Knowsley Integrated
Provider Services
(KIPS)
Quality Account
2010 – 2011
Contents
Section Content
Part 1
Part 2
Part 3
Background and Introduction
1.1 Introduction to the 2010-11 Quality Account
1.2 Statement from Chief Executive, Knowsley Health and
Wellbeing
1.3 KIPS Values
1.4 Supporting Statements (Appendix 1)
Page
Number
4
5
5
6
Looking Ahead for 2011-12
2.1 Quality Priorities for Improvement 2011-12
2.1.1 Commissioning for Quality and Innovation (CQUIN)
framework
2.2 Mandated ‘Assurance’ Statements
2.2.1 Care Quality Commission (CQC) Standards
Registration
2.2.2 Data Quality
2.2.3 Participation in Clinical Audits and Research
2.2.4 Engaging in Innovative Projects
8
9
10
Achievements against Quality Priorities 2010-11
3.1 Priority One - Effectiveness of Services
3.1.1 Implementation of NICE Guidance
3.1.2 Clinical Audit and Service Evaluation Activity
3.1.3 Wound Management Formulary
12
12
12
13
7
7
8
8
3.2 Priority Two - Stakeholder Experience
3.2.1 Engagement Activity within KIPS
3.2.2 Patient Advice and Liaison Service Data and Lessons
Learnt
3.2.3 Complaints and Compliments
3.2.4 Staff Survey Feedback
13
14
3.3 Priority Three - Patient Safety
3.3.1 Infection Prevention and Control
3.3.2 Incident Reporting
3.3.3 CQC Safety Standards
21
21
22
23
3.4 Continuous Improvement in Quality and Safety
3.4.1 CQC Trust Quality & Risk Profile
3.4.2 Clinical Quality Dashboard
23
23
23
KIPS Quality Account 2010-11
16
18
19
2
Section Content
3.5 Research & Innovation
3.5.1 Research Activity 2010-11
3.6 Response to issues raised by Regulators or Public
Representatives
3.6.1 Response to Podiatry Report Received from Knowsley
LINk
Page
Number
25
26
26
26
Summary
27
Glossary of Terms
28
List of figures and Tables
Figure / Table
Page
Number
Figure 1 Number of Patient Opinion Postings Received Per Month
2010-11
15
Figure 2 PALS Calls relating to KIPS Services 2010-11
17
Figure 3 Type of Incident Reported
22
Table 1
10
Completed National Clinical Audits
Table 2 KIPS Staff Survey Results 2010-11
20
Table 3 Group Affected by Incidents Reported
22
Table 4 Clinical Quality Dashboard Monthly Data Collection 2010-11
24
Table 5 Clinical Quality Dashboard Quarterly Data Collection 2010-11
25
Appendices
Appendix
Appendix 1 Supporting Statements
Page
Number
29
Appendix 2 CQUIN Targets
31
Appendix 3 KIPS Patient Survey Results 2010-11
32
Appendix 4 Action Plan Based on LINks Podiatry Report
35
KIPS Quality Account 2010-11
3
Part One – Background and Introduction
1.1
Introduction to the 2010-11 Quality Account for Knowsley Integrated
Provider Services (KIPS)
This is KIPS first Quality Account, covering our portfolio of services provided for
Knowsley residents and beyond. Working across a variety of services ranging from
Dietetics to District Nursing, Podiatry to Phlebotomy, Speech & Language Therapy to
School Health and Infant Feeding to Integrated Care, our multi-disciplinary, integrated
Health & Social Care teams care for people at every stage of life, from young babies to
people reaching the end of their lives. It has been another busy year, with KIPS
services having 746,909 contacts over 2010-11.
All providers of NHS Services are required to produce a Quality Account, under the
Health Act (2009), to demonstrate commitment to achieving high quality care for
everyone who uses or has potential to use services. KIPS Quality Account is published
in the format of a three-part annual report, which we will make available as a public
statement of our commitment to improving quality.
KIPS has undergone significant change during 2010-11. Under the Coalition
Government’s Transforming Community Services programme, Primary Care Trusts
(PCTs) can no longer be a direct provider of community health services. As a result,
community services from KIPS transferred to 5 Boroughs Partnership NHS Foundation
Trust on 1st April 2011, to enable the separation of our Commissioner and Provider
arms. Delivering high quality services and being flexible enough to adapt in a changing
environment is an essential part of our role and we have ensured that quality has
remained central to our work throughout this period of transition. Integration is taking
place in the widest possible sense throughout our provision to strengthen our existing
partnership with 5 Boroughs Partnership NHS Foundation Trust; working across
professional and organisational boundaries, and enabling us to offer new roles, multidisciplinary teams and joined-up health and social care to all of our stakeholders.
KIPS Quality Account gives us an opportunity to show you how quality underpins
everything that we do as an organisation in planning, delivering and monitoring
services. It demonstrates commitment to delivering the KIPS Vision and purpose, to:
‘ensure the optimum health and wellbeing for the people we serve through delivering a
choice of high quality, responsive services’.
The content of the Quality Account is a result of continuing partnership work with our
stakeholders. We look forward to continued ongoing engagement and involvement in
the quality agenda throughout all work streams during 2011-12.
Amanda Risino
Director of Knowsley Integrated Provider Services
KIPS Quality Account 2010-11
4
1.2
Statement from Acting Chief Executive NHS Knowsley & Chief Executive
Knowsley Metropolitan Borough Council
As Acting Chief Executive of NHS Knowsley, it is a pleasure to acknowledge the
commitment to quality and the drive to improve the lives of local people that underpins
the content of KIPS Quality Account for 2010-11.
It is fantastic to see the achievements within KIPS services over the last year and the
plans that KIPS have to sustain and build on quality, which will continue to reap tangible
benefits to service users, improving efficiency and reducing health inequalities.
In 2010-11 KIPS has been through a period of transition as part of the Government’s
Transforming Community Services programme. This Quality Account illustrates the
continued dedication of KIPS staff to maintaining quality services, while extensive
engagement with stakeholders, including staff and public through targeted and wideranging engagement processes has ensured that quality has been central to service
delivery and development.
I am also delighted to note KIPS continued dedication to integrated health and social
care provision through the Section 75 Partnership Agreement, which will uphold the
vision for improving people’s lives through the delivery of holistic services to Knowsley
residents and beyond.
Sheena Ramsey
Sheena Ramsey, Acting Chief Executive NHS Knowsley
& Chief Executive Knowsley Metropolitan Borough Council
1.3
KIPS Vision and Values
Our vision is to be the provider of choice in the delivery of integrated health and social
care provision. Our purpose is to ensure the optimum health and wellbeing for the
people we serve through delivering a choice of high quality, responsive services. Our
values are care, pride, responsibility, partnership, trust and professionalism.
Over 2010-11 KIPS worked to Knowsley Health and Wellbeing’s strategic vision for
local communities, which is that they will be more informed and involved in decisions
affecting them and experience better health and wellbeing.
KIPS values are reflective of those of the 5 Boroughs Partnership NHS Foundation
Trust, which are to:





Value people as individuals ensuring we are all treated with dignity and respect.
Value quality and strive for excellence in everything we do.
Value, encourage and recognise everyone’s contribution and feedback.
Value open, two-way communications, to promote a listening and learning
culture.
Value and deliver on the commitments we make.
KIPS Quality Account 2010-11
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1.4
Supporting Statements
In order to help demonstrate KIPS commitment to quality improvement, supporting
statements have been provided by:


Director of Knowsley Integrated Provider Services
Lead Commissioner (Knowsley Health and Wellbeing)
These statements are included as Appendix 1.
In addition, the Quality Account has been presented to the Local Involvement Network
(LINk) for comment and the Overview and Scrutiny Committee (OSC). LINk and OSC
comments are also included in Appendix 1.
KIPS Quality Account 2010-11
6
Part Two - Looking Ahead for 2011-12
2.1
Priorities for Improvement 2011-2012
KIPS looks forward to continuing to provide quality service to the Knowsley population
and beyond over 2011-12. We will continue to enjoy working closely with our partners
and stakeholders, including Knowsley LINk and our service users and public.
A KIPS Business Plan has been established for 2011-12, which sets out priorities for
improvement. KIPS 16 business objectives have been mapped to the 5 Boroughs
Partnership NHS Foundation Trust’s 8 Strategic Themes and in this way we can ensure
that specific actions and targets will also meet the 5 Boroughs Partnership NHS
Foundation Trust’s priorities.
There are a number of exciting projects developing over 2011-12. Examples include:

New Centre for Independent Living (CIL) - This provides a wide variety of
services which can help individuals to live an independent life. With its own open
plan showroom, patients and service users can drop in and try out a range of
stair lifts, chairs, beds, mobility, bathing and toileting equipment.

Care Campus - The purpose will be to manage people with complex health
and/or social care needs and to contribute to the overall plans to reduce health
inequalities, unscheduled admissions to hospital and improve self care and self
management throughout the Borough.

PARIS - This is the KIPS solution to ensure a move towards a single electronic
record for all service users.
2.1.1 Commissioning for Quality and Innovation (CQUIN) framework
A proportion of KIPS income for 2011-12 will be dependent on achieving quality
improvement and innovation targets agreed with NHS Knowsley as the Commissioner
through the Commissioning for Quality and Innovation (CQUIN) payment framework.
In 2011-12 CQUIN payments will be made for:








Improvements in “did not attend” (DNA) rates for specific services
Use of Brief Intervention opportunities with patients
Improvements in patient satisfaction and survey response rates
District Nurse Training in the use of MUST (Malnutrition Universal Screening
Tool).
Dementia Awareness training for applicable staff
Reasonable adjustments to services for people with learning disabilities
Establishing information about numbers of children requiring interventions and
support above the universal child health pathway.
Success of falls service in reducing A & E attendance for falls.
KIPS Quality Account 2010-11
7
2.2
Mandated ‘Assurance’ Statements
As part of our Quality Account, we are required to present a series of ‘mandated’
statements which serve to offer assurance that we are performing to national essential
standards for safety and quality and engaging in innovative projects.
During 2010-11 KIPS provided a wide variety of NHS services, the number of which is
subject to fluctuation according to securing / termination of contracts during the tender
process.
KIPS has reviewed all the data available to them on the quality of care in all of these
NHS services.
2.2.1 Care Quality Commission (CQC) Registration Standards
KIPS is required to register with the Care Quality Commission and its current
registration status is “Registered without conditions.”
The CQC has not taken enforcement action against KIPS during 2010-11.
KIPS has not been required to participate in any special reviews or investigations by the
CQC during 2010-11.
KIPS will form part of the 5 Boroughs Partnership NHS Foundation Trust’s CQC
registration during 2011-12.
2.2.2 Data Quality
KIPS will be taking the following actions to improve data quality:
KIPS has developed an over-arching data quality policy that will be underpinned by
system specific policies. These policies give explicit roles and responsibilities to staff in
order to ensure that everyone understands the importance of data quality and how is
specifically relates to their role.

NHS Number and General Medical Practice Code Validity
During 2010-11 KIPS did not submit records to the Secondary Uses service for
inclusion in the Hospital Episode Statistics which are included in the latest published
data.

Information Governance Toolkit Attainment Levels
Knowsley Health and Wellbeing has been required to complete an Information
Governance Toolkit on an annual basis, which includes both the provider (KIPS) and
commissioning arms of the organisation. For the purpose of the toolkit, the organisation
is referred to as Knowsley PCT.
KIPS Quality Account 2010-11
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The last assessment was completed in 2010-11 and Knowsley PCT’s Information
Governance Assessment report overall score was 80% and was graded red.
The percentage achieved for Knowsley PCT has increased by 4% in comparison with
2009-10 results, and results have shown an overall improvement since 2004 when the
PCT was first required to complete the toolkit.
A workplan has been drafted to further improve compliance over 2011-12, in
conjunction with 5 Boroughs Partnership NHS Foundation Trust. This will be approved
by the Trust Information Governance Committee.
The full Information Governance Assessment report is available online at:
https://nww.igt.connectingforhealth.nhs.uk/reportsnew.aspx?tk=406804462846341&cb=
c492748a-2bf7-4094-bf39-6690fe65e842&lnv=6&clnav=YES

Clinical Coding Error Rate
KIPS was not subject to the Payment by Results clinical coding audit during 2010-11 by
the Audit Commission.
2.2.3 Participation in Clinical Audits and Research

Clinical Audits
During 2010-11, six national clinical audits and 0 confidential enquiries covered NHS
services that KIPS provides.
The Department of Health clinical audits that KIPS participated in during 2010-11 are as
follows:


National Combined Audit of Falls and Bone Health in Older People
(organisational audit only).
National Audit of Psychological Therapies.
KIPS also participated in other national audits:




National Audit of Depression Detection and Management.
Improving Access to Psychological Therapies (IAPT).
National Audit of Continence Care 2010 - combined organisational and clinical
audit report.
National Audit of patient outcome following conservative spinal treatment.
The national clinical audits that KIPS participated in, and for which data collection was
completed during 2010-11, are listed in Table 1 alongside the number of cases
submitted to each audit as a percentage of the number of registered cases required by
the terms of that audit.
KIPS Quality Account 2010-11
9
Table 1 – Completed National Clinical Audits
National Audit
National Audit of
Depression
Detection and
Management of
Staff on Long-Term
Sickness Absence
National Combined
Audit of Falls and
Bone Health in
Older People
Multi-centre Audit of
Patient Outcome
Following
Conservative Spinal
Treatment
Number of
Cases
Required
Number of
Cases
Submitted
% of Required
Cases
Provided
Not specified
29
100%
Not applicable
(organisational
audit only)
Not applicable
(organisational
audit only)
Not applicable
(organisational
audit only)
Not specified
45
100%
The National Audit of Patient Outcome Following Conservative Spinal Treatment was a
pilot study which was completed in April 2011. The results will be continued into
another study and a report produced on completion.
A report has been produced following the National Audit of Depression Detection and
Management of Staff on Long-Term Sickness Absence. A meeting is planned to devise
an action plan.

Clinical Research
A number of patients receiving NHS services provided by KIPS in 2010-11 were
recruited during that period to participate in research approved by a research ethics
committee.
2.2.4 Engaging in Innovative Projects
A proportion of KIPS income for 2010-11 was conditional upon achieving quality
improvement and Innovation targets agreed between KIPS and any person or body they
entered into a contract, agreement or arrangement with for the provision of NHS
services, through the Commissioning for Quality and Innovation payment framework.
The CQUIN targets were aligned to Effectiveness of Services, Experience and Safety
and included:


Provision of brief intervention training to an agreed proportion of frontline staff
over set periods throughout 2010-11
Development of a community minimum dataset (Improving data collection and
quality of patient information)
KIPS Quality Account 2010-11
10



Development of an annual patient survey for KIPS
Improving clinical skill
Reduction in “Did Not Attend” appointments (missed appointments)
The breakdown of achievements against these targets for 2010-11 are included as
Appendix 2.
In addition to projects included within the CQUIN scheme, KIPS have engaged in a
range of other innovative initiatives including:

Skills for Health - Developing a better skilled more productive workforce to
improve not just productivity but also the quality of health and healthcare.

Intravenous Therapy in the Community - Delivery of Intravenous Therapy in
the home.

Telehealth - Delivery of health-related services and information via
telecommunications technologies.
KIPS Quality Account 2010-11
11
Part Three – Achievements Against Quality
Priorities 2010-11
This section of our Quality Account demonstrates our commitment to ensuring quality of
our services throughout 2010-11. It is presented within three overarching sections of
effectiveness of services, stakeholder experience and patient safety, which are based
on the three dimensions of quality set out in High Quality Care for All (2008).
3.1
Priority One – Effectiveness of Services
KIPS are dedicated to the delivery of high quality services which are clinically effective
and based on the best evidence available.
Clinical effectiveness is the extent to which specific clinical interventions do what they
are intended to do, i.e. maintain and improve the health of patients securing the greatest
possible health gain from the available resources
3.1.1 Implementation of National Institute for Health and Clinical Excellence
(NICE) Guidance
As part of our clinical effectiveness programme we are continually working towards the
implementation of all relevant NICE guidance.
NICE is the independent organisation responsible for providing national guidance on the
promotion of good health and the prevention and treatment of ill health. The quality of
services delivered by KIPS rely upon the local implementation of NICE clinical
guidelines, public health guidelines, technology appraisals and quality standards.
An identified lead for each service is responsible for liaising with the NICE
Implementation Programme Lead to ensure that the healthcare we provide is both in
line with the NICE recommendations and relevant to the patients we serve. All services
demonstrate their implementation through the completion of gap analysis exercises,
action plans and clinical audit. Implementation activity is recorded and reported to
ensure accountability. Significant progress was made during 2010-11 with all KIPS
teams becoming involved in the review of 60 clinical guidelines, 5 quality standards, 22
public health guidance topics and 49 technology appraisals. It is envisaged that the
NICE implementation programme will continue throughout 2011-2012.
3.1.2 Clinical Audit and Service Evaluation Activity
Clinical Audit is an essential component of our Clinical Governance arrangements.
Clinical Audit seeks to improve patient care and outcomes through systematic review of
care against explicit criteria and the implementation of change. Service evaluation is
used to define or judge current care by measuring the service without reference to a
standard, defined system or approach. Service evaluation measures the effectiveness
or efficiency of current practice or service which may include patient surveys.
KIPS Quality Account 2010-11
12
KIPS register all Clinical Audit and Service Evaluation projects on a project
management database enabling the Integrated Governance Team to support quality
assurance and monitor activity.
During 2010-11, a total of 144 Clinical Audits and Service Evaluations were completed
involving KIPS, which encompassed a wide range of services from each of the
divisions.
Within the current year 2011-12, 44 Clinical Audits/Service Evaluations are registered
as ongoing. Of those currently registered 4 are National Audit projects, 7 are based on
National guidelines and 8 against local guidelines. Those remaining are Service
Evaluation projects.
Action plans are requested on completion of all Clinical Audits to improve the quality of
local services and the outcomes of care.
3.1.3 Wound Management Formulary
A Wound Management Formulary was produced during 2010 to ensure continuous
quality improvement in prescribing and /or applying of wound care products. This is a
resource for health care professionals to use in their everyday practice to support
effective practice.
The formulary is intended to:





Promote the appropriate use of safe, effective and good quality dressings.
Reinvest savings in services / treatments for patients.
Help in the elimination of unsafe, ineffective or poor quality products by
identifying effective and safe products.
Support cost-effective utilisation of drug budgets and improve access to essential
medicines.
Meeting high Impact actions set by the Department of Health, e.g. “Your skin
matters.”
A Formulary Group has been developed to oversee development and monitoring of this
work. This ensures that there is a transparent and fair decision making process, with
representation from all relevant health care professionals.
3.2
Priority Two - Stakeholder Experience
Feedback from service users, families and carers provides an important source of
information about the quality of local healthcare services, as well as offering
opportunities for learning and improving the way we do things. The NHS Constitution
(2010) sets out responsibility of the public and service users to give feedback about
treatment and care they have received, both positive and negative. This section sets
out some examples of how KIPS have shown commitment to supporting people to
provide such feedback and have acted on this to improve services.
KIPS Quality Account 2010-11
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3.2.1 Engagement Activity within KIPS
Ongoing proactive targeted engagement has continued to grow within KIPS teams over
2010-11. Engagement has included a range of activities including information provision,
surveys, user groups / focus groups, public meetings / events and consultations
including a variety of activities. KIPS evidence engagement on Knowsley Health and
Wellbeing’s Record of Engagement Activity and Consultations (REACT) tool to support
ongoing monitoring and evaluation, including equality and diversity monitoring.
Some examples of engagement in KIPS include:

Generic Patient Survey
A Generic Service User Survey was designed for use within KIPS to gather data related
to service user satisfaction and perception of using services, coordinated by the Audit
team. This helped to gather insight about the quality of services provided and whether
standards were met. The survey asked questions based on standards from the
“Essential Standards of Quality and Safety” (2010) Outcome 16, which requires services
to assess and monitor quality. A total of 35 services took part in the survey. A list of the
participating services is provided in Appendix 3.
A total of 2927 surveys were either given or posted out to patients with a self addressed
envelope and a covering letter. Of these 1212 were returned, generating a response
rate of 42%.
The full results are set out in Appendix 3.
Overall, there was over 90% compliance for every question, except for two, which were:


“Were you given any information/advice on any other areas or available
support?”
“If you wanted to make any comments/suggestions or complaints about your care
would you know who to contact?”
Reports for each individual service have been compiled to support action planning.
Progress against action plans, including the two areas identified above with less than
90% compliance will be monitored through future survey work and ongoing engagement
activity.

Care Cards
The Care Cards model is built on the principle of “no decision about me without me” as
set out in the Equity and Excellence: Liberating the NHS (2010) white paper and
supports the principles of the NHS Constitution in terms of the NHS values and fostering
an open and honest culture in teams.
The Care Cards model was piloted within the Reablement Team and Community
Therapy Team as part of an overall pilot coordinated by the Strategic Health Authority
(SHA).
KIPS Quality Account 2010-11
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The Care Cards support staff to find out what aspects of care are important to people
accessing their services and to monitor individual service user experiences.
The pilot has generated useful feedback to support future development of the Care
Cards in other KIPS services.

Patient Opinion Postings
‘Patient Opinion’ enables patients and the public to express their views and opinions
about health and social care services. Patients can chose how they access Patient
Opinion from a variety of options, ranging from online, telephone or postal access.
Once received, individual feedback is posted onto the Patient Opinion website,
available at: www.patientopinion.org.uk.
The aim of Patient Opinion is to support organisations in shaping service delivery in a
way that is responsive to patients’ views. It is also part of ongoing evaluation of patient
experience and satisfaction monitoring.
Since September 2010, Patient Opinion has been positively promoted for feedback
regarding all Knowsley Walk-in Centres based in Kirkby, Huyton, and Halewood.
The following graphs highlight the number and nature of postings received in relation to
KIPS from 1st September 2010 to 31st March 2011:
Figure 1 – Number of Patient Opinion Postings Received Per Month, 2010-11
Postings incorporated a range of feedback, including stories, reviews, thanks to
services and suggestions for improvement. By sharing their opinions, service users and
members of the public have supported continued service improvement.
KIPS Quality Account 2010-11
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Having identified the benefits of using Patient Opinion within one particular service for
encouraging service user feedback, consideration is now being given to its further
promotion and development across KIPS.
3.2.2 Patient Advice and Liaison Service (PALS) Data and Lessons Learnt

Background:
PALS is a confidential information and advice service for patients, relatives, carers and
NHS staff. Work is carried out in accordance with the requirements of the National Core
Standards for PALS. PALS offer a bespoke and responsive service which evolves in
accordance with the needs and wishes of people using health and social care services.
PALS is an open-access service to which patients and the public can self refer.

The Complaints / PALS Interface
Following the revised Complaints procedure introduced in April 2009, PALS may refer
cases to the complaints route where the issues or concerns raised by the service user,
family member or carer cannot be resolved through informal mediation within one
working day or where the individual explicitly states that they wish to make a complaint.
Similarly, the Complaints Manager may refer cases to PALS where it is felt that the
issues could be resolved within one working day (as long as an agreement is reached
with the individual that this is the appropriate route).

Learning from PALS
By listening to people voicing their experiences about health and social care services,
PALS can facilitate early resolution to concerns and act as ‘an early warning system’.
PALS plays a pivotal role as part of a learning and responsive culture.
Delivering a quality service is an integral part of the PALS service model. Fundamental
to this is the emphasis placed on looking beyond the immediate ‘close out’ of a referral
to consider if there are steps which can be taken to avoid reoccurrence.
In order to demonstrate service changes and improvements arising from PALS work, a
‘Learning from PALS’ section is included as a standard item in each PALS report.
PALS work resulted in a significant number of service improvements during the year.
The improvements covered a wide of services ranging from Integrated Community
Equipment Services (ICES) to Phlebotomy services. The following highlights just two
examples of various service improvements:
□ Diabetes Patients
Following a call to PALS it transpired that some diabetes patients were fasting
unnecessarily when attending phlebotomy clinics. NICE guidance Type 2 diabetes: the
management of diabetes (2008) recommends that a fasting lipid sample is only
necessary if the random triglycerides are raised. Although the relevant clinical staff had
previously widely circulated the recommendation, it was considered prudent to re-issue
KIPS Quality Account 2010-11
16
the information. Further awareness was raised by including the information in the
Medical Directors Bulletin.
□ Outpatient Appointment Letters
A Practice Manager recently contacted PALS following an incident whereby a
registered patient was confused after receiving an outpatient appointment letter from a
local hospital. The letter stated that in line with hospital policy, it had been assumed
that the patient no longer wished to attend outpatients and had therefore been removed
from the waiting list. The standard letter was unclear to patients and GP surgery staff.
PALS liaised with the relevant hospital staff from the Health Informatics Service.
Standard outpatient letters have now been amended to include information which is
clear and concise.

KIPS Report:
From the 1st April 2010 to 31st March 2011 the PALS Service received a total of 138
calls in relation to KIPS.
The calls fall within the three main service areas of Targeted Services, Promoting
Health & Wellbeing and Children’s Services and Locality Services.
Figure 2 – PALS Calls Relating to KIPS Services
KIPS 2010 - 2011
(Total 138 calls)
120
100
80
60
40
20
0
Series1
Targeted Services
Promoting Health & Wellbeing Children
Services
Locality Services
101
19
18
The majority (101 calls) related to Targeted Services (the largest service area) and
included queries about:






Walk-in Centre Services
Podiatry/Orthotics
Phlebotomy Service
Occupational Therapy
Physiotherapy, Continuing Healthcare
ICES (Integrated Community Equipment Services).
The remaining 37 calls in respect of KIPS were spread over the two service areas
relating to Promoting Health & Wellbeing and Children’s Services (19 calls) and Locality
Services (18 calls).
KIPS Quality Account 2010-11
17
3.2.3 Complaints and Compliments
If people wish to make a complaint, we always aim to put things right by acting quickly,
honestly and fairly, and all KIPS staff are committed to acting swiftly to resolve concerns
and complaints as close to the source of the problem as possible. Our Comments,
Complaints and Feedback system is flexible and customer focused and provides
individuals with the choice of either speaking to the person directly involved in their care
or the manager of the service in question or, if they feel unable to do this by contacting
the Patient Advice and Liaison Service (PALS) or the Complaints Manager.
Clients, service users, families and carers can be expected to be treated with dignity
and respect whilst their complaint is being investigated and their preferred outcome,
rather than systems and processes will determine how their case is managed.
NHS Knowsley’s Board received quarterly reports on patient feedback which identified
particular trends and themes and took an active role in ensuring that improvements in
quality, innovation, productivity and prevention were made as a result of learning
outcomes from complaints.
In 2010-11, 101 complaints were managed relating to KIPS. Local handling of these
cases were guided by the Parliamentary and Health Service Ombudsman’s ‘Six
Principles of Remedy’ which are:
1.
2.
3.
4.
5.
6.
Getting it right
Being customer focused
Being open and accountable
Acting fairly and proportionately
Putting things right
Seeking continuous improvement
Although a number of individuals approached the Parliamentary and Health Service
Ombudsman to request a review of their complaint, no formal reviews concerning
Knowsley based healthcare services were conducted in the financial year 2010-2011.

Key Complaints Themes
Monitoring and analysis of complaints for 2010-2011 has identified the following four
key themes:
1.
2.
3.
4.
Frequency/lack of service
Clinical treatment/outcomes
Appointment systems
Communication/administration
KIPS Quality Account 2010-11
(18%)
(17%)
(12%)
(10%)
18
Learning from complaints and making people’s experience count is usually what all
parties seek as an outcome, and identifies ways in which we can improve the way we
do things. Particular areas where we have used complaints to improve services are as
follows:




Ongoing audits of record keeping standards across all clinical disciplines
Improving of triage process and referral pathway for Musculoskeletal Clinical
Assessment Service (MCAS)
Improved communication systems and interface between community and
secondary care services
Positive Feedback Regarding Our Health and Wellbeing Services
Compliments and positive feedback should be celebrated and we are always grateful to
hear and read positive things about our services, staff and achievements. Compliments
lift the morale of staff, as they can then see for themselves the differences they have
made to people’s lives through their hard work and professionalism. We ensure that
feedback is disseminated to staff to show that their hard work and dedication is valued.
Like complaints, compliments were monitored and reported regularly to NHS
Knowsley’s Board. This year, we received a total of 695 compliments and positive
comments, one example was:
“I have completed a pain management course today and it has changed my life in
many ways. I can’t thank the staff enough. I have benefited so much from the
course and constantly tell people who are in pain to get themselves on this course”.
(Comment from a ‘Tell Us What You Think’ Leaflet).
3.2.4 Staff Survey Feedback
The Department of Health highlight that it is crucial to have a workforce that is up to
date and fit to practice to ensure safe, effective and respectful care. KIPS recognise
the importance of understanding the needs of their workforce, which is reflected in the
KIPS Business Plan.
KIPS staff have taken part in a national staff survey annually since 2003, with the last
survey conducted in September 2010. The survey is carried out to understand the
experience of the NHS workforce and determine the effectiveness of Human Resources
policies.
An overall 2010-11 report for NHS Knowsley is available on the CQC website at:
http://www.cqc.org.uk/publications.cfm?fde_id=17425
The survey is extensive, with 45 questions, plus additional sub-questions covering a
range of eleven domains. The following is a summary of results for KIPS services in
relation to each of the domains:
KIPS Quality Account 2010-11
19
Table 2 – KIPS Staff Survey Results 2010-11
Comparison with Other Trusts /
Units
Unit scores compared to other Units
on issues relating to work life
balance are generally more positive.
Comparison Against 2009-10
Results
Overall, Unit scores compared
to last year on the resources to
deliver are mixed.
Unit scores compared to other Units
on issues relating to training are
generally less positive.
Overall, Unit scores compared
to last year on training have
fallen back.
Unit scores compared to other Units
on issues relating to support to do a
good job are generally more positive.
Overall, Unit scores compared
to last year on support to do a
good job remained about the
same.
The
organisation
Unit scores compared to other Units
on issues relating to staff views
about their job are generally more
positive.
Unit scores compared to other Units
on issues relating to the organisation
are generally more positive.
Overall, Unit scores compared
to last year on staff views about
their job remained about the
same.
Overall, Unit scores compared
to last year on the organisation
remained about the same.
A worthwhile
job & the
chance to
develop
Unit scores compared to other Units
on issues relating to a worthwhile job
and the chance to develop are
generally less positive.
Overall, Unit scores compared
to last year on issues relating to
a worthwhile job have fallen
back.
Errors, near
misses &
incidents
Unit scores compared to other Units
on issues relating to errors, near
misses and incidents are generally
more positive.
Unit scores compared to other Units
on issues relating to violence,
bullying and harassment are mixed.
Overall, Unit scores compared
to last year on errors, near
misses and incidents are
mixed.
Overall, Unit scores compared
to last year on violence,
bullying and harassment have
generally improved.
Unit scores compared to other Units
on issues relating to occupational
health and safety are more positive.
Overall, Unit scores compared
to last year on occupational
health and safety have
remained about the same.
Infection
control &
hygiene
Unit scores compared to other Units
on issues relating to infection control
and hygiene are generally more
positive.
Overall, Unit scores compared
to last year on infection control
and hygiene have remained
about the same.
HSE stress
audit
The level of stress suffered by staff
at the Unit is lower than the level of
stress in the same type of Trusts
across the country.
Domain
Work-life
balance
Training
Managers &
appraisals
About the job
Harassment,
bullying &
violence
Occupational
health &
safety
KIPS Quality Account 2010-11
20
KIPS will use the results of the survey to action plan. Information that the survey
provides will be included within performance management and contract monitoring
processes.
3.3
Priority Three - Patient Safety
3.3.1 Infection Prevention and Control
KIPS consider prevention and control of infection, and basic hygiene critical to good
management and quality assurance of clinical practice. Infection prevention and control
reduces the risk of healthcare associated infection for all health care users and staff.
Knowsley has an Infection Prevention and Control team to support this process, who
‘quality assure’ infection prevention and control activity of KIPS, advising and supporting
both managers and practitioners in protecting themselves and their population. The
team carry out regular audits to assess the level of compliance and quality of care
delivered by KIPS in respect of Infection Prevention and Control.
KIPS submits provider assurance framework data on a monthly basis, which is linked to
ensuring CQC standards compliance and a full framework quarterly. No issues have
been raised by the Commissioners regarding any elements of the framework.
Over 2010-11, Methicillin-resistant Staphylococcus aureus (MRSA) trends locally show
a fall in line with national trends reported by the Health Protection Agency.




From December 2010 to March 2011 there were no community acquired MRSA
bacteraemias reported to the Infection Prevention and Control team in Knowsley.
There was one community acquired Methicillin-sensitive Staphylococcus aureus
(MSSA) which is currently under investigation.
Early indications are that there are no notifications of clostridium difficile relating
to KIPS services.
From December 2010 to March 2011 there have been eight outbreaks of gastro
intestinal illness in four schools and four care homes. Specimen results and trend
analysis indicated that this was due to norovirus. All areas were contacted by the
Infection Prevention and Control team and procedures put in place for the
management of the outbreaks. All were of relatively short duration and are now
resolved.
The new focus for 2011 onwards will be other healthcare acquired infections and the
two main organisms being monitored from April 2011, which are multi resistant e coli
and MSSA.
The Governance department are working to produce an audit tool/quality improvement
tool to be used by all KIPS services. Regular meetings are taking place with KIPS
Infection Prevention and Control team and 5BP Infection Prevention and Control team
to look at the feasibility of combining the audits to follow the same audit programme.
KIPS Quality Account 2010-11
21
3.3.2 Incident Reporting
KIPS is committed to promoting a culture in which we can learn from what has
happened and look ahead to see how the same things can be prevented or controlled in
the future where necessary. We aim to promote an environment which encourages
staff to report all untoward incidents, ranging from potential incidents (i.e. near misses)
and actual incidents to serious untoward incidents (SUIs). Such incidents may affect
patients, staff and/or others such as visitors to Trust premises, patients, relatives etc.
Effective reporting, management and investigation of incidents means that Management
and Staff can be alerted to areas of potential risk at an early stage and can take
appropriate action to avoid reoccurrence, ensuring that the care provided is as safe as
possible.
The following provides a breakdown of the 589 incidents reported in relation to KIPS
services over 2010-11:
Figure 3 – Type of Incident Reported
Type of Incident
17%
33%
Other Incidents
Accidents
Clinical Incidents
28%
Security Incidents
22%
Table 3 - Group Affected by Incidents Reported
Group Affected by Incidents Reported
Staff
Patients
Other
Total
Number of Incidents
228
285
76
589
All incidents were reported to the Risk Management Committee and Health & Safety
Committee.
A total of 51 incidents were reported to the National Patient Safety Agency (NPSA).
The NPSA are an Arm’s Length Body of the Department of Health covering the UK
Health Service. The agency has a role in informing, supporting and influencing
KIPS Quality Account 2010-11
22
organisations and people working in the health sector, leading on and contributing to
improved, safe patient care.
A total of 10 incidents were reported via the Reporting of Incidents Dangerous Diseases
/ Occurrences Regulations (RIDDOR – Over 3 Day Injuries reported to the Health and
Safety Executive).
3.3.3 CQC Safety Standards 2010-2011
In April 2010 the CQC introduced a new registration system for providers and with effect
from 1st October 2010, every provider of health and adult social care services in
England has a legal responsibility for making sure it meets 16 essential standards of
quality and safety. NHS Knowsley successfully registered its provider services (without
condition) to deliver ‘regulated’ activities such as nursing care; personal care; treatment
of disease, disorder or injury and services in slimming clinics.
KIPS has not been required to participate in any special reviews or investigations by the
CQC during the reporting period.
3.4
Continuous Improvement in Quality and Safety
Throughout 2011-12, ongoing measurement will be undertaken of the 2010-11 quality
priorities included in section three of this document. This will provide the basis for
comparisons to enable us to demonstrate year on year improvement for each selected
quality priority.
3.4.1 CQC Trust Quality and Risk Profile
Quality and Risk Profiles are produced by the CQC on a monthly basis. They gather
relevant information about quality and risk in one place to enable assessment of
potential risks and prompts any front line regulatory activity from the CQC, such as
inspections. Quality and Risk Profiles also support continuous monitoring of compliance
for commissioner and provider services.
The Quality and Risk Profiles for KIPS has been utilised to gather relevant information
about quality and risk on a monthly basis. This has supported assessment of potential
risks and continuous monitoring of compliance for commissioner and provider services.
3.4.2 Clinical Quality Dashboard
High Care Quality for All (2008) set out requirements for ensuring that quality is at the
heart of everything that the NHS does. This involves measuring quality of services
against specific quality indicators. KIPS collects monitoring information against a
significant number of nationally and locally determined standards. An example of some
of the monthly and quarterly data collected over 2010-11 is highlighted in Tables 4 and
5.
KIPS Quality Account 2010-11
23
N: Number of
Appointments
or contacts that
were DNA’d in
the contract
month
D: Total
number of
Appointments
or contacts in
the contract
month
expressed as a
%
Percentage of
home
equipment
delivered within
5 working days
or time from
referral for
assessment of
need for
equipment at
home
% of monthly
contract activity
reports
submitted by
contract
deadline.
Apr
10
May
10
Jun
10
Jul
10
Aug
10
Sep
10
Oct
10
Nov
10
Dec
10
Jan
11
Feb
11
Mar
11
5.68
%
5.86
%
6.45
%
5.95
%
5.95
%
5.52
%
5.19
%
4.52
%
5.94
%
4.88
%
4.43
%
4.49
%
99
%
Data unavailable
Indicator
Description
Data unavailable
Table 4 – Clinical Quality Dashboard Monthly Data Collection 2010-11:
100
%
99
%
100
%
99
%
100
%
100
%
99
%
100
%
100
%
100
%
100
%
100
%
100
%
100
%
100
%
100
%
100
%
100
%
100
%
100
%
100
%
KIPS Quality Account 2010-11
24
Table 5 – Clinical Quality Dashboard Quarterly Data Collection 2010-11:
Indicator Description
Percentage of people discharged from hospital
and benefiting from intermediate
care/rehabilitation enablement still living at
home 3 months after discharge from hospital
(Data Provided is for NI 125: Achieving
independence for older people through
rehabilitation/intermediate care)
Percentage of women sustaining breastfeeding
to 6-8 weeks after delivery.
(Totally Breast Fed + Partially Breast Fed / All
Women In Cohort)
3.5
Q1
Q2
Q3
Q4
77.78
%
79.41
%
81.02
%
Not Yet
Available
19.11
%
16.74
%
20.95
%
Not Yet
Available
Research & Innovation
As part of Knowsley Health and Wellbeing, KIPS maintained an excellent track record of
high quality research management and governance over 2010-11 with responsibility for
a diverse portfolio of research. Throughout this period we continued to improve on our
Research Governance systems process.
To support Research & Development a comprehensive R&D strategy was produced
with the following aims:




To promote high quality research that is relevant to the corporate objectives and
goals of Knowsley Health & Wellbeing.
To build the organisation’s capability through collaborating with Institutes of
Higher Education in multi-centre research projects registered with the National
Institute for Health Research and develop and secure funding for high quality
PCT-led projects.
Encourage and facilitate the use of research and evidence-based information by
clinical and non-clinical decision makers across the organisation and the wider
NHS.
To endorse the local implementation of the NHS Research Governance
Framework (2005) and to be fully compliant with the CQC requirements, and in
doing so safeguard the rights and well being of patients, the public and staff
undertaking and participating in research projects.
Governance arrangements ensure all research within the organisation is conducted to
the standards, principles and requirements defined within the national Research
Governance Framework for Health and Social Care.
External audits of the research governance process are carried out by the Cheshire,
Wirral and East Mersey Research Partnership (CHAMP) for selected projects to ensure
that the required standards are met. It was acknowledged that the organisation
performed particularly well providing assurances that we fully met the required
governance standards for these projects.
KIPS Quality Account 2010-11
25
3.5.1 Research Activity 2010-11
Between April 2010 and March 2011, 26 projects were approved for Knowsley Health &
Wellbeing by the Clinical Governance Audit & Research Sub-Committee. Examples of
approved research projects included:



3.6
Parents’ Experiences with Paediatric Asthma Services in Knowsley MBC.
Reducing Inequalities in Cervical Cancer Prevention: Will Uptake Of Human
Papillomavirus Vaccination Follow The Same Pattern As Cervical Screening?
Understanding the views of health care professionals towards alcohol
consumption and the impact on the provision of alcohol advice to patients and the
public.
Response to Issues Raised by Regulators or Public Representatives
3.6.1 Response to Podiatry Report Received from Knowsley LINk
A special interest group was formed via the LINk Core Group in June 2009 with the aim
of reviewing work conducted by the Patient and Public Involvement Forum between
2005-2008 investigating perceptions of Podiatry services, particularly access to the
service.
The LINk Special Interest Workgroup for Podiatry worked with the LINk support team to
conduct a survey across the borough. The survey was the same tool used by the
Patient and Public Involvement Forum to enable comparison between results and
consider progress. Approximately 650 surveys were distributed to existing forums, with
151 returned by the close of the survey period. In addition, anecdotal data was
collected through discussions with individuals across the borough to form case studies.
A report was presented to the Knowsley Integrated Provider Board in March 2010. The
findings indicated that there were few negative comments relating to treatment received
by the Podiatry service; however issues were raised concerning the appointment
system and referral criteria. The report made various recommendations based on the
findings of the investigation.
KIPS welcomed the publication of the report. A planning group was established to
consider the issues raised and the report recommendations. An action plan was
developed, based on Quality, Innovation, Productivity and Prevention (QIPP) principles
which included short-term and long-term actions.
A full copy of the action plan is included as Appendix 4.
KIPS Quality Account 2010-11
26
Summary
This Quality Account demonstrates our dedication to the delivery of high quality,
clinically effective and evidence-based services. Some positive examples set out are:
 Continued development of service user and public engagement within KIPS
services over 2010-11 and gathering of evidence utilising the REACT database.
 Learning from patient experience through gathering, listening and responding to
ongoing feedback. This has included working closely with the Knowsley LINk
around Podiatry services.
 Development of a number of innovative projects.
 Significant progress around implementation of NICE Guidance.
 Continued development of an extensive Clinical Audit and Service Evaluation
programme to monitor and improve services.
 Favourable scores on aspects of the annual staff survey.
The Quality Account has highlighted areas for development over 2011-12, for example:
Aspect for Improvement
Two aspects of the staff survey compare
less favourably to results achieved for
2010-11, including worthwhile job and the
chance to develop and training.
KIPS will endeavour to further improve on
the Information Governance Assessment
results achieved for 2010-11.
Continued improvement in Data Quality
Reporting
Information / advice given to service users
regarding other services or available
support (highlighted through generic
satisfaction survey)
Service user knowledge of who to contact
if they would like to make comments /
suggestions or a complaint about their
care (highlighted through generic
satisfaction survey)
Four key complaints areas for 2010-11
include: frequency / lack of service, clinical
treatment / outcomes, appointment
systems, communication / administration
KIPS Quality Account 2010-11
Action to be Taken
Action plans to be developed to address
the two aspects, which will be monitored
through ongoing surveys.
A workplan has been drafted to further
improve compliance over 2011-12, in
conjunction with 5 Boroughs Partnership
NHS Foundation Trust. This will be
approved by the Trust Information
Governance Committee.
Implementation of Data Quality Policy.
Action plans developed to address this
aspect, which will be monitored through
ongoing surveys.
Action plans developed to address this
aspect, which will be monitored through
ongoing surveys.
Ongoing monitoring via feedback, e.g.
from complaints, PALS, engagement
activity and Patient Opinion.
27
Glossary of Terms
5BPFT
A&E
AHP
CHAMP
CHC
CIL
CQC
CQUIN
DNA
FNC
HCAI
IAPT
KIPS
LEAN
LINk
MCAS
MRSA
MSSA
MUST
NHS
NHSLA
NICE
NPSA
OSC
OT
PAG
PALS
PARIS
PCT
PHWCS
QIPP
QRP
REACT
RIDDOR
SUIs
5 Boroughs Partnership NHS Foundation Trust
Accident and Emergency
Allied Health Professional
Cheshire, Wirral and East Mersey Research Partnership
Continuing Health Care
Centre for Independent Living
Care Quality Commission
Commissioning for Quality and Innovation
Did Not Attend
Funded Nursing Care
Healthcare Acquired Infection
Improving Access to Psychological Therapies
Knowsley Integrated Provider Services
Service Improvement Methodology (not an acronym)
Local Involvement Network
Musculoskeletal Assessment Services
Methicillin-resistant Staphylococcus aureus
Methicillin-sensitive Staphylococcus aureus
Malnutrition Universal Screening Tool
National Health Service
National Health Service Litigation Authority
National Institute for Health and Clinical Excellence
National Patient Safety Agency
Overview and Scrutiny Committee
Occupational Therapy
Professional Advisory Group
Patient Advice and Liaison Service
Electronic Patient Care Record (not an acronym)
Primary Care Trust
Promoting Health and Wellbeing Children’s Services
Quality, Innovation, Productivity and Prevention
Quality Risk Profile
Record of Engagement Activity and Consultation Tool
Reporting of Incidents Dangerous Diseases / Occurrences
Regulations
Serious Untoward Incidents
KIPS Quality Account 2010-11
28
Appendix 1: Supporting Statements
In order to help demonstrate KIPS commitment to quality improvement, the following
supporting statements have been provided:

Director of KIPS Written Statement and Signature
I confirm that to the best of my knowledge the information in the 2010-11 Quality
Account is accurate.
Amanda Risino, Director of Knowsley Integrated Provider Services
Registered as the responsible person for KIPS with the CQC.

Lead Commissioner for Knowsley Health and Wellbeing
Written Statement and Signature
On behalf of Knowsley Health and Wellbeing, the Lead Commissioner for KIPS
Community Services, I would like to recognise and acknowledge the progress made in
the drive to deliver high quality care and services.
The submitted Quality Account represents the commitment and effort to date and the
recognition regarding areas of focus for service improvement. Moving forward there is
an enthusiasm to improve Quality, Innovation, Productivity and Prevention services to
improve the delivery of care received by the people of Knowsley using the services.
As Assistant Director of Commissioning for Community Services and Lead
Commissioner for the contractual arrangements, I can confirm that to the best of my
knowledge this Quality Account is a true and accurate reflection of the 2010-2011
progress KIPS has made against the identified quality standards. The Provider has
complied with all contractual obligations and has made good progress over the last year
with evidence of improvements in key quality measures such as Commissioning for
Quality and Innovation (CQUIN) indicators.
Knowsley Health and Wellbeing is supportive of the process KIPS has taken to engage
with service users, carers, staff and stakeholders in developing a set of quality priorities
and measures for 20110/12 and the commitment to advancing this quality improvement.
Michelle Creed
Assistant Director of Commissioning (Community Services)
*Knowsley Health and Wellbeing is a partnership between NHS Knowsley and Knowsley Council's
Directorate of Wellbeing Services, incorporating social care, leisure and cultural services.
KIPS Quality Account 2010-11
29

Comment from Knowsley Local Involvement Network (LINk)
Knowsley LINk is pleased to be able to provide a comment on Knowsley Integrated
Provider Service (KIPS) Quality Account for 2010 – 11. This response was completed
following the review of a draft copy of the Quality Account and formal presentation to
LINk members to provide further information on the content of the Account.
KIPS have responded positively to amendments LINk members suggested to their draft
report. The Service appears to have made every effort to ensure the Quality Account is
accessible to the public, through the use of a comprehensive glossary and context
setting.
For the past 12 months, Knowsley LINk has had the opportunity to work closely with
KIPS predominantly through work concerning the Podiatry service. This work has
allowed Knowsley LINk to both recommend and support changes to the service, to be
integral in the LEAN review of the service, as well as one LINk member observing the
appointment system over the course of a day to understand the system as well as the
pressures the service is under. The contribution of LINk has been welcomed and
encouraged and a strong working relationship has been established. It is hoped that
this working relationship will enable the LINk to be involved in future service reviews.
The Knowsley LINk members involved in reviewing the Quality Account felt that the
account was an honest reflection of Knowsley Integrated Provider Services strengths
and areas for improvement. Areas for challenge for which Knowsley LINk are keen to
work with the Provider Service over the next 12 months are particularly concerning
effective communication and complaints, and is willing to provide any necessary support
to ensure improvement in this area.
Knowsley LINk are pleased to see that KIPS have successfully transitioned over to the
5 Boroughs Partnership, however LINk will be keen to monitor KIPS to ensure that the
move will not adversely affect service provision, and also to monitor how the Service
progresses over the next 12 months in the faces of the current challenges.
Knowsley LINk looks forward to building on the work completed so far and providing an
ongoing critical friend relationship.

Comment from Councillor Bob Swann, Chair of Health and Wellbeing Scrutiny
Committee, Knowsley Council:
“Thank you for your invitation to contribute to the Knowsley Integrated Provider Services
Quality Account. This year, the Health and Wellbeing Scrutiny Committee will not be
providing a commentary on the content. This is because it feels that it cannot
adequately reflect on the information contained within the document. However, the
Committee would welcome future engagement with the Trust in order to inform
commentary for next year’s Quality Account.”
KIPS Quality Account 2010-11
30
Appendix 2: CQUIN Targets 2010-11
A proportion of KIPS income during 2010-11 was conditional upon achieving quality
improvement and Innovation targets agreed with NHS Knowsley as the Commissioner
and through the Commissioning for Quality and Innovation payment framework.
The CQUIN targets were aligned to effectiveness of services, experience and safety
and included:
Goal
No.
1
2
3
4
5
Indicator Name
Community
Minimum Dataset
Brief Intervention
Training
Patient Survey
Improving Clinical
Skill
Reduction in DNA
Quality
Domains
Indicator
Weighting
Achievement
Effectiveness
0.50%
Partly achieved
Effectiveness
0.25%
Achieved
Experience
0.25%
Achieved
Safety
0.25%
Partly achieved
Experience
0.25%
Achieved
Partially Achieved Targets:
The Community Minimum Dataset payment was achieved against all services included
in the requirement except District Nursing. The slight delay in the implementation of the
electronic patient care system PARIS for District Nursing led to a reduction in income for
this target. PARIS will be implemented by June 2011 for District nursing.
KIPS achieved half of the payment for improving clinical skill mainly due to a difficultly in
establishing the training information required to submit to commissioners. The
recognition of the difficulty in establishing training attendance has led to the
development and implementation of an electronic management system for 2011-12.
KIPS Quality Account 2010-11
31
Appendix 3: KIPS Patient Survey Results 2010-11
The following tables present the full results from the 2010-11 KIPS Generic Satisfaction
Survey.
Did the staff in the service treat you with dignity and respect?
Dignity and Respect
Yes
No
Not stated
No
1202
9
1
%
99.17
0.74
0.8
No
1203
5
4
%
99.26
0.41
0.33
Did the staff listen carefully to you?
Listen Carefully
Yes
No
Not stated
Did you have confidence/trust in the staff caring for you?
Confidence
Yes
No
Not stated
No
1199
9
4
%
98.93
0.74
0.33
Did you feel you had sufficient time to discuss your care with the staff?
Sufficient Time
Yes
No
N/A
Not stated
No
1189
16
1
6
%
98.10
1.32
0.50
0.08
Did you receive clear explanations of treatments/actions from the staff caring for you?
Clear Explanations
Yes
No
N/A
Not stated
KIPS Quality Account 2010-11
No
1199
8
1
4
%
98.93
0.66
0.33
0.08
32
Did you receive clear answers to any questions you may have had?
Clear Answers
Yes
No
N/A
Not stated
No
1113
12
56
31
%
91.83
0.99
2.56
4.62
Were you given any information/advice on any other services or available support?
Given Information
Yes
No
N/A
Not stated
No
894
245
7
66
%
73.76
20.21
5.45
0.58
Did you think you would have benefited from information/advice on other services or
available support?
Benefited from Information
Yes
No
No
73
166
%
30.54
69.45
Were you as involved as you would have liked to be in the decisions about your care?
Involved in Decisions
Yes
No
Not stated
N/A
No
1130
20
57
5
%
93.23
1.65
4.70
0.41
Overall are you satisfied with the care that you have received?
Overall Satisfied
Yes
No
Not stated
No
1171
8
33
%
96.62
0.66
2.72
If you wanted to make any comments/suggestions or complaints about your care
would you know who to contact?
Know who to Contact
Yes
No
No would ring CCN
Not stated
KIPS Quality Account 2010-11
No
950
199
1
62
%
78.38
16.42
5.12
0.08
33
List of Services Participating in the Generic Survey
Service
District Nurses North
District Nurses South
District Nurses Central
Out of Hours
Community Matrons
Older Peoples Nurse Advisors
Intermediate Care
Continence team - Adults
Continence team – Paediatric
Funded Nursing Care – FNC &
CHC
Community Macmillan Team
Podiatry
Dietetics
Speech and Language Therapy
Pulmonary Rehab
Learning Disability Nurse Mental
Health
Mental Health and Wellbeing
Mental Health
Substance Misuse (PHWCS)
Health Visiting & Nurse
Clinicians
School Health
Integrated Children’s Therapy
Integrated Children’s Therapy
OT & Physiotherapy
Specialist Paediatric Nurses
Special School Health
MCAS
Phlebotomy Home Visits
Phlebotomy Clinic Visits
Weight Management
Young Peoples Smoking
Cessation
Community Health Development
Team
Community Cooks
Walk in Centre
KIPS Quality Account 2010-11
Surveys
Given/Posted
90
90
100
20
45
1
61
100
45
55
Returned
Surveys
25
29
40
7
21
1
61
36
14
15
Response
Rate
28%
32%
40%
50
100
9
150
119
4
18
100
9
40
67
4
36%
100%
100%
27%
56%
100%
8
491
59
90
7
68
49
90
88%
14%
83%
100
60
200
7
52
61
7
87%
31%
100%
50
116
300
7
16
17
118
7
32%
15%
100%
43
19
25
43
19
25
100%
100%
100%
100
18
18%
50
263
7
121
14%
46%
47%
100%
36%
31%
29%
34
Appendix 4: Action Plan Based on LINks Podiatry Report
1. Responses to
the case studies
2. Short term quick
gains for
immediate
implementation
within the
immediate
capacity of the
Podiatry service
Actions
Complete responses to case
studies
Responsible Officer
Head of Podiatry
Timescale
April 2010
Progress
Achieved 27/04/10
 Development of new Podiatry
service Leaflet
Head of Podiatry
Principal Podiatrist
Achieved Printing costs
May 2010
being obtained
Leaflet completed
and ratified by
AHP PAG on
25/5/2010,
awaiting final
ratification by
Targeted Services
Governance Group
before
dissemination.
 Review and amendment of the
Podiatry patient referral form
Head of Podiatry
Principal Podiatrist
June 2010
To be agenda item
at Podiatry Service
User Group on
8/6/2010
Discussed and
agreement made to alter
procedure for referral to
include provision for
podiatry admin team to
complete referrals over
the telephone for anybody
that had difficulty filling in
the referral form.
 Issue of how we best
communicate the needs based
rationale for differing waiting
times for initial and ongoing
appointments to be discussed
with Podiatry Service User
Group.
Head of Podiatry /
Principal Podiatrist
June 2010
To be agenda item
at Podiatry Service
User Group on
8/6/2010
Current clinic waiting
times, standard item for
Patient Focus Group.
Individual clinic waiting
times discussed with
explanation of rationale
for waits.
3. Medium term
actions that
require more
significant service
redesign and
require additional
support from
within KIPS.
4. Actions that do not
lie fully within the
scope of KIPS
which require a
partnership
approach with
commissioners.
 Information to be compiled
regarding access to local
Private Practitioners; to be
available on request from the
Podiatry Service
Head of Podiatry /
Principal Podiatrist
a. Identify resource for Lean
review of Podiatry referral
management and
appointment system
Assistant Director:
June 2010
Targeted Services
Head of Podiatry
Head of Transformation
LEAN Project Team
assembled including
representation from
LINks.
b. Assemble Lean Project team
Head of Podiatry
June 2010
Action Plan formed and
progress reported at
Podiatry Patient Service
User Group in March
2011.
c. Implement Lean process
Assistant Director:
Targeted Services
Head of Podiatry
Head of Podiatry
August 2010
Ongoing progress against
this action plan to be
reported into this group.
Ongoing updating of
Caseload Profiling –
working through caseload
and newly referred
patients.
a. Complete service re-profiling
report
KIPS Quality Account 2010-11
June 2010
June 2010
Database updated
with information as
at end of April
2010. Data report
updated.
Confirmation received
from Integrated
Governance regarding
issues related to
information that
constitutes a
recommendation of
Services by the PCT
information to be
compiled within this
guidance.
36
b. Arrange service discussions
with community
commissioning team.
Assistant Director:
Targeted Services
Re-profiling report
to be updated.
July 2010
Service Review
undertaken by Knowsley
PCT Commissioners.
c. Identify options for Podiatry
service delivery models
including appropriate access
criteria to the service.
Assistant Director:
Targeted Services
Head of Podiatry
Integrated
Commissioning team
October 2010
Report / Desk Top Self
Assessment completed
and submitted December
2010 by Service.
KIPS Quality Account 2010-11
37
Your Feedback
KIPS is grateful to all those who have contributed to and supported development of our
Quality Account for 2010-11.
We would appreciate your feedback about this document to support development of our
Quality Account in Partnership with 5 Boroughs Partnership NHS Foundation Trust over
2011-12.
If you would like to comment, have further questions or are interested in getting involved
in having your say about your local health and wellbeing services, please contact:
Michelle Standing
Engagement and Involvement Manager
Integrated Governance Department
Knowsley Integrated Provider Services
2nd Floor
Nutgrove Villa
Huyton
Knowsley
L36 6GA
Telephone: 0151 244 3455
Email: Michelle.Standing@5bp.nhs.uk
If you require this document in Braille, large print
or another language please call the Patient Advice
and Liaison Service (PALS) on 0800 073 0578.
Knowsley Integrated Provider Services Headquarters
Anita Samuels Centre
4 Ellison Grove
Huyton
L36 9GA
Telephone: 0151 244 3470
www.5boroughspartnership.nhs.uk