communication             1
                       Overall                Positive                               2



                                                                                               14
Within Facilities, Capital Planning and Estates, 26 comment cards were received. 11 themes
identified including car parking being too expensive for short stays, high heating levels and
cleaning standards of toilets.

                  Division     Department        Themes Identified Number
                  Facilities,
                  Capital
                  Planning and
                  Estates
                                                 Cleaning of toilets        5
                                                 Car Parking               11
                                                 Lift                       2
                                                 Heating                    5
                                                 Vending Machines           1
                                                 Positive Cleaning          1
                                                 Buildings                  1


Women and Children Services received 2 comment cards, these included compliments to Special
Care Baby Unit and waiting time for ante natal appointment.

Clinical Support services received 25 comment cards, themes identified included waiting times
relating to waiting times in X-Ray and the Blood Clinic.

           Division             Department      Themes Identified               Number
           Clinical Support
                                X-Ray         Signage                             1
                                              Waiting times                       5
                                              Negative comments                   1
                                              Positive comments                   1
                                              Communication                       1
                                              Machinary not working               1
                                Blood clinic Waiting times                        6
                                              Positive comments                   2
                                              Signage                             2
                                Pharmacy      Waiting times                       2
                                              Communication                       1
                                Physiotherapy Negative comments                   1
                                              Positive comments                   1



Information provided:

Hamed Zarin

Patient Advice and Liaison Service
19th February 2008




                                                                                                15
                        Standards for Better Health Topic Group
                          1st April 2007 to 31st December 2007


PALS are able to resolve concerns by cooperating with different departments and
individuals within West Hertfordshire NHS but also using established external links such as
PCTs, Hertfordshire Partnership Trust, Ambulance Services, Social Services, CAB,
Hertfordshire County Council and Police amongst other organisations.


During the 3 Quarters, PALS has dealt with 546 concerns. Concerns raised have been
referred to the following areas for resolution:

                 Passed to Departmental Manager                    242
                 Resolved by PALS / Information and advice given    71
                 Passed to Admissions                               51
                 Passed to Consultant                               36
                 Passed to Modern Matron                            35
                 Passed to Medical Secretary                        33
                 Passed to Divisional Manager                       28
                 Passed to Appointments (WHHT)                      17
                 Passed to Ward Sister                              10
                 Others                                             23
                 Total                                             546

15 concerns relating to Privacy, Dignity and Respect were raised, issues include:

      Infection control
      State of Ward
      Lack of treatment and diagnosis
      Mixed wards
      Incontinence
      Awaiting transfer
      Confidentiality and data protection
      Discharge
      Left on wheelchair
      Cleanliness
      Code of conduct
      Lost property

These concerns are raised with Head of Nursing and Modern Matron level to resolve and
learn from these experiences. Outcomes include re-training for staff, Human Resources
involvement and multi-disciplinary meeting arranged to discuss concerns.




                                                                                         16
West Hertfordshire Hospitals NHS Trust aim to enable all members of the population to
access services equally. PALS organise Interpreting and Translation for service users. The
usage for Interpreting and Translation for the last financial year has 723 interpreting
assignments compared to 700 interpreting assignments (this financial year to February
2008).

Breakdown of languages as follows:

             Languages   2006/2007 2007/2008 Languages    2006/2007 2007/2008
           Albanian          3        11    Pahari           38         34
           Arabic           30        22    Polish           40         70
           Bengali          64        40    Portuguese       38         57
           BSL              79        77    Pushto            1          1
           Cantonese        40        38    Punjabi          23         13
           Dari              4         3    Romanian                    10
           Farsi             3        19    Russain           1
           French           24        20    Slovakian                    1
           German            1         4    Somali                       6
           Ghanain                     2    Spanish           9          7
           Greek                       1    Swaehili                     5
           Gujarati         25        14    Sylethi          66         14
           Hindi            12        13    Tamil            11         16
           Iranian                     1    Thai              1          9
           Italian          37        30    Tigrinya          1
           Kurdish           1         1    Turkish          35         20
           Latvian           2              Twi               1          1
           Lithuainian       5         6    Urdu             91        105
           Mandarin         37        27    Wooloff                      2




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