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Service User Survey Results 2011. Toni Martin – Senior Consultant Quality Health. Context. NHS Plan: Mandatory annual national surveys (patient and staff) Links to Vital Signs Conclusion: Patient and Staff surveys are a major source of data for CQC evaluating Trust performance
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Service User Survey Results2011 Toni Martin – Senior Consultant Quality Health
Context • NHS Plan: • Mandatory annual national surveys (patient and staff) • Links to Vital Signs • Conclusion: Patient and Staff surveys are a major source of data for CQC evaluating Trust performance • CQC’s Role: • Organise and run the national surveys – DH may take over the programme in 2012 • Publish comparative data for each Trust to inform public and guide funding. CQUIN scheme linking Patient Experience data to funding may be extended to MH • Inspection: sometimes unannounced or short notice - c.1 in 5 chance of being inspected in any one year. Inspections becoming more rigorous • Patient Reported Outcome Measures: • MH community services could be in scope for industrial scale PROMs
Operating Framework & Vital Signs • Vital Signs on patient experience: • Self reported experiences (national priority for local delivery, i.e. PCTs decide on precise content of local Vital Signs) • AND respect and dignity ratings • “Success” defined as increase in index score for each survey (national priority indicators guidance) • Operational Plans Technical Guidance Master makes clear that patient experience will be gauged using questions in 4 patient survey domains: 13 questions, flashed in this presentation
Key Points • Establish: differences between service users and managers / clinicians views of service • National Service User Surveys 2003 - 2011 used essentially same methodology • Substantial revision to questionnaire in 2011 • Comparison here with 15,159 Service User respondents from core samples in 56 MH function Trusts. • 86% of MHTs used QH • National Response Rate: 32%. Range is 26% - 42%; London and metropolitan areas lowest; shire counties with lowest levels of deprivation have highest response rates
Performance Issues Performance differences between Trusts caused by: • CQC standardise data only by age and gender. Our official study shows need to standardise for ethnicity or use unstandardised data. • Differences in practice and quality – but also: • Differences in social composition • Ethnicity: Asian and Black service users have different pattern of contact – less use of TT, more contact with Psychiatrists. Asian patients less positive about care planning, CCs, fewer have access to out-of-hours service; Black service users have double the rate of sectioning than whites • Age:Young patients less satisfied than older patients: up to 18 point difference on information issues etc between 16-24s and 64-75s • Gender: Women less positive than men • Still big differences perceived in service quality between geographically based teams in some Trusts • Differences in composition of CPA register: % of service users on new CPA ranges from 100% to 8% between Trusts in this survey • Too soon to tell how differential implementation of new CPA system will affect the data. Much looks unchanged from previous years • Under old CPA rules, enhanced CPA service users were much more likely to be aware of care plans, care co-ordinators, out of hours phone numbers, than those on standard CPA • So, the kinds of service users in your sample are crucial
Issues for Action • Better information on medication purposes & side effects, decisions on meds where possible • Ensure that all medication is being effectively reviewed congruent with your clinical guidelines • Assess unmet need for talking therapy • Further improve knowledge of who the care co-ordinator / lead professional is and awareness of how they can be accessed • Continue action to ensure all get a hard copy of care plan, understand contents, and ensure formal updating at least annually • Further improve incidence of care reviews - many say they haven’t had one in last year • Further extend help to those wanting it on finding work, benefits, housing • Ensure all service users have access to out-of-hours support telephone number • Ensure that enough information and support is given to families and carers
The Next Steps • Integrate with Quality Account and ensure Vital Signs action plans are in place. • Specific action plans in place to deal with top service user related issues. Build a performance management system which makes managers accountable; top improving Trusts pick 3-4 issues at most and rigorously performance manage them from the top. • Lead the process within the Trust. Keep the pressure up, don’t stop. Repeat messages. • Consider tracker surveys on community and IP services • Publicise achievements.
