Quality Account
High quality care for all
Reporting period:
1st April 2014 to 31st March 2015
Our CQC rating
2
Table of contents
Our CQC rating............................................................................................................. 2
Chief Executive’s Statement ......................................................................................... 7
Section 1 Improvement priorities ............................................................................... 8
Improvement priorities identified for 2015-2016 .......................................................... 8
Priority 1
Improve both internal and external integration of services at the patient
interface ................................................................................................... 8
Priority 2
Develop a closer working relationships with primary care. ....................... 8
Priority 3
Operate a seven day Palliative Care Nurse Specialist visiting
service .... 9
Progress against the improvement priorities identified for 2013-2014 ........................ 9
Progress against the improvement priorities identified for 2014-2015 ........................ 9
Priority 1
Development of a seven-bedded, step-down unit .....................................10
Priority 2
Supporting Nursing and Residential Homes ............................................10
Priority 3
Elderly and dementia services .................................................................10
Section 2 Mandated Statements ..................................................................................11
Statements of assurance from the board .....................................................................11
Review of services ..........................................................................................................11
Participation in clinical audits..........................................................................................11
Research .........................................................................................................................11
Quality improvement and innovation goals agreed with our commissioners ....................12
What others say about us .................................................................................................12
Data quality.....................................................................................................................13
Information Governance Toolkit attainment levels ..........................................................13
Section 3
Quality overview .......................................................................................14
Patients receiving care from the hospice ......................................................................14
24/7 Advice Line ............................................................................................................14
Supporting patient choice .............................................................................................15
Advance Care Planning ...............................................................................................15
Death Location ............................................................................................................16
Prevention and management of pressure ulcers ..........................................................17
Patient experience .........................................................................................................18
Patients’ Forum ...........................................................................................................18
User feedback provided during the episode of care ......................................................18
Our participation in clinical audits ..............................................................................19
3
National hospice-specific audit ....................................................................................19
Local audit
...............................................................................................................19
Patient-Led Assessment of the Care Environment. .....................................................21
What our staff says about the organisation .................................................................22
Rating of our service by patients and carers ...............................................................22
The Board of Trustees’ commitment to quality ..........................................................23
Annex ............................................................................................................................24
What Stoke -on-Trent and North Staffordshire CCGs say about the organisation ...24
Healthwatch Stoke-on-Trent Quality Account Statement for Douglas Macmillan
Hospice 2015/16 ............................................................................................................25
4
Supporting
Impact of Hospice Services 1st April 2014-31st March 2015
our
Local
The impact of our services on our local community over the past year is summarised below.
 The hospice received 1623 referrals of which 79.0% were for cancer
Community
patients and 18.7% for non-cancer patients.

Over 60% of referrals are received from GPs and hospital clinical nurse
specialists.

The advice line service took 3310 calls of which, over 60% were from
patients or their carers.

Over 50% of the support for healthcare professionals was provided to
District Nurses.

200 “999” calls were prevented.

The majority of advice requested by healthcare professionals was drug
advice.

There were 588 in-patient stays.
Supporting patient choice through advance care planning

84.3% of end of life patients with capacity had been offered the
opportunity to undertake advance care planning (ACP).
o 80% of patients, who took part in ACP discussions,
achieved their preferred place of death.
o Over 30% of patients, who did not want to participate in ACP
discussions, died in an acute hospital.
Helping patients to die where they want to

1049 patients in our local community were receiving hospice support at
the time of their death. We enabled 50.7% of these patients to die at
home or in their care home.

It is twice as likely that patients receiving hospice care will be able
to die at home when compared to those end of life patients who are
not referred to the hospice.

Hospice support is reducing the percentage of patients dying in
hospital by approximately 50% when compared to those end of life
patients who were not referred to the hospice.

Over the past year, the Hospice at Home service supported 285 dying
patients. 76.5% of the patients cared for by this service were able to
remain in a home environment (including the Community Lodges).
5
Supporting
our Local
Community
Comments patients and carers
“The staff fall over themselves to make us welcome and all the volunteers.”
“If I have any problems, they are sorted out for me.”
“The staff answer my questions and find things out for me so efficiently. I love the
company otherwise I would be sitting at home alone. I am treated as an individual here
rather than just another patient.”
“The staff have given me quality of life. They are keeping me well. I would not be as well
as I am if I didn’t come here”
“Words cannot express my sincere gratitude to all of the staff for enabling my husband to
pass away peacefully. We both received tender, loving care and support throughout our
stay with you. I was so pleased to have been with my husband at his parting.
Remembering you always with love.”
“I will be forever grateful for the wonderful care and compassion that my dad and my family
received from your dedicated staff. Your response to our needs was overwhelming and, in
particular, you allowed me to be with my dad constantly and to be just his daughter. For
this you have my deepest gratitude and appreciation.”
“Thank you for your kind attention and professional delivery when treating my mum. Your
support to mum and the family helped to keep her feeling very safe and comfortable in the
place she loved most, her home. She passed away very peacefully in the arms of her
youngest son. We send our heartfelt thanks.”
6
Chief Executive’s Statement
Together with the Board of Trustees, I would like to thank all of our staff and volunteers for
their achievements over the past year. The hospice has continued to provide a high quality
service and remains financially sound. We have achieved this by providing high quality,
cost-effective services to our patients and their families. The £8.5 million that is raised from
our local community annually is a testament to the value that the community puts on the
provision of our services.
The Douglas Macmillan Hospice has been a leader and innovator in the hospice movement
and has a well established governance function. This has enabled the hospice to focus on the
quality of the services provided. Our regulators undertook an unannounced Wave 2
inspection in August 2014. The hospice was a grading of “good” for safe, caring effective
and well-led and a grading of “outstanding” for our responsiveness. This is a tribute to the
hard work of every member of staff working for the Douglas Macmillan Hospice.
The hospice has a culture of continuous quality monitoring, in which any shortfalls are
identified and acted upon quickly.
I am responsible for the preparation of this report and its contents. To the best of my
knowledge, the information contained in this Quality Account is accurate and a fair
representation of the quality of healthcare services provided by our hospice.
The safety, experience and outcomes for all our patients and their loved ones are of
paramount importance to us. We continue to actively seek the views of our service users.
Michelle Roberts
Chief Executive
5th May 2015
7
Section 1 Improvement priorities
The Douglas Macmillan hospice underwent a Wave 2 inspection on 4 th and 5th August 2014.
The hospice achieved an overall rating of good, with good for safe, effective, caring and
well-led and outstanding for responsiveness. No areas of shortfall were identified.
The Care Quality Commission (CQC) continues to categorise the hospice as a low risk
organisation. To maintain the Quality Risk Profile at this level, the hospice provides
quarterly reports to the CQC. These reports are also provided quarterly to the commissioners
of hospice services and are scrutinised at a six-monthly Quality Review meeting.
In developing the strategic plan, the hospice has continued to pay regard to the rapidly
changing health and social care environment. The uncertainty and constant change mean
that strategic plans have to be reviewed in the short-term and that the hospice has to be
flexible and realistic. As a result, the priorities set in 2014 had to be reprioritised and we
have just completed one of our priorities identified in our 2012-13 report.
Improvement priorities identified for 2015-2016
Priority 1
Improve both internal and external integration of services at
the patient interface
1. Improve integration of service delivery between internal teams and services.
2. To improve working relationships and integration of pathways with other health
care providers in palliative and end of life care across the community and acute
sectors.
Priority 2
Develop a closer working relationships with primary care.
Throughout 2014-15, the hospice developed a formal working relationship with GP
First, the federation of GP practices across Stafford and Cannock.
Together with GP First and St Giles’ Hospice, we have developed and implemented a
dementia pathway and a Senior Life Support scheme. These are being piloted and
externally evaluated. In 2015-16, the hospice will be working with partners in the
North to begin to implement the dementia pathway in Stoke-on-Trent and North
Staffordshire based on the evaluation and learning from the pilot scheme.
.
8
Priority 3
Operate a seven day Palliative Care Nurse Specialist visiting
service
Over the past 12 months, service users have identified the difficulties of not having a
visiting service available over the weekend and bank holidays. In some cases this
has resulted in problems being experienced by the families concerned as the district
nurse service had not responded to pain control medication requests out-of-hours.
The Board of Trustees has listened to the concerns raised and has agreed to use
charitable reserve funds to extend the specialist palliative care nurse specialist
service to a seven-day per week visiting service for a limited period.
Progress against the improvement priorities identified for 2013-2014
Due to the extreme weather conditions experienced in the winter of 2013-14, building
work on the purpose-designed Day Therapy and Psychological services Unit fell
behind schedule. These Units are now open and providing:
A massive improvement in the physical environment for patients attending
the hospice for support.
A dedicated suite for psychological therapies, which maximises clients’
privacy, dignity and comfort.
A rehabilitation and physiotherapy facility to enable patients to remain
independent and self supportive.
A much improved facility for the treatment of complex lymphoedema.
A new out-patient consultation suite, which has improved the capacity of
the out-patient services.
Progress against the improvement priorities identified for 2014-2015
Throughout 2014-2015, the hospice maintained its focus on providing a more
comprehensive service to the local community, whilst remaining within the
limitations of the financial constraints at that time and needing to manage an ongoing
real terms reduction in funding from statutory sources. This situation limited progress
against our objectives.
Strategic theme: Increasing Access to a wider range of conditions
During 2014/15, the DMH put in place the processes to enable eligible frail elderly
patients, with complex needs, to access hospice services. The objectives of this
service were to provide:
an alternative care option
a reduction in the number of frail elderly people attending A&E
a reduction in acute admissions
specialist end-of-life support.
9
Priority 1
Development of a seven-bedded, step-down unit
This project remains in our strategic plan. The hospice has been recognised for its
award–winning Community Lodges, which have illustrated the value of communityled beds.
In 2014-15, as a first step towards developing satellite beds, the hospice commenced
the conversion of the old Day Therapy building into a seven bedded en suite unit.
The economics of commissioning this unit will depend upon the financial situation of
the hospice at that time. The continued uncertainty over the end of life tender with its
impact on fundraising is creating a significant blight on service development in end
of life at this time. Until this is resolved the board cannot be committed to providing
funding for this important initiative.
Priority 2
Supporting Nursing and Residential Homes
The hospice prioritised the need to develop a model of working with the Frail and
Complex Team and working closely with Nursing Homes and Care Homes.
The hospice planned to develop a frail/elderly/dementia PCNS team. Due to severe
financial restraints and changes in primary care brought about by differing initiatives
being taken at a practice level, this project is currently suspended. In addition the
validity of this model needs to be tested further following the learnings and outcomes
from the Senior Life Support program which the hospice is piloting with GP First in
Mid Staffordshire.
Strategic theme: Delivering care closer to home
Priority 3
Elderly and dementia services
These new services are enabling patients within Mid Staffordshire to receive
improved palliative care regardless of their place of care. A new service model and
diagnostic pathway for dementia was developed and piloting is ongoing.
The dementia diagnostic and supportive pathway project commenced in January 2014
in six GP practices and was soon extended to all 41 practices in Stafford & Cannock
as its effectiveness became apparent in advance of the formal academic assessment
process. Working in collaboration with NHS and third sector partners, Care
Facilitators work within GP practices to enable the assessment, coordination, support
and pathway management of dementia patients.
The Senior Life Support (SLS) service for the frail elderly is being piloted using a
similar service delivery model and pathway. Further development of this model and
pathway for SLS is currently in process.
10
Section 2
Mandated Statements
Statements of assurance from the board
The following are a series of statements that all providers must include in their Quality
Account. Many of these statements are not directly applicable to hospices.
Review of services
Between 1st April 2014 and 31st March 2015, the DMH provided the following
services:
In-Patient Unit
Day Therapy Unit
Out Patients
Hospice at Home
Palliative Care Nurse specialist Service
The DMH’s Clinical Governance Group (CGG) is a sub-committee of the Board,
which meets bimonthly. The CGG receives quality reports, which enables the group
to review the quality of care provided by all clinical services. A Clinical Governance
dashboard and a report are submitted to the Board of Trustees on a quarterly basis.
Participation in clinical audits
During 2014/15, the DMH was ineligible to participate in the national clinical audits
and national confidential enquiries.
Research
In a piece of research led by Gunn Grande and Lynn Austin, University of
Manchester, the hospice acted as a pilot site in a national, ethically approved research
project entitled “Implementation and Evaluation of the Carer Support Needs
Assessment Tool in Hospice Home-Care Services.” The hospice compared carer
assessment and support with and without the use of a formal, validated research tool.
The results of the pilot have been published.
Do the domains of the carer support needs assessment tool (CSNAT)
fully encompass carer support needs in end of life care and relate to
bereavement outcomes? Palliative Medicine, June 2014, vol. is.
28/6(622) Grande G.E., Austin L., Ewing G.
Investigating the impact of a carer support needs assessment tool
(CSNAT) intervention in palliative home care: Stepped wedge cluster
trial Palliative Medicine, June 2014, vol. 28/6(609-610) Grande G.E.,
Austin L., Ewing G.
Quality improvement and innovation goals agreed with our
commissioners
For the year 2014/15, CQUINs were not available to the hospice.
What others say about us
The DMH is required to register with the Care Quality Commission and its current
registration status is unconditional.
The Care Quality Commission has not taken any enforcement action against the
DMH during 2014/15.
The DMH is subject to regular inspections by the Care Quality commission. The last
on-site inspection was a wave 2 inspection under the new inspection regime. The
hospice achieved an overall rating of good, with an outstanding for responsiveness.
Figure 1
CGC Rating
The Quality Risk Profile of the hospice states that the hospice is low risk.
12
Data quality
In accordance with agreement with the Department of Health, the DMH submits a
National Minimum Dataset (MDS) to the National Council for Palliative Care. The
DMH provides the MDS report and a copy of the quarterly quality report to the local
CCG.
The DMH will be taking the following actions to improve data quality:

The IT Manager and the Clinical Governance Manager will continue to
review the data outputs in order to improve the quality of patient data
recording and reporting.
Information Governance Toolkit attainment levels
The Information Governance Assessment Report overall score for 1st April 2014-31st
March 2015 was 70% and was graded green. As of June 2015, the hospice is
implementing the Datix risk management database, which will increase this score.
13
Section 3
Quality overview
We have chosen a selection of quality measures to include in this report.
Patients receiving care from the hospice
To meet the end of life needs of the local community, the hospice has accommodated
a 23.4% increase in the number of patients receiving hospice care when compared to
2009. The hospice has maintained this level of support over the past three years.
The hospice is committed to meeting the requirements of all patients requiring our
specialist support. As a consequence of this commitment, there has been a steady
increase in the percentage of non-cancer patients from 8.8% year ending 31st March
2009 to 18.7% in year ending 31st March 2015.
The majority of our patients (77.7%) are aged 65 years and above. The primary care
aim of 97.9% of the patients referred to us is pain and symptom management. Most
of our referrals are from the patients’ GPs (32.4%) and hospital Clinical Nurse
Specialist (30.9%).
24/7 Advice Line
A 24/7 advice line is provided 24 hours a day for 365 days of the year by a team of
experienced and trained Palliative Care Nurse Specialists (PCNSs). The PCNSs are
provided with the necessary training, skills and information resources needed to keep
their clinical knowledge fully up-to-date.
The hospice uses an electronic patient database, which means that the PCNS taking
the call has direct access to the patient records of all patients known to the hospice
and to those patients whose GPs data share their EMIS patient records with the
hospice.
The hospice standard is that all calls to healthcare professionals will be responded to
within 15 minutes of call receipt. Over the past 12 months, this standard was met for
97.3% of calls.
Between 1st April 2014 and 31st March 2015, this service took 3310 calls, of which
61.3% of calls were from patients/carers. The Carers’ Forum has stated how
invaluable this service is to them. This is supported by the fact that 200 “999 calls”
were prevented over the past 12 months.
14
Supporting patient choice
Advance Care Planning
Between 1st April 214 and 30th March 2015, 84.3% of end of life patients with
capacity had been offered the opportunity to undertake advance care planning (ACP).
Where an ACP was put in place, achievement of the patient’s preferred place of death
is summarised in Table 1 and Figure 2.
Table 1
Achievement of the stated preferred place of death
Achievement
of PPD
86.3%
100.0%
Preferred place of Death
Care home
(n=80)
Community hospital
(n=7)
Patient's home
(n=516)
Hospice / Specialist palliative care
unit
(n=241)
Figure 2
64.7%
71.8%
Achievement of the stated preferred place of death
Staff must respect the wishes of patients not to have an ACP in place. However,
between 1st April 2014 and 30th March 2015, patients who did not express a preferred
place of death were at least twice as likely to die in an acute hospital (see Figure 3).
15
Figure 3 Proportion of patients against preferred place of death who died in an
acute hospital
Death Location
The percentage of patients receiving hospice care (all diagnoses) who died at home
was 37.5% for the year ending 31st March 2015. This compared to 19.1% of all
deaths recorded in the End of Life PCT profile for patients living in North
Staffordshire and Stoke-on-Trent (Table 2 and Figure 4).
Table 2
Location of death of all patients in our local community
and patients receiving hospice care
Those receiving
hospice care
(n=1363)
Location
Acute Hosp
Community Hosp
Home
Care home
Hospice IPU
Other
292
70
511
152
337
1
21.4%
5.1%
37.5%
11.2%
24.7%
0.1%
16
EOL PCT
profile
Oct 2012
(n=4734)
56.9%
19.1%
15.3%
6.5%
2.4%
Figure 4
Location of death of all patients in our local community and
patients receiving hospice care
The hospice has consistent, externally verified evidence that it is almost twice as
likely that patients receiving hospice care will be able to die at home as those end of
life patients who are not referred to the hospice.
The percentage of patients receiving hospice care (all diagnoses) who died in a
hospital was 26.5% for the year ending 31st March 2015. This compared to published
figures of 56.9% for all deaths of patients living in Staffordshire and Stoke-on-Trent.
The hospice has consistent, externally verified evidence that hospice support is
reducing the percentage of patients dying in hospital by over 50% when compared to
those end of life patients who were not referred to the hospice.
Prevention and management of pressure ulcers
The hospice is supportive of the national campaign to stop the development of
avoidable pressure ulcers. We are working closely with the Clinical Commissioning
Groups, sharing intelligence with respect to patients admitted to the hospice with
Grade 3 pressure ulcers.
Between 1st April 2014 and 31st March 2015, 581 patients were admitted to the InPatient Unit (IPU). A Walsall score was determined for 98.6% of patients. In 95.6%
of patients this assessment was completed within 6 hours of admission. The average
Walsall score was 14.3 with a range of 2- 29 (very high risk = a score of ≥15), which
is an indication of the frailty of the patients being cared for.
17
26.8% patients had pressure ulcers on admission. All pressure ulcers, and areas at
risk of developing into a pressure ulcer, were given a grading using the EPUAP
classification system.
All at risk patients had a documented care plan, which includes monitoring on an
ongoing basis. Preventative measures were put in place for all at risk patients, such
as pressure relieving mattresses and cushions.
No patient developed an avoidable pressure ulcer during their stay on the In-Patient
Unit.
Patient experience
Patients’ Forum
The DMH Patients’ Forum continues to be a very active group, which meets
and rotates the days of the meeting from Monday to Friday to maximise
patient involvement. Due to the type of patient treated by the hospice, the
membership of this group comprises mainly of patients from the Day Therapy
Unit (although meetings are also open to in-patients and community patients).
User feedback provided during the episode of care
The hospice undertakes real-time monitoring which enables staff to take
immediate action to address any issues raised.
Of the 507 admissions to the IPU between 1st April 2014 and 31st March
2015, 462 (91.1%) patients were randomly selected to complete the
questionnaire. Where the patient was unable to complete the questionnaire
themselves, a family member or a volunteer was asked to help the patient.
186/462 questionnaires were completed (40.3%); the other patients were too
ill to complete the questionnaire, had been admitted previously or did not wish
to complete the questionnaire. The feedback from in-patients is summarised
in Table 3. These data have a confidence level of 95% and a confidence
interval of 6.0.
18
Table 3
Real-time monitoring of in-patient satisfaction
Yes
(n=235)
.Question
CL= 95% CI=6.0
Have the first 3 days of your stay been satisfactory?
Have you understood the reasons for your admission and what
we are trying to achieve for you?
Have you found the staff approachable?
Have you been given the opportunity to discuss treatments?
Have you expressed any concerns or issues you may have?
Are we doing everything for you that you would wish us to?
If you had a complaint about the care you are receiving, would
you know what to do?
233
99.1%
235
235
230
232
231
100.0%
100.0%
97.9%
98.7%
98.3%
228
97.0%
For the patients who had concerns or did not feel they had been given the
opportunity to discuss treatments, there is documented evidence that a
member of staff subsequently spoke to the patient.
There is documented evidence that in all cases where a patient answered “no”,
the issues were addressed by the staff.
Our participation in clinical audits
National hospice-specific audit
There was no national audit in which the hospice participated.
Local audit
To ensure that the hospice is providing a consistently high quality service, we
undertake our own clinical audits, often using national audit tools developed
specifically for hospices, which have been peer reviewed and quality assessed. This
allows us to monitor the quality of care being provided in a systematic way and
creates a framework by which we can review this information and make
improvements where needed.
Each year, the Board, through the Clinical Governance Group, approves the audit
schedule for the coming year. Priorities are selected in accordance with what is
required by our regulators and any areas where a formal audit would inform the risk
management processes within the hospice.
Through the Clinical Governance report, the Board of Trustees is kept fully informed
about the audit results and any identified shortfalls. Through this process, the Board
receives assurance of the quality of the services provided.
A summary of the audits completed between 1st April 2014 and 31st March 2015 is
given in Table 4.
19
Table 4 Audit summary
Self-assessment by the
Accountable Officer
This audit has to be completed annually.
Management of
controlled drugs
This audit has to be completed annually to provide evidence to support the
self assessment by the Accountable Officer.
The hospice was fully compliant with the legal requirements.
A few minor shortfalls were identified, all of which were within acceptable
tolerance levels. The Board is assured that the hospice is safe as long as the
approved procedures are followed.
The CD Accountable Officer has robust monitoring processes in place.
Initial assessment by the
community Team
The audit was prioritised to scrutinise the initial assessment and working
practice of the community team. The team will review their assessment
process in response to the audit results.
Infection control
There has not been any cross-infection on the In-Patient Unit. However,
following admission to the hospice of a number of isolated cases of
Clostridium difficile, the hospice prioritised the audit of patient care with
respect to C. difficile on the In-Patient Unit. An audit tool was provided by
Health Protection England. The audit identified that new commodes needed
to be purchased. This was done and the hospice passed the audit on three
consecutive weeks.
Hand washing
An overt observational audit of hand washing is carried out at regular
intervals. This practice is resulting in an improvement in hand washing
technique.
The hospice audit team is continuing to develop. On June 17 th, 2014 the DMH cohosted a Regional Audit Day with St Giles’ Hospice. Auditors from the hospices
within the West Midlands presented their results and shared learnings.
20
Patient-Led Assessment of the Care Environment.
The hospice undertook the national Patient-Led Assessment of the Care Environment
(PLACE) assessment in 2013 and 2104. The results for 2015 were not available at
the time of writing this report. The assessments were undertaken by members of the
Carers’ Forum and volunteers identified via Healthwatch.
The benchmarked results are given in Figure 5.
Figure 5
PLACE assessment
The hospice scored higher than the national average in all areas. The scores for 2014
were higher in all areas than those achieved in 2013.
The DMH has worked closely with Hospice UK to encourage other hospices to take
part in this patient-lead assessment.
21
What our staff says about the organisation
The DMH values the opinions of the staff regarding the quality of the service provided. The
Hospice undertakes a staff survey every 2 years to ascertain engagement levels, celebrate
success and to highlight areas for improvement. The next survey is due after publication of
this Quality Account.
Table 5
Staff turnover
Retirements
Staff leaving
Total staff employed
200910
28
3
215
201011
6
10
255
201112
7
27
256
Turnover of DMH staff
14.40%
Comparison to Voluntary,
Community, Not-for-Profit
Sectors
16.40% 15.90% 13.10%
201213
8
32
268
201314
1
58
334
6.20% 13.30% 14.90% 17.70%
13.0%
15.20%
2014-15
10
81
335
15.67%
Not
available
Overall, over recent years, the turnover of staff has been similar to the average for the sector.
The data for 2014-15 were not available at the time of writing this report.
Rating of our service by patients and carers
We ask patients and carers to evaluate and score our services.
Figure 6
Overall rating of hospice services by patients and carers
Patients gave the hospice an overall rating of 93.4%; carers gave an overall rating of
92.9%.
22
The Board of Trustees’ commitment to quality
The Board of Trustees is totally committed to the quality agenda.
The hospice has a well established governance structure, with members of the Board having
an active role in ensuring that the hospice provides a high quality service in accordance with
its Statement of Purpose.
As a way of having first-hand knowledge of what the patients think about the quality of the
service provided, the Chair of Trustees routinely attends meetings of the Patients’ Forum.
“I attend the Patients’ Forum as it gives me the opportunity to listen to the patients’
comments on the care and support we give to them. I can then understand better their needs
and make informed decisions about the care and support the hospice should provide.
As the Trustees have ultimate responsibility for the governance of the hospice, this
interaction with the patients provides a valuable insight into the work of the hospice and how
it is perceived by the patients.
I also consider that it is of paramount importance that all new Trustees, on their
appointment, visit the hospice services and meet with the patients and staff. In this way the
Trustees have a fuller understanding of what the hospice does.”
The Board is confident that the treatment and care provided by the Hospice is of high quality
and is cost effective.
Edward Turner
Chairman
5th May 2015
23
Annex
What Stoke -on-Trent and North Staffordshire CCGs say about the
organisation
North Staffordshire CCG and Stoke-on-Trent CCG welcomes the opportunity to review
Douglas Macmillan Hospice’s Quality Account 2014/15 and to provide a statement.
The CCGs meet with the Douglas Macmillan Hospice twice annually via the Staffordshire
Hospices Clinical Quality Review Meeting to monitor and seek assurance on the quality of
services provided. From the assurances that we have received we believe that Douglas
Macmillan Hospice provides, overall, high-quality care for patients. Commissioners are
pleased to note that the hospice was visited by the Care Quality Commission on 5 th and 6th
August 2014 and was assessed as compliant with the essential standards of quality and
safety, and obtained outstanding in being responsive service; commissioners extend welldone to all staff.
We are pleased to see the chosen priority areas for improvement in 2015/16, with the
emphasis on improving patient experience, and the move to a 7 days palliative care nurse
specialist visiting service. We note the progress that has been made against 2014/15
priorities.
Douglas Macmillan Hospice continues to achieve very good results in patient surveys of
patient experience. Commissioners support the continued use of real time monitoring of the
patient forum to enable staff to take immediate action to address any issues raised. It was
pleasing to see that the hospice scored higher than the national average in all areas of the
national Patient Led Assessment of the Care Environment (PLACE) assessment.
Stoke on Trent CCG and North Staffordshire CCG look forward to working with Douglas
Macmillan Hospice, in developing and monitoring the quality of services it provides for all
patients. We hope the Douglas Macmillan Hospice found these comments helpful and we
look forward to continuous improvements in 2015/16.
19th June 2015
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Healthwatch Stoke-on-Trent Quality Account Statement for
Douglas Macmillan Hospice 2015/16
Healthwatch Stoke-on-Trent welcomes the opportunity to comment on the Douglas
Macmillan Hospice Quality Account for 2015/16.
The Account provides a very positive message about the work of the hospice and
Healthwatch is particularly pleased to see the frequent references to integration and models
of care which are being developed in other parts of the health economy. This level of
understanding of the wider health economy priorities assures us that the Hospice is working
in a complementary way with other providers and initiatives. The opening of the Day
Therapy and Psychological Therapy Services Unit, which was so delayed by the weather in
2013/14, is very welcome.
The delay in commissioning the Step Down Unit described in Priority 1 2014/15 is
understandable given the uncertainties described around the shape of services which will be
commissioned via the end of life tender. However, it is hoped that once there is some clarity
DMH will feel confident to take this project forward to provide a much needed service. The
very positive news about the progress against Priority 3 Elderly and Dementia Services is
welcomed for Mid Staffordshire patients.
Looking forward to the 2015/16 priorities the intention (Priority 1) to further improve
integration of services internally and with other providers to support end of life care is very
welcome indeed. The learning described (Priority 2) from the GP First scheme in Stafford
and Cannock will inform a very positive start to implementing the dementia pathway in
Stoke-on-Trent and North Staffs. Finally the very welcome intention (Priority 3) to provide
a seven day Palliative Care Nurse Specialist Visiting Service is seen by Healthwatch Stokeon-Trent as extremely positive, in particular because it has been initiated in direct response
to the concerns raised by service users.
The very positive ratings of Good and Outstanding in the Wave 2 inspection last August are
very welcome as is the clear acknowledgement by DMH of the need to adapt to the ever
changing health and care environment. This responsive approach whilst keeping patient
experience at the core of the work of the hospice is so important to the service provided by
DMH.
Healthwatch Stoke-on-Trent looks forward to working closely with DMH in the coming
year.
June 2015.
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