NHS Education for Scotland Always Events Duncan McNab Neil Houston Paul Watson John McKay Paul Bowie NHS Education for Scotland

A Brief Introduction Who Are You? Policy Person Centred Care Evidence for capturing and acting on patient experience and feedback Project plan

Who We Are NES Health Foundation

"Crossing the Quality Chasm" (2001), The Institute of Medicine Patient centred providing care that is responsive to individual patient preferences, needs and values and assuring that patient values guide all clinical decisions Safe avoiding injuries to patients from care that is intended to help them Effective providing services based on scientific knowledge Efficient avoiding waste, including waste of equipment, supplies, ideas, and energy Equitable providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location or socio-economic status Timely reducing waits and sometimes harmful delays for both those who receive care and those who give care

Policy Drivers Patient centred care – not new, but now the philosophy is central to policy across UK. In England, the Health and Care act 2012 legally defines quality as consisting of: Patient safety Clinical effectiveness Patient experience NHS Commissioning Board –required to demonstrate through NHS outcomes framework “ensuring that people have a positive experience of care” GMC, NMC, Health Professions Council recognise improving person-centredness as a core duty.

Examples of Policy Statements NHS Scotland should deliver patient centred care which is respectful, compassionate and responsive to individual patient preferences, needs and values.  (Better health, Better Care, 2007) Effective collaboration between clinicians, patients and others” (The Healthcare Quality Strategy for NHS Scotland, 2010) “Together, we will put people at the centre of everything we do and work to a common set of values which guide the work we do, the decisions we take and the way we treat each other.” (Everyone matters: 2020 workforce vision, 2013) “…recognise the central importance of the role of people using services, their carers and their community” (Scottish Clinical Strategy, 2016)

Person Centred Care Care that is: Personalised Co-ordinated Enabling Person treated with dignity, compassion and respect (Alf Collins, Measuring what really matters, Health Foundation ,2014)

Person Centred Care NHS Scotland’s Person Centred Collaborative - five ‘must do with me’ areas What matters to you? Who matters to you? What information do you need? Nothing about me without me Personalised contact

Issues in Person Centred Care Patients aren’t always actively encouraged to give their views, leading to disconnect Between the individual and health provider(s). Between the person using services and the wider healthcare system. Between communities and the wider healthcare system - the gap between the services provided and what communities actually need.

Capturing and Acting on patient feedback: Frustrations in Person Centred Care Objective measures often focus on structure, process or surrogate outcomes. Meaningful outcomes often lacking or unsustainable Can we Measure what really matters?

Developing the evidence But.. Patient surveys can be used to stimulate quality improvements (Chen J et al, 2013) But! Organisations may require additional help to implement change (Crawford MJ et al, 2002) Effectiveness of teams to develop and apply one particular QI method – Always Events – is under researched.

Expectations Prioritising person-centred care requires a clear commitment to implementation and measurement (Health Foundation 2014) The utility of your work is evidenced and quality assured in terms of reliability, validity, acceptability, feasibility and impact.