Patient Experience Annual Report 2022/23

Work in relation to Patient Experience has gone from strength to strength over the past year. Some of the highlights are as follows:

• The embedding kindness project which evolved from the Patient Experience Strategy has been shared with NHS England receiving National and local interest #embeddingkindness.
• Strong links with our Organisational Development Team has enabled us to develop our thinking around civility in the workplace and wellbeing in relation to kindness. Patient Experience has representation at the Workplace Civility Board to ensure that key messages and work streams work alongside and complement each other.
• Work with the national group Ageing without Children (AWOC) has resulted in a ‘Kindness Conference’ being held. This was very well received when it took place in the autumn of 2022 with a plan for a further conference in 2023.
• The Spiritual, Pastoral and Religious Care (SPaRC) service (formally chaplaincy) has received national recognition and awards for their pioneering new model of working.
• The SPaRC team have launched an interactive platform accessible by smartphone to increase their reach to patients and staff. This has gained a lot of interest from other organisations. And is supported by religious leaders from the community.
• The Trust has successfully obtained Veteran Accreditation status. A veteran lead has been identified to support veterans and serving personnel accessing healthcare. This is to ensure that service persons and their families are not disadvantaged due to them moving areas frequently.

The implementation of the VIP pathway and red backpacks was successfully launched in the early part of 2023 enabling patients with additional needs to be identified and additional support to be provided. The pathway allows for a more streamlined transition between home, community settings and hospital so that it is less overwhelming for patients and their carers. This initiative was initiated following discussions with people with additional needs and after reviewing complaints and incidents.

The Patient and Public Involvement team continue to work on a number of projects to enable public engagement to take place and changes to be made as a direct result of feedback. For example; working with partner agencies to gain feedback from service users with Special Educational Needs and Disability (SEND) in our community paediatric department; working with our local Health watch team regarding service user experience of virtual appointments, and contributing to the City of Bradford Metropolitan District Council’s stakeholder group for people with visual and hearing impairment visiting our sites to enable future improvements to be made.

Our Maternity Unit has worked in partnership with the Maternity Voices Partnership (MVP) to modernise our facilities based on the experience of women, all clinical areas in Maternity have now had a “15 step review” and the findings of these have been included in our plans to refashion the unit.

Further work has been commenced with the paediatric inpatient team and the VRI (Virtual Royal Infirmary) to produce a virtual tour of the hospital to alleviate anxiety in children with additional needs.

The Relatives Line was implemented during Covid-19, it has been so successful it has been made a substantive service. It is staffed by 3 registered nurses and reduces the number of calls from families to the wards allowing staff time to deliver care. Users of the service value the nursing expertise and the time they are able to give to their enquiries.

During 2022/23 the Trust has taken part in the mandated CQC surveys:

• Adult inpatient survey 2021 published in September 2022
• Maternity Survey 2022 published January 2023

Results were received from 399 people that show the Trust is’ about the same’ meaning that Bradford Teaching Hospitals NHS Foundation Trust is performing about the same for that particular question as most other trusts that took part in the survey. The Trust has improved its position compared to other Trusts in 2022. Key themes for focused improvement are related to the flow of patients through the hospital, help at mealtimes, communication and discharge planning and advice.

For maternity 108 people responded with responses also categorised as ‘about the same’. The maternity team are continuing the positive work and engagement with women to develop improvements.

The Outstanding Maternity Service has been working with patients and staff to improve the outcomes for service users and their babies. They have had national recognition with their television documentary following the home birth team.

The Children and Young People’s survey was carried out in 2020 with reduced scoring in some areas however the report acknowledges that the survey was conducted during the pandemic and therefore access to play facilities, access to heat and store own food were limited and this was reflected in the scoring.

It has generated a number of work streams which continue to make improvements:

• A review of the child specific menu. A trial has been undertaken in conjunction with the catering department, dietetics and children to revise the menu to a more child friendly version. To be audited in 2023/24.
• Work has been undertaken in collaboration with the theatre team to improve the experience of children attending theatres for surgical procedures. Baggins the bear is now a familiar sight around the organisation.
• Posters QR codes for patient experience.
• Play (new toys, crafts for adolescents) ordered and the playroom has now been re-opened.
• Communication bedside folders completed.
• To increase the number of responses to the next survey by actively promoting the survey to families.

The Patient Experience team receive complaints and compliments into the organisation and support the clinical service units in responding to concerns. The number of complaints as shown in the table 5.1 have reduced overall in comparison to the previous year. Many complaints are now resolved through face to face meetings with complainants. By arranging to meet with complainants it has led to a timelier investigation/response as per policy.

Learning from complaints is being shared via different forums and in liaison with patients and the Equality, Diversity and Inclusivity service. Patient stories are shared at the Trust Board with patients who are keen to support organisational learning.

The Bereavement team continue to support families after the death of their loved ones with high volumes of calls and face to face meetings being responded to. The team work closely alongside the mortuary team and the medical examiner’s office to provide holistic care to the deceased person and their family/carers.

Background/context

Friends and Family Test

The new Friends and Family (FFT) format no longer requires patients to fill the questions in once but encourages patients to complete the questions multiple times throughout their journey in the healthcare system. As a result Bradford Teaching Hospitals and other Trusts can no longer measure response rate based on admission or discharge per clinical area.

In line with the new national FFT guidance, FFT now asks “Overall, how was your experience of our service?”

The new question has a new response scale:

•  Very good
• Good
• Neither good nor poor
• Poor
• Very poor
• Don’t know

Providers are still required to include at least one free text question alongside the standard fixed question and can choose locally what question or questions to ask. BTHFT have followed the national guidance and have included the following questions:

• Please can you tell us why you gave your answer?
• Please tell us about anything that we could have done better?

The overall Trust position score from FFT at time of reporting is a decreased score of 78.9% of patients scoring the Trust as ‘very good’ or ‘good’ in comparison to the previous year of 84.0%. This is reflective of datix reports and complaints received due to a number of variables including staffing and acuity of patients which can lead to increased dissatisfaction.

SMS text messaging made up the majority of the responses included in the table below.

The Trust has recently tendered for and appointed a new contractor for FFT – Healthcare communications. The aim is to significantly improve the volume of FFT responses. There will a reduced reliance on paper feedback forms, although these will still be available, and an increased volume of SMS responses. QR codes will be added to posters in all patient areas to encourage FFT feedback through the electronic route. It is hoped that the anonymity offered by the use of QR codes will improve response rates and the quality of data. The new system has yet to be launched but the data for Jan-April 2023 will be uploaded retrospectively from feedback forms. The responses recorded in the tables above are for the period April-December 2022 as the transfer of software provider proceeds.

National Survey CQC survey updates

The NHS Patient Survey programme was established to support patients and the public to have a real say about the quality of NHS services and how they are developed. By asking organisations to carry out patient surveys in a consistent and systematic way, it is possible to build up a detailed picture across the country of patients’ experiences. This approach not only allows organisations to compare their performance with others but, by repeating the same type of survey on a regular basis, progress and improvements over time can be monitored.

During 2022/23 the Trust has taken part in the mandated CQC surveys:

• Adult inpatient survey 2021 published in September 2022
• Maternity Survey 2022 published January 2023
• Accident and Emergency Survey September 2022 published in June 2023

Results for the in-patient survey were received from 399 people that show the Trust is ‘about the same’ meaning that Bradford Teaching Hospitals NHS Foundation Trust is performing about the same for that particular question as most other trusts that took part in the survey. The Trust has improved its position compared to other Trusts in 2022. Key themes for focused improvement are related to the flow of patients through the hospital, help at mealtimes, communication and discharge planning and advice.

For maternity 108 people responded with responses also categorised as ‘about the same’. The maternity team are continuing the positive work and engagement with women to develop improvements.

The Outstanding Maternity Service has been working with patients and staff to improve the outcomes for service users and their babies. They have had national recognition with their television documentary following the home birth team.

The Accident and Emergency results will be reviewed and an improvement plan developed, celebrate any successes and learning for improvement.

All results are reported via the PE Group and developments and action plans are monitored for assurance.

Patient Experience work

Embedding Kindness

The Patient Experience Strategy clearly sets out the Trusts commitment to Embracing Kindness and to further strengthen this Embedding Kindness. Embedding Kindness is designed to build on the Patient Experience Strategy and was launched on November the 13th 2020, World Kindness Day. This work has gone from strength to strength, with national interest and recognition.

Embedding Kindness has been included in the ward accreditation scheme and forms a part of the nursing and midwifery strategy and professional practice model. A Patient Experience and Kindness Conference took place in May 2022, with a number of guest speakers including patient’s representation and a national speaker and educator. The Patient Experience Ambassador role was launched, engaging participants to help design the role and the team look forward to developing the role further during 2022/23. The role of the Patient Experience Ambassador will be a feature of the new PE volunteer role to be commenced this year.

In May 2023 the Daisy Award was launched. This is a specific award in recognition of excellent nursing care. Part of the work to launch Daisy promotes excellent, kind care of nurses/midwives with patients, carers and families to recognise this. We will support each award winner and nominee to be a PE ambassador and to support this culture continuing to flourish throughout all areas of the organisation.

Work continues to link #embeddingkindness, PE with civility and workforce well-being. The Patient Experience Lead forms part of the Workplace Civility Board who meet to ensure that key messages and work streams work alongside and complement each other’s, in order to present a cohesive and clear direction. Civility amongst staff has been shown to have a direct impact on PE.

Embedding Kindness has been recognised by other Trusts in our region, whom have adopted the approach and will continue to be key in the patient experience and engagement strategy launching in summer 2023.

Work continues to link #embeddingkindness, PE with civility and workforce well-being. The Patient Experience Lead forms part of the Workplace Civility Board who meet to ensure that key messages and work streams work alongside and complement each other’s, in order to present a cohesive and clear direction. Civility amongst staff has been shown to have a direct impact on PE.

Embedding Kindness has been recognised by other Trusts in our region, whom have adopted the approach and will continue to be key in the patient experience and engagement strategy launching in summer 2023.

Relatives Line

The Relatives Line was initiated during the Covid-19 pandemic to allow clinical staff time to focus on direct patient care and enable relatives to get up to date information about their loved ones in the absence of them being able to visit in person. Following the success, positive staff and patient experience feedback the service was made permanent. The service continuous to provide a valuable support for staff, patients and relatives, with a high number of calls being supported by the relatives line with a reduced staffing model, see table 3. During 2023 the service will work closer with the wider patient experience team, supporting bereavement and learning from Patient Advice and Liaison Service (PALS).

Bereavement service

The Bereavement team continue to support families after the death of their loved ones with high volumes of calls and face to face meetings being responded to. The team work closely alongside the mortuary team and the medical examiner’s office to provide holistic care to the deceased person and their family/carers.

Improvements to bereavement services

• Electronic records – Both Bereavement records and cremation forms are logged onto an electronic database.
• Change of Evolve – GP death notifications/final GP notifications have changed from Evolve to EPR standardising the documentation used.
• Bereavement waiting area improvements – Newly decorated Bereavement area for relatives providing a quiet reflective space.
• Revised internal property process – Electronic internal database to log all property that comes to Bereavement. All property logged and signed into the Bereavement office. Reiterated Bereavement will not take property without a property list.

Ongoing projects for bereavement team in the year ahead

• Review publications for next of kin.
• Continue to work closely with funeral directors to ensure that services can take place in a timely manner.
• Review full hospital funeral process including financial impact to the Trust.
• Working with Safeguarding team with an emphasis on safeguarding deceased and their property.
• Website content internal/external.

Veterans work

Bradford Teaching Hospitals NHS Foundation Trust, signed the Armed Forces Covenant. This is a pledge that together, the Trust acknowledges and understand that those who serve or who have served in the armed forces, and their families, should be treated with fairness and respect in the communities, economy and society they serve with their lives. By identifying members of the armed forces community and their families, our Trust will be able to treat, and/or signpost patients to other appropriate services and to access social care packages.

Becoming ‘Veteran Aware’ means that the Trust will be continuing to raise standards for all patients.

In May 2023 BTHFT obtained silver accreditation status as a Veteran Aware Trust. This means:

• The Trust supports the UK Armed Forces as an Employer.
• The Trust has established links to appropriate nearby veteran services.
• Staff at the Trust are trained and educated in the needs of veterans.
• The Trust raises awareness of veterans.
• The Trust identifies veterans to ensure that they receive appropriate care.
• The Trust will refer veterans to other services as appropriate.

An email contact address has been set up for people who would like to know more (www.veteranaware.nhs.uk) or become involved in the project: veterans@bthft.nhs.uk.

Spiritual, Pastoral and Religious Care (SPaRC)

The Bradford Model continues to deliver a service where spiritual, holistic needs are met foremost but where religious requirements are required, these are also met. The Bradford Model talks about religion and belief as an inclusive term that gives positive value to a full range of beliefs, encouraging an appreciation of the diversity within religions and across beliefs. Traditionally, chaplaincy services have worked in isolation, only linking with wards when asked to do so. Under the new model, collaborative working and becoming part of the wider MDT is paramount to the models success.

The model is underpinned by 7 anchors:

• Equality
• Person Centred Care
• Belief Based Care
• Spiritual and Reflective Spaces
• Collaborative Practice
• Professional Practice
• Data and Organising

The team have worked hard to ensure the model is embedded within the Trust and that websites, literature and identification are all brought in line with the current model. The team has undertaken further recruitment and as a result have been able to split CSU responsibility and share key work streams to forge and create greater multi-disciplinary team working and enhance relations with clinical teams.

Work has focused on the development of a mobile application (app) that provides resources and support for staff and patients on beliefs, religion and support wellbeing.

Phase two (funded by Charity) for the SPaRC app

Initially the app covered 6 beliefs (Christian, Hindi, Muslim, Buddhist, Humanist and Sikh) in phase two others to be added are: Atheist, Jewish, Baha’i, Pagan and Roma. There are six circumstances identified as a frequent focus for SPaRC interactions to be included on the app and more will be added on topics such as baby loss, critically ill child and regret. The WebApp will also be available in other languages. The SPaRC team have been shortlisted for the HSJ Digital Award in Empowering Patients through Digital.

In 2023/24 the team are aiming to embark on new work streams that showcase and support the SPaRC model, including working with the University to support placement of Psychology students. There has been a re-launch for the pastoral volunteering service in line with the SPaRC model.

Voluntary services

Voluntary Services at BTHFT is currently undergoing a redesign and during this really exciting time there will be many changes paving the way for an excellent volunteering service.

Volunteering really complements and enhances the quality of trust services. Volunteer input is extremely valuable and makes a real difference to the experience of people who access our services, their carers and families. Volunteering has moved forward nationally since the pandemic and Trusts are really seeing the importance of having robust and valued volunteer services.

In 2023 a new Volunteer Service Improvement Lead started in post, the focus of the service redesign is on:

• Volunteer Governance and Risk Management – the correct Governance procedures in place for volunteers. There is currently a review of all processes ensuring everything is current and refreshed.
• Recruitment process – Volunteers will experience a smooth and robust recruitment process, working in collaboration with other departments.
• Training and Induction – All volunteers will receive a basic standard Induction and Training package. This will use the online National Volunteer Learning Pathway which has been developed by HEE and forms the basis of the National Volunteer Certificate. An accessible version is being developed alongside Education and Training.
• Assemble – The implementation of a specific Volunteer Management Database will take us away from a paper-based service, and completely changes the way volunteering is managed. Assemble is a web based database to manage volunteering inside one platform, from recruitment, to applications and checks, training, managing volunteers to retaining them.
• Role development – All roles are developed in a consistent manner across the trust, and every role will have a clear and detailed role description. The team will be supporting services across the Trust to development meaningful and impactful volunteer roles
• Embed values –The Trusts People’s Charter will be embedded within both the staff team and volunteers.
• Rebranding – Rebranding the whole service to ensure Volunteering has an identity across the Trust, and At Place.
• Staff engagement – Staff will be made aware of the future plans for volunteering, whilst also gaining their insight into their own experience of volunteering, workshop already taken place.
• Staff and supporting services – Resource within Voluntary Services to support clinical staff in developing meaningful and impactful roles.
• Culture – Ensure the culture of volunteering is championed at senior levels, and volunteers are recognised and rewarded for what they do.
• At Place – Plans to make volunteering portable across BTHFT, BDCFT and Airedale, however it is important that all foundations are in place first, and then work can really start in this area.

The next 12 months is a really exciting time for volunteering at BTHFT with a really opportunity to stand out nationally alongside other Trusts in the district.

Dementia

Throughout 2022/23, dementia has remained a high priority throughout the organisation, with an increased focus on providing clinical support for those who have received inpatient care. As an organisation one of our priorities for 2023 is the improvement of patient care for those with a diagnosis of dementia. The main focus is training; this includes promoting the available e-learning package on ESR (level one dementia awareness training). The dementia lead is currently developing a robust training package that can be delivered face to face in accordance with the Health Education England standards around developing a dementia workforce. BTHFT have secured the dementia bus to deliver some simulation training to the dementia champions.

The Dementia lead continues to promote the use of the Forget me not tool (magnets behind the bed/ blue wristband/ this is me document at the bedside) across the organisation. Funding has recently been approved for the development of a memory lane corridor outside wards F5 and F6 at St Luke’s this is still in the planning stages but it is a very exciting project that will benefit our patients and visitors.

The Trust dementia strategy action plan continues to be progressed and updated with governance and oversight via the Dementia Steering Group.

Whilst the organisation continues to strive to deliver outstanding care for people living with dementia, as discussed in 2022 there continues to be some further work that needs to be undertaken regarding:

• recognition of delirium in someone who already has a cognitive impairment
• recognising when somebody living with dementia is entering the end stage of their life
• recognising pain and how this can present as a behaviour that challenges

The local dementia strategy group for Bradford has now re-started with areas coming together once again to plan how dementia care across the district can be improved. The Royal College of Psychiatrists data collection is now taking place for the national audit of dementia.

An ongoing focus is exploring how we can better support carers. There is engagement with voluntary care sector agencies to determine available support in the community. A resource pack is being developed to give to patients with dementia and their carers to allow them to access further support post discharge.

Dementia action week took place with a stall on the concourse during the week and representatives from 3rd sector organisations to offer guidance around the services that are available for those with dementia and their carers.

Learning disability

The learning disability lead nurse continues to support the delivery of patient focused care to meet the needs of patients with learning disability. The main focus of the role is equitable care and ensuring people with a learning disability are recognised and offered reasonable adjustments so they can access health care at BTHFT.

The learning disability nurse continues to be supported by the additional needs healthcare assistant who provides distraction therapy, supports wards to make reasonable adjustments and encourages referrals to the lead nurse.

Areas of specific focus have been:

• Attending wards to ensure support / provide personalised care highlighting the importance of the VIP passport in understanding every individual patient’s needs.
• Building strong community relationships with Waddiloves Learning Disability Health Centre, care homes and supported accommodation.
• Undertaking Structured Judgement Reviews following the death of patients with a Learning Disability to ensure any learning is identified and shared across the Trust.
• Completion of the annual National Benchmarking audit.
• Implementation of the VIP Red Bag Pathway supporting the use of the VIP passport, critical medications, items of comfort and possible equipment for safe eating and drinking.
• Trial implementation of the VIP wristbands to promote the recognition of a person with a learning disability in ED and into other departments.
• Mental Capacity Assessments to support the use of a legal framework with a Deprivation of Liberty Safeguard.
• Increasing attendance to regional and local meetings such as Bradford People First.
• Building relationships with theatres to enable a person with a learning disability to access dental care through reasonable adjustments.
• Therapeutic care and distraction through resources funded by BTHFT Charities and the Amazon Wish list.

Areas of further development will focus on:

• Implementation of the Oliver McGowan Training for People with a Learning Disability and/or Autism.
• Further work with transition services to ensure the needs of children with a Learning disability are recognised and understood as they move to adulthood.
• Mental Capacity Assessments to support the use of a legal framework with a Deprivation of Liberty Safeguard in a timely manner.
• Recognition of a person with a learning disability who may be viewed as more able to reduce the risk of missing services.
• Roll out of the Get Me Better Respiratory Pathway in conjunction with BTHFT Respiratory Physiotherapists and Waddiloves.

Interpreting services

The interpreting team is now aligned to the Chief Nurse Office and the patient experience team. During 2023 there will be continued focus on Interpreting, translation, Communication and accessible information. Interpreting services team have supported people on 50,363 occasions, and in over 50 different languages. The service meets the needs of non-English speakers and British Sign Language users, primarily through face-to-face interpreting. Support is also provided using telephone and video, to ensure 24-hour access, seven days a week. Requests for support in other formats, such as Braille have been met. As the range of languages continues to increase the Interpreting Service have carried out further recruitment to ensure the needs of all our patients are met effectively. As part of this work there is a link to the recognition of developing clinical translators with the University of Bradford. The top 10 languages requested are shown below:

Partnership working and engagement

The Patient Experience Team continues to work with partners in the district to improve patient experience and engagement. The Trust is part of the Citizen Engagement Forum, which has membership from across the Bradford District and Craven Health Care Partnership. The patient experience and engagement strategy will be launched summer 2023.

Regular meetings and joint work takes place with local Health watch. This ensures that team are sighted on any areas of concern raised by the public at the earliest opportunity and provides the opportunity for the teams to invite relevant staff to answer to areas of concern raised. There is also proactive work being carried out between Health watch and the Virtual Royal Infirmary (VRI) work to get patients views on how services are being run and the patient education they provide for these patients.

Patient and Public Engagement (PPE) provide three patient stories a year presented to the Board. Each story has a theme that provides invaluable lessons when caring for our patients. Themes for this year covered:

1. Diversity, Dignity and Respect.
2. Patient perception of care and communication.
3. Non patient friendly administration systems.

There are a number of projects and initiatives where PPE are involved below as an example:

Complaints

During 2022/23 the Patient Experience team have continued to focus on measures to improve the quality and timeliness of responses to complaints by continuing weekly complaints meetings and keeping complaints under constant review via the complaints tracking system. A total of 411 complaints were received within the Trust.

One of the key objectives of the central complaints team was to track and ensure that the Trust minimised the number of complaints that were responded to beyond 6 months from receipt, to fall in line with national recommendations and Trust policy. Table 5.3 highlights a steady position of maintaining near to zero complaints over 6 months with the last two months with 0 complaints going over 6 months.

Of the 411 annual complaints received, table 5.4 demonstrates the annual position of all specialties. Accident and Emergency Department (AED) remain the area that received the highest number overall (N=68) for the year. Whilst the aim is always to have no complaints, this figure should be considered against the 141,024 attendances the AED department managed during 2022-23. Also there has been a decrease in the number of complaints in AED compared to last year which was 98.

Following a deep dive into the themes of AED the following areas were identified as common themes within the complaints:

• appropriateness of treatment
• missed diagnosis
• delay in treatment being received

All complaints are fully investigated and the detail shared in the complaint response. Themes and trends are reviewed as part of the safety event group and quality of care panel.

Table 5.5 reports the top overall themes of complaints during 2022/23. It should be noted that complaints usually contain more than one theme. Triangulation against other sources of data i.e. patient feedback surveys and safety events are monitored within the CSU and at quality and safety performance meetings.

Reporting of themes is monitored at the Patients Experience Group meeting, along with actions being taken to address issues identified. Reports on complaint themes have also been supplied for departmental quality improvement initiatives, such as ‘deep dives’ and ‘time-out’ sessions to review services.

The Care and Treatment theme broken down into sub–subjects

Sub–subject	Complaints
Appropriateness of care for diabetic patients	3
Appropriateness of request	2
Appropriateness of treatment	146
Buzzer not being answered	1
Buzzer out of reach	2
Care issues for vulnerable patients	10
Delay in treatment being received	29
Inadequate pain relief	18
Not treated as an individual	32
Patient left in soiled bedding	1
Patient left in soiled clothes	5
Patient’s decency not maintained	1
Personal hygiene needs not met	5
Pressure areas not relieved	2
SATS not being taken	2
Total	259

When complaints are received and reviewed, they are recorded and graded on the Trust Datix system. There was one complaint received during 2022/23 graded as high. This complaint was also declared as a Serious Incident. There continues to be ongoing collaborative work and scrutiny between the quality and complaints team. Table 6 provides the annual position.

Parliamentary and Health Service Ombudsman (PHSO)

Complainants are entitled to take any unresolved concerns they may have to the Parliamentary and Health Service Ombudsman (PHSO) for further independent review once they have exhausted local resolution and received two written responses from the Trust in relation to their complaint. During 2022/23 the Trust received 4 cases with the following outcome:

• 1 PHSO decided not to investigate
• 3 still awaiting outcome from the PHSO

The below table 7 provides detail of the PHSO cases and the outcome decisions for the Trust received during 2022/23. The team continue to work with the PHSO and follow up cases as there is a delay in the PHSO processing these.

Patient Advocacy and Liaison Service (PALS)

The total number of PALS issues continues to remain high with an annual increase for a number of consecutive years. Table 8 draws comparisons to previous years, highlighting the increase.

These numbers demonstrates the high volume of activity that the Patient Experience Team are dealing with; in many cases they are resolving at first contact and preventing issues being progressed to formal complaints. PALS issues are dealt with quickly to prevent escalation. At the time of writing this report of the 2,181 only 5 remain open.

AED received the highest number of PALS contacts N=183, around 8% overall annual PALS (table 9).

Analysis of the themes of the annual PALS sees appropriateness of treatment as the highest value (13%).

Compliments

Compliments are simple ways for people to show their appreciation and kindness. At the Trust there are many ways that staff receive compliments; thank you letters, emails, tweets and cards.
During the past year whilst carrying out a number of patient experience initiatives throughout the Trust, areas and teams have been encouraged to log these compliments on Datix in the same way that a complaint or PALS are logged. There is much work to be done to capture and celebrate this success and plans to strengthen and expand our kindness pledge. Table 11 highlights the compliments by speciality.

There is a new icon on everyone’s PC for any staff member to log a compliment.

During the pandemic the Trust has seen a wealth of praise in many forms, sadly the use of iPad collection was limited to record these for IPC reasons and time for logging being a constraint factor for staff. Below are a few statements extracted from a few of the many compliments received to demonstrate the impact staff have had on Patient Experience and their family members.

Learning from complaints

Below is a summary of some of the learning from complaints that has been captured and the action taken to make improvements for patients.

Proposal

The Patient Experience Team and Chief Nurse Office will continue to develop work to enhance patient and relatives encounters with the Trust. Work will continue to extend Embedding Kindness via the Patient Experience Strategy.

Improvement work will continue working collectively with CSUs and corporate teams to identify leaning and implement improvements or make recommendations from all forms of patient feedback. Valuable patient and public collaboration and engagement work will continue to ensure voices are heard and influence Patient Experience projects for the next year ahead.

The overall complaints process and numbers will continue to have ongoing oversight from the central team, to enable challenge, monitoring and tracking to agreed timescales. The Central team will continue to provide support and training and assist with training and complex cases where required.

The specific focus for 2023/24 will be:

• Wider engagement with the community and hearing from a variety of service users. There are some great examples of this across the Trust. An area of focus will be the feedback to our community of the work undertaken to improve following the feedback we have been provided.
• Recruit to new and innovative volunteers roles as part of the volunteer redesign to enhance patient and staff experience.
• Patient education and the use of virtual information.
• Enhancing the bereavement service and link with relative’s line team.
• Continue to use the patient voice and patient story at the heart of improvement work.
• Link with the findings and outcome from the worry and concern task and finish group undertaken around the care of the deteriorating patient.
• Links with patient safety partners as part of the Patient Safety Strategy work.
• Feed into the patient safety agenda through use of Patient Measurement of Safety (PMOS) captured at ward level and reviewed as part of the ward accreditation processes.
• Revamp patient bedside information and visitor’s charter.
• Focus on communication and Accessible Information Standard (AIS), interpreting and translation and review our approach to a communication passport to meet the needs of patients accessing our services.
• Launch our revised patient experience and engagement strategy for 2023-2028 with a focus on embedding kindness, capturing experience, co-production, share changes with the community and developing toolkits to simplify engagement for busy clinical staff.
• In partnership with the University of Bradford launch our “Clinical Customer Care” training.
• Increase the number of Patient Led Assessment of the Care Environment (PLACE) visits.

Finally the teams will look at ways of continuing to celebrate success and capture compliments received to ensure teams and individuals are recognised for the kindness and compassion they share daily.

Benchmarking implications

The information for Patient Experience held on the model hospital portal is out of date compared to the information in the report and has therefore been excluded. As this data is updated nationally this will be included in future reports.

Risk assessment

Risks related to patient experience are captured and monitored through the Patient Experience Group and reported to the Academy as part of the work plan.

Recommendations

Risks related to patient experience are captured and monitored through the Patient Experience Group and reported to the Academy as part of the work plan.

The Academy is asked to note the report of the work undertaken to improve the patient experience at Bradford Teaching Hospitals NHS Foundation Trust.

• The Academy is assured of the work undertaken as part of the Patient Experience Group.
• The Academy is asked to support the focus for 2023/24 in each of the areas covered in the report.