Improving Donor Experience

1. Improving Donor Experience Board Presentation March 2014 Jane Pearson

2. Complaints - National Teams above target Donor Complaints per million Donations vs. Target (4,500) YTD There are 41 teams above 4,500 YTD West 6181, East 5457, North 4566 Numbers of donors complaining YTD / No of donations Mobile teams: North: 2567 / 562150 West: 2858 / 462400 East: 3354 / 614580 Donor centres: YTD 506 whole blood donors / 143506 YTD 56 platelet donors

3. Top 5 Complaint Categories KEY December-12 December-13 YOY Change • Slot availability, Not seen at time and turned away are the highest causes of complaints. • All five categories have deteriorated with particular focus on turned away and slot availability. • The implication is that opportunity to walk-in is the major driver of complaints increase.

4. Team Level Diagnostics • Two Steps to Diagnostics: • What is the problem? (Hypothesis) • Why does the problem exist? (Root Cause Analysis - holistic and whole team and donor engagement) This simple approach will ensure that even incoming managers with little to no experience of managing session environments (e.g. external appointments) will be able to easily understand issues and action plan appropriately.

5. What is the problem (Hypothesis)? Hypothesis Questions Validation Do donor satisfaction comments support hypothesis? Session Capacity Observe session flow and speak to donors on session. 1 Is waiting time satisfaction <56%? Is peak queuing time above 40 mins? Do donor satisfaction comments support hypothesis? Customer Service Is there a trend of staff attitude complaints? Observe staff-donor interactions and speak to donors on session. 2 Do donor satisfaction comments support hypothesis? Are deferrals and/or FVPs above the national average? Is needle satisfaction lower than national average? Observe clinical practice and speak to donors on session. 3 Clinical The majority of donor complaints can be separated into one of the above 3 categories. An initial hypothesis about the main cause of complaints on any team can be confirmed and validated using the above approach.

6. Worcester example – Hypothesis Hypothesis Questions Validation Do donor satisfaction comments support hypothesis? Session Capacity Observe session flow and speak to donors on session. Is waiting time satisfaction <56%? Is peak queuing time above 40 mins? Team and review of data indicated that most issues were related to donor waiting times and donors turned away. Yes – waiting time satisfaction is the lowest in the country at 30.4% YTD. Yes – the majority of donor comments relate to long waiting times. Yes – peak queuing times are regularly above 40 mins. Area Manager session visit observed waiting times on under attended session (confirmed by donor feedback). The expected problem on Worcester team was Session Capacity contributing to high waiting times and turned away donors. This hypothesis was proven and validated by the steps above.

7. Worcester example – Root Cause • Establish: • Were too many donors called up? • Were the appointment grids reflective of donor attendance? • Was there excessive marketing? • Interrogate TPBs: • Is target reflective of capacity? • Is the balance of attendance even? • Was donor attendance above 130% of grids? • Is the throughput/ 20 mins reflective of number of beds? • Is there an effective ramp up? • Are beds kept full? Yes Planning Pre Session No Marketing Yes Session Capacity • Establish: • Were there venue issues? • Was staffing reduced on the day? • Are the team working at a slow pace? On Session Yes Manager No Team Yes

8. Why does the problem exist (root cause)? • Establish: • Does investigation of circumstances indicate individual is at fault? • Does investigation of circumstances indicate donor complaints were actually for a different reason? • Investigate issues: • Do complainants identify one individual? • If donor does not know name, does review of DHC indicate individual? • Do complainants indicate multiple individuals? • Is there a poor team attitude to customer service? Yes Individual Individual Yes Restart process at different category Yes 2 Customer Service • Establish: • Are team at fault? • Were cause of complaints a different reason? Team Yes Yes Team Restart process at different category Yes

9. Worcester example – Action Planning Root Cause Actions Deadlines • The team will be taken off road for dedicated development day to increase understanding, set performance expectations, ensure understanding of operating model/task timings and Customer Service Improvement (CSI). • Donors will be updated every 15 minutes on anticipated wait times. • Complaints, Compliments and Comments to be fed back to the team regularly. • Daily performance observations and feedback/coaching by managers and OTP experts on sessions. • Supervisors and Nurses will visit and learn from a high performing team. • Waiting time satisfaction and peak queue times will be displayed prominently on each session, with clear targets for improvement in each measure (targets to be agreed with Senior Sister). • PDPR objectives will encompass session flow management, with clear standardised targets and objectives. • The capability policy will be invoked if staff are unable to manage session flow effectively after training. Performance against targets and management observations will inform a decision to invoke this policy. • Mar-14 .. . • Mar-14 • Mar-14 . • Mar-14 . • Apr-14 . • Apr-14 . • May-14 . • Jun-14 The team does not effectively manage the flow of the session, meaning that donors are often seen beyond their appointment time and walk ins are turned away.

10. Action Planning Options Planning Marketing Manager Team Individual • Reduce calls ups. • Reshape appointment grids. • Move session times to fit donor attendance patterns. • Reduce local marketing initiatives. • Change marketing messages – encourage more appointment donors. • Change NCC message to donors, “If you turn up, you will be seen”. • Ensure NCC and Nurses are working to same guidelines (e.g. calendar month vs. days). • Venue issues resolved, or new venues found. • Communicate likely staff reductions to Planning well in advance of sessions. • Feedback compliments and best practice to team staff. • Ensure team ramp up session effectively and flex to maximise throughput. • Review A/L management, Union Duties and all absence impact. • Appropriate dedicated development time • Controlled acceptance of return of staff on restricted duties. . • Display waiting time expectations on session. • Tie customer service levels into PDPR objectives. • Team members to observe the process with donor’s eyes (15 Steps). • Update on waiting time every 15 minutes. • Disciplinary policy invoked in all proven staff attitude cases. • Capability policy invoked for staff who cannot achieve required throughput.

11. What is CSI? Customer Service Model Change Culture, Change behaviour Principles, Values and Core Behaviours Recruit the Right People Peer to Peer Training Managers Commitment Ongoing tools Develop Achieving Excelling DEVELOPMENT OF PERSONNEL Local ownership local solutions Assessment Centre DVD & Discussion Role Model, Coach & Give Feedback Visibility & Participation Keeping it ‘alive’ everyday Feedback on the floor and in PDPR Observation of Team & Individual Information Guide Nomination cards Our CS Approach PDPR Tool Character Profiles Scripted Phraseology

12. CSI Team Roll Out – National Trial Phase 1st Wave 2nd Wave 3rd Wave 4th Wave • Gloucester • Manchester E & W • Sheffield N & S • Epsom • WEDC • Kings Norton • Sutton Coldfield • Teesside • Newcastle • Lincoln • Hither Green • Brighton • Mitcham  • Exeter • Portsmouth • Worcester • Gloucester DC • Liverpool • Northwich • Wrexham • Leicester • Horsham • Harlow 2 • City  • Cornwall • Southampton • Solihull • Southampton DC • Cumbria • Hull • Caernarfon • Ipswich • London Middlesex • Maidstone • Bristol DC • Oxford DC • Bristol North/South • Bath • Lancaster • Nottingham • Stoke • Leeds/Bradford • York • Norwich • Ashford • Tooting DC Completed Start: late Jan 14 Start: late March 14 Start: late May 14 Start: late July 14 Roll out of each phase will take a total of 12 months

13. Planned Initiatives (1) Initiative Summary Team Date 1 “Sandwich” grids – appts at start and end, walk ins in middle Oxford May 14 2 Clinical leadership autonomy trial (no Hemocues, CST etc.) Brighton/Horsham March 14 3 Text Messaging Service trial (session running late) trial Kings Norton March 14 4 Stop call up text messages National Complete 5 Appointment and walk in only session trials Cambridge/Huntingdon March 14 6 Introduction of script for Welcomers Oxford/Newcastle TBC 7 Venue assessment change to enable venue WiFi if possible National TBC 8 Continuous session trial (bleed throughs) Cumbria March 14 9 PDPR objectives linked to Customer Service standards National April 2014 10 PDPR Reviewer training for Senior Sisters / Charge Nurses National TBC 11 Session Management training for Sisters and DCSs National April 2014 12 Introduction of volunteer queue management training National TBC

14. “Sandwich” Grids 14:00 DNA 14:05 14:10 DNA 14:15 DEF 14:20 DNA 10 x walk ins 14:25 DEF 14:30 DNA 14:35 14:40 14:45 14:50 14:55 15:00 • Idea originates from staff and designed by staff on teams for roll out based on local knowledge. • Evidence based on walk in, appointment attendance, deferral rates and times of walk ins per team. • Pilot teams to design management at reception, including visual indicators. • Appointment donors will be seen on or closer to appointment time and walk in donors can be more accurate donation time. • Better staff experience – including more controlled session flow and fewer overruns.

15. Planned Initiatives (2) Initiative Summary Date 5 Target the dissatisfied donors with a recovery programme letter May 14 Undertake a portal promotion to those individuals who have walked-in over the last 12 months and to whom we have an email address – 170,000 6 May 14 7 Change the text reminder system and only text non-appointment call up at certain times of the year and for certain blood group May 14 8 Roll-out the portal Ongoing March 14 9 Implement compliment and complaint of the month to illustrate and showcase positive behaviours 10 Work with Customer Service team and Comms team to improve standard responses Ongoing 11 Refresh the previous approach to seeking donor feedback via various donor engagement forums – proposal to SMT. April 14