Learning to listen

Jennie NegusDeputy Director of Patient Services

ULHT context

• 3 main sites– 7,800 staff– 40 wards– 1,072 beds

• Had a few challenges recently………very public……– Pilgrim Hospital, Boston CQC, NMC & Deanery.– Lincoln County Hospital CQC.– Keogh review

But, lots of work – we are on a journey……

• Complaints.• Survey results.• Letters to local papers.• Media………• Focus on the negative• Staff impact.

How are challenges reflected day to day?

• If patients and families read these how will they feel?

• Lack of confidence…• Fear and anxiety…• Expecting poor care….

• 113 stories have been posted on Patient Opinion and were viewed 18,031 times.

• Crudely shared across the year:

• 50 people a day reading about ULHT patients experiences.

• 6 people an hour over an 8 hour day

• Considerable numbers……………

2012 - 2013

Moderately critical

Francis Recommendations112: Patient feedback which is not in the form of a complaint but which suggests cause for concern should be the subject of investigation and response of the same quality as a formal complaint, whether or not the informant has indicated a desire to have the matter dealt with as such.

111: Provider organisations must constantly promote to the public their desire to receive and learn from comments and complaints; constant encouragement should be given to patients and other service users, individually and collectively, to share their comments and criticisms with the organisation.

109: Methods of registering a comment or complaint must be readily accessible and easily understood. Multiple gateways need to be provided to patients, both during their treatment and after its conclusion, although all such methods should trigger a uniform process, generally led by the provider trust.

254 & 255: Refer to the gathering of patients’ comments and the use of patient feedback and that qualitative information is made available in as near real time as possible.

How?

• PALs response & structure

• Informal complaints structure

• Different forms of feedback

• Ownership; accountability

• Sharing lessons learned

Power is in how you use all this data……

Learning from listening

• 22 staff listed within subscriptions; matrons, deputy directors, therapy leads.

• The site deputies receive e-mails about a new story and also reports on a site basis. Stories have been used in matrons meetings, sisters and ward meetings, been printed and posted on team noticeboards and created an e-mail discussion amongst medical colleagues.

• Included in site patient experience reports to Patient Experience Committee & reported to the Trust Board in the monthly Patient Experience report.

• Currently reviewing complaints & PALs; PO will feature within PALs role.

Using the stories

John’s story

Early December 2012 John left his story on PO about the care of his mother:•hygiene standards, basic care, lack of information, poor handovers and attitude of staff though equally highlighted good care and staff. •His opening line recognised the prompt and professional work of the Macmillan nurses. •We responded on 18th December.•Heard nothing more.

John’s storyDecember 2012 John left his story on PO:•In February PO contacted me. •John wanted to reply; his mother had died – on the day we left our response.•He had many questions and PO recognised his need to talk to us.•We met in April – a very tough, emotional meeting.•Despite complaints and concerns John still recognised what went well; especially Macmillan CNS.•Ended the meeting with a gift……..

Learning from Johns story• That patients and families need a voice and Patient Opinion is one way to

ensure that voice is heard.• That Trusts need to hear that voice; but more importantly to genuinely

listen.• That the value of time spent with patients and families answering their

unanswered questions or clarifying details cannot be underestimated both in terms of value to an organisation in knowing about patient’s experiences but more importantly in terms of patients and families understanding.

• That whilst the written word in a complaint or web based patient story is powerful – listening face to face is much more so.

• That listening needs to start sooner and that as professionals we need to check whether we have heard and whether our responses have been understood.

John’s story told this week at ULHT Public Trust Board.

To story-teller themselves

To commissioners & regulators

To people who read the story

To providers of care

Collective value of PO

Thank you