Quality account
2012/13
Medway Community Healthcare CIC providing services on behalf of the NHS
Registered office: 5 Ambley Green, Bailey Drive, Gillingham, Kent ME8 0NJ
Tel: 01634 382777
RegisteredHealthcare
in England
and
Wales,services
Company
number:
Medway Community
CIC
providing
on behalf
of the07275637
NHS
Registered office: 5 Ambley Green, Bailey Drive, Gillingham, Kent ME8 0NJ
el: 01634 382777
Registered in England and Wales, Company number: 07275637
www.medwaycommunityhealthcare.nhs.uk
…we are caring and compassionate
…we deliver quality and value
Page 1
…we work in partnership
…we are caring and compassionate
…we deliver quality and value
Contents
Page
A message from our Board
3
About us
4
Medway Cares charity
5
Looking forward
7
Priorities for improvement
7
Statements related to the quality of services provided
8
Participation in clinical audit
10
Implementing NICE guidance
11
Participation in research
12
Goals agreed with commissioners
13
What others say about MCH
14
Review of quality performance
18
Privacy and dignity
18
Patient experience
19
Compliments and complaints
22
Supporting and developing our staff
27
How you can provide feedback on the account
29
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…we work in partnership
…we are caring and compassionate
…we deliver quality and value
…we work in partnership
A message from our Board
Medway Community Healthcare (MCH) has been operating for two years and we continue to make
progress in improving the quality of community healthcare for the local population. Established in April
2011, as an employee-owned organisation, our primary aim is to provide high-quality health services to
the people of Medway and beyond. In this, our third quality account, we describe some of the practical
steps we have taken to make this happen and look forward to how we will continue to do this in the
coming year.
MCH was established as a not-for-profit organisation with a key set of values that include putting
patients first and delivering high quality care. Any surplus we make is re-invested in ways that support
the communities we serve. We are a very unique type of organisation where our employees own the
organisation. We believe our model of co-ownership drives innovation and enthusiasm in our staff to
make services better. This drive to continuously improve quality and efficiency in all we do for our
patients is essential at a time of major change in the NHS.
We are proud to say that, on the whole, our patients tell us they are happy with the services they
receive from MCH. Once again, we have received some very positive feedback from our patients. This
gives us much to celebrate. However, we are determined not to become complacent. We know we can
always do more to improve the quality of our services and learn from innovative practise elsewhere.
Our quality account acknowledges and illustrates the areas where we know that we can make further
improvements. It also outlines the valuable contribution our established patient experience programme
and robust assurance processes for safety, effectiveness and experience brings to our delivery of
quality. These measures alongside more formal feedback from our regulators, provides us with the
evidence and reassurance we seek to ensure we continue to meet the needs of our patients and local
community.
We will also continue to maximise the very positive impact of our unique business model in which every
one of us has a role to play in improving care.
Our apprenticeship programme, now in its third year, attracts local young people, giving them hands on
experience in clinical and non-clinical work. Through our charity, Medway Cares, we were able to
provide community awards worth a total of £33,000.
How we work alongside clinical commissioning groups (CCG) for the benefit of patients is absolutely
central to how patients experience healthcare. We want to get better and better at this, with patients at
the centre of our relationship. This aspiration applies equally to working with colleagues in general
practice, social care and the voluntary sector and in local hospitals. Much of the care we provide
supports patients after a hospital stay, helping them to regain independence or adapt to life following
illness. How we make connections on behalf of patients can make a big difference. These themes are
core to our continuous improvement plans for the coming year.
Putting together this year’s Quality Account has been a great opportunity to pause, take stock and talk
to people about how we are doing. Our conversations have been with the staff who deliver services,
stakeholders who oversee them on behalf of local people, our commissioners who buy services on
behalf of the local community and, most importantly, with our patients.
On behalf of the MCH Board we confirm that our quality account has been developed and reviewed by
the Board, executive and senior managers and is an accurate account of the high quality care we
provide and the data that supports our achievement.
Martin Riley
Peter Horn
Managing director
On behalf of the MCH Board
Chair
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…we are caring and compassionate
…we deliver quality and value
…we work in partnership
About us
…leading the way in excellent healthcare
MCH is a £57 million business with 1,250 staff providing a wide range of both planned and
unscheduled care in local settings such as healthy living centres, inpatient units and
people's homes.
I had an
excellent experience.
Continue what you are
doing.
On 1 April 2011 MCH became a social enterprise
Community Interest Company (CIC), providing
community NHS services to the people of Medway. We
have a strong history of partnership working with local
GPs, Medway NHS Foundation Trust, Medway Council
and other local stakeholders.
Becoming a social enterprise is a significant opportunity
for MCH and for the local community. We are an
organisation that provides a range of high quality clinical services across Kent and
Medway and our vision is to continue to deliver high quality clinical services supported by
professional business support services whilst maintaining financial sustainability and
delivering excellent clinical outcomes for patients.
As part of our culture, working closely with our local community to deliver high quality
healthcare, we now have the ability to be different and make a significant difference to the
way we provide services.
We are part of the new enterprise culture and one of the first phase of social enterprises
delivering high quality community health care to local people; from community nurses and
health visitors to speech and language therapists and out of hours urgent care.
As a social enterprise, MCH is owned and run by its staff
members on behalf of the community and trades as a
business for social purposes. Many commercial
businesses would consider themselves to have social
objectives; social enterprises are distinctive because
their social purpose is absolutely central to what they do.
We have made a commitment to ‘leading the way in
excellent healthcare' and our patients, local stakeholders
and our staff as co-owners, will have the opportunity to
ensure that we are able to:





She is a
credit to the
service and was
a great help with not
only the assessment but
also with making my
life a lot more
bearable.
deliver services according to need and not perceived demand
deliver innovative ways to provide care closer to home
deliver services in a more flexible, productive and efficient manner
deliver services that respect every patients’ dignity and right to privacy
our standards
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…we are caring and compassionate
…we deliver quality and value
…we work in partnership
Our approach is focused on improving service quality, patient experience and clinical
outcomes; ensuring better use of resources and maximising value for money, and includes
six key transformational areas:






acute care closer to home
services for children, young people and their families
services for health, wellbeing and reducing inequalities
rehabilitation services
services for people with long term conditions
end of life care
I'm treated
with dignity and
respect at all times. Also,
I can discuss with the
nurse about my condition,
and feel reassured and
cared for - thank you.
We have been reviewing the provision of all of our
services and strategies have been implemented to
restructure, redesign and integrate the operational
services to deliver high quality care more efficiently.
We are embedding equality impact assessments into
this process to ensure any changes do not have a
negative impact on any sectors of the community or
our staff.
Our aims and objectives ensure that MCH continues
to focus on the right things and we work as a team. It
is vital that everyone understands the part they play
in successfully achieving these aims and objectives.
It is important that we also continue to measure our progress so that everyone knows how
we are doing both as individuals and together as an organisation delivering excellent
healthcare to our local
community.
Our charity:
Medway Cares
Helping to make a
difference
Medway Cares,
established in 2012,
aims to promote and
protect the physical and
mental health of people living in Medway. As a social enterprise, one of the ways we can
make a difference is by investing some of our operating surplus in the community we
serve. At our first annual general meeting shareholders were given the chance to vote for
who should benefit from the community awards and they chose children and young
people; people with learning difficulties and older people.
This year, we were able to offer Medway Cares community awards worth a total of
£33,000. Local groups were invited to apply for a community award of up to £10,000 and
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…we are caring and compassionate
…we deliver quality and value
…we work in partnership
we were supported by local KM newspaper the Medway Messenger in encouraging groups
to apply.
We were delighted by the number of applications we received from local organisations. A
charity review group made up of a range of staff selected the recipients. Thank you to
everyone who took part and congratulations to all our beneficiaries.
Beneficiaries 2012-2013
Organisation
Project
Award
4th Gillingham Sea
Scout Group
A safety boat will be purchased to support children
to try out water activities on the river Medway.
£2,500
Age UK
Portable ramps on day centre buses will help older
people to attend activities at day centres.
£1,800
All Saints Community
Project
Funding will create 120 free places on the Sam's
Place holiday play scheme.
£4,000
Breakaway
Four chairs with arm rests and lumbar supports
and additional tables will enable more isolated
people to attend a luncheon club.
£750
Hands and Gillingham
Volunteer Centre
Support community volunteers/befrienders will be
recruited to support older people, disabled people
and people with mental health problems.
£9,000
Holding On Letting Go
Weekend grief support programmes will continue
to support bereaved children, young people and
their parents or carers.
£6,000
Medway Dragons
Rugby League Club
Primary school children will be encouraged to be fit
and healthy. The award will enable coaches to
£3,000
deliver ten weeks of fun fitness sessions in 20 local
schools.
The Word on the Street
More children and young people will be able to
attend the Activity Loft which provides a safe haven
£6,000
with after school clubs and school holiday
activities.
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…we are caring and compassionate
…we deliver quality and value
Part two: looking forward
This second part of our quality account looks forward to the next
financial year (2013 -14) and details what areas have been
identified as priorities for improvement, why these priorities have
been chosen, how improvement will be achieved and how it will be
measured.
…we work in partnership
A pleasure
to deal with
people who have
a good attitude…
There are also Board statements relating to the quality of the services we provide.
Priorities for improvement 2013-14
Understanding what is important to our stakeholders is a key objective of our organisation;
consulting on our priorities for improvement gives us the opportunity to ask for input on
what is important to them. It is essential that as many people as possible are involved in
developing the priorities for the next year.
Consultation on the priorities for 2013-14 started with a review
of
last year’s
They always
performance on the priorities. The seven priorities were
have a friendly and
classified as recommended to continue or not, depending on
comforting word.
whether practice required further improvement or not. We
reviewed patient feedback, complaints and enquiries, as well as
commissioning intentions and other local priorities. From this
rich mix of data we looked for key themes and trends to compile a list of draft priorities that
was presented to our quality committee in December and subsequently circulated to key
stakeholders for them to vote for their top priority in each category.
Patients, staff, Medway LINk, our community forum and Medway CCG were given the
opportunity to vote via our Internet site. All the responses were collated and from this we
determined six priorities for improvement.
Patient safety:
1. Continue to provide environments and care where the risk of infection is minimal.
How will we measure?
 staff being bare below the elbow
 compliance with hand hygiene requirements
 cleaning audits in areas we are responsible for
 compliance with MRSA screening in St Bart’s
 reported C difficile infection or MRSA bacteraemia
How will we report?
 Quarterly updates will be published on our website
2. Continue to reduce incidences of avoidable falls and pressure ulcers, as well as
enable patients and carers to understand what they can do too.
How will we measure?
 Use safety thermometer to monitor progress
How will we report?
 Quarterly updates will be published on our website
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…we are caring and compassionate
…we deliver quality and value
…we work in partnership
Clinical effectiveness:
3. Support patients with long term conditions – encouraging self-care and reducing
acute hospital admissions through use of technologies, eg telehealth.
How will we measure?
 Working with Medway CCG and other providers to implement the long
term conditions Commissioning for quality and innovation (CQUIN)
scheme.
How will we report?
 Quarterly updates will be published on our website
4. Improve the health and wellbeing of children, as part of an integrated approach to
supporting children and families through the delivery of the healthy child
programme.
How will we measure?
 Through the implementation plan we will monitor progress against key
milestones
How will we report?
 Quarterly updates will be published on our website
Patient experience:
5. Continue to work to reduce waiting times and
appointment cancellations for patients in services
where there are challenges.
How will we measure?
 Through monthly service performance
indicators identify key services and monitor
progress against achievement of improvement
plans
How will we report?
 Quarterly updates will be published on our website
You
cannot
improve on
the existing
standards being
practised.
6. Palliative care – continue to build on giving patients ownership of their care through
advance care planning and provide them with a copy of their agreed management
plan.
How will we measure?
 Using the Community IT System monitor the use of My Plan
How will we report?
 Quarterly updates will be published on our website
Statements related to the quality of services provided.
During 2012/13 MCH provided 46 NHS services.
MCH has reviewed all the data available to them on the quality of care in all of these
NHS services.
The income generated by the NHS services reviewed in 2012/13 represents 100% per
cent of the total income generated from the provision of NHS services by MCH for
2012/13.
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…we are caring and compassionate
…we deliver quality and value
…we work in partnership
MCH performance monitoring process
By seeing the
same people they get a
feel for how you respond
and are able to make
more personalised plans
which is so much better.
MCH has a clear and transparent performance framework
that draws together the available data from all services into
a comprehensive overview and the analysis is described at
organisational, business unit and service level.
The monthly dashboards of performance are reviewed and
analysed at the business unit meetings and commentary is
then provided to the operational performance meeting. The
business units include service management leadership and
performance is shared within all service areas.
The data collected comprises key indicators across the four cornerstones of performance:
 clinical quality and outcomes
 patient activity
 financial health
 organisational health (workforce)
Additional reporting of complaints, incidents and
contractual performance and CQUINs are included as part
of this review.
You can’t improve on
excellence.
The purpose of the operational performance group is to scrutinise this data, identifying any
areas where performance is of concern or exemplary. Key actions for any required
resolution are then identified and implementation sought. The process also identifies and
reviews any risks associated with performance, eg increased patient waiting times,
vacancy levels, high levels of safeguarding work, etc and seeks assurance in regard to
mitigation.
Key issues within services are considered for more comprehensive review through a ‘deep
dive’ process which is undertaken at various levels dependent upon the issue/s. These
investigations will, where appropriate, include peer review/support. The outcomes and
action plans resulting from the ‘deep dive’ process are
reported to the executive team and quality committee,
presented by service managers and team members where
Always
possible.
on time with
appointments;
Service level performance is reported to the quality
always very helpful
committee where there is challenge and interrogation from
and pleasant.
executive and non-executive Board members thus enabling a
highlight report to the Board allowing further opportunity to
challenge key issues and actions to provide our Board with
the assurance they demand.
There is a consistent level of data across all services and data quality assurance built into
the process, including review of both the process and the data enabling appropriate detail
to understand the key issues, variables and influences.
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…we are caring and compassionate
…we deliver quality and value
…we work in partnership
There is a formal contract review process in place which is supplemented and enhanced
by regular meetings between commissioners and MCH executive and senior management
teams.
These processes review the delivery of the contract from a quantitative and qualitative
perspective. The performance data and key service issues are highlighted and managed
through the Service Delivery Improvement Plan (SDIP); the quality performance indicators
and CQUINs are monitored through the clinical quality review meeting.
Participation in clinical audit
During 2012/13 three national clinical audits and no national confidential enquiries
concerned NHS services that MCH provides.
During that period MCH participated in 100% of the national clinical audits it was
eligible to participate in.
The national clinical audits that MCH was eligible for and participated in during 2012/13
are as follows:
Audit title
National Audit of
Intermediate Care
HTM01-05
Decontamination in
Dental Services
National Sentinel Stroke
Audit and SINAP (Stroke
Improvement National
Audit Programme)
Findings
This audit was completed by St Bartholomew’s Hospital.
The overall compliance was 86%.
All sites achieved 91% or above. Majority of sites do
meet best practice. Majority of failures due to poor
ventilation in decontamination rooms, no washer
disinfectors and general fabric of rooms are poor.
We have moved up from 3rd to 2nd quartile of
performers. Average percentage of the 12 key
indicators has increased from 66% to 70.7%.
Clinical improvement programme
At MCH we have an annual clinical improvement
I felt
programme that includes mandatory audits, which all
supported,
services are required to participate in that are
listened too,
reported to our quality committee. Local service
involved, cared
audits are reported to business units and
for and they were
performance meetings. All improvement programme
always on time too.
findings are shared within the organisation through
our new governance assurance information network
(GAIN). We undertook 11 mandatory audits (not
including infection control or medicines management
audits); this is a decrease from last year to ensure we are focusing on quality rather than
quantity. These included a mixture of clinical and workforce audits ranging from staff
engagement, student placement, record keeping (quality and governance), food and
nutrition and patient experience.
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…we are caring and compassionate
…we deliver quality and value
…we work in partnership
The reports of all local clinical audits were reviewed by the MCH in 2012/13. The
following are findings and actions that have or will improve the quality of healthcare
provided.





The development of personalised care plan tool My plan is being introduced
through a series of workshops focusing on appropriate goal setting techniques and
motivational interviewing.
High quality pre-registration student placements were evidenced and led to the
development of our intranet site and placement information for students
The return rate for all audits has improved significantly improving the quality of the
information; we will continue to improve this.
The preceptorship programme for our newly registered clinicians has enabled
improved staff retention and evidenced an increase in confidence in undertaking
their roles.
A new drug trolley at the Wisdom Hospice has reduced the risk of drug errors
through improved efficiency, fewer interruptions and improved the stock control.
Implementing NICE guidance
Many thanks for the
time and care he
showed in dealing
with me, the doctor
is a credit to you.
The National Institute for Health and Care Excellence (NICE)
produce evidence based guidance and standards to ensure
best practice in health and now social care too. We are
compliant with guidance that is relevant to our services. Every
piece of NICE and other national guidance is reviewed and,
where needed, action plans are developed to ensure the
recommendations are implemented by services. The table
below outlines the guidance that required action plans and
the improvements made:
NICE guidance
CG148 and
QS15 Patient
Experience
Improvements 2012-13
Our pledge implemented in each service to encourage
ownership of improving and ensuring all patients have a good
experience and to manage expectations.
CG140 Opioids in
palliative care
CG127 Hypertension
Patient information leaflet produced.
CG139 - Infection
control
CG88 Low back pain
Waiting times reduced for blood pressure monitoring to six
weeks.
Waiting times reduced for electrocardiograms to four weeks.
Competency checklist produced and being utilised.
Improvements made to continence care training.
The number of spine fit exercise classes has decreased due to
non-attendance of patients. A weekly Pilates group is now
being run within physiotherapy.
The format of back education has changed and is now not a
stand-alone package as non-attendance was extremely high
and it was not cost effective. Education is now provided during
the treatment session.
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…we are caring and compassionate
NICE guidance
PH35 Preventing type
2 diabetes
TA249 Atrial fibrillation
- dabigatran etexilate
QS2 Stroke
QS9 Chronic heart
failure
…we deliver quality and value
…we work in partnership
Improvements 2012-13
Clinicians give Arthritis Research booklet on low back pain.
Pathway launched September 2012.
Training required and completed.
All MCH stroke nurses are trained to complete swallow
assessments and can insert naso-gastric tubes if necessary
improving patient outcomes by ensuring appropriate
medication and nutrition
Patients usually seen within two weeks but always within three
weeks.
Participation in research
The number of patients receiving NHS services provided by MCH in 2012/13 that were
recruited during that period to participate in research approved by a research ethics
committee was 29, although only eight are allocated to the organisation as the patients
were recruited by our stroke team at either Medway Foundation Trust or Sheppey
Hospital.
Research is a core part of the healthcare, enabling the NHS to
improve the current and future health of the people it serves. As a
provider of NHS services we aim to provide high quality
healthcare. Research helps ensure that high-quality provision is
supported by a good evidence-base. Our Research strategy for
2013 -15 recognises research as a means to improving the quality
of patient care and services, implementing models of good practice
and reducing clinical risk.
They
go the
extra mile
and then some.
Although the organisation as a whole is fairly new to participating in research our clinicians
have always applied research and evidence to ensuring the highest standards for our
patients, staff and stakeholders. Continuing to utilise research findings and increasing
participation in research is being encouraged and promoted across the organisation. We
are working in partnership with the Kent and Medway Comprehensive Local Research
Network1 (CLRN), Health and Europe Centre2 (HEC) and are participating in the Academic
Health Science Network3 (AHSN) as well as working closely with our local higher
education institutions and other healthcare providers.
The new service has
improved things 100% - much
more efficient and quicker too.
Some of our services and clinicians are actively
engaged in research, recruiting patients to
trials, participating in and undertaking studies.
Further developing services and staff to
support participation in research is essential if
we are to be recognised as a research friendly
organisation, and enable us to retain and
1
http://www.crncc.nihr.ac.uk/about_us/ccrn/kent_medway
http://www.healthandeuropecentre.nhs.uk/
3
http://www.dh.gov.uk/health/files/2012/06/Academic-Health-Science-Networks-21062012-gw-17626-PDF229K.pdf
2
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recruit high quality staff.
There were 41 clinical staff participating in research approved by a research ethics
committee in MCH during 2012/13. These staff participated in the following studies:






Emotional Processing and Social Cognition in Amyotrophic Lateral
Sclerosis/Motor Neurone Disease
CLOTS 3 A randomised controlled trial to establish the effectiveness of
intermittent pneumatic compression to prevent post stroke deep vein thrombosis
BMET The Brief memory and Executive Test a screening tool for identifying
cognitive impairment in small vessel disease.
CROMIS-2 Clinical Relevance of Microbleeds in Stroke - a study looking into
their clinical relevance
SO2S Stroke Oxygen Study- A multicentre randomised control study assessing
whether routine oxygen in the first 72 hours after a stroke improves longer term
outcome
Vestibular stimulation
In the last three years, no internal publications have resulted from our involvement in
NIHR
research. with clinical research demonstrates our commitment to testing and
Our engagement
offering the latest treatments and techniques.
Goals agreed with commissioners
Use of the CQUIN payment framework
A proportion of our income in 2012/13 was conditional on achieving quality
improvement and innovation goals agreed between MCH and the commissioners we
entered into a contract, agreement or arrangement with, for the provision of NHS
services, through the CQUIN payment framework.
The CQUIN payment framework aims to support making
quality the organising principle of NHS services, by
embedding quality at the heart of commissioner–provider
discussions. It is an important lever, supplementing quality
accounts; to ensure that local quality improvement
priorities are discussed and agreed at board level within,
and between, organisations. It makes a provider’s income
dependent on locally agreed quality and innovation goals.
The team were all
very supportive
and gave me the
willpower to do
things for myself.
Use of the CQUIN framework indicates that we are actively
engaged in quality improvements with commissioners,
some of which impact beyond the boundaries of the organisation and improve patient
pathways across the local health economy. Agreement being reached with commissioners
about quality improvement goals is an indicator of our contribution to quality improvement
in local health services more broadly.
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Overview of 2012/13 CQUIN achievements
The 2012/13 CQUIN Scheme for NHS Kent and Medway (K&M) contains six headline
topics with 12 indicators. The indicators have different financial values attached to them
dependent on the activity and weight placed on the scheme by the commissioners.
CQUIN Scheme
Q1
Q2
Q3
Q4
Patient Experience
100%
100%
No target
100%
Safe Care
100%
100%
100%
99%
Enhancing Quality programme
100%
100%
100%
100%
Safe Workforce
100%
100%
No target
100%
Innovation Health and Wealth HII
No target
100%
No target
100%
K&M Long Term Conditions Programme
100%
100%
100%
100%
Full details of the 2012/13 CQUIN Scheme is available on request from
medwaycustomercare@nhs.net.
What others say about MCH
Statements from the Care Quality Commission
MCH is currently registered with the Care Quality Commission (CQC) with no
conditions. The CQC has not taken enforcement action against MCH during 2012/13.
As providers of regulated health services we have a legal responsibility to make sure they
are meeting essential standards of quality and safety. These are the standards everyone
should be able to expect when they receive care. The essential standards are described in
the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the CQC
(Registration) Regulations 2009. The CQC regulate against these standards.
They go the extra
mile and then some.
The CQC carry out inspections at least once a year to judge
whether or not the essential standards are being met. All
inspections are unannounced unless there is a good reason
to do otherwise.
There are 16 essential standards, grouped into five key
areas that relate directly to the quality and safety of care. When the CQC inspect they
check all or part of any of the standards depending on the individual circumstances of the
service, however they will always inspect at least one standard from each of the five key
areas every year. The CQC have completed the 2012/13 inspections of MCH’s five
registered sites: St Bartholomew’s Hospital, the Wisdom Hospice, Darland House,
Medway on call care (MedOCC) and Unit 5 Ambley Green (a total of 16 different services).
Five standards were inspected:
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Outcome 1 Respecting and involving people who use services
Outcome 4 Care and welfare of people who use services
Outcome 7 Safeguarding people who use services from abuse
Outcome 14 Supporting workers
Outcome 16 Assessing and monitoring the quality of service provision
During the inspection visits the CQC inspector observed how people are cared for and
talked to people who use the service, to their carers and to staff. They also reviewed
information about our processes and checked service records to ascertain whether the
right systems and processes are in place.
St Bartholomew’s Hospital: ‘People told us they understood and had been involved in
setting goals for their rehabilitation. People described the support and care the therapists
were providing for them in order to regain independence to return home.
Staff we spoke with were aware of who they must report any suspicions of abuse to. Staff
had also received training in the Mental Capacity Act and deprivation of liberty. All new
staff were subject to police checks before commencing employment, as well as robust
recruitment checks including checks of identity and taking up of references. Staff had a six
month period of probation before being confirmed in their posts.’
Wisdom Hospice: ‘There were a range of activities and complementary therapies
available for people, including massage, physiotherapy, sensory treatments, as well as
arts and crafts.
People and relatives we spoke with said that the care and support they or their loved one
received was outstanding. One person said "I can't praise them enough." another said
"You couldn't wish for a better place."’
Darland House: ‘We found that people were receiving the
care and support they needed. We saw that staff assisted
people in a caring and sensitive way and understood
people's complex needs.
They gave my wife her
dignity back.
We saw that staff treated people with respect and with regard for their privacy and dignity.
A relative we spoke with said that Darland House was, "Marvellous" and, "I can't fault the
place."
Staff said that they received the training and support they needed to enable them to care
for the people living at the home.’
MedOCC: ‘We saw that that any discussion about people's care and treatment and the
treatment itself happened in private consulting or treatment rooms. There was a notice in
the waiting room telling people that phone calls were recorded. Call staff were discreet
when answering calls from people and there was a secure fax where information about
people was received from GPs. Patient records could only be accessed using a smart card
system.
The organisation's privacy officer monitored access to make sure only authorised and
appropriate people accessed patient records at appropriate times.’
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Ambley Green: ‘The inspection was conducted over two days by two inspectors. We
visited eight services that provided three of the six regulated activities registered from Unit
5.
We observed interactions between staff and people using the services. We found that staff
took time to listen to people, answer their questions fully and check people’s
understanding. We saw that staff were polite and provided explanations about people’s
care and treatment. One person who used the dermatology service told us, "They always
tell me what they are doing and why, they explained what I needed and I was happy with
that."’
MCH has not been required to participate in any special reviews or investigations by
the CQC during the reporting period.
Data quality
The importance of reliable data is both operationally and strategically important for MCH:
 for safe and effective treatment and care of our patients
 for evidencing contracted outcomes
 for identifying current trends and predicting future trends in activity so that plans can
be made based on the predicted demand
Everyone
is always willing
to help and answer
patients’ needs.
Processes to validate the quality of data are now well
embedded into ways of working through the combined efforts of
system support staff and clinical services. In addition to
maintaining robust validation processes MCH has successfully
implemented new systems and tools during the course of
2012/13 which enable achievement of data quality
improvement objectives. Notable achievements and progress
have been:
1. New community IT system - The first phase of MCH’s deployment of a new
community IT system, Advanced Community, went live in August 2012. By
replacing paper patient records and enabling electronic sharing of patient data the
level of duplication and mistyped information will be significantly reduced.
2. Data migration onto new community IT system – having considered the possibility
of automating the data migration from the old system to the new one the decision
was made to perform a manual cleanse of the data held on the old system before
entering it into the new one. This will ensure the quality of data held on the new
system will be as accurate as possible from day one.
3. Personal Demographic Service (PDS) - this is the national electronic database of
NHS patient demographic details eg name, address, NHS Number. Access to this
service was made available in January 2013. In addition to avoiding duplication of
demographic information it has improved accuracy across the system.
4. Data Quality Improvement Plan (DQIP) – the following were achieved: minimising
the changes in data after ‘freeze’ dates; improving waiting time data; data cleansing
in preparation for migration onto new community healthcare IT system;
standardised clinical coding.
5. Secondary Uses Service (SUS) – MCH agreed its first data quality strategy for SUS
submissions in relation to inpatient activity data.
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The new community IT system will continue to be deployed to our various clinical services
throughout 2013/14 and into 2014/15 and so the benefits described in points 1, 2, and 3
will be further realised as new services go live. As with any deployment the scope for
errors due to unfamiliarity are higher in the early stages. To mitigate against this, training
and education on the importance of data quality form part of the training provided to all
staff using the system. Occasional errors in respect of inaccuracies in inputting were
identified early on, so to ensure improvements are implemented all such incidents are
logged on our incident reporting system to ensure patterns are identified and addressed.
As a result some enhancements were implemented by the supplier to reduce the
opportunity for error.
NHS number and general medical practice code validity
MCH submitted records during 2012/13 to the Secondary Uses service for inclusion in
the Hospital Episode Statistics which are included in the latest published data. The
percentage of records in the published data which included the patient’s valid NHS
number was 99.5% for admitted patient care and those which included the patient’s
valid General Medical Practice Code was 99.8% for admitted patient care.
Information governance toolkit attainment levels
The MCH information governance assessment report overall score for 2012/13 was
78% and was graded green. This means we scored at or above the required national
requirements.
The information quality and records management attainment levels assessed within the
information governance toolkit provide an overall measure of the quality of data systems,
standards and processes within an organisation.
The information we hold in patient records is of huge personal significance and for details
to be disclosed, maliciously accessed or lost would represent a serious infringement of
patient privacy. We place great emphasis on the need for confidentiality in respect of
personal information. This applies to manual and computer records as well as any
conversations about a patient or their treatment.
All our staff are required to complete annual training to ensure they are updated on the
best ways to prevent information loss or disclosure. We have had a small number of minor
information breach incidents, eg a letter being posted to a patient at an old address. Each
incident has been investigated and any measures we identify to prevent the same thing
happening again are put in place. For example, as a result of an email containing
information being sent to the wrong recipient our staff are now required to password
protect emails that contain patient or staff identifiable information.
Clinical coding error rate
MCH was not subject to the payment by results clinical coding audit during 2012/13 by
the Audit Commission.
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Part 3: Review of quality performance
Improvements in the delivery of patient care have been identified within a number of
services both through the performance framework and intelligence from other sources
such as complaints, incidents, patient experience, recruitment and feedback from our
stakeholders.
Key review areas:
The podiatry service - where a number of patients have experienced issues
contacting the service and the length of time they have had to wait for their appointments.
The data we reviewed clearly showed evidence of increasing waiting times and delays in
communication and / or booking of appointments.
The review considered the clinical quality of the service and found no concerns relating to
clinical quality however there are clear issue related to processes, response times and
engagement with users. A detailed action plan resolving the process and booking system
have been put in place and additional short term staffing used to address the waiting
times.
St Bartholomew’s Hospital - there were a number of areas of concern relating to the
experience of patients whilst in the hospital, staff engagement generally, as well as
recruitment and absence issues. The review has illustrated a need to enhance the clinical
leadership and support to front line staff including reviewing the way the various means of
communication directly with patients and carers but also through utilising a multidisciplinary approach to providing care in this rehabilitation unit.
The community nursing service - to review service
You have
delivery which is and has been under considerable
provided high quality,
pressure due to the increasing demand for the service
professional care.
from an ageing population with long term conditions (eg
heart and respiratory disease, diabetes, etc), as well as
the delivery of care closer to home, and challenges
recruiting suitably qualified senior members of staff. A comprehensive service
development plan has been put in place to facilitate the delivery of the long term
conditions pathway and a workforce plan underpins this at the same time seeks to address
the recruitment issues.
The health visiting service is under re-development as a result of the national Call
for Action for the service. This includes considerable expansion and development of the
workforce to identify and deliver the core elements of the Healthy Child Programme to
ensure the best start for children and the right support for parents.
Privacy and dignity
It is extremely important that anyone being treated by any of our services is treated with
respect and inpatients cared for in an environment that meets their needs.
We initially carried out an internal audit throughout our clinic location environments to
pinpoint areas in need of improvement. Significant changes were made, such as new
signage and bariatric seating; however without consulting with our patients we couldn’t
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fully understand their needs, which is vital to providing a first class service. We have now
ensured that the question of privacy and dignity has been included in every patient
experience questionnaire throughout our services. The results were excellent for the third
year running with 98% of those who responded stated privacy and dignity was good or
very good. Further questions have now been implemented into the 2013/14 patient
experience programme to further improve feedback so that we continue to improve the
services we provide.
Patient experience
The patient
experience
programme for
Medway Community
Healthcare 2012/13
entailed the
development of
service specific
toolkits that
examine the needs
of our patients. The
toolkits were
developed, piloted
distributed and
analysed throughout
the year. The return
rate remains high at
36%, significantly
above the 20% national target. The overall experience score for 2012/13 remains identical
to the score achieved in 2011/12, although there is a significantly higher percentage of
respondents stating very good rather than just good (15%).
The friends and family test
All surveys included the friends and family test; a validated, reliable tool to establish the
population’s loyalty to services. The question is, ‘How likely would you be to recommend
this service to your family and friends?’. The score is calculated in a way that provides a
percentage that can then be compared locally and nationally to evidence improvements or
to benchmark across the services. The score is between -100 to +100.
The overall friends and family score for the organisation is 74% which indicates: good to
excellent services, the service level score will be utilised as a benchmarking outcome
measure for 2013/14 programme.
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What our patients say
The word cloud above shows the adjectives used by patients in our patient survey - the larger the words
appear the more frequently they have been used.
A graph to demonstrate the friend and family score (-100 to +100%) for each service.
(Key - Independent unit, Planned care, Unplanned care business units). Scores between 50 and 0 are deem poor to fair, 0-50% fair to good, >50% good to excellent.
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Recommendations for 2013/15:




Continue to enhance our culture of putting patients at the centre of all we do.
Ensure all service users are offered the ability to feedback and improve the
dissemination of findings.
Utilising new systems improve the quality and real time reporting capabilities.
Review cost implications verses quality of the data required when developing future
toolkits
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Compliments and complaints
Feedback given by patients about their experience of care and treatment is important to us
and helps us to make improvements. Patients are actively encouraged to provide
feedback and share their comments, compliments, concerns and complaints and we
promote this through our Tell Us leaflet and website.
During 2012/13 we saw 796,130 patients, some for the first time and some for follow up
appointments. Over that time, we received 163 complaints; that is one complaint for just
under every 5000 patient appointments. Three complaints were reviewed by the Health
Service Ombudsman and of those; one required us to take action. An expert clinical
advisor recommended we ensure our care provision was compliant with the end of life
care standards, our review of these showed that we were compliant and met the
standards.
Although we have not identified any trends in the clinical care or treatment, we have
identified some issues with communication, and therefore understanding, between
clinicians and patients and carers. Our staff have customer care training however we are
looking at further communication training that may be required. Our organisational values
and the service pledges support working in partnership and being caring and
compassionate both of which inform individual staff performance review.
A number of comments have been received by our customer care team about the
difficulties accessing the podiatry appointment telephone system. The issues have
included the telephone not being answered, not being able to leave a message or no
response when a message was left. Following a review of podiatry systems and processes
we are now commissioning a new telephone system - specifications have been drawn up
and hopefully a more efficient system will be in use in the next few months.
A number of patients described turning up for blood tests before the end of a clinic and
being turned away as there were too many patients waiting. We have amended our
advertised clinic times so that all patients who attend will be seen. In some areas the clinic
days have been changed to meet the demand and plans are in place to open more clinics
including Saturdays and early morning.
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Changes this year
The National Quality Board requires, for the first time this year, reporting against a core set
of quality indicators. These core indicators identified in a Department of Health (DH) letter
(January 2013) describe only one indicator relevant to MCH, which we may choose to
report on:
The percentage of staff employed during the reporting period who would recommend
the organisation as a provider of care to their family or friends.
The staff survey that we undertook last year did not ask this question therefore we have no
data to report however for the coming year we will be asking staff whether they would
recommend their service and the organisation as a provider of healthcare services and as
an employer. Additional questions will asked as to whether staff feel able to raise concerns
about patient care and whether they believe that quality is the first priority for MCH.
Staff surveys will be undertaken twice in the coming year to ensure that any issues
highlighted through the initial survey are acted on and improvements made. We will report
the friends and family score in the 2013/14 quality account.
Achievement against our quality priorities for 2011/12
In our 2011/12 quality account we identified seven areas that our patients, staff and
stakeholders said were important for MCH to focus on. The table below gives the progress
we have made on the priorities throughout the year.
Indicator
Target Q1
1. Patient safety
a. Reduce the number of patients acquiring a
pressure ulcer
b. Provide environments and care where the risk
of infection is minimal
 Staff being bare below the elbow
Q2
Q3
Q4
53
32
46
43
87%
90%
87%
99%
99%
100%
100% 100% 100% 100%

Compliance with hand hygiene
95%
99%
99%
99%
99%

Cleaning audits
87%
91%
92%
93%
90%

Compliance with MRSA screening
100%
100%
91%
93%
98%

Reported Cdiff or MRSA
0
2. Clinical effectiveness
a. Develop personalised care plans for patients
with long term conditions
b. Develop outcome measures
No attributed infections
Met
Partially met
3. Patient experience
c. Patient feedback – working toward real-time
feedback.
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d. Intentional rounding
Met
e. Reducing waiting times in services where
there are challenges
Partially met
The following provides more detail on each of the priority areas action we have taken,
processes we have put in place and our achievements as well as areas for continuing
focus.
1. Patient safety
a. Reducing the number of patients acquiring a pressure ulcer whilst in our care
Over the last two years we have worked to ensure all patients who are found to have a
pressure ulcer are reported through our incident reporting system. This enables us to
undertake an investigation into each and every one to identify why and where the patient
developed the pressure ulcer and what, if anything, our services could have done to
prevent the ulcer happening.
Pressure Ulcer Incidents
by Type 2012/13
Acquired (unavoidable)
Acquired (avoidable)
Inherited (informed)
Inherited (uninformed)
Totals:
Q1 Apr 12 Jun
48
5
46
19
118
Q2 Jul Sept
30
2
41
18
91
Q3 Oct Dec
40
6
30
25
101
Q4 Jan 13 Mar
41
2
44
29
116
Patients developing pressure ulcers are categorised in one of four ways:
 Acquired (unavoidable) – despite appropriate pressure relief and advice patients
develop a pressure ulcer due to, for example, their deteriorating health or not using
equipment appropriately.
 Acquired (avoidable) - appropriate equipment or advice, or plan of care was not
sufficient to prevent the pressure ulcer.
 Inherited (informed) – a patient is referred to the care of our services with a
pressure ulcer, for example from a care home, GP, or on discharge from hospital.
 Inherited (uninformed) – as above but the service is not informed that the patient
has a pressure ulcer, most commonly hospital acquired.
We are pleased that very few of the thousands of patients we provide care for develop a
pressure ulcer as a result of less than optimum care from our services; however we are
not complacent and continue to work with Medway Foundation Trust, local care homes
and others to reduce the number of patients who develop pressure ulcers.
Of the 15 patients who did developed avoidable pressure ulcers two were grade 3 and one
a grade 4; all of which were reported and investigated as Serious Incidents (reportable to
the Department of Health). In all cases the lack of appropriate information and continuity of
care led to the patient’s condition to deteriorate. Lessons from these incidents, and many
of the others, have led to a review of the leaflet we provide to our patients describing how
they can best care for their skin to prevent the risk of pressure damage. We have updated
the training staff receive in managing patients who are vulnerable to pressure damage and
we are reviewing the provision of equipment such as mattresses and cushions used to
prevent and treat such damage.
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Reducing harm to our patients remains a quality priority for 2013/14 and we will continue
our focus on reducing the incidence of patients suffering pressure damage.
b. Continue to provide environments and care where the risk of infection is minimal
We continue to work with staff, landlords and our patients to ensure that the patient
treatment areas are clean and well maintained. All of the buildings where we provide
services are audited against a cleaning standard. Where shortfalls are found, we will take
corrective action immediately. However, due to the age of some of the buildings we use,
the cleaning scores are not as high as we would aspire to due to the condition things such
as flooring and paintwork.
Our dress code requires our clinical staff to wear short sleeves and no jewellery except a
plain wedding ring. Correct hand hygiene by our staff is one of the important ways we
prevent infection and keep our patient safe. All our staff are kept up to date with our hand
hygiene approach through their infection control link practitioner, annual training and each
clinician is audited for their compliance too. All services are monitored and held to account
for their compliance.
At St Bartholomew’s Hospital patients are screened for MRSA bacteria on their skin as
safe patient care requires. This ensures that if a patient does have MRSA on their skin we
can give the correct treatment to remove the bacteria and reduce any risk to them.
We are required to report any blood stream MRSA or C.difficile diarrhoea infections that
occur in our patients while under our care, through this year we have had no patients
acquiring an MRSA blood infection. One patient developed a C.difficile diarrhoea infection
as a result of previous treatment in the acute hospital. Our staff are required to undertake
a range of training programmes and supervision to keep up to date on preventing this type
of infection.
2. Clinical effectiveness
a. Developing personalised care plans for patients with long term conditions –
The community nursing and community physiotherapy teams have developed a single
personalised care plan, My Plan, which aligns to the electronic patient record that is being
utilised as part of the roll out of our new community information system. This is being
further developed in 2013/14 in line with the multi-disciplinary case management approach
within the new long term conditions pathway as well as being rolled out across all services
ensuring the patient has one jointly agreed plan that meets their care and treatment
needs.
Within the palliative care service the staff work with their patients and families to ensure
their advance care wishes are explicit and that information made available, with the
patient’s consent, through the use of the my wishes register.
b. Development of care outcome measures implementation
Each of our services has been developing outcome measures that really identify the
experience of patients. This is being achieved by three ways:
Patient experience – all services are involved in the patient experience programme and
have the friends and family test as a key outcome measure for the service. This year’s
scores will be used as a benchmark for improvement. To assist with improving the quality
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of the information we receive, we have developed a standardised customer survey which
includes the friends and family test as well as 12 core experience indicators. This will be
used to review the quality of the services across the organisation.
Specific Measureable Attainable Realistic Timed (SMART) goals – SMART goals are
written and agreed with the patient to ensure they are fully involved and consent to care. It
has been evidenced that personalised goals and care plans improves the quality of the
care and improves outcomes. During 2012/13 we conducted an audit on the quality of our
care plans. The results consistently demonstrated that although we provide care plans for
our patients, the detail and use of SMART goals will ensure we are accurately measuring
outcomes. These results were presented to the staff at GAIN, it was agreed there were
two main requirements to enable improvements; the development of a standardised
personalised care plan tool (My Plan) and training on SMART goal setting, motivational
interviewing and utilisation of the tool. Training has been arranged throughout 2013/14 and
will be mandatory for all staff that develop care plans with patients. To enable us to
evaluate the training, this will be re-audited on an individual rather than service basis in the
Clinical Quality Improvement Programme 2013-14.
Clinical quality measures (eg quality of life questionnaires) -The introduction of the
community information system allows services, as implementation rolls out to include
clinical outcomes to their assessment forms. This will allow easier access to the
information for auditing purposes therefore generate outcome measure reports.
3. Patient experience
a. Patient feedback – working toward real-time feedback
We researched and procured a new survey system that provides scope for greatly
improved feedback and audit systems. The real benefit of this programme will be the
availability of real-time reporting. This provides services with instant feedback to allow
immediate action, which will ensure customer experience is at heart of all they do.
Implementation is now completed and operational from 1 April 2013.
b. Intentional rounding
National concerns about the ability to provide essential aspects of care have focused
attention on ensuring that these are delivered effectively and consistently. Intentional
rounding involves health professionals carrying out regular checks with individual patients
at set intervals.
The approach has clear, measurable aims and expected outcomes that have been
evidenced in research studies. Ward teams organise their workload, providing more
consistent, individualised and safe patient care.
Rounding had been shown to reduce adverse incidents, such as falls and pressure ulcers,
and to generally improve patients’ experience of care.
The CQC noted in their unannounced inspection report on St Bartholomew’s Hospital: ‘We
saw that a two hourly check was carried out on all the people using the service, this check
included asking people if they would like a drink, checking their call bell was within reach
and having a quick chat to ensure they were not in any pain.’
The nurses and therapists, at St Bartholomew’s Hospital, have consistently maintained
intentional rounding throughout the year.
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c. Reducing waiting times in services where there are challenges
MCH has seen a consistent reduction in the numbers of patients waiting to access
services, and improvements generally in waiting times across services.
Significant improvements are evident within children therapy services and the children’s
pooled budget for school aged speech and language therapy.
Dermatology services have also seen a significant improvement.
Within physiotherapy (musculoskeletal) and podiatry services there was initially a
considerable improvement. However, the demand for both services has increased and this
is reflected in waiting times for routine patient referrals although urgent treatment referrals
have maintained the improved position. This issue is being addressed in discussion with
Medway CCG to seek safe and effective ways to manage the demand.
Podiatry has an action plan in place to review waiting times with key actions for increasing
patient access and improving the booking process which will help to address the issue.
A review of waiting times and booking processes is underway within the nutrition and
dietetics service.
Supporting and developing our staff
Organisational values and our pledge
Our organisational values are well established and integral to staff induction, the probation
period we have for all new members of staff, individual assessment of performance and
recognition of those staff who go above and beyond. Every service through 2012/13 has,
or is in the process of, developing a pledge. Based on the NICE quality standards for
patient experience and aligned to our organisational values and the NHS Constitution
these help to bring policy into practice by engaging teams to present a united agreement
that is signed as a commitment by each member of staff. These bespoke pledges also
provide outcome measures which we will utilise in future patient experience programmes.
Recognising excellence awards
November 2012 saw the first MCH annual recognising excellence awards presentation
where the overall winners of our caring and compassion, partnership, quality and value
and outstanding achievement awards were celebrated. The awards recognise individuals,
volunteers and teams who provide excellent care and service and the difference it makes
to patients and colleagues. They are based on our organisational values, that



we are caring and compassionate
we deliver quality and value
we work in partnership
Congratulations to the winners, runners-up and everyone who has been nominated on
their achievement. Nominations continue to flood in every month from patients and staff –
a testament to the high quality of the daily work of our staff.
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Winner
Name
Team
Outstanding
achievement
Kate Henderson-Thynne
Children's therapy
Frances Okomah, Annabel Cole,
Danielle Wanstall and Abi
Human resources
Durham
Caring and
compassion
Runner-up
Winner
Partnership
Runner-up
Winner
…we work in partnership
Award
Runner-up
Winner
…we deliver quality and value
Quality and
value
Runner-up
Shelley Liddle
Adults’ integrated
Gillingham community nursing
team - Kelly Spooner, Kay
Brisley, Amanda Haley and
Sarah Hope
Adults’ integrated
MedOCC receptionists - Carolyn
MedOCC
McNally and Justine Myton
Sam Clark
Human resources
Margaret Howard and Belinda
Jones
Business intelligence
and IT
Chris Gedge
Stroke
Pre-registration student placements
MCH provided placements
for 284 students during the
period Sept 2011- Aug
2012; this amounted to
1504 placement weeks.
This is an average of 5.2
weeks per student. There
was an increase in nursing
placements from 205 in
2010/11 to 219 in 2011/12.
Students on placement
within teams receive local
induction and are fully
supervised and supported
by local teams, this enables
them to develop good
relationships.
“The team worked well
together and they embraced me and made
me feel respected and an important member. This
was my first placement in the community and after
guidance and orientation to the system was able to
gain more confidence and was able to engage and
work with a small caseload. Everyone was very
willing to help with any queries although my time
spent in this placement was a hectic and changing
environment.”
“Working with other professionals and teams was
particularly well facilitated. Self-directed learning
and management of own learning needs was
encouraged and respected.”
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Nursing Times Awards 2013: our nurses were shortlisted in the
community placement category of the Nursing Times Awards 2013.
In the last year, over 218 nurses have undertaken a placement at
Medway Community Healthcare across a range of services
including specialist nursing, palliative care and community nursing
in clinics; inpatient units and people’s homes across Medway.
Preceptorship
The organisation recruited higher numbers of newly registered practitioners in 2012/13
than previous years, the majority of them were nurses, and we have also improved our
overall retention rate of newly registered practitioners. All newly registered practitioners
have a preceptor to support them through the initial period as a clinician. There is strong
evidence that these staff feel supported in their role and are generally gaining in
confidence in all areas and are highly satisfied with the programme. Preceptors have also
described how valuable the support of their manager is and this is an improvement
compared to last year.
Developments in preceptorship have meant that a new programme will be introduced
using the National Leadership Framework.
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Statements
In line with the Department of Health letter, the draft version of our quality account was
shared with HealthWatch and Medway CCG for comment. We also sought comments from
the Medway Council Health Overview and Scrutiny Committee. Their responses are
below. We did not receive any comments from HealthWatch.
Our draft quality account was also shared with our community forum, the MCH elected
members’ forum and staff - their comments have been incorporated.
We thank everyone for their interest and support.
Medway Council
Health and Adult Social Care Overview and Scrutiny Committee:
I am writing to thank you for inviting the Health and Adult Social Care
Overview and Scrutiny Committee to comment on your Quality Accounts.
As the Quality Accounts are often received outside of the business cycle for the
Committee the Assistant Director, Adult Social Care and the Assistant Director, Customer
First, Leisure, Democracy and Culture have a delegated authority, along with the
Chairman and spokespersons of the Committee to respond.
Set out below is the response on behalf of the Committee:
`The Health and Adult Social Care Overview and Scrutiny Committee welcome the
opportunity to comment on Medway Community Healthcare’s Quality Accounts.
During the past year the Committee expressed concerns regarding the podiatry service.
Concerns about some of the shortcomings with the service are already reflected in the
Quality Account The Committee will be taking a continuing interest in the improvements
set out in Medway Community Healthcare’s action plan going forward.
The Committee looks forward to further engagement with the organisation over the next
year’.
Kind regards
Rosie Gunstone
Democratic Services Officer on behalf of the
Health and Adult Social Care Overview and Scrutiny Committee
NHS Medway Clinical Commissioning Group:
In response to the draft Medway Community Healthcare
(MCH) 2012/13 Quality Account submitted to NHS
Medway Clinical Commissioning Group (MCCG) please
find detailed below the MCCG statement in accordance
with the National Health Service (Quality Accounts) Amendment Regulations 2012.
NHS MCCG welcomes the 2012/13 draft Quality Account submitted by Medway
Community Healthcare and can confirm that the CCG has reviewed it against all the
Department of Health reporting requirements and as far as can be determined the
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…we deliver quality and value
…we work in partnership
commentary and data presented are an accurate and honest reflection of progress made
in improved service delivery and patient outcomes.
The Quality Account sets out the priorities identified for the year and demonstrates how
most of these have been fully achieved or surpassed. The CCG acknowledges the ongoing excellent record MCH has with regards to health care acquired infections and
acquired pressure ulcers as well as using patient engagement to set priorities and using
patient feedback were services have not met their expectations to make necessary service
changes.
The MCCG acknowledges and supports the 6 priorities for 2013/14 detailed within the
Quality Account around Patient Safety, Clinical Effectiveness and Patient Experience.
The Medway population will continue to age and with that will come a population that has
increased prevalence of longer term conditions with many more people having more than
one. This will mean an increased reliance on Community services to help and support
people to live with their long term conditions ensuring that where possible we avoid
unnecessary hospital admission, whilst always aiming to deliver care closer to home with
the right service to meet the patients need. MCH are responding positively to this
challenge through continuous review of services and pathways as well as ensuring that
the care given is patient centred and that improvement goals are jointly agreed and moved
towards.
NHS MCCG look forward to continuing to work closely with the Clinical Quality Director
and colleagues at all levels within the organisation. We look to continue to strengthen our
relationship through the Clinical Quality Review Group with the aim of gaining the on-going
assurance that the quality of local services provided by MCH are maintained and
continually improved in all areas of the organisation.
Yours sincerely
Dr Peter Green Chief Clinical Officer
NHS Medway Clinical Commissioning Group
How you can provide feedback on our account
We would like to hear your comments and feedback on the quality account and any
suggestions you may have for the priorities and content for future reports.
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For further information or to request a hard copy of this report please contact the
communications team or call 01634 382211.
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Visit www.medwaycommunityhealthcare.nhs.uk to find out more about us
and the services we provide.
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