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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. Questions?