Minutes from the Trustwide Patient Experience Group meeting
5th May 2015, 11:00AM – 13:00PM
Large Board Room, ECAO, Canterbury
Present:
Pippa Barber
Janet Lloyd
Nick Dent
Linda Stocker
Ian Oliver
Kathryn Ayles
Stephanie Taylor
Louise Jessup
Dawn Hyde
David Hough
Cathy Neymeck
Mike Curtin
Kamila Lobuzinska
Apologies:
Kelly August
Dr Adesola Sewo
Sam Spence
Jo Pannell
Stephen Sawoy
Catriona Brodie
Nicole Bannister
1.
Executive Director of Nursing and Governance
Patient, Public and Community Involvement Manager
Patient Experience Team Manager
Community Recovery Service Line Lead for Allied Health Professions
AHP Professional Lead for OPMHN & Specialist Services
Service Line Lead for Allied Health Professions and Patient Experience
Forensic and Specialist Service Line
Clinical Quality & Compliance Lead
Acute Service Line
Lived Experience Practitioner
Carer & KMPT Volunteer
Swale User Representation Forum (SURF)
CMHT Service manager- Thanet
Lead Nurse, Acute Service Line
Patient, Public & Community Involvement (PPCI) Administrator and Personal
Assistant to Janet Lloyd, PPCI Manager (minutes)
Senior Communications Officer
Specialty Doctor to Dr Matthew Debenham, Consultant Psychiatrist and
Interim Assistant Medical Director (Acute Inpatient)
HR Business Partner Community Recovery Service Line
HealthWatch Kent
Associate Hospitals Manager
Practice Support Manager
Senior Communications Officer (Internal Comm. & Engagement)
Welcome and apologies
Lead by Pippa Barber (PB)
2.
Minutes of the meeting 7th April and action plan update
Minutes from previous meeting approved by all members of the panel
Matters arising and actions;
3rd March (2)
Stephanie Taylor (ST) admitted that actions and solutions raised for carers during Stakeholder Focus
Group haven’t been included in the current action plan for the Acute service line. She will send an
update to Pippa Barber before Thursday, 7th May.
ACTION ST
David Hough (DH) has visited Emerald Ward. The impression was good, the new ward is different from
others and is focussed on purpose. He suggested to PB to present the number of patients which will
be transferred from Swale to the new ward during the Carers’ Conference. Nick Dent (ND) will check
this number with Sarah Holmes-Smith.
ACTION ND
3rd March (2)
Posters for the Wellbeing Cafe – ND presented the poster the ‘Wellbeing Café’ in Sheerness and
Sittingbourne which were produced by Maidstone and Mid-Kent Mind. Louise Jessop (LJ) highlighted
the importance of being consistent with the name Wellbeing Café and not to mix it with Crisis Café.
Cathy Neymeck (CN) asked if the Crisis Team needs to refer people to Wellbeing cafes. The Crisis
Team can refer people and ND confirmed that those places have an open access but the one in
Canterbury is different, where a referral process is needed. ND will share info about the Wellbeing
Centre in Canterbury with the Crisis Team.
ACTION ND
3rd March (5)
Linda Stocker (LS) and Ian Oliver (IO) to find out when clinicians are cancelling appointments – this
point is still ongoing but a report has been generated. Each team will receive information about
cancellations and they will need to act on it locally. The Report will be presented during the next
meeting
ACTION LS and IO
3rd March (11)
Jo Pannell (JO) to update group on the HealtWatch Kent complaints report relating to the complaints
system across the NHS, in JP’s absence this point will be moved to the next meeting and JL will
contact JP for the update
ACTION JL
3rd March (12)
Triangle of Care – steering group meeting will take a place on 18th May in Priority House, PB asked for
an update from the Acute Service Line and the Community Recovery Service Line on Triangle of Care,
also she asked which carers have been invited to attend and asked for representatives from the North
Kent Carers Consultative Committee, West Kent Carers Consultative Committee and East Kent Carers
Consultative Committee.
ACTION ST
3rd March (12)
‘Out of area bed information sheet’ has been produced, it needs to be branded, JL to contact
Communication Team
ACTION JL
7th April (4)
Quality accounts Patient Experience Priorities – JL will check with Kelly August if link on staff zone
relating to medication leaflets works
ACTION JL
7th April (12)
Carers Guide to Confidentiality – document sent to the Communication Team, it needs to be branded;
JL will chase this up
ACTION JL
3.
Policies
1. Policy and Procedure for Listening and Responding to Concerns and Complaints
Presented by ND, he focused on the amendment made to the policy which was adding a paragraph
about Duty of Candour.
From November 2014, the Trust is required to comply with a new Statutory Duty of Candour. The duty
of candour regulations apply to any unintended or unexpected incident that occurs in respect of a
service user during the provision of services, or is suspected to have occurred that could/appears to
have resulted in death, severe harm, moderate harm or prolonged psychological harm. This equates to
level 3 – 5 incidents.
The Trust must:
- Make sure we have an open and honest culture at all levels within our organisation
- Tell patients in a timely manner when serious incidents have occurred
- Provide reasonable support to the person after the incident
- Provide in writing a truthful account of the incident and an explanation about the enquiries and
investigations we will carry out
- Offer an apology in writing.
PB asked panel for feedback, policy ratified.
2. Policy on The Use Of Mobile Phones Within Inpatient Settings
Presented by Mike Curtin (MC)
Objective of this policy is to enhance service user engagement and patient experience, improve patient
experience, work with patients, carers, staff and our partners.
The policy covers the use of mobile phones within the inpatient settings through encouraging
appropriate use, enabling service users to keep in touch with family friends and significant others. Use
of cameras and other recording media are prohibited within the inpatient settings to protect other
service users privacy and dignity. Inappropriate use of mobile phones may result in removal.
Kathryn Ayles noticed this policy is Trust wide but doesn’t fit Forensic and Specialist Services (FSS)
and their policy where service users can use mobile phones only when they are on unescorted leave.
MC will modify the policy and add separate requirements for FSS
ACTION MC
ST suggested creating a leaflet about use of mobile phones and present this leaflet to service users
with an admission pack and nurses could have a discussion with service users.
PB asked MC to present poster/leaflet
ACTION MC
PB concluded that the policy will be ratified subject to the above amendments.
3. Patients Property Policy
Presented by MC, objective of this policy is to enhance service user engagement and patient
experience, improve patient experience, work with patients, carers, staff and our partners.
The patients’ property policy has been reviewed and updated to ensure that the trusts responsibilities in
relation to patients’ property are more explicit. Trust disclaimers are now included as part of the policy.
Responsibilities in relation to capacity are also included.
The policy also sets the minimum standards for documentation for recording property, also allowing for
flexibility for the diverse needs across the service lines, for example short stays within the acute service
line and longer stays within continuing care in older peoples services.
The policy is currently being utilised as a draft working policy with no adverse feedback from teams or
services.
LS asked how this policy sits with cell phone policy
KA added that the policy needs to have reference to local policies in terms of details of prohibited and
lockable items
PB said the policy will be ratified when amended with suggested changes
4.
Service Lines Action Plans
Forensic & Specialist Services Service Line, presented by Kathryn Ayles (KA)
1. Informing staff
To disseminate the survey results, Board presentation and improvement plan following discussion at
the Clinical Cabinet and Operations Board – completed
2. Enhancing the service Uses experience
a) Ensure that a comprehensive care plan is in place and shared with service users following
assessment
In-patient services are currently monitored by through the monthly pccp audit. Care plans should be in
place within 72 hours and this is monitored through supervision – March data shows the service line at
98%. Copy of care plan given is monitored through a monthly BI report. 82% of services users audited
in the March PCCP audit had been offered a copy of their care plan (forensic inpatient). 100% of
service users audited in the March PCCP had been offered a copy of their care plan (specialist services
inpatient).
b) Ensure that there is an agreed crisis plan in place and easy access to support in crisis
This is monitored through the monthly pccp audit. 100% care plans audited within in-patient forensic
services in March 2015 had a crisis and contingency plan. Improvement action: To ensure local patient
experience surveys cover this point- ongoing. To seek clarification on need for crisis and contingency
plans for non mental health specialist services - confirmed that non-mental health specialist services do
not need this
c) Ensure that CPA reviews take place in accordance with Trust policy
Improvement action: To ensure local patient experience surveys for specialist services ask questions
about involvement in care - ongoing
d) Further develop and implement the Recovery and Wellbeing
To ensure that the Recovery Star is offered to all service users - assessed by audit through quarterly
patient experience surveys. Forensic mental health services using My Shared Pathway Outcome
measure. Not applicable to non-mental health specialist services. To monitor use in outpatient Eating
Disorders services.
PB asked that the timescale be captured more accurately
ACTION KA
3. Improving / supporting carer involvement
Secure services: CQUIN 2014 /15 – Supporting carer involvement – extended for a year. Target to
establish carers forum
ACTION KA
Acute Service Line, presented by ST
1. CPA and interface across services to support discharge planning
The acute care pathway has been reviewed and the service line now has a patient flow protocol.
There is weekly reporting on patient flow including confirmation as to discharge plans, DToCs and
those in hospital over 100 days. Each Mental Health Locality holds a Local Leadership Group (LLG)
which is attended by representation from across the service lines. A joint service line leadership forum
has taken place across CRSL and Acute services which culminated in pledges being made for
improvements to patients flow and interface between the services.In the East and Medway the ASL has
joined up with the local CMHT Patient Consultative Committee meetings which provide useful forums
for gaining feedback on service user experience of transition between services. Work is being done
locally within each Acute Service, which audits Care Coordinator contact with service users accepted
into Acute Services. This is focussing on Care Coordinator contact prior to admission/HT and during
the period of acute care. There is particular focus on readmissions. Themes, issues and concerns are
then fed back into local interface meetings and discussed at the LLGs.
Add Friends and family test to patient discharge protocol and patient flow protocol
ACTION ST
2. Care Planning - patient centred, patient involvement, recovery outcome focussed
The Service Line has developed guidance for Acute Staff with regards to ensuring that Service
User’s Advanced Care Plan Directives are being recognised and used. The nursing metrics for this
particular quality measure of care is improving. The most recent PCCP Audit Results for the Service
Line indicated that some wards/teams have a poor return this is being addressed by Service Managers.
CRHTs have improved in quality however are not able to demonstrate sharing of care plans. This is
ongoing work proving difficult to resolve due to the complexity of the intensive nature of short term
home treatment. For inpatient services, Recovery Clinics are in place and continue to receive positive
feedback from service users and staff. Within the CRHT, there has been recent increased recruitment
of Support, Time and Recovery Workers (STR). STR workers are ring-fenced from the day to day work
of each CRHT Team. They are able offer more intensive and recovery focussed interventions in
partnership with service users at home. The service line is using the Friends and Family Test however
response is poor. The service line is also receiving feedback in CRHT Teams via a bespoke survey
returned to the team in a stamped addressed envelope. Results are yet to be collated
The carers booklet produced for the west to be altered and used in the east. What is the patient and
carer involvement for ASL update on peer worker appointments etc?
ACTIONS ST
3. Crisis contingency planning
For inpatients discharged from wards a ‘Recovery Card’ has been developed for immediate use,
which provides essential information and contact numbers. Dartford ‘s pilot of the use of a small care
plan card to give to patients on each visit outlining what CRHT will do, what the patient will do and
goals for recovery has been evaluated. Feedback from service users has been mixed and
unfortunately the card has not driven the anticipated improvement in care-planning. It has been decided
therefore that this will be used on an individual basis, offered to service users on an individual basis
rather tan being implemented as a blanket rule.
4. Ward Reviews
The service line has agreed a carers protocol which has been circulated to all teams
The Carer’s Information Booklet and Service User’s Information Booklet for inpatient services has been
finalised for Priority House and can now be amended for use at St Martins and LBH. The East Kent
Acute and community forum has been re-formed to ensure effective carer involvement across the 2
service lines
5. Improved access to therapeutic interventions when acutely unwell
Recovery clinics are in action on most Wards. These clinics are supported in most areas by the OT
Service and where psychology is available, have input via supervision from psychologists.
The acute wards are rolling out the safe wards initiative which includes interventions in line with
recovery to ensure patients and staff are safe
Older People Service Line, presented by IO
1. Ensure that a comprehensive care plan (or plan of care) is in place and shared with service users
following assessment – decreasing performance around care planning, ongoing
The monthly person centred care plan audit of wards and community teams will identify if service users
have received a copy of their care plan & monitor for identifiable qualitative elements of person centred
practice. Current ‘Digital pen’ pilot - aims to allow written care plans to be agreed with and provided to
service users at the time of meeting with the service user, with automated upload of this information to
Rio.
ND said that Expert by Experience survey was completed with younger adults and they will move to
older adults and will provide feedback
2. Ensure that there is an agreed crisis plan in place and easy access to support in crisis (though
access to the single point of access)
Question 9 in the person centred care plan audit has been changed to ask ‘is there a Crisis plan and an
advanced care plan?
Triangulated with BI report & monitored weekly at service line performance meeting.
W/C 9.2.15 95.1%
Current
94.9 %
Crisis plan is integral to care plan and is monitored as above.
There is regular audit that RiO crisis plans are in place but potential to improve the quality of data
captured [e.g. question of what is included in the crisis plans]. The redesign / re-configuration of HTS,
CMHTOP and MAS to include extended working hours which will impact on crisis and contingency
provision. Options available will be clearer at the end of consultation period.
3. All service users to be fully involved and informed about their care during CPA reviews
Monitored weekly through BI currently at 93.5% but some data quality issues are impacting this figure.
4. Ensure that inpatients are on CPA and care co-ordinated - service managers to develop a protocol
regarding how they will ensure this - ongoing
5. To ensure that the Recovery Star is offered to all service users
To look at how we might include some of the 10 recovery star points as part of the initial assessment these would be re worded to ask questions around Trust and Hope/somewhere to live/something to
do/someone to love( the last 3 have been identified as central to recovery)
For discussion with CRSL patient experience lead
6. Ensure that care is service user centred and service user led - the person centred care plan audit
continues to take place in all community teams
Community Recovery Service Line, lead by LS
LS explained changes in CRSL, Angus Gartshore, Director for Community Recovery Service Line and
senior managers will bring back the business and performance meeting, also CRSL’s Patient
Experience Group will be created.
1. To disseminate the survey results, Board presentation and improvement plan following discussion
at the Clinical Cabinet and Operations Board
All service managers to share the plan with their teams for them to decide how they will implement
locally. A Locality Plan to be developed by the Locality Service managers which will be monitored at
monthly Patient Experience Meeting
2. Ensure that a comprehensive care plan (or plan of care) is in place and shared with service users
following assessment
The monthly person centred care plan audit will identify if people have received a copy of their care
plan. Locality trajectories updated following report from Business Performance manager monitored at
PMM. Digital pen pilot – this aims to allow cares plans to be agreed and provided at the time of meeting
with service use and then an automated upload to RIO
JL to send terms of reference to LS
ACTION JL
Care Planning Update
It was identified through the Appreciative Enquiry, Care planning Project that the RiO system could be
improved. The trust is getting its own flexible version of RiO in autumn. The core group have devised a
draft which they are aiming to send out for full Consultation (including members of this group) in June
2015.
It has been agreed by all service lines that when staff are recruited they will sit a care planning
competency test, this will then ensure that only staff who are competent in writing care plans are
recruited and further training can be identified.
This process is already in place for Nurses and Occupational Therapists within the CRSL. Competency
tests for social workers have been agreed in principle but are currently been written.
Within older adult services, the process has been agreed and the scenarios have been written, they are
due to start in practice in June.
The competencies already occur within the acute and forensic services.
3. Further develop and implement the Recovery and Wellbeing Approach for our service users
Four key works streamlined:
- access to service
- care coordinator
- Wellbeing
- Discharge
5.
Stakeholder Focus Group for the relocation of Emerald Ward
ST to email Janet Lloyd – meeting needed prior to the Carers Conference on 9th June
6.
ACTION ST
Update of Friends and Family tests
JL explained that the Team still waits for the results of the first submission of cards to the Department
of Health.
Cards were sent to all services and wards; response is still quite low across the whole organisation.
Patient Experience Team prepares a bi-monthly report which contains responses and number of
responses per ward, teams which are not sending cards. PB requested to have this report for next
TWPEG meeting
ACTION ND
PB suggested that JL will have a chat with Sussex and Surrey NHS to compare their responses
ACTION JL
7.
Associated Hospital Managers Report
Panel members agreed to move this item to the next meeting in Stephen Sawoy’s absence
8.
HealthWatch Kent
Panel members agreed to move this item to the next meeting in Jo Pannell’s absence
To update group on the complaints report commissioned by HealthWatch Kent at the next meeting
ACTION JP
9.
AOB
PET Report
This report summarises the activity within the Patient Experience Team [PET] in respect of feedback,
concerns, PALS and complaints for the period 1 February to 31 March 2015.
The report includes statistical information regarding complaint handling within the main body of the
report and summarised Service Line information is included within the Appendices.
The amount of contacts/complaints is an increase on the previous reporting period and every effort is
being made to liaise with complainants to agree the way forward and respond within the agreed
timeframe
The TWPEG are asked to consider and discuss the content of this report to gain assurance that patient
feedback and complaints are being handled appropriately and that any learning/actions are undertaken
appropriately.
During February and march 2015, we received 99 reportable Complaints and MP Enquiries. 50 of
these were Level 2 Complaints, 40 Level 3 Complaints, 0 Level 4 Complaint and 7 MP Enquiries.
Number of reportable complaints has increased; that could be a reflection of the CQC inspection.
Mostly they are locally made complaints, main issue is a lack of treatment or a perception of lack of
treatment.
DH concluded that this is about the expectation from SU, ND said that team needs to encourage staff to
not to make promises but focus on what is achievable and realistic
PB asked to change report and add 5 quality committee issues
ACTION ND
Out of area treatment
ST asked for the PET team view on use of secure transport
ND talked about training available i.e. complaint training, patient experience training during induction.
Training is advertised by the Communication Team, to add this point to the next agenda
Carers Awareness Training (ND & LS)
Presented by LS, she said this training is a part of the engagement event. First part is a feedback from
locality survey and second is a presentation why this is important. Carers have a chance to tell their
story, this part was named “walking in my shoes”. Carers are aware of the structure of the meeting and
expectations from both sides are explained. Implementing the Carer’s protocol was discussed along
with confidentiality issues for carers and the triangle of care. Similar workshops are planned for
Ashford, Medway, Dartford and Thanet Community Mental Health Teams.
David Hough mentioned that HealthWatch hasn’t put any references to carers and patient input into
their work.
Dawn Hyde mentioned Carers week and Carers conference; Louise Jessop asked what happened to
the service users conference.
13.
Next meeting dates
Date
Time
Venue
Updated Action Plans
Tuesday 3rd February
Tuesday 3rd March
Tuesday 7th April
Tuesday 5th May
Tuesday 2nd June
Tuesday 7th July
Tuesday 1st September
Tuesday 6th October
Tuesday 3rd November
11.00am – 1.00pm
11.00am – 1.00pm
11.00am – 1.00pm
11.00am – 1.00pm
11.00am – 1.00pm
11.00am – 1.00pm
11.00am – 1.00pm
11.00am – 1.00pm
11.00am – 1.00pm
Large Boardroom
Large Boardroom
Large Boardroom
Large Boardroom
Large Boardroom
Large Boardroom
Large Boardroom
Large Boardroom
Large Boardroom
Not required
Required
Not required
Required
Not required
Required
Required
Not required
Required