Report to: Health Scrutiny Committee

Subject: Service User and Carer Satisfaction Levels in HPFT

Author: Jonathan Wells Head of Practice Governance

Date of Meeting: 21st June 2012

  1. Introduction

This summary report outlines the Trust’s systems for hearing from those who use our services and gives some results. A wide range of supporting information is available from the author.

  1. Governance.

The Chief Operating Officer is the Trust lead for patient experience, which is treated as one of the three key elements of quality of care and treatment.

The traditional Complaints and PALS Team has been expanded in the past two years to include a Customer Experience service. Statutory quarterly and annual Complaints Reports to Board (which are then shared with commissioners) are now Customer Experience and Complaints reports.

One of the sub-groups of the Quality and Risk Management Committee (which forms part of the integrated governance structure) is the Service User and Carer Engagement Group. Its membership includes several service user, carer and third sector representatives. Its main function is to ensure that the Trust is effective in hearing back from service users and carers, that satisfaction rates are improving and that changes are made to services in response to what is heard.

The main sources of information are shown below.

  1. Having Your Say.

The Trust has seven versions of these simple questionnaire forms so that they are suitable for younger people and people withlearning disabilities as well as adults with mental health problems and their carers..

These can be completed on paper, by phone or electronically via the Trust website. Volunteers are being recruited to help with completion of forms and the plan is to move over to the vast majority of forms being completed on toughbooks, kiosks or on-line in the next two years.

Around 800 responses are received per quarter, with an increasing number of teams using posters to say what they have been told and what they have done about it.

The Meridian system runs the surveys and reports results. Real time information is available to managers about their service users’ and carers’ levels of satisfaction. The overall satisfaction rating for the Trust for the last quarter is shown below.

HAVING YOUR SAY – QUARTER 4: JANUARY – MARCH 2012

Results are available for carers, people with learning disabilities, and adults and children with mental health problems – broken down by team and by any time period.

Figure 1 shows some satisfaction rates last year in community mental health services.

Figure 1: Community

Figure 2 shows some satisfaction rates last year in inpatient mental health units.

Figure 2: Inpatient

  1. National Service User Surveys.

Each year the Trust participates in the mandatory national survey which is usually about the experience of community mental health service users. We also voluntarily undertake the national acute inpatient survey each year.

Results of both for 2011/2012 are expected shortly.

  1. Complaints.

Comprehensive reports are provided both to teams and externally on numbers of complaints. The information is analysed in various ways including:

  • Over time
  • By service
  • By theme
  • By demographic factors
  • How many are joint health and social care complaints
  • How many are addressed promptly (within 25 working days)
  • How many are fully or partially upheld

Examples of learning from complaints are shared through practice governance meetings.

Figure 3 shows complaints during last year according to the four service streams the Trust was divided into.

Figure 3: Number of complaints by service stream by quarter for 2011-12

Service Stream / 2011 - 2012
Quarter 1 / Quarter 2 / Quarter 3 / Quarter 4 / Total
Acute & Rehabilitation / 14 / 20 / 10 / 23 / 67
Community / 18 / 21 / 26 / 29 / 94
LearningDisabilities & Forensic / 3 / 2 / 3 / 2 / 10
Specialist / 16 / 24 / 17 / 13 / 70
Other / 0 / 0 / 1 / 3 / 4
Totals: / 57 / 67 / 57 / 70 / 245
  1. PALS and Compliments.

The Trust had 105 Patient Advice and Liaison Service (PALS) contacts in quarter 4, and 141 compliments reported centrally. These figures on their own do not say very much about the overall levels of service user and carer satisfaction, but they can be more meaningful when analysed over time.

  1. Other Forms of Involvement and Feedback.

These include the following:

  • A range of consultation forums including the Service User Council and Carer Council, with the Trust chair as a key member
  • A strong service user and carer voice amongst members and Governors
  • Close relationships with partner agencies which enable service users and carers to speak up (such as Carers in Herts and Viewpoint)
  • An Involvement Strategy setting out aims with regards to service user and carer participation in training and recruitment and as members of staff (paid or voluntary)
  • Service users with learning disabilities as Health Access Champions working alongside staff as equal partners in training, and at conferences
  • Innovative projects such as peer experience listeners interviewing those who have used the new Single Point of Access,or CAMHS services, or the out of hours helpline to find out what can be improved
  • Local services increasingly developing relationships with their service users and carers, who help them in various ways such as evaluations, audits, and selection of new staff.

These approaches – often local and less formal – can be as valuable as the big central initiatives in enabling staff to pay attention to the satisfaction levels of their service users and carers and to respond to their requirements.

  1. Next Steps.

It is vital that staff manage to adjust the services they provide in response to what those in receipt of them are saying if they are to be made more effective at this time of reduced investment.

In 2011/2012 there was considerable evidence of high levels of service user and carer satisfaction (the Trust was successful in all CQUIN and quality account targets based on this type of measure). Having Your Say results in particular have been very positive and very encouraging for staff when fed back to them.

In the coming year the main aims are:

  • To monitor closely the patterns of complaints and take steps to halt any ongoing negative trend
  • To maintain the excellent Having Your Say results spreading best practice as necessary across the organisation
  • To rise to the top 20% of Mental Health Trusts in terms of the national service user survey
  • To continue to develop a culture where all teams grasp the importance of learning from their service users and carers in order to make improvements to services

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