0.0.
QUALITY
ACCOUNT
2013/14
1
Our Vision
Putting local patients and families at the heart of everything we do, we will
ensure that on the journey towards the end of life, we provide the right care,
in the right place, at the right time
Our Values:
Care – We will provide 1st class care, delivered by competent people who
put the patient at the heart of all we do
Compassion – We will treat everyone with respect, dignity and empathy
Collaboration – We will work with others to ensure that patients and
families receive the best end of life care possible
Charity – We will provide care free of charge to patients and families and
will connect with our local communities so that they continue to finance
our present and our future
St John’s Hospice
Built by the people, for the people
2
Part 1
Chief Executive’s Statement
It gives me great pleasure to present this Quality Account for St John’s Hospice. In this
account our aim is to show how the Hospice measures quality, involves patients, carers and
staff and strives to always look for areas where we can improve our care.
A Quality Account is an annual report to the public from providers of NHS healthcare about
the quality of services they deliver. It is important to note that St John’s Hospice only
receives around 30% of its funding from the NHS, the rest (£2.7million) is donated by the
local community. The majority of services described in this document are funded by
charitable donation rather than by the NHS.
Quality sits at the centre of all that the Hospice does. Our vision is that everyone in our
catchment area of South Lakeland, parts of North Yorkshire and all of North Lancashire with
any life-limiting condition will have high quality care and support at the end of their life in
the right place, at the right time.
We asked patients, families, volunteers and staff to sum up in one word what St John’s
means to them. Their key words can be seen here:
3
Our Corporate and Clinical Governance structures ensure that we have both the systems and
processes in place to maintain a viable and responsible business, whilst ensuring that our
services are of the highest quality and meet the aspirations of our vision. Our services are
subject to unannounced inspections at any time.
On the 13th February 2014, the Care Quality Commission (CQC) conducted an unannounced
inspection of the Hospice. A CQC Inspector and an “expert inspector” specialising in
Governance attended. They spent a full day speaking to patients, families and staff and
scrutinising records and documentation. The Hospice was judged to be fully compliant in all
areas inspected. They said:
“We found there were good systems and processes in place to monitor the quality of the
service being provided. Staff told us this was underpinned by an open reporting culture and
strong leadership.”
This year we are proud to have achieved:
An increase in the number of patients being cared for at home
An increase in bed occupancy on our Ward
A complete review of our policies and procedures
The joint recruitment of a Palliative Care Consultant in partnership with the local
Acute Trust
Our goals for future improvement include:
To move from paper to electronic records, using an IT system that our GP colleagues
also use
To implement the findings of a review of food and nutrition throughout the Hospice
To gather accurate data and information in order to demonstrate our value to
commissioners
To extend our reach into South Lakeland
To provide more Day Hospice opportunities for patients
I am responsible for the preparation of this report and its contents. To the best of my
knowledge, the information contained in this Quality Account is accurate and a fair
representation of the quality of healthcare services provided by our Hospice.
Sue McGraw
Chief Executive
26th March 2014.
4
Part 2
Priorities for Improvement 2014/15
The priorities for improvement we have identified for 2014/15 are set out below. These
have been developed in conjunction with feedback from patients, carers, staff and
stakeholders. We have expressed our priorities in terms of the three domains of quality:
Patient safety
Clinical effectiveness
Patient experience
Priority 1 – Patient Safety & Patient Experience
Develop a workforce that is “Fit for the Future”
Review of staff competencies, training and the structure of our nursing teams
How was this priority identified?
Working with data from Cumbria and Lancashire North CCGs, it is clear that over the next 20
years the profile of the patients we care for will change. We will be faced with increased
demand as the population ages, people’s conditions will be more complex as they live with
co-morbidities and people’s expectations about the level of the service they receive will rise.
The Help the Hospices Commission into the future of Hospice care has produced a number
of important reports for Hospices to consider. These will be reviewed and analysed to
ensure that the Hospice is “fit for the future” by ensuring our team has the skills and abilities
they will need to care effectively for future generations.
In short, the demand for care at the end of life will rise and the nature of that care will
become more complex.
Whilst our workforce is skilled and extremely caring, we need to review whether the
competencies we have are the ones we will need for the future. Indeed, we need to consider
whether continuing with the current or increased level of employed staff is the right model
or whether we can increase/extend the number of volunteers; our volunteer support is
strong but volunteers are usually deployed in non-clinical areas, if we are to develop a
sustainable model for the future, the potential contribution of clinical volunteers must be
explored.
How will progress be monitored and reported?
• Develop a “Future Nursing Strategy” which will be monitored by the Care & Quality
Committee
• Volunteer roles and recruitment to be reviewed and reported to the Board
• Working with partner Hospices, develop a competency framework for staff at all levels
to be applied across all clinical areas and to be monitored by the Board
5

Work with the Help the Hospices Commission into the future of Hospice care by
taking part in research activities and benchmarking exercises as they arise

Working with partner Hospices to develop a management & leadership programme
Priority 2 – Clinical Effectiveness
Conduct a Food and Nutrition Review across the Hospice
Ensure that patients’ food and nutrition requirements are met and that staff have the skills
and abilities to provide first class nutritional advice
How was this priority identified?
The demise of the Liverpool Care Pathway in 2013 prompted the hospice to review the
provision of food and hydration to patients at the end of life. Reading Baroness Julia
Neuberger’s report “More Care, Less Pathway”, it was clear that the withdrawal of food and
nutrition from dying patients was a major and traumatic issue for people her team
interviewed. We are confident that the poor practice described in Baroness Neuberger’s
report does not apply at St John’s, however, the harrowing descriptions in the document
led to the CEO commissioning a review of food and nutrition across the Hospice.
The research was conducted in January 2014 by a member of the Board, results and
recommendations will be implemented over the coming year.
How will progress be monitored and reported?
 A food and nutrition steering group will be established, chaired by the Head of
Nursing & Quality with a direct line report to the Board
 Patient satisfaction surveys will be reviewed to ensure that issues regarding food
and nutrition are captured
 The Head of Nursing & Quality will ensure that the staff we employ have appropriate
skills training to deliver nutritional advice
 The Hospice will take part in a national food and nutrition in Hospices research
project
Priority 3 – Safety
Adoption of an electronic patient record system to ensure patients receive safe, effective
and consistent care
We will adopt the system used by GPs in both our Commissioning areas
How was this priority identified
This was identified as a priority for improvement l a s t y e a r , h o w e v e r , t he panLancashire project stalled and the Hospice’s ability to make progress was delayed by
this.
6
It became clear that our current team do not have the knowledge, skills and abilities to lead
a major IT project so the Board agreed to create a new post, IT and Information Governance
Co-ordinator. The Co-ordinator will be responsible for supporting the implementation of the
new IT system and for ensuring that our team has the necessary skills to face the “brave
new world” of electronic records.
As the hospice is a charity and not part of the NHS, we do not have access to the IT
infrastructure that many of our colleagues in the wider healthcare community are currently
using. When patients are transferred to us, we have to access paper documentation which is
not always available in a timely manner. Equally, on discharge, our colleagues in the
community have little or no information immediately. Clearly this has the potential for delay
and mistakes in communicating key information which may affect patient safety.
We will adopt EMIS web, the IT system used across GP Practices in South Cumbria and North
Lancashire.
How will progress be monitored and reported?
 A cross healthcare community project group will monitor and report on the
effectiveness of the new system
 Regular audits will be undertaken
 Staff will be consulted to ensure they are involved in the development of the project
 Surveys of partners will be undertaken to ensure that the project is effective
 Progress will be report to the Care and Quality Sub-Committee who, in turn will
report progress to the full Board
Review of 2013/14 Priorities for Improvement
Ward Improvements
Following a complete refurbishment of the Ward, we have gradually increased bed
occupancy to put us in the upper quartile for bed occupancy as guided by the National
Council for Palliative Care Minimum Data Set
Review
This refurbishment has been achieved this year but will always be “work in progress”.
New beds were purchased with state of the art pressure relieving mattresses – this was
achieved by applying for charitable grant funding.
Patients and families have been involved in discussions regarding colour schemes for the
refurbishment of the communal areas and ventilation and weather-proofing work has been
undertaken.
Simple things such as ensuring the bird-feeders outside the bedroom windows are topped
up providing endless interest and entertainment and the provision of well-presented trays at
mealtimes, including cloth napkins and individual hand-wipes seem to make the biggest
difference for patients.
7
Our patient and family survey comments are extremely positive and the CQC inspectors,
th
when they made their unannounced inspection on the 13 February 2014, included the
following comment from a service user:
“I can’t fault any aspect. It’s faultless and I don’t say that lightly.”
However, from the staff point of view, space on the Ward is limited. Whilst we make every
effort to ensure that patient care is not compromised, equipment is not stored close at
hand. Indeed oxygen cylinders are stored in the yard at the back of the Hospice and can be
cumbersome for staff to move when needed urgently. As the service gets busier, there is a
need to store more large equipment such as beds and hoists. Another sign of a shifting
demographic is the demand for bariatric equipment – since the 1st April 2013, our team has
nursed 3 bariatric patients . Our “standard” equipment is not always adequate and it looks
likely that we will need to invest in more bariatric equipment in the coming months and
years. Again, this is problematic for staff as there are no storage facilities on the Ward. The
new Head of Nursing & Quality is working with the Ward team and our Facilities Coordinator to address these issues. We will apply for grant funding to support the costs of any
building/improvement works that may need to be done to accommodate these changes.
Become the Palliative Care “Hub” for North Lancashire and share our learning with
neighbouring commissioning groups
Provide a telephone “hub” and a 24/7 rapid response service in the community for end of
life patients in North Lancashire
Review
The introduction of this service has been a major success for the Hospice. Patients in the
North Lancashire CCG area now have access to specialist palliative care 24 hours a day, 365
days a year. This round the clock service is coordinated from St John’s Hospice and has been
part funded by Lancashire North CCG.
The successful Hospice bid for capital bid funding from NHS England was used to support
the development of a purpose built space to accommodate the new service. The 24 hour
service offers:
Home nursing care and a rapid response service 7 days a week provided by St John’s
Hospice nurses between the hours of 7am and 10pm
Respite support for carers provided by St John’s Hospice nurses 7 days a week
Urgent, “out of hours” care from 10pm to 7am 7 days a week provided by the Marie
Curie rapid response
Single point of access telephone support for referrers, patients and families
Bereavement support provided by St John’s Hospice Family Support Team
8
To be referred to the service the patient must:
Want to stay at home
Be aged over 18
Be registered with a GP in the Lancashire North CCG commissioning area
Have end of life needs (any diagnosis) and be experiencing a sudden deterioration in
their condition
Have urgent palliative care needs (nursing, social or symptom management- physical
or psychological)
Have a carer who is in crisis and needs support
The service was launched fully in June 2013. Since the 1st April 2013, the team have made
more than 12,000 face to face visits and handled more than 10,000 telephone calls. Whilst
difficult to quantify, we know that the team have helped prevent numerous unnecessary
hospital admissions since the service began. A family member wrote to us to say:
“My dear ‘Team’ I can’t thank you enough for all your help, care, concern and support. I have
an overwhelming feeling of thankfulness that my Husband was able to die so peacefully at
home with all our familiar things around us. It was just as we had discussed and very much
hoped would happen. An ending most of us would probably hope for. God bless all of you.”
The introduction of the 24 hour palliative care hub has been a great success in Lancashire
North. We are working with Commissioners in South Lakes to identify gaps in end of life care
provision. We hope Commissioners in South Lakes may recognise the value of this 24 hour, 7
days a week “hub” model for their area and patients too.
Part 2 (Continued)
Statements of Assurance from the Board
Quality Accounts have a series of statements that MUST be included. Many of these
statements do not apply to St John’s Hospice. Explanations of these statements are given
where appropriate and are prefaced by the words: “MANDATORY STATEMENT”.
During 2013/14, St John’s Hospice provided the following services:

In Patient Unit – 17 beds (registered for up to 20)

Hospice at Home Service

Day Hospice

Family Support and Bereavement Service
9





COPD/MND/Parkinsons Support Groups
Education and Training – Including 6 Steps to Success programme with Care Homes
Education and Training – Including Lancaster University GP trainees, GPSTRs from the
Lancaster University Medical School, Nurses and Occupational Therapists from UCLAN
and University of Cumbria
Out Patient Clinics
Physiotherapy, Occupational Therapy, Social Work and Lymphoedema Services
Charitable donations support 70% of this work, the remaining 30% comes from the NHS.
MANDATORY STATEMENT – St John’s Hospice has reviewed all the data available to them
on the quality of care in all these NHS services.
Participation in Clinical Audits
The Hospice audit calendar is led by the Head of Nursing & Quality, co-ordinated by the
Education department and overseen by the clinical team. Audits are a standing item on the
Care and Quality Committee agenda and are discussed monthly at the clinical management
meeting. The following are examples of audits conducted within the Hospice in 2013/14:
Pressure Ulcer Management
Discharge Summaries
Steroid Use on the Ward
End Stage Heart Failure Case Notes
Resuscitation Status Documentation
Drug Allergies
Bedrails Decision Record Documentation
Information Governance Compliance
The Hospice also took part in a North West Audit Group Fentanyl Patch review. This was a
multi-centre, regional audit covering Hospice, Hospital and Community sites.
Research
MANDATORY STATEMENT - The number of patients receiving NHS services provided or subcontracted by St John’s Hospice in 2013/14 that were recruited during that period to
participate in research approved by a research ethics committee was NONE
10
Use of the CQUIN Payment Framework
For the first time the Hospice at Home Hub was asked to work on the CQUIN framework
below, results are indicated, all goals were achieved.
Goal
Number
Goal Name
Description of
Goal
Goal
weighting
(% of
CQUIN
scheme
available)
Expected
financial
value of
Goal (£)
Quality
H@H Hub
Domain
Response
(Safety,
Effectiveness
Patient
Experience
or
Innovation)
Friend and
Family Test
Develop and
pilot family &
carer survey in
year
50.00%
£1,440.50
Patient
Experience
Completed,
although
this will
continue.
£0.00
0
N/A
£1,440.50
Effectiveness
Completed.
£0.00
Patient
Experience
N/A
1
2
3
4
Locally develop
NHS Safety
implementation 0.00%
Thermometer of safety tools
applicable to
the service
All staff
Dementia
undertake
50.00%
Dementia
awareness
training
Training to
VTE
identify, assess 0.00%
and manage
treatment of
VTE, where
appropriate in
year
Total
100.00%
MANDATORY STATEMENT - £2881.00 of St John’s Hospice NHS income in 2012/13 was
conditional on achieving CQUIN targets as outlined above. All targets were achieved.
11
Statement from the Care Quality Commission (CQC)
St John’s Hospice is required to register with the CQC; we are registered to carry out the
following regulated activities:
Treatment of disease, disorder or injury
Diagnostic and screening processes
Transport services, triage and medical advice provided remotely
St John’s Hospice has the following conditions on registration:
Only treat people over 18 years old
Only accommodate a maximum of 20 in-patients
The CQC has not taken any enforcement action against St John’s Hospice during 2013/14.
On the 13th February 2014, two inspectors made an unannounced visit to the Hospice. The
Inspectors’ overview of the Inspection was as follows:
“We spoke with a range of people about the hospice. They included the registered manager,
staff members, volunteers, patients, relatives and visitors. We also asked for the views of
external agencies in order to gain a balanced overview of what people experienced using St
John’s Hospice. We spoke with patients and relatives. They told us they could express their
views and were involved in making decisions about their care. They told us they felt listened
to when discussing their care needs. Staff confirmed to us they also involved relatives, where
possible to ensure people received the right care and support. We spent time in all areas of
the hospice, including the day centre and in-patient unit. This helped us to observe the daily
routines and gain an insight into how people's care and support was being managed. Staff
treated people with respect and ensured their privacy when supporting them. They provided
support or attention as people requested it. We spoke with people about the care and
support they received. They said they were happy with the care and support being provided.
We looked at how the service was being staffed and reviewed staff training and supervision.
We saw there were sufficient staff on each shift with a range of skills and experience. Staff
told us they felt supported, had regular meetings with their manager, and their training was
kept up to date. We found there were good systems and processes in place to monitor the
quality of the service being provided. Staff told us they felt this was underpinned by an open
reporting culture and strong leadership.”
Areas inspected were:
 Treating people with respect and involving them in their care
 Providing care, treatment & support that meets people's needs
 Caring for people safely & protecting them from harm
 Staffing
 Management
12
All areas inspected fully met CQC standards. The full report can be seen here:
http://www.cqc.org.uk/sites/default/files/media/reports/1126938839_St_Johns_Hospice_INS1-674602270_Scheduled_06-03-2014.pdf
Data Quality
MANDATORY STATEMENT - St John’s Hospice did not submit records during 2013/14 to the
Secondary Users Service for inclusion in the Hospital Episode Statistics which are included in
the latest published data.
However, St John’s Hospice does submit data to the Minimum Data Set (MDS) for Specialist
Palliative Care services collected by the National Council for Palliative Care on an annual basis,
with the aim of providing an accurate picture of Hospice and Specialist Palliative Care service
activity. Data taken from the MDS is reported in section 3, Review of quality Performance.
Information Governance Toolkit
St John’s Hospice Information Governance Assessment Report overall score for 2013/14 was
76%. This is considered a “satisfactory” score. The % mark for compliance this year was 66%.
Clinical Coding Error
MANDATORY STATEMENT – St John’s Hospice was not subject to the payment by results
clinical coding audit during 2013/14
13
Part 3
Review of Quality Performance
In this section, we have chosen to provide data benchmarking St John’s Hospice with figures
from the National Council for Palliative Care Minimum Data Set, (MDS.) The MDS is the only
national benchmarking tool for Hospices.
In Patient Unit
2013/214
2012/13
2011/12
Total number of
patients
295
293
286
Number of new
patients
258
259
248
% Occupancy
77%
74%
67%
Location after end of
stay
159 – Deaths
161 – Deaths
160 – Deaths
152 – Home
169 – Home
172 – Home
16 – Care home
7 – Care Home
14 – Care Home
3 – Acute Hospital
4 – Acute Hospital
12 – Acute Hospital
22 - Other
9 - Other
7 - Other
13.4
15.4
11.6
2013/14
2012/13
2011/12
Total number of
patients
541
315
250
Total number of visits
face to face
12,327
4902
4155
Total number of
telephone calls
10,302
4722
3858
% of people who died
at home
85%
92%
93%
(NB Figures do not
total because some
patients were
admitted more than
once.)
Average length of
stay( in days)
Hospice at Home
14
Average length of care
43 days
25.9 days
38.4 days
2013/14
2012/13
2011/12
Total number of
patients
147
140
144
% new patients
66%
69%
74%
Average period of
attendance
80.5 days
85 days
91.4 days
2013/14
2012/13
2011/12
Total service users
420
456
444
Number for whom
formal support ended
344
391
379
Average length of
support
45.4 days
47 days
88 days
Day Hospice
Family Support and
Bereavement Service
Feedback from Staff
St John’s Hospice is a significant local employer with low rates of staff turnover and high
levels of applicants when vacancies are advertised.
An annual staff satisfaction survey is conducted, benchmarking St John’s with 93 other
Hospices nationally. The top three statements that staff agreed with were:
If a friend or relative needed treatment, I would be happy with the standard of care
provided by the Hospice – 99% (95% national benchmark)
I enjoy the work I do – 98% (95% national benchmark)
I am proud to work for St John’s Hospice – 97% (91% national benchmark)
15
Feedback from Patients, Families and Carers
Feedback from patients, families and carers is one of the most important ways for us to
understand and improve the services we provide. In the past 12 months, our patient user
group have been put to good use! We invited a local GP to come to speak to them about the
difficulties they face when they cannot get a GP appointment, they took part in a workshop
with the “Better Care Together” communications team and most recently, they helped us to
review our Hospice vision and values as we refreshed our Corporate Strategy.
We often receive comments and compliments by letter or email, here is a montage of some
of them:
We never forget that the sign above the door here reads “built by the people for the
people”. Putting patients and families at the heart of what we do is fundamental for the
Hospice.
16
Surveys
Our Vice-Chairman and Chair of the Care and Quality Committee conducts patient
surveys on the Ward. This year, comments have been almost 100% positive.
For the first time this year, we conducted surveys with bereaved relatives who had used our
Hospice at Home service. Again, feedback was overwhelmingly positive.
Complaints 2012/13
Complaints are all monitored by the relevant member of Senior Management Team,
clinical complaints are discussed at the Care and Quality Committee and are reported to
the full Board.
Complaints
Number
Total number received
2
Total number of complaints upheld in full
2
Total number of complaints upheld in part
_
Total number of complaints not upheld
_
Opportunities to give Feedback on this Quality Account
We welcome feedback on our Quality Account. If you have any comments, please email:
Sue.mcgraw@sjhospice.org.uk
Or write to:
Sue McGraw
Chief
Executive
St John’s
Hospice Slyne
Rd Lancaster
LA2 6ST
17
Annex
Comments from Healthwatch Cumbria
Healthwatch Cumbria is pleased to be able to submit the following considered response to St.
John’s Hospice Quality Accounts for 2013/14. Our comments and questions have been
developed in consultation with Healthwatch Board Members, lay representatives and the
Healthwatch Manager.
Healthwatch Cumbria welcomes the opportunity to provide feedback in response to the
Quality Account Report and would like to comment on the clear and concise presentation of
the report. The responding group found the report gave a good account of the quality and
safety of care, in an open and transparent manner in line with the Francis Recommendations
also noted by the CQC along with strong leadership.
We commend the Hospice on acknowledging the need for forward planning for future
workforce and their competencies to best support the future needs of service users and the
need to align itself with computerised systems used by GP’s that will ensure easier and safer
access to patient information by both care providers to best support the patients in a timely
manner, which demonstrates best practice.
It is good to see the Hospice prioritising the views of both staff and patients although it is not
exactly clear how feedback is used to gather this information. The Hospice is clearly working
in partnership with its staff and patients as evidenced in the Chief Executives statement that
includes testimonial phrases from both parties.
Following the outcome of Baroness Julia Neuberger’s report it is good to see that St. John’s
Hospice Chief Executive was proactive in the commissioning of a review of Food and Nutrition
across the Hospice and will be able to demonstrate the findings through evidential data and
training of staff.
In the hospice’s priorities for next year (2014/15) it would be helpful to include some detail of
the processes used for gathering feedback, specifically on how it is translated into chosen
priorities.
This concludes the response from the Healthwatch Cumbria’s responding group to St. John’s
hospice Quality Accounts Report for 2013/14. Once again we would like to commend the
Hospice on the presentation and content of this report and for the continued improvements
across the Hospice’s services.
Signed for Healthwatch Cumbria
Sue Hannah
Senior Engagement Officer
Comments from Healthwatch North Lancashire
The hospice is to be commended for producing a Quality Account, as it is not entirely clear
that they are obliged to do so. It is also apparent that the QA pro forma does not fit well
with the services provided by the hospice. Presumably this is an issue of wider concern than
St John’s and it may be that there is a role for Help the Hospices to develop a more useful
format.
We have no reason to doubt the accuracy of the information contained within the
document. We received no comments – positive or negative – from the public regarding St
18
John’s Hospice in 2013/14. They have had very positive local media coverage.
We have some comments on specific issues raised by the Quality Accounts:
•
We believe that the hospice is right to prioritise workforce development. The health
and care sector in general is looking at very significant challenges to its future
workforce in terms of enough people and the right skills. The hospice clearly has some
advantages as a small organisation that people actively want to work for. A tightening
labour market in the medium term may well threaten this and we urge the
organisation to keep workforce development at the forefront of its efforts. The
hospice already works very successfully with volunteers, who play a key part in
delivering services. In the context of workforce development, it is likely that
volunteering will become even more important to the hospice in the future.
•
We welcome the Food and Nutrition Review and would appreciate seeing more detail
about this in the future.
•
The narrative of the document suggests a successful, empathetic organisation. The
challenge for the Hospice, based on the document, is the provision of outcome data
showing improvement in things like life quality, general health, and mental wellbeing,
across the community. These outcomes are clearly a key part of the work of the
Hospice and they should be a key part of its Quality Account. The test of inpatient care,
the hub, hospice-at-home and the phone service is the impact they have on people’s
lives.
•
The Hospice is to be congratulated on having a loyal and highly motivated staff team.
We understand that the dynamics of a hospice may make a complaints policy difficult
to manage and we would be happy to assist the hospice in developing its thinking
about this. We presume that the two complaints recorded in 2013/14 were formal
written complaints and we wonder how informal complaints and comments are dealt
with. Really important information about service quality can be gleaned from informal
complaints and comments, and a learning organisation will want to capture this.
Comments from Cumbria CCG (South Lakes Locality)
“Cumbria CCG recognise the great work St John’s Hospice does in ensuring the best quality
of care, for patients, which is so well reflected in this Quality Account. They continue to be
great advocates for the improvement of those services and they and their staff should be
commended on the services they provide.”
Senior Commissioner Cumbria CCG
Comments from North Lancashire CCG
“I think the report is an excellent reflection of the level of consideration you have given to
leading and developing the Hospice and the staff are to be commended on their hard work
and commitment.”
Commissioning Manager, Lancashire North CCG
Comments from Lancashire County Council Overview and Scrutiny Committee
“The Lancashire Health Scrutiny Committee made no comment on the St John’s Hospice
Quality Account”
19
Comments from Cumbria County Council Health Scrutiny Committee
The Cumbria Health Scrutiny Committee welcomes the opportunity to comment on the St
John’s Hospice Quality Accounts for 2013-14.
Councillors have highlighted how clear and well written the report is, clearly setting out the
improvements you aimed to achieve, the rationale for these and the desired outcomes and
monitoring procedures in place. It was felt that there was a good use of the CQC evidence
and patient and others’ views.
In future it was suggested that the document could be further developed to include more
like for like comparisons in the data section. It may also be useful to highlight if there were
any areas for development arising from the surveys that you reference, and if so what is
being done to progress these, in addition to the excellent feedback that is also coming out
of these.
The overall picture is of a well-run and caring establishment and Health Scrutiny members
appreciate the work that has taken place over the recent year and look forward to
continuing to work with the Hospice.
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