Improving patient experience across London Cancer Exploring and analysing emerging themes Fiona McKenzie, Macmillan Project Manager for Patient Experience 21 January 2015

Mapping patient experience efforts Visited 8 London Cancer trusts, covering 10 hospital sites Spoke with 21 staff who had some form of responsibility for patient experience at their trust including Patient Experience Leads, Deputy Chief Nurses, Lead Cancer Nurses, Patient Experience Project Managers, CNS Asked 22 questions covering: Patient experience team, remit, resources and engagement Real-time feedback – measuring patient experience Trust Board-level engagement Areas of focus and challenges in improving patient experience e-HNA data: Over the last year, 139 individuals have received a holistic needs assessment with an average of 9 concerns being identified per assessment. Top four concerns identified: worry, fear and anxiety, sleep issues, fatigue, and sadness

Patient experience team, resources and engagement All had at least 1 person tasked with responsibility for patient experience across Trust but title and level of responsibility varied tremendously from Director to Facilitator Many general roles across sites have patient experience improvement embedded within them Staff from 4 trusts talked about engaging staff and developing strategy and action through patient experience committees Lead Cancer Nurses have assumed responsibility for cancer patient experience, whilst others have a defined remit, but majority spoke of struggling without a member of staff to help them understand data and spread learning e-HNA data: Over the last year, 139 individuals have received a holistic needs assessment with an average of 9 concerns being identified per assessment. Top four concerns identified: worry, fear and anxiety, sleep issues, fatigue, and sadness

Patient experience team, resources and engagement Close working relationships with: Communications (6/8 trusts) Quality, Innovation, Productivity and Prevention (QUIPP) (5/8 trusts) Healthwatch (2/8 trusts) Governance (2/8 trusts) Volunteers (1/8), Estates (1/8), Equality and Diversity (1/8), Chaplains (1/8) All Trusts spoke about working closely with Macmillan Cancer Support and other charity or voluntary sector organisations including Healthwatch, Spurs Foundation e-HNA data: Over the last year, 139 individuals have received a holistic needs assessment with an average of 9 concerns being identified per assessment. Top four concerns identified: worry, fear and anxiety, sleep issues, fatigue, and sadness

Real-time feedback – measuring patient experience All are measuring improvement in patient experience through some form of real-time feedback How - between 8 and over 100 surveys have been prepared for use Data analysis is provided by patient experience facilitators or project managers, some systems do their own analysis, or some performance teams ‘Real-time’ doesn’t really mean real-time feedback to staff One trust (where patient experience responsibility is held by all) focuses on face to face feedback, working through teams of senior staff to share feedback with colleagues e-HNA data: Over the last year, 139 individuals have received a holistic needs assessment with an average of 9 concerns being identified per assessment. Top four concerns identified: worry, fear and anxiety, sleep issues, fatigue, and sadness

Trust Board-level engagement All Boards examine family and friends test data at each meeting Boards don’t regularly see thematic analysis of free text comments, complaints or comment cards 4/8 Trusts use patient stories at each Board meeting to get across a particular issue or concern Board leadership is felt to be key – those staff that felt they had a clear strategy and action plan had engaged Board Directors in their ongoing work e-HNA data: Over the last year, 139 individuals have received a holistic needs assessment with an average of 9 concerns being identified per assessment. Top four concerns identified: worry, fear and anxiety, sleep issues, fatigue, and sadness

Common areas of focus Understanding patients’ experience - listening to patients Listening to feedback and affecting immediate changes - ‘ You Said, We Did’ boards In Your Shoes training to understand patient experience Supporting Staff Staff awards – monthly and annual Focus on staff experience, staff pride and values Embedding values and behaviour Implementation of behaviour and values for staff, following wide staff engagement Customer care training e-HNA data: Over the last year, 139 individuals have received a holistic needs assessment with an average of 9 concerns being identified per assessment. Top four concerns identified: worry, fear and anxiety, sleep issues, fatigue, and sadness

Common trust priorities for the coming year Holistic Care across the patient journey Implementing health and wellbeing clinics and wider recovery package Improving seamless care between primary, secondary and social care services Values and Behaviours Listening events, patient engagement, meaningful patient involvement Staff experience – Schwartz Rounds, staff retention, recruitment and appraisals Communication Communication - communication skills training, breaking bad news workshops, patient information Providing more communication options for patients, carers and families Measurement Measuring patient experience without duplication and helping others to do this well e-HNA data: Over the last year, 139 individuals have received a holistic needs assessment with an average of 9 concerns being identified per assessment. Top four concerns identified: worry, fear and anxiety, sleep issues, fatigue, and sadness

Biggest challenges in improving patient experience Around 40 comments from staff about this, focused on: Measuring improvement – making effective use of real-time feedback Embedding culture that delivers high quality patient experience Staff morale and vacancies Resources dedicated to patient experience Leadership and influence at Trust Board level Getting first impressions right every time Preconceptions of patients and carers Prioritisation Diverse population and needs e-HNA data: Over the last year, 139 individuals have received a holistic needs assessment with an average of 9 concerns being identified per assessment. Top four concerns identified: worry, fear and anxiety, sleep issues, fatigue, and sadness

What next Analysis to be completed and report outlining detail of this work published Today’s event, together with the report, will inform and influence improvement activities across our providers London Cancer with UCLP will continue to support Trusts in achieving further improvements in patient experience through the Patient Experience Learning Community Inform National Cancer Patient Experience Survey developments through Macmillan and NHS England e-HNA data: Over the last year, 139 individuals have received a holistic needs assessment with an average of 9 concerns being identified per assessment. Top four concerns identified: worry, fear and anxiety, sleep issues, fatigue, and sadness

Questions?