Devon Partnership
NHS Trust
Quality
Account
2010/11
Contents
Part 1
Chief Executive’s Introduction
Part 2
Priorities for Improvement in 2011/12
4-5
Statements of Assurance
6-8
Part 3
Review of Quality Performance
Statement of Directors’ Responsibilities
Supporting Statements
3
9 - 23
24
25 - 28
Quality Account 2010/11
Devon Partnership NHS Trust
Chief Executive’s Introduction
Welcome to our second Quality Account which provides an accurate
summary of our continuing work to improve safety, clinical effectiveness
and the experience of people using our services.
At Devon Partnership NHS Trust, our benchmark for quality is to provide
services that are ‘good enough for my family’, by which we mean
services that are Safe, Timely, Personalised, Recovery-focused and
Sustainable.
We have continued to make good, steady progress towards delivering
these objectives during the last year and this fact was borne out
by the overall ‘clean bill of health’ given to our organisation by the
independent regulator, the Care Quality Commission (CQC), in March
2011, following a rigorous review of our services.
The CQC made15 unannounced visits to ten locations across the
county, during which inspectors assessed the quality and safety of the
care being provided and spoke to staff and people using services. The
visits were part of the CQC’s new assessment arrangements, which
measure the performance of services against 16 essential standards.
Iain Tulley
Chief Executive
As well as areas for praise, the CQC also identified some areas where
there is still room for improvement. We have already started to address
these and will be reporting back to the CQC on our progress in due
course.
The CQC also acknowledged the significant improvements we have
made in staff supervision and appraisal. Last year, our performance in
this area resulted in a condition being placed on our CQC registration. I
am pleased to say that this condition has now been lifted, which leaves
us free to proceed with our very important bid to become an NHS
Foundation Trust.
The CQC’s new assessment process is extremely demanding but it has
definitely been a helpful addition to the work we were already doing
to drive-up quality and safety. We are all delighted with the outcome
of the review and our frontline staff, in particular, deserve a huge vote
of thanks for their tireless hard work and their commitment to driving-up
quality.
Formal feedback from the CQC is, of course, only one indicator
of quality and I am pleased to report that, during the last twelve
months we have also been looking closely at how we can capture,
measure and act upon feedback from the people using our services.
An important part of this work has been the introduction of a regular
monthly survey of people who use our services. The early results of this
are very encouraging, with more than 90% of people reporting that they
are treated with dignity and respect and almost 90% confirming that
they would recommend the service to a relative.
Iain Tulley
Chief Executive
Quality Account 2010/11
3
Devon Partnership NHS Trust
Priorities for Improvement
The Trust has expressed its aim to provide services that are ‘good
enough for my family’ and the organisation’s long-term strategic
objectives are designed to support the attainment of this goal. In order
for services to be good enough for our own families the Trust believes
that they have to be:
Safe
Minimum risk of harm to people and best
possible quality of care
Timely
Services available when people need them,
without unnecessary waiting
Personalised
Tailored to meet the needs of individuals,
and planned with them
Recoveryfocused
Emphasising hope, opportunity and the
ability to exercise control over treatment
and life choices
Sustainable
Making best use of our human and
financial resources, building our reputation,
establishing consistency and reducing our
carbon footprint
The Trust has identified three priorities as quality improvement indicators
for 2011/12 in the fields of safety, clinical effectiveness and improving
the experience of people who use services.
To establish these priorities, the Trust set-up a representative group
that included clinicians, senior managers and representatives from
the medicines management and safety teams. They were also
shared with the Quality and Safety Committee, shadow Governors
and non-executive directors of the Board. In addition, the indicators
that have been selected reflect the priorities expressed by the Trust’s
commissioners and are aligned to the Trust’s Commissioning for Quality
and Innovation (CQUIN) priorities (see page 23 for further details).
4
Quality Account 2010/11
Devon Partnership NHS Trust
Performance against the priorities
will be reviewed each month at
Quality and Safety meetings and
also considered by the Trust’s
Board of Directors. The Trust’s
capacity and capability to deliver
enhanced quality improvement
will also be regularly considered at
these groups.
Priorities for 2011/12
Safety
The Trust has invested significantly
in medicines management over
the last couple of years and is
committed to doing everything
possible to improve quality and
reduce errors and mistakes in the
administration of medicines.
The goal for 2011/12 is for 95% of
people to have their medicines
checked within 72 hours of
admission to hospital. This will be
monitored through audits of
people’s medicines charts.
Maintaining good communication
when people are transferred from
one place or service to another is
a key factor in delivering safe care.
The goal for 2011/12 is to followup 95% of adults within 48 hours
of their discharge from hospital.
This will be recorded on the RiO
electronic care records system.
Quality Account 2010/11
Clinical Effectiveness
The Trust has set-out a clear set of
standards that relate to the care
and recovery of people using its
services.
The goal for 2011/12 is to
increase the percentage of
recovery standards that are
being met across the Trust. This
will be measured through the
refreshed Clinical Record SelfMonitoring tool (see page 11 for
further details).
Improving the Experience of
People Using Services
What people say about the
service they receive is one of
the most important indicators of
quality and whether or not the
Trust is getting the basics right.
The goal for 2011/12 is to
increase the percentage of
people who rate the service as
good or excellent and would
recommend it to a family
member. This will be measured
through the monthly survey
which now goes out to 1,000
people who use the Trust’s
services.
Compliance with National
Priorities
The Trust will strive for continued
compliance with those priorities
identified at the national level
for all mental health trusts (see
page 9) and, in particular, will
be planning to further minimise
delayed transfers between
different care settings.
5
Devon Partnership NHS Trust
Statements of Assurance from
the Board of Directors
During 2010/11 Devon Partnership NHS Trust provided and/or subcontracted four NHS services.
The Trust has reviewed all the data available to it on the quality of
care in all four of these NHS services.
The income generated by the NHS services reviewed in 2010/11
represents 100% of the total income generated from the provision of
NHS services by the Trust for 2010/11.
During 2010/11, seven national clinical audits and one national
confidential enquiry covered NHS services that the Trust provides.
During that period the Trust participated in 43% (3 out of 7) national
clinical audits and 100% (1 out of 1) national confidential enquiries of
the national clinical audits and national confidential enquiries which it
was eligible to participate in.
The national clinical audits and national confidential enquiries that the
Trust was eligible to participate in during 2010/11 are as follows:
6
Audit
Participation
% cases submitted
Depression and Anxiety
Yes
70%
Prescribing Observatory for
Mental Health (POMH) audits:
Topic 9 Use of antipsychotic
medication in people with a
learning disability
Yes
100%
POMH audits: Topic 11
Prescribing of antipsychotics for
people with dementia
Yes
100%
POMH audits: Topic 2e
Screening for metabolic side
effects of antipsychotic drugs
in people treated by assertive
outreach teams
No
N/A
POMH audits: Topic 7b
Monitoring of people prescribed
lithium
No
N/A
POMH audits: Topic 10a
Prescribing antipsychotics for
children and adolescents in
June
No
N/A
POMH audits: Topic 8b
Medicines Reconciliation
No
N/A
The National Audit of
Schizophrenia (NAS)
No
N/A
The National Confidential Inquiry
(NCI) into Suicide and Homicide
by People with Mental Illness
Yes
NCI information requests are
made directly to clinicians (who
ordinarily respond directly) there is
only involvement centrally when
there is uncertainty as to how to
respond or it is unclear who is best
placed to respond. The number of
responses made during this period
is not known.
Quality Account 2010/11
Devon Partnership NHS Trust
No national clinical audit reports were reviewed by the Trust.
The reports of 48 local clinical audits were reviewed by the Trust in
2010/11 and the Trust is taking the following actions to improve the
quality of healthcare provided:
üThe Trust records specific action points following clinical audits
which are presented to the Clinical Effectiveness Group on a monthly
basis. The Clinical Effectiveness Group members inform the relevant
Directorate Governance groups in all localities and specialities across
the Trust. In addition to this, the Clinical Effectiveness Group is
informed of key issues and any risks identified as a result of an audit
are brought to the attention of the Risk Management Team. The
Clinical Effectiveness Group also formally reports to the Quality and
Safety Committee within the Trust’s governance reporting structure.
üThe number of people receiving NHS services provided or sub contracted by the Trust in 2010/11 that were recruited during that
period to participate in research approved by a research ethics
committee was 252.
üA proportion of the Trust’s income in 2010/11 was conditional on
achieving quality improvement and innovation goals agreed
between the Trust and any person or body with whom it entered into
a contract, agreement or arrangement for the provision of NHS
services, through the Commissioning for Quality and Innovation
payment framework.
üThe Trust is required to register with the Care Quality Commission
and its current registration status is registered to provide the following
regulated activities: Treatment of disease, disorder or injury;
Assessment or medical treatment for persons detained under the
1983 Mental Health Act; and Diagnostic and screening procedures.
As at 31 March 2011, the Trust has no conditions on its registration.
üThe Trust is fully compliant with its registration with the Care Quality
Commission.
üThe Trust has not been asked to participate in special reviews or
investigations by the Care Quality Commission during 2010/11.
Quality Account 2010/11
7
Devon Partnership NHS Trust
The Trust takes the following actions to improve data quality:
• Clinicians use online data quality reports to identify and resolve
individual data errors
• The Trust complies fully with the Information Governance Toolkit
requirements for data quality and has a data quality policy
which guides action in relation to data quality improvement
• Trends are monitored routinely to ensure data quality issues are
dealt with
• Audits have been, and will continue to be, carried out against
the data quality of key performance and quality indicators,
including those highlighted in this publication.
The Trust submitted records during 2010/11 to the Secondary Uses
Service for inclusion in the Hospital Episode Statistics, which are included
in the latest published data. The percentage of records in the published
data:
• Which included people’s valid NHS number was 99.28% for
admitted patient care (figures for outpatient care and accident
and emergency care not applicable)
•
Which included the people’s valid General Medical Practice
Code was 99.64% for admitted patient care (figures for
outpatient care and accident and emergency care not applicable).
The overall score for the Trust’s Information Governance Toolkit
Assessment for 2010/11 was 72% and all individual requirements were
scored at 2 or above, resulting in a rating of ‘satisfactory’ and a grading
of ‘green’.
The Trust was not subject to the Payment by Results clinical coding audit
during 2010/11 by the Audit Commission.
8
Quality Account 2010/11
Devon Partnership NHS Trust
Review of Quality Performance
Last year, the Trust set out three
priority areas as indicators of
quality improvement. These were:
Improving Care Planning
A good, up-to-date personal care
plan is a key factor in providing
a safe, high quality service for
people. Our aim for 2010/11 was
to ensure that every person using
the Trust’s services, if appropriate,
had a personal recovery plan that
was reviewed at least once every
six months.
How did we do?
Data from the Trust’s Clinical
Record Self-Monitoring tool
shows that more than 86% of
people had a personal recovery
plan in place and that more
than 78% of people had had
their plan reviewed within
the past six months. The Trust
is continuing with its plans to
increase these percentages.
Reducing Slips, Trips and Falls
The organisation is committed
to ensuring that every aspect of
a person’s care and treatment
is safe and of a high quality
– including their physical care.
The Trust’s aim for 2010/11 was
to reduce the number of slips,
trips and falls experienced by the
people in its care.
How did we do?
The Trust has now developed
a falls protocol based on
national best evidence. We are
now focusing on the training
required to ensure that the
management of slips, trips and
falls is embedded into practice
across all services.
Quality Account 2010/11
Although there is not yet sufficient
data to demonstrate a sustainable
downward trend, the Trust has
seen a reduction of more than
50% in the number of slips, trips
and falls recorded between
2009/10 and 2010/11
The issue of flooring has been
carefully considered during the
£4.6m refurbishment of four of
the Trust’s older people’s wards.
Safety, infection control, slipresistance, ease of cleaning and
design are all factors that have
been considered and a floor
covering that appears to meet all
of these criteria is currently being
piloted at one site. In due course,
the Trust plans to establish a
working group to review the issue
of flooring to ensure consistency
and maximum safety across the
whole organisation.
Improving the Patient
Experience
What people say about their
experience of the service, or that
of a family member, is one of
the most important indicators of
quality. The aim for 2010/11 was
for people who have experienced
services to say that they would
recommend them to a family
member or friend.
National compliance
The Trust complied
with the three national
performance indicators
specified for all mental
health trusts during
2010/11:
•
96% of people
received follow-up
contact within seven
days of their
discharge from
hospital (against
a target of 95%)
•
only 4.4% of hospital
bed occupancy
was due to a delay
in the transfer of
care to another
setting (against a
target of 7.5%)
•
97% of people
received an
assessment by the
crisis resolution
and home
treatment service
before they were
admitted to hospital
(against a target of
90%).
How did we do?
At the end of 2010, the Trust
introduced a regular monthly
survey which is sent to 1,000
people who use services. The
early results of this are very
encouraging, with more than
90% of people reporting that
they are treated with dignity
and respect and almost 90%
confirming that they would
recommend the service to a
family member or friend (see
page 16 for further details).
9
Devon Partnership NHS Trust
Other Developments and Improvements
Quality Improvement
Framework
The Trust has developed a
quality improvement framework
based on the measurement
of compliance with standards
and the evaluation of services
by people who use them. These
measures are combined with
other quality and performance
information to allow monitoring
at the individual team level
through the quality performance
‘dashboard’. The dashboard,
which has been developed over
the last couple of years, enables
teams to see performance
data quickly and easily to
assess how they are doing
against the key indicators and
standards. It also enables the
Trust to identify those teams
that require additional support
to maintain standards, allows
comparisons between teams
and directorates and informs the
Trust’s Quality Improvement Plan,
which is monitored fortnightly
at the Quality Improvement
Coordinating Group.
Care Quality Commission
Compliance
At the end of 2010, the Care
Quality Commission (CQC)
began a planned review of
the Trust’s services under its
new performance assessment
arrangements, which measure the
performance of services against
16 essential standards.
Every team was required
to complete a series of selfassessments, known as Provider
Compliance Assessments (PCAs),
under each of the 16 outcome
10
areas, resulting in about 1,700
PCAs being completed across
the Trust. While this process was
extremely demanding in terms
of the time and commitment of
frontline staff, it has been a helpful
addition to the work that was
already under way to drive-up
quality and safety.
The CQC made 15 unannounced
visits to ten locations across the
county, during which inspectors
assessed the quality and safety
of the care being provided and
spoke to staff and people using
services.
The feedback from the CQC,
which was received in March
2011, was very positive.
Commenting on the review, Ian
Biggs, Regional Director of the
CQC in the South West, said:
“This has been a very thorough
review of the services provided
for people with mental illness in
Devon. Devon Partnership NHS
Trust provides a vital service to a
large population – and overall the
trust has emerged with a clean bill
of health.”
In particular, the CQC
acknowledged the significant
improvements that have been
made to staff supervision and
appraisal across the Trust. Last
year, poor performance in this
area resulted in a condition
being placed on the Trust’s CQC
registration. This condition has
now been lifted, which leaves the
Trust free to proceed with its very
important bid to become an NHS
Foundation Trust.
The CQC did identify some
areas where there is still room for
improvement.
Quality Account 2010/11
Devon Partnership NHS Trust
The Trust has already started
to address these and action
plans have been submitted and
approved by both the CQC and
the Board.
Concerns were raised at six sites
but the majority of these were
relatively minor in nature. More
serious concerns were raised in
relation to the Melrose Unit in
Tiverton, which was suspended
by the Trust in December 2010
because of its own concerns
and those of local GPs. The Trust
has, however, worked hard to
address the issues and the Melrose
Unit re-opened on a phased
basis at the end of March 2011.
The longer-term function of the
unit is being considered by a
stakeholder group which includes
local GPs, Age UK, a local carer
representative and clinicians
from both the Trust and Tiverton
Hospital.
The actions to address the CQC’s
moderate concerns regarding
one standard at Whipton Hospital
and Langdon Hospital have
now been completed and the
CQC has been notified that this
improvement work has been
undertaken.
Teams will continue to use the PCA
process to assess their compliance
with both CQC and Trust
standards. Progress with action
plans is monitored using an impact
rating score and exceptions are
monitored by the Coordinating
Group.
Improving Standards of Practice
The Trust has worked with
clinicians, managers and people
who use services to set standards
of practice for the assessment,
planning, delivery, coordination,
and review of care.
Quality Account 2010/11
Compliance with these practice
standards is now monitored
through the review of a monthly
sample of clinical records which
is taken by each clinical team
leader or ward manager. The
Clinical Record Self-Monitoring
(CRSM) tool has been developed
for this purpose and has three key
functions:
•
To provide assurance through
the team dashboard that the
standards of practice are
being met
• For clinical team leaders to use
in their supervision and
appraisals with staff
•
To measure the impact of
the Care Quality Development
Programme, a Trust-wide
initiative to underpin the work
that is being done to drive-up
quality.
The CRSM tool was reviewed with
clinicians in February 2011 and
teams’ performance is regularly
monitored by the Coordination
Group. The Trust’s Quality
Improvement Plan sets targets for
improved CRSM performance and
compliance with standards and
the implementation of RiO and
the Care Quality Development
Programme will support continued
improvement across all practice
standards.
The results of the CRSM review
indicate that the following three
areas are priorities for further
training and development:
• Clinical risk assessment and
management (including
contingency planning)
• ‘Think family’ (improving
support for families at risk) and
safeguarding
• Routine enquiry for trauma
and abuse (including domestic
abuse).
11
Devon Partnership NHS Trust
Electronic Patient Records
The Trust has gradually been
introducing a new records system,
called RiO, over the last couple
of years and the system is now
operational across the majority of
the Trust’s services. This has been
a major project and has involved
the training of 1,850 staff, as well
as a significant investment in new
technology and support services.
The RiO system, which is widely
used by mental health Trusts across
the South of England, replaces
paper records and the existing
electronic recording system. It
means that the Trust now has an
integrated patient record that
can follow a person seamlessly
from hospital to community, with
different healthcare professionals
able to share a single, secure care
plan that they can all update in
real time. People who use services
will benefit from improved quality
of care and safer services as
the risk of losing paper records,
duplicating information and
holding multiple records for one
person is removed.
Recovery Coordination
Nationally, the Trust is at the
forefront of work to embed the
notion of personal recovery and
recovery practice at the heart of
mental healthcare. Much of the
material that the organisation
has produced is endorsed by
the Royal College of Psychiatrists
and is available on its website.
Recovery is about building a
meaningful life, as defined by the
person themselves, whether or
not there are ongoing problems.
It represents a movement away
from focusing on illness and
symptoms towards a focus on
health, strengths and wellness.
12
Over the past year, the Trust
has continued to embed the
principles of personal recovery
and has placed a sharp focus
on the quality of individual care
planning - which is an important
component of the Care Quality
Commission’s standards. The
work so far has been particularly
concentrated in inpatient settings,
where a good deal of training
and development has taken
place to raise the overall quality of
people’s care plans.
The Trust has also been selected as
one of just six pilot sites across the
country to participate in a new
initiative to put recovery at the
heart of mental health services.
The Supporting Recovery project
will use research from the Centre
for Mental Health which sets out
ten key indicators for organisations
to support the recovery of people
using mental health services.
It is the result of a partnership
between the Centre for Mental
Health, the NHS Confederation
and the National Mental Health
Development Unit and is a
national initiative.
Initial evaluation results will be
published nationally within 12
months. The Supporting Recovery
project will assist organisations to
undertake self-assessments against
ten indicators, plan changes and
report their outcomes over two
years.
This work addresses the following
High Impact Areas:
•
More people will receive
care which is, as far as possible,
‘self-directed’ and reflects their
preferred goals and outcomes
Quality Account 2010/11
Devon Partnership NHS Trust
•
More people with serious or
severe mental health problems
will be able to use their own
experience and expertise
to manage their symptoms, in
partnership with professionals
• More people with serious or
severe mental health problems
will be in employment
•
More people with serious
mental health problems will be
living in appropriate
accommodation.
The Trust offers recovery
coordination master classes and
provides the opportunity for staff
to undertake a degree module
Understanding Recovery Principles
and their Application to Practice
at the University of Plymouth. The
expectation that all staff have
appropriate recovery knowledge,
skills and qualities for their work is
now in all job descriptions.
The How well is life working out for
you? practice tool helps support
the principle of being more
person-led and becoming much
more focused on how someone
is doing, rather than leading on
what the service has to offer.
Services for Older People
The Trust has worked closely with
the Care Quality Commission over
the last couple of years to develop
and improve its services for older
people. Of particular note in this
work is the investment of almost £5
million to refurbish four of the Trust’s
inpatient wards for older people
in Barnstaple, Exeter and Torbay.
These wards are due to re-open
between August and October
2011 and will provide far safer,
more therapeutic environments in
which to deliver high quality care.
The environments will also provide
more privacy and dignity.
Quality Account 2010/11
The Trust is continuing with its
plans to shift the emphasis away
from inpatient care towards more
and better community services
for older people. This will enable
greater access to services by the
ever-increasing number of older
people with mental health needs
while ensuring that hospital beds
are available for the very small
number of people with the most
severe and challenging needs.
Last year also saw an important
development in terms of access
to a wider range of services by
older people. The Trust’s Crisis
Resolution and Home Treatment
teams, which were previously only
accessible to people under 65
years of age, have now received
additional resources and their role
has been extended to provide
care for adults of all ages.
Peer Validation Visits and
Executive Safety Walkarounds
As part of its plans to drive-up
safety and quality, and maintain
an accurate picture of frontline
services, the Trust has initiated
a programme of regular visits to
frontline services.
Peer Validation Visits are carried
out by clinical peers, are focused
on the standards developed by
the Care Quality Commission and
provide immediate feedback to
staff so that action can be taken
back into practice.
This technique offers a powerful
tool for quality improvement and
patient safety. Progress on each
team’s compliance in meeting the
standards is reported to the Board
and to the teams themselves
via the quality performance
dashboard.
For more information
about the Supporting
Recovery project go
to the Networks, Mental
Health Section at
www.nhsconfed.org
13
Devon Partnership NHS Trust
Executive Safety Walkarounds
are conducted regularly by
executive directors. Verbal
feedback and recommendations
for action are given to the local
team immediately after the
walkaround, and in writing as soon
as possible. Where appropriate,
important issues and themes
picked-up during these visits are
also escalated for discussion and
action.
Single-sex Accommodation
In line with best practice and
national guidance, mixed-sex
accommodation has been
eliminated in all of the Trust’s
inpatient services. Every person
using these services has the right
to receive high quality care that
is safe, effective and respectful of
their privacy and dignity. Devon
Partnership NHS Trust is committed
to providing everyone with samesex accommodation, because it
helps to safeguard their privacy
and dignity when they are often
at their most vulnerable.
From April 2011, all NHS Trusts are
required to display a declaration
of compliance on their website.
The declaration for our Trust is set
out opposite and can be found
at www.devonpartnership.nhs.uk
There are certain circumstances
where, for reasons of clinical
need, the same-sex guidelines
may be breached and these
circumstances have been agreed
and set out with NHS Devon, as
the Trust’s lead commissioner.
Reporting arrangements to
monitor performance are in place
through regular monthly meetings
and no reportable breaches have
occurred to date.
14
In general, people can expect the
following when they use the Trust’s
inpatient services:
• The room where their bed is will
only have people of the same
sex as them
•
Their toilet and bathroom will
be for people of their sex only,
and will be close to their
bedroom
•
There will be both men and
women on the ward, but they
will not share sleeping areas.
People may have to cross
a ward corridor to reach their
bathroom, but they will not
have to walk through oppositesex areas
•
Most communal space, such as
day rooms or dining rooms, will
be used by both men and
women but there will be a
sitting room reserved for women
only
•
It is probable that both male
and female nurses, doctors and
other staff will need to come
into people’s bed area on
occasion
•
If people need help to use the
toilet or take a bath (for
example to use a hoist or
special bath) then they may be
taken to a ‘unisex’ bathroom
used by both men and women,
but a member of staff will be
present, and other people will
not be in the bathroom at the
same time.
The Board of Directors closely
monitors the delivery of samesex accommodation and the
Trust will seek feedback from
people who use services through
its questionnaires, programme of
independent ward visiting and
comments made through the
Patient Experience Team.
Quality Account 2010/11
Devon Partnership NHS Trust
Talking and Listening to People
A strategy and workplan are in
place to ensure that the Trust talks
and listens to people who use its
services, their families and the
wider community. This currently
includes key stakeholders such
as Local Involvement Networks
(LINks) and local authority
Health Overview and Scrutiny
Committees, although these
arrangements are set to change
under the government’s new
Health and Social Care legislation.
The aim is to encourage people to
seek information, comment, raise
concerns or make a complaint
on an individual or representative
basis. This can be through
contacting the Patient Experience
Team, completing a comment
card, participating in a survey
or attending an open meeting
or focus group to hear about
developments and provide views.
Many people are involved in
sharing their personal experience
and opinions at specific meetings
to plan or monitor services. Others
are involved in activities such
as visiting wards to meet with
people using services, working
in partnership to recruit staff or
specific activities such as creating
training DVDs for staff.
In recent years, feedback from
all sources has revealed that
the attitude of staff and the
need for good communication
are amongst the top priorities
for people. The main reasons
for raising concerns or making
a complaint continue to be
insufficient information about
the services available and how
to access them, or a quality
of service which falls short of
people’s expectation.
Quality Account 2010/11
As a result, a number of
programmes have been
introduced where people who
have personal experience of
services are involved in staff
learning and development. This
includes revised and improved
monthly staff induction sessions
and In My Shoes training.
These activities provide an
important source of feedback
to the Trust. Much of this activity
is captured through the Patient
Experience Team, which provides
advice and support, handles
enquiries, complaints and patient
and public involvement. The
Patient Experience Team reports
on a quarterly basis to the Quality
and Safety Committee. These
reports provide examples of
feedback received, arising themes
and action taken.
New Survey Launched
The Trust has worked with
people who use services to
identify the key qualities of
services which underpin a
good experience and positive
outcomes. A questionnaire has
been developed to measure the
degree to which people consider
they have experienced these
qualities and their satisfaction with
the service provided. This is now
sent to a sample of 1,000 people
each month and the results are
analysed and reported in team
dashboards.
Single-sex
Accommodation Declaration of
Compliance
Devon Partnership NHS
Trust is pleased to confirm
that we are compliant
with the Government’s
requirement to
eliminate mixed-sex
accommodation, except
when it is in the patient’s
overall best interest, or
reflects their personal
choice. We have the
necessary facilities,
resources and culture
to ensure that patients
who are admitted to our
hospitals will only share the
room where they sleep
with members of the same
sex, and same-sex toilets
and bathrooms will be
close to their bed area.
Sharing with members of
the opposite sex will only
happen when clinically
necessary such as where
people need the highest
level of one to one nursing
support and observation
for short periods of time
(for example in a high
dependency or ‘extra
care’ area in an acute
inpatient ward).
If our care should fall short
of the required standard,
we will report it. We will
also set up an audit
mechanism to make sure
that we do not misclassify
any of our reports. We
will publish the results
of that audit as part of
our ‘quality of care and
patient experience’ report
in September 2011.
15
Devon Partnership NHS Trust
Feedback From People Using Services
(December 2010 - May 2011)
100%
90%
80%
% of
responders
70%
60%
50%
40%
30%
20%
10%
0%
Service met
needs at all
times
Treated with
courtesy and
respect at all
times
Service rated
as good or
excellent
(4 or 5*)
In relation
Would
to care it is
recommend
clear what will the service to a
happen next
relative
Overall, the results are extremely encouraging, with more than
90% of people reporting that they are treated with dignity and
respect, almost 90% confirming that they would recommend the
service to a relative and around 70% rating the service as good or
excellent. Areas where the survey has identified the need for further
improvement are:
• Having support available to meet personal goals
• Knowing who is responsible for care and who to contact if
concerned
• Having the possible side-effects of medication explained
• Knowing what is happening next with someone’s care
• Support with physical health conditions and the provision of
practical support.
The key qualities or features of services that have delivered
particularly positive feedback from the users of services include:
• Involvement in decision making about care
• Staff skills
• A clean and well-maintained environment.
16
Quality Account 2010/11
17
0
10
20
30
40
50
60
70
80
ion
90
lve
ecis
abo
u
t ca
rm
to m
re
a
s
te
d to
se
t go
ls
ee
als
ble
a
trol
to
100
invo
d in
d
info
t to
ke d
ec
ision
por
por
goa
was
av
aila
anc
aint
to k
rted
in w
el
lbei
ng
o
ver
de
cisio
ain
w
with
ns
as
of li
fe
pra
with
nee
ds
phy
sica
ln
is re
sp
eed
s
on
kno
ww
h
sible
fo
r ca
o to
c
ont
sati
act
ern
spo
s
nse
ted
or
re
if co
nc
sfac
tory
re
sta
ff ha
ve
upp
or
sup
p
t av
ail
ed
to c
on
cer
me
ns
to k
ee
p sa
abl
e in
staf
f
clea
na
nd
u
rge
nt
hav
fe
nee
ds
en
wel
ece
ssa
l ma
int
pur
ry sk
aine
d
ills
env
iron
m
po
se o
fm
ent
edi
pos
The table below gives further details of how people evaluated the Trust’s services:
fully
give
n
atio
n
sup
sup
me
et
give
ng
uid
e to
m
h
elpe
d
pc
on
sup
po
ma
int
pec
ts
h
elpe
d
ctic
al
h
elpe
d
kno
who
Quality Account 2010/11
ca
tion
e
sib
le si
de
xpla
effe
ined
c
ts e
xp
lain
ed
% agree or
strongly agree
% neither agree
nor disagree
% disagree or
strongly disagree
% no response
Devon Partnership NHS Trust
Devon Partnership NHS Trust
Acting on Feedback
In its recent review, the
CQC found evidence that
improvements had been made in
response to feedback at a team
and service-wide level. Examples
of service improvements resulting
from feedback during 2010/11
include:
•
Depression and anxiety service
- staff instructed to routinely
give written information to
people about how they can
raise concerns
•
Addiction services - better
management of the ‘smoking
garden’, improved medicines
management and additional
essential training for staff
•
Recovery and Independent
Living team - change of policy
in relation to supporting
people with their funding
applications (direct payments)
and improved arrangements
for sharing information with
people who use services
•
Crisis Resolution and Home
Treatment team - people are
now routinely given a copy of
their assessments
•
Haldon Eating Disorder
Service - review of nutrition
options and changes to the
way food is offered.
Engaging with People to
Develop Services
NHS organisations have a statutory
duty to involve people (directly
or through representatives)
in the planning of healthcare
services, in the development and
consideration of proposals for
changes in the way those services
are provided and in decisions
affecting the operation of those
services.
18
Outcome 16 of the CQC’s
new performance assessment
framework requires evidence that
people who use services, and
their relatives, are involved in the
review and monitoring of service
provision.
At Devon Partnership NHS Trust, the
principle forum for engagement
with people is the Network Action
Groups (NAGs) that are held
regularly across the county. The
objectives of NAGs are to:
• Provide information about
national, local and Trust
developments
• Encourage membership
and feedback about the
quality of services
• Encourage feedback about
proposed service development
or change
•
Offer partner organisations
an opportunity to promote
their services and engage
in discussions about a range of
issues
• Provide the opportunity for
people to meet with senior
staff.
During the latter part of 2010/11,
discussion topics at NAGs included
the quality of inpatient care, the
development of older people’s
services and the introduction of
the RiO electronic care record
system.
Infection Prevention
and Control
The Trust has developed a
proactive approach to infection
prevention and control. Each year
the Trust develops an annual work
programme which is approved by
the Board of Directors.
Quality Account 2010/11
Devon Partnership NHS Trust
This is monitored through the work
of the Trust Infection Prevention
and Control Committee which,
in addition, provides assurance
reports to the Quality and Safety
Committee.
The Board of Directors receives
monthly statistics against MRSA
bacteraemia and also Clostridium
difficile, which provides an
additional alert to the Board
of any developing patterns or
concerns.
The Trust has identified a Nonexecutive Director as a champion
for infection control and also
has a number of identified Link
Practitioners within frontline teams
who help promote best practice in
infection prevention and control.
The Care Quality Commission
has confirmed that the Trust is
compliant with its standards
(outcome 8) and that appropriate
arrangements are in place for
the prevention and control of
healthcare associated infections,
with the exception of Exeter Prison
– where some concerns remain.
The Trust has been working in
partnership with Her Majesty’s
Prison Service, NHS South West
and the Health Protection Agency
to undertake the necessary
improvements to comply with
the standards. Many of the issues
relate to the physical environment
at the prison and the fabric of
the building. The short-term issues
have now been addressed and
an improvement plan for the
inpatient unit at the prison is soon
to be agreed. Work to refurbish the
primary care areas at the prison
is planned to start during 2011
and this will ensure compliance
with the relevant environmental
standards.
Quality Account 2010/11
There have been no cases of
MRSA bacteraemia, but there was
one healthcare associated case
of Clostridium difficile in an adult
inpatient unit in November 2010
– the first in the Trust since 2008.
A root cause analysis was
conducted which revealed good
adherence to infection control
procedures and there was no
transmission to other people.
The Trust is performing well in
terms of meeting the national
specifications for cleanliness.
Patient Environment Action Team
(PEAT) inspections took place
in March 2011 and have been
submitted to the National Patient
Safety Agency. Encouragingly,
there has been an improvement
across-the-board in terms of
the level of compliance with
cleanliness standards, which rose
from 73.9% in the first quarter of the
year to 93.2% in the third quarter.
The latest data shows that 89%
of staff are up-to-date with their
online compulsory training in
infection prevention and control.
Face-to-face essential training is
also provided for relevant staff
groups and plans are in place to
maximise attendance at these
sessions. In 2011, the Infection
Prevention and Control Team will
also be piloting a new system of
practical hand hygiene training for
staff working in hospital settings.
Mental Health Act
The Trust sets out its arrangements
and authorisations in relation
to the Mental Health Act in a
Scheme of Delegation, which
is approved by the Board of
Directors. The Trust is responsible
for the appointment of Hospital
Managers who act on behalf of
people detained under the Act.
19
Devon Partnership NHS Trust
The Trust has 15 Hospital Managers,
who ensure that the Act is applied
appropriately and fairly, and that
hearings, appeals, reviews and
other activities are conducted in
accordance with the legislation.
To ensure that Hospital Managers
understand their role and remain
up-to-date, training seminars,
including assessing and managing
risk, have been established on
a twice yearly basis. Additional
training is provided for those who
Chair Mental Health Act hearings,
appeals and reviews. The Mental
Health Act administration office
works closely with the Hospital
Managers and a wide range
of clinicians from across the
organisation to improve the quality
and safety of the Trust’s services
and develop best practice.
Patient Safety Programme
The theme of patient safety has
been at the heart of much of
the Trust’s work during the past
few years and will continue
into 2011/12 and beyond. The
organisation has invested in
leading-edge Patient Safety
Officer training with the Institute of
Health Improvement and provides
leadership for patient safety
training. It also provides a range of
quality improvement techniques
for senior staff, such as the Plan,
Do, Study, Act (PDSA) approach,
which uses small tests of change
to explore potential improvement
in a wide range of areas, for
example shorter waiting times, a
reduction in serious incidents or
improved access to services.
The Trust is now working with other
mental health services in the
region, and NHS South West, to
improve services across a range of
areas, including:
20
•
Safe and reliable care
(including falls prevention)
– adopting local, national and
international evidence-based
best practice
• Prevention of suicide –
improving communication after
discharge from hospital
• Provision of patient and family centred care
•
Medicines management
– improving safety around the
prescription and administration
of medicines.
Medicines Management
The Trust has made significant
strides forward in the field of
medicines management over the
last couple of years. It has been
an area of sustained improvement
and good practice is now
becoming embedded in every
part of the Trust where medicines
are used. The recent review by
the Care Quality Commission
did identify some relatively minor
areas for improvement but these
have now been addressed and,
overall, the feedback was very
positive.
In addition to providing a
comprehensive range of policies
and procedures related to core
medicines management activities,
the Medicines Management Team
continues to enable people to use
medicines safely and effectively
by:
•
Supporting prescribers
– a range of evidence-based
prescribing guidance is
available. A recent example
is the launch of information
that has been developed
jointly across the local
community giving up-to-date
guidance on the treatment of Quality Account 2010/11
Devon Partnership NHS Trust
Behavioural and Psychological
Symptoms of Dementia (BPSD).
The last year has also seen
the introduction of prescribing
reports for each of the clinical
directorates, which enable
and encourage peer review
and best practice discussions
between clinicians.
Involved Devon, which
represents people using
services. There is also ongoing
work to improve the efficient
delivery of medicines from our
supplying pharmacies to
ensure that people get timely
access to the medicines they
need.
•
Supporting health care
professionals – education and
training, an extended range
of e-learning and a number of
tailored medicines
management courses and
resources are now available
to staff. An annual
competency assessment for
nurses has been introduced
and the sharing of learning and
best practice is being
promoted through regular
audits, the network of wardbased medicines management
Link Practitioners and routine
ward visits.
•
Supporting people who use
our services – the introduction
of a Choice and Medication
website www.choiceand
medication.org/devon is
an extremely useful innovation
that provides individual,
carer-friendly information about
medicines and the conditions
they are used to treat. It is
now the preferred source of
information used by our teams
and the people using services
and their families and carers.
There is now also increased
face-to-face contact
between members of the Medicines Management Team
and people in hospital;
improved access to selfmedication and one-stop
dispensing schemes; easier
access to medicines
information and advice and
greater involvement with Be
•
Long term commitment to
medication safety – the
Trust is actively participating
in NHS South West’s Quality
and Safety Improvement
Programme for Mental
Health. Our Associate Director
of Medicines Management
is a faculty member and leads
the ‘getting the medicines
right’ work stream. This focuses
on further work to enhance
people’s experience and
outcomes of using medicines.
The Trust’s Medicines
Management Team is also
working with colleagues in
psychological therapies to
develop a support programme
and training package for
people who use our services
and teams to improve joint
decision making, adherence to
the correct use of medicines
and recovery-orientated
prescribing.
Quality Account 2010/11
Staff Survey
The motivation, morale, attitude
and engagement of staff are
important factors in delivering
safe, high quality services. The
results of the latest staff survey
show that, overall, there has
been a small increase in staff
satisfaction, but there has been
significant improvement in other
areas, such as the number of staff
having well structured appraisals
and personal development
plans – an area where the Trust
has worked hard to improve
performance.
21
Devon Partnership NHS Trust
Other notable findings include:
Areas where we performed well:
• Percentage of staff having
equality and diversity
training in the last 12 months
(81% against a national
average of 47%)
•
Percentage of staff
receiving health and safety
training in the last 12 months
(95% against a national
average of 80%)
•
Percentage of staff feeling
valued by their work
colleagues (83% against a
national average of 79%)
•
Percentage of staff using
flexible working options (74%
against a national average
of 67%)
Areas where we have to improve:
• Percentage of staff
feeling that there are good
opportunities to develop
their potential at work (34%
against a national average
of 45%)
•
Percentage of staff
receiving job relevant
training, learning or
development in the last 12
months (73% against a
national average of 80%)
•
Staff recommendation of
the Trust as a place to work
or receive treatment (score
of 3.18 compared to a
national average of 3.49)
•
Fairness and effectiveness
of incident reporting
procedures (score of 3.30
compared to a national
average of 3.45)
The overall indicator for staff
engagement was below the
average for mental health
providers and this will be an
area of sharp focus over the
forthcoming year.
The Trust will be looking closely
at the findings from this year’s
staff survey and is taking action
to address the key themes. For
a full report on the survey, visit
www.cqc.org.uk or call the
Communications Team on
01302 208693.
Clinical Audit
The Clinical Audit Programme
for 2011/12 was developed in
conjunction with staff from the
Trust’s four Clinical Directorates
and is led by a Co-Medical
Director. The programme
integrates quality improvement
and mainstream clinical audit
work. This reflects the wider
organisational shift towards an
increased emphasis on service
improvement, safety and the
quality of people’s experience of
services. The work programme is
based on the Trust’s priorities for
quality improvement and clinical
audit activity and reflects both
national and local priorities in the
field of mental health.
The Trust’s current priority areas for
clinical audit cover both national
and local priorities and include:
• Medicines management
• Schizophrenia
• Dementia
• Violence
• Improving communication at
discharge from hospital
• Physical health checks
• Mental Health Act compliance.
22
Quality Account 2010/11
Devon Partnership NHS Trust
Research and Innovation
Devon Partnership NHS Trust
is committed to increasing its
participation in research and
contributing to better health
outcomes for the people using its
services. In 2010/11, the number
of people recruited to research
projects approved by a research
ethics committee was 252. The
organisation is currently involved
in conducting 16 clinical studies,
of which 12 are supported within
the National Institute of Health
Research portfolio.
The Trust collaborates with the
Peninsula Medical School and
co-hosts its Mental Health
Research Group. It has close
links with the West Hub of the UK
Mental Health Research Network
and the South West Dementia
and Neurodegenerative Diseases
Network.
Data Quality
The Trust has moved to a new
electronic clinical record system,
RiO, which is a major step forward
in terms of data quality. In the
past, data entry was additional
to the updating of the paper
care record – now the core role
of clinicians documenting care
Quality Account 2010/11
is through the electronic system.
Inevitably, some new data quality
issues have emerged and the
Performance Information Team
continues to identify these and
has systems in place to rectify
errors quickly and effectively. High
priority issues are flagged-up and
monitored by senior managers
within the Trust’s four clinical
directorates.
Commissioning for Quality and
Innovation (CQUIN)
The CQUIN payment framework
is a national initiative that
makes a proportion of income
(1.5%) available to those Trusts
providing services if they meet
certain quality and innovation
targets agreed with their local
commissioning organisations.
For its 2011/12 CQUIN scheme,
our Trust has agreed a list of
indicators which includes targets
related to dementia, followingup people after discharge from
hospital, personal health budgets,
medicines management and
improving the patient experience.
The priority areas for quality
improvement selected by the Trust
for 2011/12 reflect some of these
indicators.
23
Devon Partnership NHS Trust
Statement of Directors’
Responsibilities in Respect of the
2010/11 Quality Account
The Directors are required under the Health Act 2009, National Health
Service (Quality Accounts) Regulations 2010 and National Health
Service (Quality Account) Amendment Regulation 2011 to prepare
Quality Accounts for each financial year. The Department of Health has
issued guidance on the form and content of annual Quality Accounts
(which incorporate the above legal requirements).
In preparing the Quality Account, Directors are required to take steps to
satisfy themselves that:
•
The Quality Account presents a balanced picture of the Trust’s
performance over the period covered.
•
The performance information reported in the Quality Account is
reliable and accurate.
•
There are proper internal controls over the collection and reporting
of the measures of performance included in the Quality Account,
and that these controls are subject to review to confirm that they
are working effectively in practice.
•
The data underpinning the measures of performance reported in
the Quality Account is robust and reliable, conforms to specified
data quality standards and prescribed definitions, is subject to
appropriate scrutiny and review: and the Quality Account has
been prepared in accordance with Department of Health
guidance.
The Directors confirm to the best of their knowledge and belief they
have complied with the above requirements in preparing the Quality
Account.
By order of the Board
Date 30th June 2011
Date 30th June 2011
24
Mark Taylor, Chairman
Iain Tulley, Chief Executive
Quality Account 2010/11
Devon Partnership NHS Trust
Supporting Statements
Prior to publication, the Trust
complied with the requirement
to share its Quality Account for
2009/10 with:
• NHS Devon (the main
commissioning
Primary Care Trust)
• Devon County Council’s Health
and Adults’ Services Scrutiny
Committee.
• Devon and Torbay LINks.
The Trust ensured that NHS Devon
met its legal obligation to review
and comment on the publication,
and that the Devon County
Council’s Scrutiny Committee
and Devon and Torbay LINks
were offered the opportunity to
comment on it. A range of other
stakeholders were also given the
opportunity to contribute to the
report.
Commentary by NHS Devon
Devon Partnership NHS Trust has
worked exceptionally hard in
2010/11 to meet the challenges
of the Care Quality Commission
and in pursuit of the assurance
of high quality and safe care
for the population it serves. As
lead commissioner NHS Devon
remains committed to working in
partnership with Devon Partnership
NHS Trust in support of their future
priorities for continuous quality
improvement in the delivery of
care.
The Trust has made significant
improvements in the key areas
identified by the Care Quality
Commission (CQC) and the
Quality Account not only
describes the achievements over
the last year but also identifies
plans for 2011/12 to progress
national, local and regional
priorities for quality improvement
in those areas which we know are
Quality Account 2010/11
important to people who use our
services, their carer’s and their
families.
As a result of the extensive review
through the Provider Compliance
Assessments (PCAs) the Trust
has been able to demonstrate
the key areas which needed
to be given priority last year,
for example improvement in
the estate at a number of sites
has created a better and safer
environment for people in their
care. In conjunction with this there
have been a number of initiatives
to ensure that staff are better
supported through improvements
to staff appraisal and supervision.
Devon Partnership NHS Trust
are aware of the impact that
good physical health has on
people that use their services,
which is demonstrated in their
prioritisation of continuous
improvement in areas such as
slips, trips and falls and infection
control. Prevention of infections
such as Norovirus, MRSA and
C.Difficile can be challenging,
however the Trust has worked
hard to ensure that avoidable
infections are virtually eliminated.
Devon Partnership NHS Trust is also
including the prevention of Venous
Thromboembolism (VTE) in the
‘Commissioning for Quality and
Innovation’ (CQUIN) scheme for
2011/12 which rewards Trusts who
embed quality improvement in
service delivery. These targets are
locally agreed and ambitious and
require a sustained cultural shift in
practice.
Patient experience was given
increased attention by the Trust
last year and this will continue
through 2011/12. This has resulted
in significant changes in clinical
practice and the experience of
individuals and families as and
25
Devon Partnership NHS Trust
has been a focus for quality
improvement. NHS Devon is
supporting further improvement
in this area through next year’s
CQUIN scheme.
NHS Devon supports the Trust’s
priorities for 2011/12 which are in
line with those of NHS Devon in
improving people’s experience
of mental health services through
the provision of consistently high
quality care across all service user
pathways.
The Quality Account recognises
the importance of joint working
relationships and NHS Devon is
delighted to support the Dementia
work programme that is planned
with The Royal Devon and Exeter
NHS Foundation Trust. This joint
work will enable staff to more
easily identify the individual needs
of one of our most vulnerable
groups of people in order that
they have a better healthcare
experience.
NHS Devon will continue to
support quality improvements
through the agreed CQUIN
schedule for 2011/12. The Trust has
focused on areas that will make
a significant impact on improving
patient outcomes, for example
improving follow up on discharge
from inpatient services, medicines
management and reconciliation
and carer assessments for
those caring for someone with
dementia. The 2011/12 CQUINs
are challenging this year but
both the Trust and NHS Devon are
aware that these are issues which
can make a significant difference
to patient outcomes and their
individual healthcare experience.
NHS Devon supports the ongoing
progress made in quality
improvement within the Quality
Account and support Devon
26
Partnerships NHS Trust’s total
commitment to place quality and
safety at the heart of everything
they do. The Trust has performed
well overall against the 2010/11
quality schedule, however the
Trust recognise within the Quality
Account that there are still areas
where further improvement must
be achieved. Both organisations
will continue to work together to
ensure these areas are addressed
in 2011/12.
The alignment of the Trust’s
philosophy for quality of care with
NHS Devon is critical as it is only
a partnership of commissioner
and provider and its managers
and clinicians that will drive
improved outcomes for people
using the service. The description
of the achievements made in
2010/11 and the focus on quality
during 2011/12 demonstrate the
commitment of the Trust from
ward to board in improving quality
of care and NHS Devon supports
the approach the Trust is taking for
the future.
Commentary by Devon County
Council’s Health and Adults’
Services Scrutiny Committee
Devon County Council’s Health
and Adults’ Services Scrutiny
Committee (SC) determined to
comment on Devon Partnership
NHS Trust’s (the Trust) Quality
Account 2011-12. All references
in this commentary relate to the
reporting period 1 April 2010 to 31
March 2011 and pertain only to
the Trust’s relationship with the SC.
The SC believes that the Quality
Account 2011-12 is a fair reflection
of the services provided by the
Trust and gives a comprehensive
coverage of the provider’s
services, based on the knowledge
the SC has of the Trust.
Quality Account 2010/11
Devon Partnership NHS Trust
The Trust is currently registered
with the Care Quality Commission
(CQC) without conditions after
significant improvements had
been achieved in the arena of
staff supervision and appraisal.
Last year, the performance in
this area resulted in a condition
being placed on the Trust’s CQC
registration which has now been
lifted. This provides very powerful
external assurance of the Trust’s
quality of services.
The Trust has been engaging
regularly with the SC throughout
the reporting period and
has responded to reporting
requirements promptly, for
example to the older people
mental health task group update
in November 2010 or the support
for carers task group update in
March 2011. The SC continues to
have an excellent informal as well
as formal working relationship with
the Trust.
The SC is content with the level
of the Trust’s public engagement
which demonstrates that the Trust
values a continued dialogue
and stakeholders’ views and is
committed to partnership working.
For example, the Trust’s Chief
Executive and senior managers
invited the SC’s Chairman for an
informal briefing on the Trust’s
older people mental health
programme in March 2011. The
Trust has also been providing
regular newsletters, briefing
notes and reports on various
topics at its own initiative, such
updates on developments within
inpatient units as part of the
wider older people mental health
programme.
The SC also fully supports the Trust’s
benchmark for quality to provide
services that are ‘good enough for
Quality Account 2010/11
my family’ as well as its long-term
strategic objectives, to provide
services which are safe, timely,
personalised, recovery-focused
and sustainable.
Commentary by Devon LINk
LINk Devon’s remit is to promote
and support the involvement of
people in the commissioning,
provision and scrutiny of their
local health and care services. To
this end, LINk Devon welcomes
the opportunity to provide a
statement to Devon Partnership
NHS Trust for their Quality Account.
The LINk’s response is based on
involvement with and knowledge
of the Trust to date.
LINk feels that this is a coherent
and carefully prepared account,
which makes clear the Trust’s
continuing commitment to
ongoing improvement and to
the importance of systematically
collecting, analysing and using
feedback from people who use
our services and their carers in
the development of their policy,
practice and provision which LINk
Devon commends.
LINk Devon is encouraged by the
Trust’s commitment to improving
the patient experience and
will support any effort to work
in partnership with the Trust to
ensure the views of patients
and the public are heard and
improvements are implemented
as a result. LINk Devon has taken
every opportunity to regularly
feed back comments or concerns
via the Trust’s patient and public
involvement structures. These
views have been received
through community engagement
and LINk’s own surveys, and LINk
Devon undertakes to continue this
activity.
27
Devon Partnership NHS Trust
Feedback that LINk has received
from the public, has provided
the basis for project work that
LINk Devon has carried out
relating to ‘Access to Emotional
Wellbeing Services’ and ‘Leaving
Hospital’. For both projects, the
Trust has provided information
on request from LINk Devon. LINk
Devon proposes that the Trust
considers the evidence and
recommendations provided in
both reports, which are due to be
published imminently, with a view
to developing a joint approach to
development work that may arise
from the recommendations made
by the LINk.
LINk Devon acknowledges (on
page 16) the Trust’s recognition
for where further improvements
can be made. As a result of their
patient experience questionnaires,
areas of concern have been
recognised which are similar to
those raised with the LINk, and
the recommendation that better
communication from health
professionals to patients is a
constant in all three of the areas
identified.
LINk Devon attends the Network
Action Groups (NAG) and has
developed a working partnership
with Be Involved Devon (BID).
BID and LINk Devon are looking
at current working practices as
commissioning for BID is under
review.
28
LINk Devon undertakes to promote
and support involvement under
any new arrangements that may
be made.
LINk Devon will continue to
engage with the Trust, in particular
by highlighting to them, on
a regular and ongoing basis,
any concerns people raise
within the network, as well as
continuing to publish reports and
recommendations about specific
issues, enabling communities to
represent their views about the
quality and standard of services
provided through the Trust. LINk
welcomes the opportunity to
work in partnership with the Trust
as a result of any LINk project
development work.
Commentary by Torbay LINk
Comments were sought from
the Torbay LINk on the Quality
Account 2010/11 but none were
received.
Engagement in Producing the
Quality Account
The Trust sought ideas and
suggestions for inclusion in the
Quality Account from all of its key
stakeholder groups, including staff,
the people using services and their
carers and families. The Quality
Account was also discussed with
shadow governors at the Trust’s
shadow Council of Governors’
meeting on 21 April 2011.
Quality Account 2010/11
Devon Partnership NHS Trust
Wonford House Hospital
Dryden Road
Exeter
EX2 5AF
Tel: 01392 403433
www.devonpartnership.nhs.uk
Ref number: 247/06/11