Service User
Survey Results
2011
North East London NHS Foundation Trust
Toni Martin – Senior Consultant
Quality Health
Service User Survey 2011
Context
o
o
o
NHS Plan:
+ Mandatory annual national surveys (patient and staff)
+ Links to Vital Signs
+ Conclusion: Patient and Staff surveys are a major source of data for
CQC evaluating Trust performance
CQC’s Role:
+ Organise and run the national surveys – DH may take over the
programme in 2012
+ Publish comparative data for each Trust to inform public and guide
funding. CQUIN scheme linking Patient Experience data to funding may
be extended to MH
+ Inspection: sometimes unannounced or short notice - c.1 in 5 chance of
being inspected in any one year. Inspections becoming more rigorous
Patient Reported Outcome Measures:
+ MH community services could be in scope for industrial scale PROMs
Service User Survey 2011
Operating Framework & Vital
Signs
o
Vital Signs on patient experience:
+ Self reported experiences (national priority for local delivery, i.e. PCTs
decide on precise content of local Vital Signs)
+ AND respect and dignity ratings
+ “Success” defined as increase in index score for each survey (national
priority indicators guidance)
+ Operational Plans Technical Guidance Master makes clear that patient
experience will be gauged using questions in 4 patient survey domains:
13 questions, flashed in this presentation
Service User Survey 2011
Key Points
o Establish: differences between service users and managers /
clinicians views of service
o National Service User Surveys 2003 - 2011 used essentially
same methodology
o Substantial revision to questionnaire in 2011
o Comparison here with 15,159 Service User respondents from
core samples in 56 MH function Trusts.
o 86% of MHTs used QH
o National Response Rate: 32%. Range is 26% - 42%; London
and metropolitan areas lowest; shire counties with lowest levels
of deprivation have highest response rates
Response rate: 26% ( 213 respondents)
Additional sample: 21% ( 31 respondents)
Service User Survey 2011
Performance Issues
Performance differences between Trusts caused by:
o CQC standardise data only by age and gender. Our official study shows need to
o
o
o
o
o
standardise for ethnicity or use unstandardised data.
Differences in practice and quality – but also:
Differences in social composition
+ Ethnicity: Asian and Black service users have different pattern of contact – less use of TT,
more contact with Psychiatrists. Asian patients less positive about care planning, CCs, fewer
have access to out-of-hours service; Black service users have double the rate of sectioning
than whites
+ Age: Young patients less satisfied than older patients: up to 18 point difference on
information issues etc between 16-24s and 64-75s
+ Gender: Women less positive than men
Still big differences perceived in service quality between geographically based
teams in some Trusts
Differences in composition of CPA register: % of service users on new CPA ranges
from 100% to 8% between Trusts in this survey
+ Too soon to tell how differential implementation of new CPA system will affect the data. Much
looks unchanged from previous years
+ Under old CPA rules, enhanced CPA service users were much more likely to be aware of
care plans, care co-ordinators, out of hours phone numbers, than those on standard CPA
So, the kinds of service users in your sample are crucial
Service User Survey 2011
CPA Range
Percentage of Sample on Enhanced or new CPA by Trust
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
0%
Service User Survey 2011
National Trends 2003-2011
Service User Survey 2011
National Trends 2003-2011
Service User Survey 2011
National Trends 2003-2011
Service User Survey 2011
National Trends 2003-2011
Service User Survey 2011
Key Scores in 2011
Key Scores Comparison
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Trust and Confidence in Told about side effects
last staff seen
of medication
Know who Care Coordinator is
Given Copy of Care Plan
in last year
Had Care Review in
Last year
Have Out-of-Hours
Number
Overall Care Excellent /
V Good
Service User Survey 2011
Respondents Details
TRUST
ALL
 Women
53%
58%
 Men
47%
42%
 White British
67%
84%
 Ethnic Minority
20%
9%
 16-34 Year Olds
17%
16%
 65 Years Old and Over
21%
30%
 In Paid Work
14%
15%
 Unable to work because of MH problems
38%
37%
 Current mental health good to excellent
46%
40%
 Not admitted to hospital in last 12 months
87%
86%
 Service User Filled in Questionnaire
70%
68%
Service User Survey 2011
Contact & Staff
TRUST
ALL
 In contact with service less than 1 year
20%
15%
 In contact more than 10 years
30%
31%
 Last contact with service in last month
 Staff most recently seen:
48%
60%
20%
7%
39%
11%
31%
11%
28%
16%
5%
9%
5%
7%
+
+
+
+
+
+
+
+
Community Psychiatric Nurse
Social Worker
Psychiatrist
Mental Health Support Worker
Occupational Therapist
Psychologist
Pyschotherapist
Other
2%
14%
6%
3%
Service User Survey 2011
Staff Attitude
TRUST
ALL
 Views about staff seen
+ Definitely listened carefully
78%
79%
+ Definitely took views into account
71%
74%
+ Definitely had trust and confidence
68%
71%
+ Definitely treated with respect and dignity
+ Definitely given enough time to discuss condition
/ treatment
86%
68%
87%
72%
Service User Survey 2011
Medications
TRUST
 Medication taken in last 12 months
ALL
89%
89%
+ Definitely had views taken into account
57%
56%
+ MH worker prescribed new meds in last 12 mths
34%
45%
+ Definitely had purpose of new meds explained
73%
68%
+ Definitely told about possible side-effects
45%
43%
+ Information definitely easy to understand
61%
53%
+ Had check to see how getting on with meds
70%
79%
Service User Survey 2011
Talking Therapy
TRUST
 Had talking therapy in last 12 months
ALL
42%
39%
+ Asked for, but didn't get, talking therapy
14%
13%
+ Definitely found talking therapy helpful
52%
47%
Service User Survey 2011
Co-ordinators & Care Plans
TRUST
 Know who care co-ordinator is
ALL
55%
71%
+ Can always contact if there is a problem
66%
72%
+ Care organised very well
55%
61%
33%
42%
+ Definitely understand what is in care plan
37%
43%
+ Definitely had views taken into account
51%
54%
+ Care plan definitely sets out goals
41%
41%
+ MH service definitely helps achieve goals
43%
44%
+ Plan definitely covers what to do in a crisis
50%
52%
 Given / offered hard copy of care plan in last
year
Service User Survey 2011
Care Reviews
TRUST
ALL
 Had at least one care review in last year
46%
56%
+ Told could bring friend / relative to review
67%
71%
+ Able to talk to care co-ordinator before review
60%
59%
+ Definitely given a chance to express views
72%
70%
+ Definitely found care review helpful
64%
50%
62%
59%
+
Definitely discussed need to continue using
service
Service User Survey 2011
Crisis Care
TRUST
 Have telephone number to call out-of-hours
ALL
42%
51%
+ Called number in last 12 months
39%
37%
+ No problem getting through
67%
75%
+ Definitely got the help wanted
51%
50%
Service User Survey 2011
Day to Day Living
TRUST
 Given support by MH services for physical
health
 Not asked about either alcohol or non-scrip
drug use in last 12 months
ALL
32%
35%
+ Alcohol
33%
30%
+ Drugs
46%
46%
29%
31%
56%
41%
 Would have liked help finding / keeping
accommodation but didn't get any
47%
37%
 Would have liked help getting benefits but
didn't get any
50%
37%
 Given support by MH services for caring
responsibilities
 Would have liked help finding / keeping work
but didn't get any
Service User Survey 2011
Overall
TRUST
ALL
 Overall rating of care in last 12 months:
+ Excellent / very good
+ Poor / very poor
 Service definitely involved family as much as
would like
51%
59%
9%
8%
40%
49%
Service User Survey 2011
Comparisons with National Data
TRUST
ALL
 Had contact with service in last month
48%
60%

 Treated with respect and dignity by staff
86%
87%

 Had trust and confidence in staff
68%
71%

 Views taken into account on medication
57%
56%

 Purposes of medication explained
73%
68%

 Told about possible side-effects
45%
43%

 Had review of medicines in last 12 months
70%
79%

 Know who care co-ordinator is
55%
71%

 Given or offered copy of care plan in last year
33%
42%

 Care plan definitely set goals
41%
41%

 Had care review in last year
46%
56%

 Got number to call out-of-hours
42%
51%

 Rating of care in last year excellent / very good
51%
59%

 Family involved as much as would like
40%
49%

Service User Survey 2011
Movement 2010-11
2010
2011
 Treated with respect and dignity by staff
85%
86%

 Had trust and confidence in staff
67%
68%

 Views taken into account on medication
57%
57%

 Purposes of medications explained
63%
73%

 Told about possible side-effects
41%
45%

 Had review of medicines in last 12 months
72%
70%

 Know who care co-ordinator is
52%
55%

 Given or offered copy of care plan in last year
22%
33%

 Care plan definitely set goals
36%
41%

 Had care review in last year
40%
46%

 Got number to call out-of-hours
34%
42%

 Rating of care in last year excellent / very good
48%
51%

 Family involved as much as would like
45%
40%

Service User Survey 2011
Issues for Action
o
o
o
o
o
o
o
o
o
Better information on medication purposes & side effects, decisions on meds
where possible
Ensure that all medication is being effectively reviewed congruent with your
clinical guidelines
Assess unmet need for talking therapy
Further improve knowledge of who the care co-ordinator / lead professional
is and awareness of how they can be accessed
Continue action to ensure all get a hard copy of care plan, understand
contents, and ensure formal updating at least annually
Further improve incidence of care reviews - many say they haven’t had one
in last year
Further extend help to those wanting it on finding work, benefits, housing
Ensure all service users have access to out-of-hours support telephone
number
Ensure that enough information and support is given to families and carers
Service User Survey 2011
The Next Steps
o Integrate with Quality Account and ensure Vital Signs action
plans are in place.
o Specific action plans in place to deal with top service user
related issues. Build a performance management system
which makes managers accountable; top improving Trusts pick
3-4 issues at most and rigorously performance manage them
from the top.
o Lead the process within the Trust. Keep the pressure up, don’t
stop. Repeat messages.
o Consider tracker surveys on community and IP services
o Publicise achievements.
Service User Survey 2011