Quality Account
Reporting period: 1st April 2012 to 31st March 2013
“I just wanted to say thank you.
My mother has just spent two weeks with you, and has received
magnificent care and support from everyone in the team.
When she was admitted two weeks ago, my father and she were
absolutely at the end of their ability to cope on every level. From
the original home visit and instant assessment of the gravity of
the situation, through to the day to day dedication of your
doctors, nurses, carers, physios, support team and volunteers,
we are in awe of the level of support provided.
The EllenorLions support has restored our belief in the presence
of both compassionate care and expert advice, and transformed
the situation.
Thank you.”
Thank you received from relative - March 2013
1
Part 1: Chief Executive’s Statement on Quality
EllenorLions Hospices supports the view that everyone in need should be enabled, by
good palliative care, to enjoy the best quality of life possible and to die in the manner
and place of their choosing.
EllenorLions has two key roles:
• to lead and coordinate the development of services, offering the best care for
people approaching the end of life and,
• where appropriate, to provide a comprehensive, high quality hospice care
service for children, adults and young people.
Care is provided
…..for all ages, from the very young to the very old
…..for all diagnoses – not just for cancer
…..to support all needs, physical, practical and spiritual
…..in all places, at home, hospital, care home or hospice
…..to all concerned, patients, carers and families
The organisation has a robust and open Clinical and Corporate Governance structure.
Risks, complaints and incidents are investigated thoroughly. Policy and practice are
amended as an outcome of learning and performance is managed accordingly. The
Trustees are provided with the information they require in order to carry out their
responsibilities. The Senior Executive Officers of the charity are in attendance at the
Board and Sub Committee meetings and there is regular contact between the CEO
and Chair of Trustees.
Patient and family experience is important to us and every comment, however
informal, is followed up. We strive to do the very best we can and are grateful to those
who help us identify improvements in our care. We participate in the national hospice
patient survey, as well as our own internal surveys, and have a suggestion box for
comments. We work on a no blame culture and encourage staff to feel able to identify
situations they are finding difficult.
Patient safety is ensured by a comprehensive programme of staff education and
support. The recent review and improvements to the incident reporting system means
that we can more quickly assess the root cause and the action and learning from
situations. All health and safety rules and guidance are observed, audited and a
report is available at the Governance and Risk committee. In the role of SIRO, the
CEO takes overall responsibility for all aspects of Information Governance and holds
current certification in this area. All staff and volunteers have training as part of their
regular updates and there are clear policies and procedures.
2
Clearly to have the best outcome our work needs to be clinically effective. The
restructure of multi disciplinary team meetings now allows for more joined up care
across the various settings and, supported by senior clinical staff, are an opportunity
for practice based learning and development.
This is our first set of Quality Accounts and I commend them to you as an honest and
open account of some key aspects of our work. I congratulate the Director of Patient
Care, Claire Cardy, and those who have supported her in the production of the
document.
Carol Stone
Chief Executive
5th June 2013
3
Part 2: Priorities for improvement 2013-2014
In developing the 2013-18 strategic plan for the organisation, particular attention was
paid to the rapidly changing health and social care environment. The Board looked at
how the hospice could extend its services to meet the growing needs of the local
population, enabling more people to receive care in the place of their choice.
Following our inspection against the Essential Standards of Quality and Safety by the
Care Quality Commission, there was one minor area for improvement identified. This
related to record keeping and an action plan has been developed to address this key
area. All other standards were fully met.
Following consultation with a range of stakeholders including patients, relatives, staff,
volunteers and trustees, EllenorLions Hospices confirmed the top four quality
improvement priorities for 2013 to 2014 to be as follows:
Future planning 2013-14
Priority 1: Documentation review
The organisation recognises the need to urgently review and streamline its record
keeping, to ensure improved accuracy and completeness of patient records.
How was this priority identified?
Our own internal audit process, and the most recent CQC inspection highlighted this as
an area for improvement, and senior managers reviewed the current practices. We
identified that the current patient records system is too complex and cumbersome, and
makes it more difficult for clinical staff to record patient care appropriately and effectively.
There has also been some degree of mismatch between electronic and paper records.
How will it be achieved?
A small working group is meeting to identify the priorities for patient records and to
simplify the structure of the current database, incorporating paper documentation as well.
It will also establish clear standards for record keeping and set out an improved audit
process to ensure effective monitoring and compliance with the standards. The standards
will include mandatory data fields which must be completed for each patient in a stated
time, including consent and risk assessments. The resulting streamlined system will also
improve data collection and reporting on activity statistics, as an additional benefit.
How will progress be monitored and reported?
The governance structure in the organisation has been amended to establish a
Documentation Standards group, to ensure that monitoring occurs at the right level and in
the right forum. The working group will report regularly against the development of the
new system to this over-arching governance group. It has also been recorded on the Risk
Register which is reviewed quarterly. Audits will be conducted on a monthly basis against
the standards, and reported to the Board of Trustees annually.
4
Future planning 2013-14
Priority 2 - Meeting Carers’ needs
The organisation is developing a co-ordinated approach to assessing and meeting the
holistic needs of carers, as one of its strategic priorities. This is in line with the NICE
quality standard for end of life care which states “families and carers of people
approaching the end of life are offered comprehensive holistic assessments in response
to their changing needs and preferences, and holistic support appropriate to their current
needs and preferences.”
How was this priority identified?
We looked at the guidance around carers’ needs, and reviewed the evaluation of the
ongoing carers’ programmes that we have been providing. The hospice already runs a
successful Carers’ Course with support from our Family Support Team and Day Therapy
nursing team. This has been extremely well evaluated by attendees, but only reaches a
small proportion of carers. We have identified this as a priority to develop to ensure that
other carers can also access appropriate support and help. We also offer respite care and
short breaks support for carers and have scope to develop this important area further.
How will it be achieved?
Assessing Carers’ Needs: We have been actively involved as part of a national
palliative care research project assessing the needs of carers. Nurses in the adult
hospice at home team are utilising a validated tool for assessing carers’ support needs
during the second phase of a national pilot study.
Carers’ Support: We are linking with external agencies locally, such as Carers First, to
utilise services that are already in place to help the carers of hospice patients.
A new carers’ drop-in session is being initiated, to enable carers to receive information
and signposting to support services, as well as to gain peer support and social contact.
Support for carers is also being introduced within the local Sikh community, with a carers
outreach session being planned at a Sikh day centre with translation services available. A
project to look at the specific needs of young carers is also being developed. We are also
reviewing the respite and short breaks we provide in the home and in day care settings,
across all our services, with a view to increasing and enhancing this support.
All these projects aim to give carers greater confidence to help them to deal with the
pressures of caring for someone with a life limiting illness.
How will progress be monitored and reported?
We will obtain feedback from carers accessing the new services and report this at the
Care Practice Group and to the Board of Trustees. The carers’ needs assessment tool is
being evaluated as part of the national research project.
5
Future planning 2013-14
Priority 3 - Achieving Preferred Place of Care
The organisation is continuing to develop a wide range of programmes and interventions
to enable more people to achieve their preferred place of care, and to be able to die in
their chosen setting. Patient choice is a key driver for the care we provide, and we have
been able to increase the proportion of our own patients who are able to die in their place
of choice. As a key influencer of improving end of life care for all, we wish to enable more
people in our local area to achieve their preferred place of care.
How was this priority identified?
We listened to patients and families and have responded to their needs to achieve choice
around place of care and death, as this is an important issue for them. We work in
partnership with other health and social care agencies in our local area, and are aware
that admissions avoidance is a key strategic aim for commissioners and providers across
the locality. We already have a high level of success of achieving preferred place of death
– around 86% of patients under our care are able to die in their place of choice, compared
to around 32% nationally. Our aim is to lead the spread of this good practice to enable
more people to achieve this, even if they are not directly under the care of our services.
How will it be achieved?
A number of service developments are underway to continue to improve the achievement
of this aim. These include:
Care homes support – we currently have a small team of staff who work with local care
homes to support and educate their staff in care at the end of life. This programme
promotes competence and confidence in staff in care homes, to enable them to have
conversations with patients and families at an early stage, recognise when someone is
dying, and advocate for them to avoid inappropriate hospital attendances. This project
has been shown to have a positive effect on admissions avoidance and achieving
preferred place of care. Funding will be sought to expand this work to enable a greater
number of care homes staff to be trained.
End of life crisis support service – this pilot project has been providing hands-on care
and emotional support in the home to people at the very end of life in a crisis situation, to
enable them to stay at home. It has shown a great deal of success in avoiding hospital
admission – 100% of professionals referring to the service stated they felt it enabled them
to stay out of hospital. It is currently funded for one year and the aim is to build a strong
enough evidence base to enable it to be funded long term, through the cost savings made
on avoided hospital attendance.
How will progress be monitored and reported?
We will continue to lead initiatives to enable this to be achieved, and spread awareness of
good end of life care through education and training. We will continue to keep records of
the work we do in these projects, and to demonstrate that patients are enabled to die in
their place of choice. Feedback from bereaved relatives and staff is collected and
analysed. This information will be reported through the End of Life Care Locality Steering
Group.
6
Future planning 2013-14
Priority 4 – Support for Young People
As a provider of both children’s and adult’s palliative care, the organisation is well-placed
to ensure good care through Transition from children’s to adult services. We have been
pioneers in developing this area of work, and have the opportunity to continue to develop
this aspect of our services to reach a wider group.
How was this priority identified?
Transition is widely recognised as a difficult and challenging time for young people and
their families, facing a stressful time which is made more complicated by organisational
barriers and obstacles in the way services are delivered. We have developed a range of
services to help address some of these issues, including employing a Youth Worker. We
have listened to young people and their families who tell us that some of the challenges
remain, especially those who live outside our normal catchment area and have fewer
options available to them.
How will it be achieved?
We aim to develop and extend the Transition service to become a regional resource. We
have established a steering group to oversee the development of this area of our
strategy, and we are making links with Learning Disabilities teams in order to develop
opportunities for joint initiatives. We are starting to identify the referral and assessment
criteria for young people under our adult service, and to develop better promotional
materials for our various Transition services, such as the youth groups and inpatient
admissions. We will arrange meetings with relevant commissioners to discuss our service
offer and secure statutory funding where appropriate.
How will progress be monitored and reported?
The steering group will meet regularly to review progress against the agreed objectives.
The group will report to the Care Practice Committee against the project targets.
Feedback from young people and their families will be sought and reviewed regularly.
7
Mandated Statements
Statements of assurance from the Board
The following are a series of statements that all providers must include in their Quality
Account. Many of these statements are not directly applicable to hospices.
Review of services
During 1st April 2012 to 31st March 2013, EllenorLions Hospices provided specialist
palliative care in a range of settings, available 24 hours a day and 7 days a week. The
provision comprised the following services:
For adults living in Dartford, Gravesham and Swanley:
•
In-Patient Unit (ages 14+)
•
Day Therapy Unit
•
Out Patients Clinics
•
Hospice at Home including
•
Specialist Palliative Care Service
Palliative Care Support Team
End of Life Care Crisis Support Service
Hospital Support Team
For children and young people in Dartford, Gravesham and Swanley, West Kent
and the London Borough of Bexley:
•
Hospice at Home including:
Specialist Palliative Care Service
Community oncology service
Respite and Short Breaks
•
Family Drop In sessions and Day Care Facilities
•
Transition services including Youth Groups
All these services are delivered by a specialist multidisciplinary team, comprising nurses,
doctors, allied health professionals, and psycho-social staff (including social workers,
chaplains and counsellors). Patients and families under the care of the organisation
receive regular assessment and review by an appropriate member of staff or registered
volunteer.
8
Hospice at home services are provided 7 days a week with a 24 hour on call service
staffed by Specialist Nurses and Doctors, and with access to other staff to visit and
provide care as required.
EllenorLions Hospices receives funding from the NHS through grants from local CCGs.
The income from this funding represents approximately 30% of the overall running costs
of the organisation. The income generated by the NHS services in 2012-13 represents
100% of the total income generated from the provision of the NHS services by
EllenorLions Hospices. 70% of the organisation’s income is provided by fundraising
activities, including the generous support of the local community and businesses,
legacies and shops.
Participation in clinical audits
During 2012-13, EllenorLions Hospices was ineligible to participate in the national
clinical audits and national confidential enquiries, as they cover subjects which are not
applicable to this sector. However, we do regularly undertake audits of our own services
against national or local standards. In 2012-13, the audit programme has included the
following:
Audit topic
Outcomes of audit
Actions / implications
Review of adult team MDT
meetings, after structure
changed to a more integrated
model, incorporating all adult
patients under the care of the
organisation.
Improved attendance at MDT
meetings.
Review and develop
educational input at the
meetings.
Greater collaboration and crossreferral.
78% felt that discussion at the
meeting was helpful.
Educational aspect not apparent.
Some staff feel rushed.
Evaluation of nurse-led
clinics.
Well evaluated by patients and
relatives, many of whom prefer
to attend the hospice instead of
a home visit.
Plan to introduce a
rotating chair person, and
to introduce more
guidance and support on
how to present clinical
information succinctly and
clearly.
Clinics to be developed
and expanded, enabling a
more flexible approach for
patients where
appropriate.
Some practical issues to
resolve around room use.
Staff training to be
reviewed.
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Evaluation of “Friday Fun
Club” (children’s day care).
Well evaluated with positive
outcomes for children and
families.
Service to continue,
pending ongoing funding.
Review of incident reporting
system.
Confusion over reporting system;
lengthy delays in the process.
New electronic system
implemented and training
for all staff rolled out.
Re-audit in 1 year.
Review of “Quiet Time” on
the Inpatient Unit, through
staff and patient feedback.
Staff and volunteers expressed
some reservations, largely
concerning the rigidity of
implementing quiet time as it
detracted from individual care.
The patients and relatives
overwhelmingly supported it.
100% said there were clear
benefits and wanted it to
continue as it is.
The principle of a Quiet
Time is to be encouraged
but in a more relaxed
manner to tailor visiting to
meet individual needs.
Increased support and
training for staff and
volunteers has helped.
Accountable Officer audit of
Controlled Drugs
Drugs destruction needs to be
more frequent, and to include
controlled drug liquids not used
as often.
Review of destruction
timetable for controlled
drugs.
Drug register to be reviewed to
avoid potential errors between
patients own and stock
medication.
Entries of receipts of controlled
drugs in the register are very
complete, as are the signatures
of new doctors and nurses.
A review of allocation of
drug cupboard space has
resulted in clearer
demarcation of both the
register and the drugs,
hence avoiding potential
errors.
In February 2013, the organisation submitted evidence against the National Peer
Review standards for Specialist Palliative Care Services. We achieved 100%
compliance against the standards, which relate to multidisciplinary team review of
patients under our care.
Research
The organisation supports appropriate research in palliative care with the aims of
enhancing the experiences of patients and families. There is a research governance
committee which approves the participation in all research studies as appropriate, to
ensure good governance. All research undertaken within the hospice setting has
received appropriate ethics approval. Several members of staff have been undertaking
studies at Masters level.
10
In the past year, we have been actively involved in the following research studies:
a national, ethically approved research project entitled “Implementation and
Evaluation of the Carer Support Needs Assessment Tool in Hospice Home-Care
Services.” We are a pilot site in this multi-centre study which will compare carer
assessment and support with and without the use of a formal, validated research
tool. This project is scheduled for completion in November 2013. The research is
led by Gunn Grande and Lynn Austin, University of Manchester. Number
recruited to date: 258.
a national, ethically approved research study entitled “Assessment of accuracy of
prognosis prediction by the Palliative Prognostic Index (PPI)”: This is a multicentre study which aims to review the accuracy of prognosis prediction by the PPI
scores by using a larger patient sample drawn from multiple sites. This research
is being undertaken by Dr Siva Subramaniam. Number recruited to date: 50.
a national, ethically approved research study entitled: SOB– LC2 Trial: Shortness
of Breath in Lung Cancer. A Randomised Trial of High Versus Low Intensity
Training in Breathing Techniques for Breathlessness in Patients with Malignant
Lung Disease: Early Intervention. The study compares the effect of three training
sessions at weekly intervals with a single training session. This is a multi- centre
study led by Dr Miriam Johnson, University of Hull. Number recruited to date: 14.
a local ethically approved “Service Evaluation of the Advance Care Plan Tool”
used for children, led by Jenny Billings from the University of Kent. Number
recruited to date: 14.
a local ethically approved qualitative study to explore the palliative care needs of
the South Asian population and why they do not access hospice services.
Number recruited to date: 6 (NB: not hospice patients as recruitment was from
the local South Asian population who do not access our services).
The organisation has a strong track record for publishing good practice and innovative
service developments. In the past year, two posters were presented at national
conferences on the following topics:
•
“chYps, ChAPs and Short Breaks” (a review of the innovative short breaks
delivery across the 0-19 age range) presented at the Together for Short
Lives conference 2012 and awarded First Prize.
11
•
“Death, Dying and Dementia: diminishing dilemmas and distress” (joint
collaboration between a dementia continuing care unit and the hospice)
presented at the Hospice at Home conference 2012.
In addition, an oral presentation was given at the Together for Short Lives conference
entitled, “A Seamless Service….Evaluation of an integrated model of delivering both
Palliative Care and Community Oncology Services to Children & Young People with Life
Limiting and Life Threatening Illnesses”.
What others say about us
EllenorLions Hospices is required to register with the Care Quality Commission (CQC)
and it has current registration status. The hospice has no conditions on its registration.
The Care Quality Commission has not taken any enforcement action against
EllenorLions Hospices during 2012/13.
The last on-site inspections were on 20th and 21st March 2013. The hospice has one
action to take as a result. The hospice was fully compliant on all but one measure and
rated as having a minor impact on people who use the service. An action plan has been
developed and submitted to address the minor point regarding record keeping. This has
been identified as a priority for the coming year. Overall, we received some very positive
comments and feedback. The inspection found that patients were receiving care and
support that met their needs and protected their rights. One of the adult patients
described the care as “excellent” and another said, “It is wonderful, I feel as if I have
come to heaven”. A parent whose child is under the care of the service said, “I can’t
fault them at all. They’ve been fantastic”.
Data quality
In accordance with the agreement with the Department of Health, EllenorLions Hospices
submit a National Minimum Dataset (MDS) to the National Council for Palliative Care.
We provide the MDS report and a copy of the quarterly activity report to the local
commissioning organisations. A summary of the activity statistics can be found in Part 3.
Information on the number of patient records held by an organisation which includes
NHS number and General Medical Practice Code: 568 out of 584 current patients
(97.3%) have an NHS number recorded. 100% have a GP practice recorded.
12
Number of errors introduced into a patient's notes: there were 117 reported errors in our
patient documentation during the year 2012-13.
EllenorLions Hospices will be taking the following actions to improve data quality:
•
A new governance framework for documentation is being implemented to
ensure a high level of consistency and accuracy for recording clinical activity.
•
A data quality project is being initiated during June 2013 to improve the
accuracy and timeliness of clinical information reporting for both internal and
external stakeholders.
Information Governance
The organisation is an NHS business partner and successfully achieved 79%
compliance against the Information Governance toolkit, enabling N3 connection.
13
Part 3: Review of quality performance (2012-13)
A wide range of activity and quality measures are recorded, for internal purposes as well
as in response to requests from commissioners.
Activity statistics are submitted as part of the Minimum Data Set (MDS) and are detailed
below. Comparisons with the national average figures are given where appropriate, and
are based on the National MDS 2010-11 (the latest report available). Some comparison
is also made to hospice figures from the previous year where available.
Hospital Specialist Palliative Care Team
Number of new patients
756
Total number of patients
816
% of patients with a non-cancer diagnosis
34% (national 20%)
In Patient Unit
Number of patients admitted
283
% of new patients (i.e. admitted for the first time)
75%
% of patients admitted within 24 hours of referral
84%
% of patients with a non-cancer diagnosis
16% (national 11%)
Average length of stay
11 days (national 13.5 days)
Bed occupancy
92% (national 73%)
Infections
4 in total (1 C Diff, 1 HIV, 2 MRSA)
all acquired before admission
Day Therapy Unit
Number of patients
172
% attendance
80% (national 74%)
Average length of care
273 days (national 180 days)
% of patients with a non-cancer diagnosis
20% (national 17%)
Hospice at Home - Adults
Number of new patients
632 (26% increase on previous year)
Total number of patients
935 (26% increase on previous year)
% of patients with a non-cancer diagnosis
23% (national 16%)
Average length of care
148 days (national 108 days)
14
The demand for our services has increased significantly over the past year. This
probably reflects demographic changes and greater partnership working with external
colleagues, increasing the numbers referred to us, especially for conditions other than
cancer which now account for 23% of patients. Despite this rising demand, outcomes for
patients indicate a high quality of service and in achieving preferred place of care.
Preferred Place of Care achieved (%) at death – adult patients
86
90
80
70
60
50
ELH
40
32
All
30
20
10
0
PPC achieved
We review all deaths and compare against the patient’s stated preference. This
shows that 86% of patients known to our hospice services are able to die in their
preferred place, which compares extremely favourably with the estimated national
average figure for all deaths. (Source: National End of Life Care Intelligence Network,
2010).
Place of Death
100
80
60
40
20
0
ELH - all
ELH - crisis
support
Home
Hospital
15
West Kent
Hospice
64% of all patients under the care of EllenorLions Hospices died at home (including care
homes) during the year. For patients receiving the End of Life Crisis Support service,
this number rose to 82%. These figures are compared to West Kent PCT data, where
the figure is only 38%. Only 13% of all hospice patients died in hospital, and only 2.5%
for patients receiving Crisis Support. These are compared to 51% across the PCT area.
(Source: National End of Life Care Intelligence Network).
This demonstrates that patients receiving our services are much more likely to die
at home and much less likely to die in hospital.
The End of Life Crisis Support Service is a pilot project, currently funded by the CCG on
a short term basis. It provides practical care and emotional support in the home when an
individual is deemed to be at the end of life, where a crisis has occurred which would
otherwise result in a hospital attendance. By the provision of competent nursing staff,
people can be supported to remain in their place of choice to die and avoid unnecessary
admission. During the year, 196 patients received this service. Most were able to die at
home, as demonstrated above. Relatives whose loved ones received the service are
asked their views afterwards. Below is a summary of some responses:
"It helped just to know someone was there"
Agree strongly
Agree
No response
"Did you have the right amount of support?"
About right
More support
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Children and Young People’s Service
Number of new patients
49 (58% increase on previous year)
Total number of patients
154 (17% increase on previous year)
% of patients with a non-cancer diagnosis
53%
Average length of care
1247 days (NB difficult to be
meaningful due to very low numbers
of discharges / deaths)
100%
% of patients who die in their preferred place of care
Complaints – all services / departments
Number received
Number upheld
15
8
Trends noted
None apparent, except comments made by
relatives concerning discharge to care homes when
they would have preferred to remain at the hospice
longer term.
The organisation treats all complaints seriously and records all expressions of
dissatisfaction, both verbal and written, as complaints. These are all reviewed by the
Director of Patient Care for opportunities to learn and improve practice. A regular report
is provided to the Board of Trustees.
The Board of Trustees’ commitment to quality
The Board of Trustees regularly review the performance measures above. One of the
Trustees undertakes an annual visit. During visits, the Trustee visits different parts of
the organisation and speaks to patients and staff. At the last visit, carried out in May
2012, the Trustee found that patient care remained the main priority. Staff reported that
communication was generally good. There were concerns expressed, particularly in one
department, that staff shortages and staff sickness could adversely affect performance.
Since this visit, the vacancies have been recruited and the sickness absence resolved.
There is a Sub-Committee focusing on care services, reviewing varied information
relating to the quality of care provided. This information now includes statistics relating to
staff shortages in clinical areas. In this way, the Board has knowledge of the quality of
the service provided, through regular reports. The Board is confident that the treatment
and care provided by the Hospice is of high quality and is cost effective.
17
The Board of Trustees is fully committed to the quality and safety agenda. The hospice
has a well established governance structure, with members of the Board having an
active role in ensuring that the hospice provides a high quality service in accordance
with its Statement of Purpose. Sub-committees with Trustee representation are well
established in order to monitor and review services. This year a revised Risk and
Governance Committee was established, to provide a forum for regularly reviewing the
Risk Register and identifying the priorities to improve. This committee reports to the
main Board regularly.
Feedback from external colleagues
The organisation has a strong track record of working in partnership with colleagues
from other health and social care organisations. We adopt a collaborative approach in
order to enhance the quality of care we can give to patients and families through joint
working and communicating effectively with other agencies and professionals, such as
GPs and District Nurses. Below are some quotes from colleagues who refer into our
services:
“The service has complemented our own service and we have worked
well together to ensure the patient / family have the best experience
possible. Thank you.”
“Your services are excellent – I have used your out of hours / weekend
service for advice.”
Feedback from patients and families
A User Involvement Group is in place to provide a forum for reviewing and reporting
feedback from patients and families. All services are encouraged to seek and use the
views of the people who use them. Comments are collated and reported, a small
selection of which are shown on the next page, representing the whole range of areas:
18
Quotes from patients and families
“The quality of care,
not only towards
our sick relative but
also the support for
the whole family,
which we found
professional, caring
and nonjudgemental”.
“The experienced
teamwork at night in our
home was very much
appreciated. Nonintrusive, sensible,
pleasant and just right
for us. It enabled me to
go on to the very end.”
“We will
never forget
your caring
support”
“We are eternally
grateful to all the
hospice staff for
their care and
kindness given
to our friend”
“To the most
caring people we
have all had the
greatest pleasure
in knowing…”
“My husband was
always treated with
dignity and spoken to
as a person even
when he was not
aware of his
surroundings or
helpers.”
“My Mum had someone
she trusted, who kept her
going. We were able to
ask someone for advice,
to help us make sense of
all the medical opinions.
Thank you again.”
What I appreciated most: “The care and
compassion shown by ALL at the
hospice. The patience shown to
everyone and the accessibility to
everyone including doctors. I couldn't
have coped without the hospice. I feel
lucky and privileged to have had their
support and services. I feel indebted to
ELH and cannot begin to express my
appreciation.”
“We just want to
thank you for the
kindness and
compassion shown
to our brother”
“It’s been a lifeline
for us, we wouldn’t
have managed
without them at all,
and it’s taken us
over some very,
very hard and
difficult times”
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“I am eternally grateful for
the kind friendly care and
support from everyone,
from Doctors, Nurses,
even the tea ladies and
cleaners, in fact everyone
there, they were all
superb”
Statement from the Dartford, Gravesham and Swanley CCG
The organisation’s draft Quality Accounts document was sent to Clinical Commissioning
Groups (CCGs) for consultation and comment. The CCG’s have a responsibility to
review Quality Accounts each year, using the Department of Health’s Quality Accounts
checklist tool to ascertain whether all of the required elements are included within the
document.
The CCG has now completed its review and is pleased to confirm that the necessary
data requirements have been included and that the account contains accurate
information in relation to the NHS Services provided.
This is the organisation’s first year at completing a Quality Account document and they
should be commended on a document that is well written, structured, clear and concise
and follows a consistent format throughout the whole document in line with national
requirements.
The organisation has identified clear and focussed priorities for 2013/14, which aim to
improve quality services further for patients, carers and their families. It is apparent
patient preferences and choice is taken seriously by the organisation and will remain a
key focus during 2013/14.
It is clear that the organisation listens to its patients and/or family and has included some
of their comments within the document. A user involvement group has been set up by
the organisation for reviewing and reporting back feedback from patients and their
families. It would be useful to include, in future Quality Accounts, the process that the
organisation has in place to act on both positive and negative comments to ensure that if
necessary, actions are put in place to further improve services.
In conclusion, the CCG can see that the organisation puts the patient at the forefront of
its service provision and pro-actively ensures that quality is a key priority area. The CCG
thanks the organisation for the opportunity to comment on this document and it looks
forward to working more closely together within the new NHS infrastructure.
Nicola Jones - Quality and Safety Lead
Statement from Healthwatch Kent
Healthwatch Kent is still in the process of setting up as a new organisation, and
therefore has not had the opportunity to comment on this Quality Account in a
meaningful way, but is looking forward to working more closely with EllenorLions
Hospices in the coming year. We see the Hospice as a key partner in the development
of health services locally, and there will be opportunities to be involved strategically in
the way that services are shaped, ensuring that the voice of families supported by the
Hospice can be heard.
Charlie Fox – Director, Healthwatch Kent
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