NHS Blackpool Community
Health Services
Quality Account
1st April 2010 to 31st March 2011
Contents
Section 1 - Chief Executive’s Statement of Quality
5
Section 2 - Looking Forward - Priorities and Proposed initiatives for 2011 / 2012
6
Section 3 - Looking Backwards - Review of 2010 / 2011:
8
The effectiveness of services
Participation in Clinical Audit
9
Participation in Clinical Research
10
Goals agreed with commissioners - use of the CQUIN payment framework
10
Productive Community Services
12
Data Quality
14
Primary Intermediate Mental Health Team Award
15
The experience of people who use our services
Patient Experience Events 2010 / 2011
16
Compliments and Complaints 17
The safety of services
Incident Reporting
19
Introduction of ‘Lessons Learned Bulletin’
19
Infection Prevention 20
What others say about NHS Blackpool Community Health Services
Care Quality Commission 21
NHS Litigation Authority Level 1 Assessment 21
2010 National NHS Staff Survey
22
Statements from the Local Involvement Network, NHS Blackpool Commissioners and
Blackpool Council Health Overview and Scrutiny Committee
3
4
Section 1
Chief Executive’s
Statement of Quality
This Quality Account is written for
members of the public, patients
and staff so that they can share
in our service experiences over
the last 12 months and know
our plans for the forthcoming
year. Quality accounts are annual
reports to the public from
providers of NHS healthcare
about the quality of services they
deliver.
NHS Blackpool Community Health
Services is an organisation which has
a strong commitment to improving
the quality of care provided.
As an organisation we strive to ensure
that the quality of healthcare is at
the very centre of everything we do
and aim to exceed the expectations
of our service users by learning and
improving on our performance.
During 2010 / 2011 Blackpool
Community Health Services was the
provider arm of Blackpool Primary
Care Trust and delivered integrated
community health services to the
population of Blackpool and some
surrounding areas.
From September 2011 Blackpool
Community Health Services will
transfer along with NHS North
Lancashire Community Health
Services to the local Foundation Trust,
Blackpool Teaching Hospitals NHS
Foundation Trust, as a result of the
Transforming Community Services
Programme.
This has been a challenging year as
the organisation continues to work
hard to provide the best possible
care for service users and carers
in Blackpool. The focus has been
on continuously improving the
organisation’s performance and
ensuring consistently high standards
in all service areas.
The focus on quality will continue as
the services provided to the people of
Blackpool improve to meet the needs
of the diverse local communities. We
remain committed to understanding
the views and experience of our
patients and commissioners thus
allowing them to shape the services
we provide.
We readily acknowledge that our
ability to deliver the quality and safety
agenda rests on the co-operation and
commitment of our staff, patients and
other stakeholders and would like
to say “thank you” to all those who
have worked with us thus far.
Our approach is to encourage,
support and empower our staff to
strive for excellence in their work.
The focus of this report is on the key
components of quality as described
by Lord Darzi:
• The effectiveness of services
• The experience of people who use
our services
• The safety of services
The organisation has made good
progress in developing services and
there are numerous examples of
excellent practice contained within
this Quality Account. The challenge is
to make this best practice evident in
all areas of service provision.
2011 / 2012 will continue to be
challenging in an increasingly tight
financial environment, although
patient safety, positive patient
experience and effectiveness of
services will remain paramount.
Blackpool Community Health Services
are very proud of the hard work of
our staff, and the improvements
they have helped us to introduce.
Nevertheless there is still much
more to do and we will continue to
support our staff to be innovative in
developing and enhancing services.
We will review our progress
continuously, noting any changes in
national and local circumstances and
assess our delivery against all our key
strategic objectives.
We hope you share our quality beliefs
- and that you will continue to see us
make a real difference in Blackpool
and the surrounding areas.
The Trust Board has approved this
account as a representative picture
of the status of quality within the
organisation.
Wendy Swift
Liz Holt
Chief Executive NHS
Blackpool
Director of Community
Health Services
5
Section 2
Looking forward
Priorities and Proposed Initiatives
for 2011 / 2012
In selecting our priorities for
quality improvement for the
forthcoming year, we have
concentrated on areas which are
both a priority and where the
organisations performance could
be improved.
• 48 hour target to access sexual
health services
• Continue to implement the
Productive Community Services
Programme (See page 12 for full
description)
• Choice of where to die for patients
who are at the end of their lives
(Preferred place of death)
• Introduce real time patient
experience questionnaires
• Reduction in pressure ulcers
grades 3 & 4
• Reduction in Methicillin-resistant
Staphylococcus aureus (MRSA) &
Clostridium difficile
• Reduction in Urinary Tract Infections
6
Quality
Improvement
Area
Quality
Improvement
Target
Quality Improvement Measure
Clinical
Effectiveness
48 hour target to
access sexual health
All first attendances at the Genito-urinary medicine (GUM) service
to be seen within 48 hours of contacting the service. (This is part of
national reporting that the Department of Health requests to ensure
anyone who contacts the GUM service is seen within 48 hours, they
only ask that we count first attendees, however this also includes
rebook patients. A rebook patient is someone who has accessed
the service previously for an episode of care, has been discharged
and then re-attends for further screening or advice).
Clinical
Effectiveness
Productive
Community Services
Implementation
Services to complete at least one Productive Community Services
module and provide evidence that they are working towards
another during 2011 / 12. This will ensure our services are
implementing LEAN techniques to improve service delivery. (LEAN
Management is a process improvement technique. ‘LEAN’ is a way
to reduce waste using an approach that centres around creating
value for customers).
Patient Experience
Choice of where to die
The service will record the number of patients on their caseload
who die and the proportion of these who have been facilitated
to die in their preferred place of death. (By introducing nationally
recognised end of life documentation, staff are encouraged to ask
the patients preference of place to die).
Preferred place of
death
Patient Experience
Introduce real time
patient experience
questionnaires
Within a number of our services we will introduce real time patient
experience questionnaires to ensure we capture more accurately
the views of our service users. (Real time patient experience enables
patients to capture their own personal experiences of their visit to
our services, before they leave the building).
Patient Safety
Reduction in grade 3
& 4 pressure ulcers
Increase the number of patients with a waterlow score of 15 or
above to have a Malnutrition Universal Screening Tool (MUST
Tool) completed. This is important to ensure our patients are not
malnourished which can affect wound healing.
Increase the number of patients with a grade 2 pressure ulcer
to have had a Malnutrition Universal Screening Tool (MUST Tool)
completed.
80% of community nursing staff to complete pressure ulcer
training.
Training to incorporate preventing / treating pressure ulcers and
National Institute for Health and Clinical Excellence (NICE) guidance.
Reduction in the number of hospital admissions / hospital
attendances for patients requiring tissue viability care. Our aim is to
provide high quality care in the community.
Patient Safety
Methicillin-resistant
Staphylococcus Aureus
(MRSA) & Clostridium
Difficile (c difficile)
All confirmed cases of Methicillin-resistant Staphylococcus Aureus
(MRSA) & Clostridium Difficile are reported and investigated. A
very low number of cases each year are identified as having been
acquired through contact with the Blackpool Community Health
Services. This position must be monitored and maintained and
will be reported to the Infection Control Prevention Committee.
Trajectory for 2011 / 2012 is less than 5 MRSA reported incidents.
Patient Safety,
Clinical
Effectiveness and
Patient Experience
Reducing Urinary Tract
Infections
Increase the number of staff trained to carry out male and female
catheterisation.
Develop a catheter care leaflet in line with National Institute for
Health and Clinical Excellence (NICE) guidance (2006) for
patients / carers.
7
Section 3 Looking Backwards
Review of 2010 / 2011:
Strong leadership is essential
within a successful organisation
and as reflected in our strategic
objectives, our Board is committed
to ensuring that we provide safe
quality care to the people who
use our services.
8
During 2010 - 2011 NHS Blackpool
Community Health Services provided
17 NHS services.
NHS Blackpool Community Health
Services has reviewed all the data
available to them on the quality of
care in 17 of these NHS Services.
The income generated by the NHS
services reviewed in 2010 - 11
represents 100% per cent of the
total income generated from the
provision of NHS services by NHS
Blackpool Community Health Services
for 2010 / 2011.
The Effectiveness of Services
Participation in
Clinical Audit
Clinical audit is used as a driver
for improvements in quality
and we aim to ensure that all
clinical professional groups
participate in clinical audit.
We recognise that clinical audit
is a key component in the
Community Health Services
quality assurance system and have
invested in providing clinicians
with sufficient support to enable
them to participate in both
national and local audits.
The clinical audit team provides
assistance throughout the
organisation by co-ordinating the
annual clinical audit programme
and maintaining a database of the
national and local audit projects
undertaken by the organisation.
Table illustrating some of the improvements we have made through
audit projects
Audit title
Improvement
End of Life
Records Audit
Increase in the number of patients seen by
community nurses in the dying phase commenced on
the Liverpool Care Pathway.
Increase the use of just in case boxes. To improve
access to medication and remove delays for patients
in the dying phase. (Just in case boxes are drug
boxes that provide drugs which may be required
immediately at the end of life).
Audit of NICE
Depression
Guidelines
Introduce a validated scoring tool for measuring
depression for use by all clinicians as agreed by IAPT
(Improving Access to Psychological Therapies).
Currently in the process of establishing group based
Cognitive Behavioural Therapy.
Audit of Feverish
Illness in Children
- NICE guidelines
In 100% of cases the temperature is recorded.
In 100% of cases allergies are recorded.
In 100% of cases parents / carers are provided with a
safety net.
(A safety net is the provision of support for patients
in whom the clinician has some uncertainty as to
whether the patient has a self-limiting illness and
is concerned that their condition may deteriorate.
The safety net may take a number of forms, such as
dialogue with the patient or carer about symptoms
and signs to watch for, advice about when to seek
further medical attention, review after a set period,
and liaising with other healthcare services).
All children with “red” features are referred to a
paediatric specialist.
Oral antibiotics are not prescribed to children without
apparent source (children with no known focus of
infection and no symptoms or signs of serious illness).
Paracetamol and Ibuprofen are never prescribed
together in accordance with NICE guidance.
Antipyretic agents are never prescribed to prevent
febrile convulsions in accordance with NICE
guidance).
Audit of Falls Risk
Assessment
Increase in the use of the Falls Risk Assessment Tool
and Increase in falls discussions being documented in
clinical records.
Audit of Trust
Waste Policy for
District Nursing
Waste Policy for District Nursing has been reviewed
and rewritten.
Audit of District
Nursing Well Leg
Clinic
Evidence based wound care is delivered at the Well
Leg Clinic.
Audit of staff
training passports
Managers and staff are more aware of the
importance of attending mandatory training and
ensuring all staff have access to training passports.
MUST
(Malnutrition
Universal
Screening Tool)
Audit District
Nursing
Increase the number of service users who have a
complete nutrition screening undertaken.
During 2010 / 2011 there were
two national clinical audits and
no confidential enquiries covering
the NHS services provided by NHS
Blackpool Community Health
Services.
During that period NHS Blackpool
Community Health Services
participated in 100% of the
national clinical audits that we
were eligible to participate in and
no national confidential enquires.
The national clinical audits that
NHS Blackpool Community Health
Services was eligible to participate
in during 2010 / 2011 are as
follows:
• National Audit of Psychological
Therapies - Royal College of
Psychiatrists
• National Audit of Falls and Bone
Health in Older People - Royal
College of Physicians
The reports of 91 local clinical
audits were reviewed in 2010
/ 2011 and NHS Blackpool
Community Health Services
intends to take the following
actions to improve the quality of
healthcare provided as a result of
the findings from these audits.
9
Participation in
Clinical Research
The number of patients receiving
NHS services provided or
sub-contracted by NHS Blackpool
Community Health Services in
2010 / 2011 that were recruited
during that period to participate
in research approved by a research
ethics committee was zero.
Goals agreed with
commissioners - Use
of CQUIN payment
framework
Commissioning for Quality and
Innovation (CQUIN) aims to embed
quality as the ongoing principle for
NHS services and place quality at
the heart of every organisation.
A proportion (1.5%) of NHS
Blackpool Community Health
Services income in 2010 / 2011 was
conditional on achieving quality
improvement and innovation goals
agreed between NHS Blackpool
Community Health Services 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.
Further details of the agreed goals
for 2010 / 2011 and the following
12 month period are available
electronically at:
www.institute.nhs.uk/world_class_
commissioning/pct_portal/cquin.
html
CQUIN Goals for 2010 / 2011
CQUIN 1 was a regionally mandated goal and the others were agreed locally.
Goal
Goal description
CQUIN 1
Improve data collection and quality of patient
information in order to optimise service delivery
CQUIN 2
Implement “You’re Welcome” criteria
CQUIN 3
Improve End of Life Care
CQUIN 4
Community Falls Screening Promotion
CQUIN 5
Brief Interventions Promotion
CQUIN 6
Productive Community Services Programme
CQUIN 7
Implement the Blackpool Service Experience Toolkit
CQUIN 8
Develop a wound care formulary
Within in 2010 / 2011 NHS Blackpool Community Health Services achieved the
majority of its CQUIN targets and achieved £322,212.50 payment.
CQUIN Scheme
CQUIN Total
Payment Achieved
CQUIN Scheme 1 (0.50%)
£110,347
Full Payment £110,347
CQUIN Scheme 2 (0.08%)
£17,655
Full Payment £17,655
CQUIN Scheme 3 (0.08%)
£17,655
Full Payment £17,655
CQUIN Scheme 4 (0.08%)
£17,655
Full Payment £17,655
CQUIN Scheme 5 (0.08%)
£17,655
50% payment £8827.50**
CQUIN Scheme 6 (0.525%)
£115,864
Full Payment £115,864
CQUIN Scheme 7 (0.075%)
£16,552
Full Payment £16,552
CQUIN Scheme 8 (0.08%)
£17,655
Full Payment £17,655
Total
£331,040
£322,212.50
** For CQUIN 5 it was decided that NHS Blackpool CHS would submit
any work that had been completed for this indicator. Upon receipt of this
evidence NHS Blackpool commissioners advised they would authorise a 50%
achievement against the indicator.
10
Improvements in quality as a result of undertaking CQUIN
CQUIN
Objective
Benefit
CQUIN 1
National target to improve data
collection and quality of patient
information in order to optimise
service delivery
The quality of the data has improved an
average of 96.8% as at the end of January
2011. Therefore the information we have
about our patients is more accurate leading
to fewer errors: e.g. letters being sent to the
wrong address.
CQUIN 2
Implementation of
‘You're Welcome’ criteria
Child & Adolescent Mental Health Services,
School Nursing and Dental Services
implemented the 'You're Welcome' criteria to
improve the quality of care for young people.
Connect Young People Services were very
pleased to be awarded the ‘You’re Welcome’
accreditation in 2010 - 2011, which shows their
commitment to providing services specifically
for young people across the Fylde Coast.
CQUIN 3
End of Life Care improvement
Within the organisation there has been a
targeted approach to End of Life care. We are
constantly striving to improve the care
provided to patients at the end of their life.
CQUIN 4
Community Falls Screening
promotion
As a result of the project, more patients in the
community are not screened using the falls
risk assessment tool.
CQUIN 5
Brief Interventions promotion
Brief interventions attempt to increase a
person's awareness of the potential problems
caused by alcohol, smoking and obesity.
CQUIN 6
"Community Productive" LEAN
process to increase face to
face contacts
All teams have commenced Productive Community Services modules. 2 showcase events
have been held in conjunction with the NHS
Institute for Innovation and Improvement
(See page 12 for full description).
CQUIN 7
Improving responsiveness to the
personal needs of patients
All services have held patient experience
events where patients have expressed their
opinion on the service they have used. This
allows us to improve the quality of the services
we provide.
CQUIN 8
Wound Care Formulary
As a result of developing the Wound Care
Formulary, patients now receive evidence
based care and there has also been a financial
saving associated with this project.
11
Productive Community Services
Productive Community Services is an organisationwide change programme which aims to help
systematic engagement of all front line teams in
improving quality and productivity. It is a practical
application of LEAN based techniques that aims to
increase the organisation’s capacity and capability
for continuous improvement. The modules are
listed below:
• Well Organised Working Environment
• Knowing How We are Doing
• Patient Status at a Glance
• Managing Caseload & Staffing
• Planning our Workload
• Working Better With Our Key Care Partners
• Agreeing the Care Plan with the Patient
• Standard Care Procedures
• Perfect Intervention
• Patient Perspective
Organising Stock Cupboards - (Well Organised
Working Environment) Module
The Well Organised Working Environment Module can
help ensure work areas positively contribute to the care
delivered, making better use of team space, saving time by
making it easier to find things.
The project involved organising the nursing stock
cupboards in all the nursing teams and as a result of the
project, stock is no longer being wasted, staff can find
what they need and an estimated saving of £39,016.22
has already been made his year.
Staff Activity - Knowing How We Are Doing Module
The Knowing How We are Doing Module leads to
an understanding of how to use facts and data to
demonstrate improvements. This also includes learning
which measures will become really useful to teams in
making decisions about how to make things better.
As a result of the project the nursing team:
• Met data input targets-many teams consistently
achieving 100%
• Have an accurate picture of activity
• Enabled staff to use information systems to review
caseload and reduce duplication
• Developed confidence in reporting system
• Enabled significant cost improvement
• Reduction in the use of bank staff
• Savings in clinical posts
• Reducing the number of patients waiting a long time
before receiving treatment.
ARC / Hoyle linking with the mental health team Working Better With Our Key Partners Module
With community services playing a crucial role in the
shape of the new NHS, and care shifting away from
acute services, the new Productive Community Services
programme from the NHS Institute for Innovation and
Improvement has been seen as a timely opportunity to
revitalise the workforce and increase NHS capacity to care
for patients in community settings.
Achieving the Productive Community Services Programme
Indicator (PCS) was a large part of NHS Blackpool
Community CQUIN scheme for 2010 / 2011 as it
accounted for 0.5% of the overall 1.5% CQUIN value.
Our target for CQUIN achievement was to ensure that
all community health services had started on the PCS
pathway by March 2011.
A total of 30 projects were completed by our services
during 2010 / 11 as part of The Productive Community
Services Programme.
In February and March 2011 we held two showcase events
to present the work that has been undertaken within
Community Health Services as part of this programme.
12
This project was undertaken as the Arc and Hoyle
Intermediate Care Centres were experiencing difficulties
accessing Mental Health services for their residents and
there was a lack of support for clients who presented with
challenging behaviour.
As result of the project, staff from ARC / Hoyle now have
regular supervision with the adult safeguarding lead and
have formed links with primary and secondary mental
health workers.
The Primary Care Mental Health Team now meet monthly
at ARC / Hoyle to discuss clients and quarterly with
secondary care. Clients are also now offered a psychiatric
review during their in-patient rehabilitation.
Clinic Time Changes - Planning Our Workload Module
The Planning Our Workload module is focused towards community teams who travel as part of their daily work.
As suggested in the module handbook, Sexual Health Services altered the concepts in the module to suit their services
but still focused on:
• Improving patient experience and access to the service
• Improving the balance of work across the team
• Ensuring planning was carried out at team level rather than individual level
Outcomes from this project included reviewing clinic opening times at Connect, a young people’s sexual health service
and Sexual Health Services based at Whitegate Health Centre, matching staffing levels to clinic activity to ensure busy
clinics were allocated more members of staff and training staff to the same level to provide consistency across all sexual
health services.
Community Nursing Wound Formulary Standard Care Procedures Module
The Standard Care Procedures module helps to
standardise the clinical care we deliver. As a result
of this project a robust, evidence based wound care
formulary prescribing guide for Community Nursing
staff was produced. The guide ensures all patients
who require wound care treatment receive the best
quality care.
The introduction of the formulary has delivered an
18% cost reduction against last year’s costs.
Compliance
Since the formulary was launched in July 2010,
Community Health Services prescribers have
consistently met and exceeded the formulary target.
The target is to achieve 80% compliance with the
wound care formulary to ensure all patients receive
the same high quality care. This has been tightly
managed with prescribers being advised if they have
missed or been close to missing their formulary
target.
Apr-10
May-10
Jun-10
Jul-10
Aug-10
Sep-10
Oct-10
Nov-10
Dec- 10
Jan-11
Feb -11
Mar-11
58%
61%
62%
69%
83%
82%
85%
86%
86%
89%
90%
90%
13
Data Quality
Good quality information
underpins the effective delivery
of patient care and is essential if
improvements in quality of care
are to be made. Improving data
quality, which includes the quality
of ethnicity and other equality
data, will thus improve patient
care and value for money.
NHS Blackpool Community Health
Services will be taking the following
actions to improve data quality:
• Increase recording of NHS numbers
• Increase recording valid postcodes
• Increase recording GP
practice codes
• Increase recording valid
contact methods
A series of data quality reports
including data quality monitoring
and patient level reports have been
developed over the last 12 - 18
months. Using the information
reported a series of high priority data
items were identified, which needed
to be resolved urgently. Discussions
with commissioners also identified a
number of high priority data items.
In order to improve the quality of
these data items the Information
Department has engaged with each
service, showing them their data
quality performance and identifying
the best approach to deal with the
data quality issues. This has seen the
quality of the data items within the
Community Minimum Dataset (MDS)
achieve almost 97% accuracy.
NHS Blackpool Community Health
Services was not subject to the
payment by results clinical coding
audit during 2010 / 2011 by the Audit
Commission.
Our score for information quality and
records management as assessed
using the information governance
toolkit was 80%. Trusts are rated
red, amber, green denoting level
of concern. This organisation is
compliant with the standard and
rated green.
NHS Blackpool Community Health
Services did not submit records during
2010 / 2011 to the Secondary Uses
Service for inclusion in the Hospitals
Episode Statistics which are included
in the latest published data.
14
Priority Data Items
100
% Valid NHS Numbers
50
99.7%
0
100
% Valid Post Codes
50
99.1%
0
100
% Valid Referral Dates
50
100%
0
100
% Valid GP Practice
Codes
50
85.6%
0
100
% Valid Contact
Methods
50
99.7%
0
100
% Valid Discharge Dates
50
100%
0
Primary Intermediate Mental
Health Team Award
Our Primary Intermediate Mental
Health Team were shortlisted
for a prestigious “Mental Health
and Wellbeing” award from the
NHS Institute for Innovation and
Improvement in October 2010
with their involvement with the
‘Think Family’ Initiative.
The ‘Think Family’ project is a
collaboration between various
agencies including the Police, Mental
Health Services and Children’s Services
that aims to support the families
within Blackpool who have the most
complex needs.
15
The experience of people
who use our services
One of the most important
aspects of quality relates to
patient experience. It is very
important to us that we seek the
views of our service users and
understand the experiences of the
people who use our services. This
feedback is invaluable in helping
support the development and
improvement of our services to
meet the demands and needs of
our service users.
Patient Experience covers a wide
range of aspects including travel and
access, waiting times for referral,
waiting times to be seen, how people
were spoken to and treated by staff,
cleanliness, whether they were
treated as an individual and treated
with respect and dignity. We use
different methods to collect patient
feedback about their experience and
use this to inform our improvement
work.
“Happy to come back
to the service in future”
with a number of patient experience
events being held throughout the
year.
The patient experience events have
resulted in a number of positive
changes being made to services and
action plans being developed to take
forward the changes suggested by
our service users.
“Would be happy to reuse
and recommend”
We have produced a separate report
detailing the patient experience
events and actions suggested but
below are a few of the comments
we have received. A full copy of the
patient experience report is available
by contacting the Governance Team
at NHS Blackpool Community Health
Services.
“Staff always nice to me”
“They make sure you get what
you came for and chase you up
afterwards if needs be”
We want our patients to receive
effective treatment from competent
staff using the latest technologies to
get the best outcomes.
There has been a huge emphasis put
on patient experience within NHS
Blackpool Community Health Services
“Staff friendly and made to feel
comfortable. No judgement or stigma,
was seen quickly so no waiting”
Patient Experience Events Held in 2010 / 2011
16
Service
Date of Event
Allied Health Professionals (Community Occupational Therapy
and Physiotherapy)
7th February 2011
Child and Adolescent Mental Health Services
9th February 2011
Community Nursing
7th December 2010
Connect
9th & 14th December 2010
Dental
30th September 2010
Health Visiting
15th, 16th, 17th Feb 2011
PIMHT
28th Feb, 1st March 2011
Sexual Health
6th & 8th December 2010
School Nursing
9th February 2011
Compliments
NHS Blackpool Community Health Services
encourages people to tell us about their experience
of using our service.
Compliments can be given either verbally or written if a
person has received a particularly good service from NHS
Blackpool Community Health Services.
Comments and compliments as well as complaints help
us in making decisions about the services we provide and
how we can improve them.
Service
2009 / 2010
2010 / 2011
Adult Mental Health
27
28
CAMHS
Child & Adolescent Mental Health Services
0
6
Community Nursing
239
192
Connect
1
11
Dental
0
35
Directorate
0
2
Health Visiting
22
15
Integrated Services
Community Occupational and Physiotherapy or Allied
Health Professional for consistency
8
18
School Nursing
11
9
Sexual Health
3
67
TOTAL
311
383
Complaints
All staff work hard to get things right, but
sometimes things do go wrong and if people are
not happy with the level of service received they
are encouraged to let us know in order that we can
better understand and improve our services.
Complaint handling co-ordination for NHS Blackpool
in 2010 / 2011 was delivered through a joint service
level agreement between Community Health Services,
Commissioners and the Customer Care Team based within
Blackpool Council.
All complaints are handled according to NHS Blackpool’s
complaints procedure and approved by the Trust Board.
With the introduction of new complaints handling
regulations in April 2009, NHS Blackpool Community
Health Services reviewed and revised complaints posters,
leaflets and training, led by the Governance Team. It is
considered that this proactive approach has led to an
increased awareness with both the public and staff on
“how to complain”.
NHS Blackpool Community Health Service complaints are
reviewed in detail with a Non Executive Director at least
quarterly through a Complaints Review Group, at which
recommendations for further actions are made.
Complaints are reviewed with individual service managers,
and are reported to our commissioners through the
contract monitoring process.
17
Complaints by service
2009 / 2010
2010 / 2011
Service
Verbal
(resolved
within 24 hrs)
Unresolved
verbal and
written
Verbal
(resolved
within 24 hrs)
Unresolved
verbal and
written
Adult Mental Health
0
0
0
0
CAMHS
5
4
9
6
CHS Admin
0
0
0
1
Community Nursing
1
7
5
5
Connect
1
0
2
1
Dental
0
2
0
1
Health Visiting
3
1
1
5
Community Occupational
and Physiotherapy or
Allied Health Professional
for consistency
0
1
0
0
School Nursing
2
3
2
0
Sexual Health
9
3
10
3
TOTAL
21
21
29
22
Reasons for complaints written and unresolved verbal complaints
Service
Child and Adolescent Mental Health
Services
Community Nursing
Dental
Sexual Health
18
Number in
Number in
2009 / 2010
2010 / 2011
Appointments
0
1
Communication
3
2
Clinical Treatment
0
3
Appointments
4
3
Attitude of Staff
1
0
Communication
2
1
Clinical Treatment
0
1
Attitude of Staff
0
1
Communication
0
1
Appointments
1
1
Attitude of Staff
1
0
Attitude of Staff
1
0
Communication
3
0
Appointments
1
0
Communication
2
1
Clinical Treatment
0
1
Patients Privacy
0
1
Category of Complaint
The safety of services
Incident Reporting
Blackpool Community Health Services reports all patient safety incidents to the National Reporting and
Learning System (NRLS) which is organised by the National Patient Safety Agency (NPSA).
The aim of the National Reporting and Learning System is to share learning nationally from incidents that occur locally.
We are a high reporter of incidents in comparison with other NHS organisations nationally which indicates we have an
open culture for reporting.
Blackpool Community Health Services supports a culture of incident reporting to allow us to learn from our mistakes.
Between 1st April 2010 and 30th September 2010 241 incidents were reported to the National Reporting and Learning
System. Thus putting us in the top 25% of reporters nationally.
Introduction of a
Lessons Learned Bulletin
In March 2010 the first issue of
a lessons learned bulletin was
published. The bulletin aims to
share learning amongst staff to help
prevent future mistakes.
The introduction of the lesson learned
bulletin has had a positive impact on staff
learning from incidents with the National
Staff Survey indicating a 7% increase
in the number of staff learning from
incidents and receiving feedback
Lessons learned is
produced monthly and
circulated to all NHS
Blackpool Community
Health Services staff.
19
Infection Prevention
Clostridium Difficile (c.difficile) and Methicillin-resistant
Staphylococcus aureus (MRSA) are two common bacterium that
can cause problems for our patients, and as a result patients
may develop a healthcare associated infection; (HCAI). These
can cause significant harm and in the worst cases cause pain,
anxiety and suffering. NHS Blackpool Community Health
Services are committed to delivering high standards of care and
patient safety through the delivery of high standards of infection
control in all our services. This is achieved through ensuring that
appropriate management arrangements are in place in relation
to HCAI and that effective prevention and control is embedded
into everyday practice and applied consistently by everyone. It is
important that good standards of infection control and careful
antibiotic prescribing are adhered to at all times to prevent
MRSA and C.difficile infections being spread to patients.
As an organisation we look at each case of MRSA bloodstream
infection and Clostridium difficile infections to understand how
this occurred and to identify any learning in order to prevent a
similar infection in other patients.
Information on infection control audit, outbreaks and incidents
are reported to the Trust Board at its monthly meetings.
We are proud of the way our staff have worked hard to reduce
healthcare acquired infection.
There have been no outbreaks of Clostridium Difficile or MRSA
in Community Health Services during 2010 / 2011.
20
What others say about NHS Blackpool
Community Health Services
Care Quality Commission
The Care Quality Commission
(CQC) is the independent
regulator of all health and adult
social care in England. Their aim is
to ensure better care is provided
for everyone, whether in hospital,
in care homes, in people’s
own homes, or elsewhere.
NHS Blackpool is committed to
delivering high quality healthcare,
and works closely with the CQC
to put people first and make real
quality improvements across the
services we provide.
In April 2010 it became a legal
requirement that all regulated
health and social care services are
registered with CQC and show that
they continually meet certain criteria,
known as the Essential Standards of
Quality and Safety. People can expect
services to meet essential standards
of quality and safety that respect their
dignity and protect their rights. They
are focused on outcomes, rather than
systems and processes, and place the
views and experience of people who
use the services at their centre.
any special reviews or investigations
by the CQC during the reporting
period.
As an organisation we continually
monitor each service we provide to
ensure that these standards are being
met and maintain our registration
status.
NHS Blackpool is required to register
with the CQC and its current
registration status is ‘fully registered
without conditions’. The CQC has
not taken enforcement action against
NHS Blackpool during 2010 / 2011.
NHS Blackpool has not participated in
NHS Litigation Authority
NHS Blackpool Community Health Services underwent an NHS Litigation Authority (NHSLA) level 1
assessment in March 2010.
The assessment was based on the NHSLA Risk Management Standards for Primary Care Trusts 2009 / 2010.
The organisation was assessed against five standards each containing ten criteria giving a total of 50 criteria. In order to
gain compliance at level 1 the organisation was required to pass at least 40 of these criteria, with a minimum of seven
criteria being passed in each individual standard.
The organisation scored as follows:
2 Competent &
3 Safe Environment
Capable Workforce
Standard
1 Governance
Score
8/10
8/10
Compliance
Achieved per
standard
Yes
Yes
4 Clinical Care
5 Learning from
Experience
8/10
9/10
7/10
Yes
Yes
Yes
Overall Compliance Achieved: 40 / 50
The scores indicate the organisation was successful in achieving compliance at level 1 of the NHSLA standards and as
such will receive a 10% discount from both the Clinical Negligence Scheme for Trusts and Risk Pooling Scheme for Trust
compliance.
21
2010 National NHS Staff Survey
The annual Staff Survey now forms part of the
Trust’s assessment by the Care Quality Commission
(CQC) on the premise that the staff experience of
NHSB as an employer has an impact on the patient
experience. NHS Blackpool Community Health
Services participated in the National staff survey
carried out by the Care Quality Commission.
within the top 20% of Trusts and higher than the national
average. This includes staff from the commissioning part
of NHS Blackpool.
The 2010 Survey is an excellent result again for NHS
Blackpool Community Health Services particularly against
the background of financial constraint and uncertainty
pervading from the end of 2010.
In the 2010 Survey almost 63% of staff took part
compared with 71% in 2009. Our return rate is still
Detailed below are the four key findings in which Blackpool PCT compares most
favourable with other PCT’s in England:
Percentage of staff reporting good
communication between senior
management & staff
50
Fairness & effectiveness of incident
reporting procedures
Effective
/fair
procedure
40
20
4
3
30
%
5
47
34
3.6
3.4
Blackpool
National Average
2
1
10
Ineffective
/unfair
procedure 0
0
Blackpool
National Average
Percentage of staff experiencing
physical violence from staff in the last
12 months (lower scores are better)
Work pressure felt by staff
(lower scores are better)
100
5
80
4
60
3
%
0
40
1
20
2.8
3.0
Blackpool
National Average
2
1
0
0
Blackpool
National Average
Four key findings where staff experiences have improved most at Blackpool PCT since the 2009 survey
22
Service
2009
2010
1) Percentage of staff appraised with personal development plans in last 12 months
65%
80%
2) Percentage of staff appraised in last 12 months
70%
84%
3) Percentage of staff reporting good communication
between senior management and staff
37%
47%
4) Fairness and Effectiveness of incident reporting procedures (higher scores are better)
3.5
3.6
Statements from the Local
Involvement Network, NHS
Blackpool Commissioners and the
Blackpool Council Health Overview
& Scrutiny Committee
In terms of overall quality, NHS Blackpool Community
Health Services have delivered positive outcomes against
the Commissioning for Quality and Innovation (CQUIN)
schemes during 2010 / 2011. The commitment to
quality has extended to national programmes such as
clinical audits; ranging from Childhood health to Waste
management.
Blackpool LINk welcomes the publication of the Quality
Account for NHS Blackpool Community Health Services. It
is good to read about the work that has been undertaken
in a readable format and we suggest that a ‘Glossary’
be included in next year’s report. Congratulations to the
Primary Intermediate Mental Health Team for their award.
Blackpool LINk are aware that a great deal of work has
been done in this area and look forward to working with
the team in the future as we feel there is still a lot to be
achieved. Blackpool LINk provided helpful comments in
relation to the clarity of the terminology used in the quality
account and these suggested changes have subsequently
been incorporated in the quality account.
During 2011 / 2012 NHS Blackpool Community Health
Services plan to build on the work undertaken during
2010 / 2011. We welcome the increased focus on
treating pressure ulcers. This focus will aim to ensure
effective treatment of all grades of ulcers, and improve
catheter care to reduce the discomfort associated
with incontinence. Improvements in end of life care, a
continued focus on reducing Health Care Associated
Infections and patient nutrition screening as part of home
visits will be fully supported during 2011 / 12.
The Health Overview and Scrutiny Committee were invited
to comment on the Quality Account but due to recent
local elections and a change in local government have
decided they are not in a position to comment.
NHS Blackpool Commissioning Comments
NHS Blackpool Commissioners welcome this first
publication of quality accounts in a simple easy to read
format. The detailed evidence of quality achievement
demonstrates that NHS Blackpool Community
Health Services is proactive in its cycle of continuous
improvement. The patient experience work evidences a
service that listens to patients views and acts on them.
The staff engagement in shaping services is evident in staff
survey responses, and nationally accredited Community
Productive Series (CPS) success. The CPS has supported
engaged staff, safer practices, clinically effective savings
and improved patient care.
We look forward to continued close working with
NHS Blackpool Community Health Services through
2011 / 2012 and development of integrated provision with
the Blackpool Teaching Hospitals NHS Foundation Trust.
How to Provide Feedback on the
Quality Account
We welcome any comments you may have on our first
Quality Account and ask you to become involved in
next year’s Quality Account by sharing your views and
experiences of using our services.
This can be done by contacting NHS Blackpool Community
Health Services on 01253 651200. Alternatively, you may
choose to write to the Director of Community Health
Services, The Stadium, Seasiders Way, Blackpool, FY1 6JX.
Additional copies can be downloaded from the website:
www.blackpool.nhs.uk
The increased number of compliments in 2010 / 2011
compared to 2009 / 2010 is evidence that patient
experience is improving. Add this to continued initiatives
related to patient and staff safety, NHS Blackpool
Community Health Services continues to develop a
learning culture, with regular staff updates on lessons
learned from projects and schemes delivered.
The safety of care is evident by the information
governance rating; which reflects both good practice
and high standards in the management of personal data.
This should give patients confidence during their time
in services. The quality of data reporting is to a high
standard, giving patients confidence that the service
performs well against its contract.
23
Health... at the heart of life in Blackpool
NHS Blackpool Believes in Access for All
To ensure services provided by NHS Blackpool are accessible
information is available upon request in a variety of formats including
large print, Braille, on audio cassette or computer disk. We can also
provide help for British Sign Language users and provide information in
languages other than English. Please ask for details from the addresses
or numbers listed.
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NHS Blackpool
Blackpool Stadium
Seasiders Way
Blackpool
Lancashire
FY1 6JX
Tel: 01253 651200
Fax: 01253 651210
Website: www.blackpool.nhs.uk
Email: firstname.lastname@blackpool.nhs.uk
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