Patient Experience Report for

Planned Care, Urgent Care, and

Diagnostics and Pharmacy forMay 2016

  1. OVERVIEW

During May 2016the Trust investigated 19 new complaints (9less than in April 2016). This welcome drop in new complaints means that this is the lowest number of complaints received in month since November 2015. Thenumber of complaints continues to remain extremely low when compared to patient activity.

Of the new complaints received in May 2016, 15complaints related to Planned Care, 3 complaints related to Urgent Care and 1 complaint related to Diagnostics and Pharmacy. Of note is that 4 of the Planned Care complaints relate to the ending of the Bariatric Service contract. A further 4 Planned Care complaints relate to postponed surgery or rearranged outpatient appointments. These mainly relate to General Surgery.

  1. COMMENDATIONS

During May 2016 the Chief Executive received a number of letters of commendation. These were in addition to the Thank You cards and letters sent directly to wards and individual members of staff.

Examples of the positive comments received included:

‘We would like to draw to your attention to the excellent treatment our daughter … received at the Countess of Chester hospital on 11.02.16. … has complex special needs. She has cerebral palsy, severe learning difficulties, autism and epilepsy. She is extremely anxious about any medical visits, has very little understanding of what treatment she will receive and becomes severely distressed in hospitals making it very difficult for hospital staff to treat her. … attended last week for surgery on her toe, which was carried out by Mr Edward Wood.

At our request, … also had her teeth scaled and polished whilst under anaesthetic as this is not possible when … is awake. Mr Wood and the dental surgeon liaised to arrange these treatments to take place on the same occasion.

From our arrival at the surgical lounge until our departure from Ward 40, we were treated with the utmost kindness and understanding. We felt all staff members with whom we came into contact demonstrated a considerable awareness of autism and treated … and ourselves with empathy. Mr Wood, the dentist and Carolyn, the anaesthetist all made every effort to make …surgical experience as stress-free as possible. The nurse who was with …in the recovery room kept us well informed of her post-operative condition and was very reassuring.

All staff on Ward 40 were kind and considerate. The staff nurse, Kim, who was …named nurse was extremely attentive, efficient and showed awareness of … needs. We would be grateful if our thanks could be conveyed to these staff members. They all helped to minimise the distress for … and ourselves and we are very appreciative’.

Mr Wood, Orthodontics, Anaesthetics, and Ward 40

‘I attended the Countess of Chester hospital on Monday 9th May for a Bronchoscopy, and would like to give some feedback on my experience. I really don't know where to begin. My experience was overwhelmingly positive. I was very nervous, not having had this procedure before, but aware of what it entailed. The staff who looked after me were, without exception, kind, caring and understanding. They didn't dismiss or make light of my fears; instead they were reassuring and supportive. I was taken care of very well.

I would like to mention some staff in particular: Dr Ponnuswamy, the nurses in recovery - Jenny and Vanessa. Also the nurses in theatre who did introduce themselves, but unfortunately as I was so nervous, I'm not able to remember their names. (Apologies to them). The staff were both friendly and professional, and I would have no hesitation in recommending their care. I would also like to comment that the unit was bright, clean and tidy - very pleasant’.

Dr Ponnuswamy, Theatres

  1. COMPLAINTS RECEIVED IN MAY 2016

Table 1 below highlights the number of complaints investigated by the Trust each month since January 2015.

Table 1

  1. COMPLAINTS – HOW RECEIVED?

12 complaints were received by letter via the Chief Executive. 9 complaints were received via email either to the Chief Executive, or direct to the Complaints & PALS Department.

  1. COMPLAINTS BY PROFESSION

Table 2 below highlights complaints investigated in May 2016 by profession.

Table 2 –Complaints Breakdown by Profession,May 2016

Division / Profession / Number
Planned Care (15) / Clinical / 4
Management and Clerical / 4
Clinical and Nursing / 3
Other / 4
Urgent Care (3) / Clinical / 2
Clinical and Nursing / 1
Diagnostics & Pharmacy (1) / Professions Allied to Medicine / 1
Total / 19
  1. COMPLAINTS BY SPECIALITY

Table 3 below highlights the complaints investigatedin May2016by speciality.

Table 3 –Complaints Breakdown by Speciality,April 2016

Division / Speciality / Number
Planned Care (15) / General Surgery / 8
Ophthalmology / 2
Orthopaedics / 1
Plastics / 2
Urology / 1
Vascular Surgery / 1
Urgent Care (3) / Emergency Medicine / 1
Gastroenterology / 2
Diagnostics & Pharmacy (1) / Radiology / 1
Total / 19

In 2013/14 Planned Care, Urgent Care,and Diagnostics and Pharmacy investigated 220 new complaints (out of a total number of 228 new complaints investigated).

In 2014/15 Planned Care, Urgent Care,and Diagnostics and Pharmacy investigated a total of 264 new complaints (out of a total number of 266 new complaints investigated). The 266 complaints investigated in 2014/15 represents an increase of 38 new complaints (14%) in comparison to 2013/14.

In 2015/16, Planned Care, Urgent Care, and Diagnostics and Pharmacy investigated a total of 249 new complaints (out of a total number of 258new complaints investigated). The 249 complaints investigated in 2015/16 represents a decrease of 17 new complaints (6%) in comparison to 2014/15.

The numbers of complaints investigated can be found in Table 4 below.

Table 4 –Complaints Breakdown by Speciality, 2013/14 –YTD

Division / Speciality / 2013/14 / 2014/15 / 2015/16 / 2016/17
Planned Care / Audiology / 0 / 0 / 2 / 0
Breast / 2 / 5 / 3 / 0
ENT / 7 / 8 / 7 / 2
Fertility / 1 / 1 / 0 / 0
General Surgery / 34 / 34 / 28 / 16
Gynaecology / 9 / 16 / 13 / 1
Obstetrics / 24 / 20 / 12 / 0
Orthodontics / 3 / 2 / 1 / 0
Pain Management/
Anaesthetics / 2 / 1 / 4 / 0
Plastic Surgery / 4 / 2 / 5 / 3
Trauma & Orthopaedics / 19 / 22 / 22 / 3
Urology / 10 / 13 / 18 / 3
Vascular Surgery / 7 / 19 / 12 / 2
Ophthalmology / 10 / 6 / 10 / 3
Maxillo Facial / 0 / 0 / 2 / 1
Urgent Care / Emergency Medicine / 36 / 26 / 47 / 4
Care of the Elderly / 16 / 22 / 16 / 3
Acute Medicine / 2 / 13 / 8 / 1
Paediatrics / 10 / 11 / 5 / 0
Gastroenterology / 4 / 10 / 7 / 2
Cardiology / 1 / 10 / 2 / 1
Dermatology / 0 / 0 / 1 / 0
General Medicine / 8 / 5 / 1 / 0
Respiratory Medicine / 7 / 8 / 5 / 0
Renal Medicine / 0 / 0 / 1 / 0
Rheumatology / 0 / 2 / 4 / 0
Therapies / 1 / 2 / 2 / 0
Stroke / 0 / 0 / 5 / 1
Diabetes/Endocrinology / 0 / 0 / 2 / 0
Diagnostics
and Pharmacy / Pharmacy / 0 / 1 / 0 / 0
Radiology / 3 / 5 / 3 / 1
Other Provider / Mental Health Services / 0 / 0 / 1 / 0
Total / 220 / 264 / 249 / 47
  1. COMPLAINTS CATEGORIES & TRENDS

Table 5 below highlights the key themes identified:

Table 5 – Overview of the Patient Theme by Location in May2016

Division / Trend / Location / Number
Planned Care (15) / Clinical Treatment (5) / Ambulatory Care Unit / 1
Ward 44 / 1
Plastics OPD / 1
Westminster Eye Centre / 2
Delay in Treatment (4) / Admissions Department / 2
Office / 2
Communication (1) / Ward 53 / 1
Commissioning (4) / Off Site / 4
Privacy & Dignity (1) / Jubilee Day CC / 1
Urgent Care (3) / Communication (2) / Gastroenterology OPD / 2
Treatment and Care (1) / ED / 1
Diagnostics & Pharmacy (1) / Communication (1) / Radiology / 1
Total / 19
  1. PARLIAMENTARY & HEALTH SERVICE OMBUDSMAN INVESTIGATIONS

Nonew investigations were accepted for investigation by the Ombudsman in May 2016. 1 ‘live’ Ombudsman investigation (C170/14) remains ongoing.

Table 6 below has further details of these cases.

Table 6 – PHSO Ongoing Investigations

Division / Ref. No. / Speciality
Urgent Care (1) / C170/14 / Stroke
  1. PALS

During May 2016 the Trust received 204 new PALS enquiries, 2 more than in April 2016. Of these, 110 related to the Planned Care Division, 50enquiries related to the Urgent Care Division, and 6 related to Diagnostics and Pharmacy. The remaining 36 enquiries related to other areas.

Table 7 below has further details of the key themes relating to PALS enquiries.

Table 7 – PALS Themes

Theme / Number
Information Request / 65
Waiting Time / 26
Communication / 23
Staff Attitude / 21
Access / 10
Appointments / 10
Medical Treatment / 10
Postponements / 9
Test Results / 6
Discharge/Transfer Arrangements / 5
Nursing/midwifery care / 5
Miscellaneous / 3
Hotel Services / 2
Property / 2
Commissioning / 1
Confidentiality / 1
Consultation / 1
Delay / 1
Equipment / 1
Not referred to specialist team / 1
Privacy & Dignity / 1
  1. HOT TOPICS
  • Ombudsman Report into unsafe discharges from hospital

The Ombudsman recently published a report highlighting the number of unsafe discharges from hospitals around the country. Although we have low numbers of complaints relating to discharge and transfer arrangements, the Ombudsman has identified a number of themes and lessons to be learned, which will ensure that we continue to discharge patients safely and appropriately. The following link has further information:

  • How can we make things better for patients?

Complaints relating to the failure to follow the appropriate proceduresremain a recurring theme. These include issues relating to consent, lack of documentation, and poor communication. Previous concerns have included patients who have been lost to follow up, and incorrectly listed for day case surgery. More work needs to be done within the Divisions to prevent these types of avoidable complaints from occurring.

  • Delayed Responses

In May88%of responses were sent out on time (upfrom 70% in April). Although it is recognised that the current level of activity is having an impact on clinical and nursing staff’s ability to respond to complaint, we still have a number of overdue complaints due to delays in receiving responses from an individual member of staff. What is disappointing is we are now seeing PALS enquiries convert into formal complaints because the member of staff has not responded to the PALS service.

  • Requests for Meetings

The number of requests to meet has remained constant in May. Although a number of meetings have taken place, the number of meeting requests has risen slightly to4. Evidence has shown that the majority of issues can be successfully resolved when we meet with complainants quickly, and we are grateful to those staff who have given up their time to help us to resolve outstanding complaints.

  • Accuracy of Responses

It is vital that complaints responses are factually correct. Otherwise this damages the integrity of our investigation as well as the reputation of the Trust if the complainant subsequently puts their complaint to the PHSO. We continue to receive responses which contain inaccurate information and as a result, a number of complaints are being successfully challenged by complainants. It is the responsibility of individual members of staff to ensure that the information they provide is factually correct.

  • Action Plans

We are still encountering delays in receiving completed action plans. This has been highlighted recently following an audit of the Complaints and PALS service by the Mersey Internal Audit Agency. When an investigation has identified shortcomings in the service provided, an action plan must be completed and returned promptly confirming the action being taken to address the concerns, and a deadline for completion. Divisions are reminded of the need to complete any actions identified by audits.

Geraint Jones

Head of Complaints and PALS

7 June 2016

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