Recommendation F256: Follow up of patients

Accepted.
A good trust will take every opportunity to seek patient feedback. A good complaints system will recognise that some people will give fuller feedback once they have had time to reflect and therefore it is worth making arrangements to follow-up with patients once they have been discharged. Trusts will need to work out how they do this.
The Care Quality Commission will be assessing complaints as part of its inspection process.
Case study: Northumbria Healthcare – developing a meaningful patient experience programme
Northumbria Healthcare NHS Foundation Trust provides acute and community health services and adult social care to a population of over half a million people in the North East. The Trust runs nine hospitals (three general hospitals plus six community hospitals) and employs about 9000 staff. The level of engagement they now enjoy means that every day, somewhere in the organisation, somebody will be having a conversation about patient experience.
The Trust listens to the views of more than 30,000 patients every year through the following different survey methods:
• Patient Perspective surveys: To ensure ownership, results are reported at an individual consultant level, ward level, site and specialty and business unit level. Conducting these once people leave hospital allows them to give a more rounded view of their experience of care – evidence suggests that patients are likely to be at their most dissatisfied two weeks after discharge. In many ways this is ‘right time’ data which is less likely to be biased by the gratitude people feel towards hospital services and staff during the very acute phase.
• Real Time Surveys: Initially the Trust conducted face to face interviews with patients on 8 pilot wards across 2 sites. The real time programme has been rolled out incrementally allowing the Trust to improve in a sustainable way – they now interview over 500 patients a month across 7 sites and 35 wards. These results are fed back to clinical teams within 24 hours of capture, allowing the Trust to act rapidly on patient feedback while patients are still in our care.
• 2 Minutes of Your Time: This is a short quick exit survey which allows for a broad coverage across the Trust. Patients answer 6 key questions about the quality of care just before they leave hospital – this has included the Friends and Family question for the last 3 years. All data including all free text comments are fed back to clinical teams within a week.
Communicating results with the public: The Trust has developed innovative info graphics to ensure all the experience results are shared with patients, families and the public. Posters are updated each quarter so that the latest results are always on display.
Supporting staff to deliver patient-centred care: In designing the programme in 2010 the Trust deliberately aimed for a patient centred approach. What they hadn’t appreciated was the degree to which the real time programme would engage and support staff. In the annual NHS staff survey the Trust performs exceptionally well, with 94 per cent feeling their work makes a real difference.
Key learning from implementation has included the following:
• no single method has given the Trust all they need – they continue to rely on a combined approach;
• they’ve seen significant benefits of real time reporting;
• executive management team support has been crucial;
• ensure patients and families are part of the improvement team – this could be a ward based team or multidisciplinary team across a service;
• Patients have been involved in information development, teaching and training, service evaluation and mystery shopping;
• focusing on metrics that matter most has made sense;
• incremental roll out, change and improvement has given time for the programme to embed properly;
• keep expenditure on measurement to a minimum – invest in improving instead;
• qualitative feedback appears particularly important in engaging staff; and
• transparency of reporting matters.