Patient Experience Report For

Patient Experience Report for Planned Care, Urgent Care, and Diagnostics and Pharmacy for March 2016

1. OVERVIEW

During March 2016 the Trust investigated 30 new complaints (2 less than in February 2016). Although this remains one of the highest number of complaints received in month since 2014, the number of complaints continues to remain extremely low when compared to patient activity. The annual return of 258 complaints represents a small decrease (by 8 complaints) in the number of complaints received in comparison to 2014/15.

Of the new complaints received in March 2016, 14 complaints related to Planned Care, 14 complaints related to Urgent Care, and 1 complaint related to Diagnostics and Pharmacy. 1 other complaint was subsequently found to relate to another Trust.

2. COMMENDATIONS

During March 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:

“ I cannot praise the dedicated staff of A&E sufficiently highly. They worked with calm efficiency and a high level of professionalism. The same is true of the staff on Ward 47… they treated everyone with care and kindness despite some difficult situations”.

“… I was transferred to Ward 48. I have the highest regard for all the staff connected with this ward. One was treated as an individual and with great care and kindness… I feel I am receiving the best possible care”.

Dr Ponnuswamy, Dr Scott, ED, Ward 47 and Ward 48

“ I write to thank and compliment the members of your Endoscopy Department… I was really impressed and most grateful for the excellent treatment I received from the moment I booked in at reception to the moment I left the recovery room. I was kept fully informed of what was happening every step of the way and everyone concerned was so kind, friendly, helpful and considerate.

During the past six years I have received treatment, of one kind or another, at the Countess Hospital three times and, I have to say, I have been delighted and completely satisfied on each occasion. In my view the NHS receives a great deal of unjustified criticism and, in the light of that, I feel it is right and proper for me to express my admiration for the dedication and professionalism of the staff at your hospital. They do a wonderful job!

Endoscopy Unit

1 In addition, the Trust also received a small number of comments on the NHS Choices website and the Patient Opinion website. An example of the positive comments received included:

“ My mother spent 8 weeks on Ward 45 and I would like to thank the Sisters and their marvellous members of staff for all their care and attention. From Doctor’s, Nurse’s. Healthcare Assistants , Physiotherapists, Stoma team, House Keepers, Domestics, Macmillan team, the Chaplins for their kind words, and the Night Staff. They not only looked after mum but were brilliant with my father who struggled to come to terms with mum’s illness, and also us as a family although a very busy ward. Nothing was too much trouble for any of them. I’d also like to thank other wards in the Countess – Ward 47, Coronary Care, Intensive Care, and Wards 42 and 54. Also to all support and Resus and A and E. Thank you all”.

Ward 45

3. COMPLAINTS RECEIVED IN MARCH 2016

Table 1 below highlights the number of complaints investigated by the Trust each month since April 2014.

Table 1

4. COMPLAINTS BY PROFESSION

Table 2 below highlights the number of complaints investigated in March 2016 by profession.

Table 2 – Complaints Breakdown by Profession, March 2016 Division Profession Number Planned Care (14) Clinical 5 Nursing and Midwifery 0 Management and Clerical 6 Clinical and Nursing 1 Clinical and Nursing and 1 Management Professions Allied to Medicine 1 Urgent Care (14) Clinical 4 Clinical and Nursing 7 Clinical and Therapies 1 Nursing 2 Diagnostics and Clinical and Nursing 1 Pharmacy (1) Other Provider (1) N/A 1 Total 30

5. COMPLAINTS BY SPECIALITY

Table 3 below highlights the number of complaints investigated in March 2016 by speciality.

Table 3 – Complaints Breakdown by Speciality, March 2016 Division Speciality Number Planned Care (14) Anaesthetics/Pain Management 1 Audiology 1 General Surgery 2 Obstetrics 1 Orthopaedics 3 Gynaecology 1 Urology 3 Vascular Surgery 2 Urgent Care (14) Care of the Elderly 2 Emergency Medicine 5 Gastroenterology 1 Respiratory Medicine 2 Acute Medicine 3 Rheumatology 1 Diagnostics and Radiology 1 Pharmacy (1) Other Provider (1) Mental Health 1 Total 30

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 258 new complaints investigated). The 249 complaints investigated in 2015/16 represents a decrease of 17 new complaints (6%) in comparison to 2014/15.

A breakdown of the numbers of complaints investigated can be found in Table 4 below.

Table 4 – Complaints Breakdown by Speciality, 2013/14 and 2014/15 (YTD) Division Speciality 2013/14 2014/15 2015/16 Planned Care Audiology 0 0 2

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

Table 5 below highlights the key themes identified:

Table 5 – Overview of the Patient Theme by Location in March 2016 Division Trend Location Number

Central Labour Suite 1 Ward 44 1 Clinical Treatment (5) Ward 54 1 Admissions Office 1 T&O OPD 1 Delay in Treatment (6) ED 1 Audiology OPD 1

4 Appointments Office 1 Planned Care (14) Management Office 3 Pain Clinic 1 Communication (2) Jubilee Day Centre 1 Transport (1) T&O OPD 1 ED 4 Ward 34 1 ICU 1 Clinical Treatment (10) Ward 47 1 Urgent Care (14) Endoscopy Unit 1 Ward 51 1 Ward 48 1 Communication (1) Ward 50 1 ED 1 Delay in Treatment (2) Rheumatology OPD 1 Discharge Arrangements Ward 51 1 (1) Diagnostics and Radiology 1 Clinical Treatment (1) Pharmacy (1) Other Provider (1) Access (1) Other Trust 1 Total 30

7. PARLIAMENTARY & HEALTH SERVICE OMBUDSMAN INVESTIGATIONS

No new investigations were accepted for investigation by the Ombudsman in March 2016. However the Ombudsman completed their investigations into C132/13 and C156/14. In both cases, the Ombudsman advised the Trust that it is proposed to partially uphold both cases. In the case of C132/13 the Ombudsman felt that the Trust should have considered a differential diagnosis of delirium earlier than we did, even though it was acknowledged this would have not had any bearing on the patient’s treatment or the outcome. In C156/14 the Ombudsman decided that the patient had not been fully consented prior to surgery. 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 Planned Care (2) C132/13 Plastic Surgery C156/14 Ophthalmology

Urgent Care (1) C170/14 Stroke

8. PALS

During March 2016 the Trust received 189 new PALS enquiries compared to 248 new enquiries in February 2016. Of these, 92 related to the Planned Care Division, 57 enquiries related to the Urgent Care Division, and 9 related to Diagnostics and Pharmacy. The remaining 31 enquiries related to other areas.

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

Table 7 – PALS Themes Theme Number Information Request 50 Communication 27 Postponements 25 Waiting Time 23 Staff Attitude 19 Medical Treatment 11 Discharge/Transfer 7 Arrangements Nursing/midwifery care 6 Test Results 5 Access 3 Appointments 2 Miscellaneous 2 Hotel Services 1 Admission Arrangements 1 Appliances 1 Child Protection 1 Consent to treatment 1 Lack of Follow Up Care 1 Not referred to specialist 1 team Property 1 Record keeping 1

9. HOT TOPICS

 How can we make things better for patients?

Complaints relating to the failure to follow the appropriate procedures remain 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 March 85% of responses were sent out on time (the same as in February). 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 currently have 14 overdue complaints due to delays in receiving responses from an individual member of staff.

6  Requests for Meetings

The number of requests to meet has remained constant in March. However a number of meetings have taken place and the number of outstanding meetings has reduced to 7. Unfortunately a number of meetings have been unable to be confirmed due to the unavailability of clinical staff and this is causing considerable distress to complainants and additional work in the Complaints and PALS team. A number of overdue meetings have had to be escalated to clinical leads and senior managers for assistance. 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 14 April 2016