1. Transforming Patient Experience: The essential guide www.institute.nhs.uk/theguide

2. Transforming Patient Experience: the essential guide This resource is for people with designated responsibility for improving the patient experience – both as providers of services and as commissioners. It is intended to provide you with the evidence you need to influence others – both at board level and team level, to focus on improving patient experience. The resource provides a rich source of research evidence, stories from patients and staff, along with many examples of innovative ideas. It illustrates a range of well-tested techniques to help you work more closely with patients to understand their experience and use it to improve services.

3. The Research In 2010 the Department of Health and the NHS Institute commissioned King’s College London and The King’s Fund to undertake research into: What Matters To Patients? Developing the Evidence Base for Measuring and Improving Patient Experience. The research featured interviews with patients, case studies from across health services and resources provided by people working to improve services. The research includes: What matters to patients – particularly in the non-acute sector. What do NHS organisations in England currently measure in relation to what matters to patients? Examples of NHS organisations who are using information and insights into patient experience to improve the quality and productivity of health care services.

4. Why Improve Patient Experience? Understanding what matters to patients

5. Start with the patient Experience is personal and although some experiences are common to many, everyone experiences things differently Each experience is made up of a Number of experiences or ‘moments

6. What matters to patients Feeling informed and being given options Staff who listen and spend time with the patient Being treated as a person, not a number Patient involvement in care and being able to ask questions The value of support services Efficient processes

7. Commissioner and provider challenges The challenge to providers: How will you transform the experience of patients in your care? The challenge to commissioners: How will you work in partnership with the services you commission to enable them to deliver a positive patient experience?

8. Key factors to consider Patient Experience Improvement Programmes need to be: Embraced by leaders Connect to the role of staff experience Use the power of stories Central to the organisations vision and culture

9. Functional or Relational?

10. Why Improve Patient Experience? Making the case for patient experience

11. Making the case for patient experience It is imperative that the NHS now makes a concerted effort to collect a body of evidence that will convince business leaders across the service of the importance of investing in improving patient experience. The business case for experience includes: the evidence of the impact of experience on organisational reputation, the impact of patient choice and increased control of care and treatment on experience, the link between experience and health outcomes, the link between experience and cost of care and the relationship between staff and patient experience

12. Making the case for patient experience “The experience of patients have of the treatment and care they receive – how positive an experience people have on their journey through the NHS can be even more important to the individual than how clinically effective care has been" Lord Darzi, The Next Stage review

13. Making the case for patient experience Patient experience is a key element of quality alongside providing clinical excellence and safer care The staff experience and the organisational culture that supports it are the most important elements of any customer experience programme Senior leadership and support for experience is essential

14. How to Improve Patient Experience? Measuring Experience

15. Measuring experience Methods of collecting and reporting patients' feedback should be tied as closely as possible to clinical services so that clinicians identify with the results. Middle managers and clinical teams should monitor quality of care as often as they monitor budgets NHS trust commissioners, planners and policy makers should make use of the data collected to support management and improvement of front line services and should avoid demanding fresh collections of data for their own purposes

16. What does good measurement look like? Commit resources to develop local infrastructure for collecting, analysing, interpreting and reporting on patient experience data Collect information about patient experience in a variety of ways Use feedback to improve services Facilitate and support the ongoing involvement of patients Prepare staff and equip them to respond Triangulate data from different sources to try and get a more complete picture

17. The 7-step measurement process The seven step process makes the link between data collection, analysis, finding and reports patterns and communicating both the decisions and the process to patients and the public. We collect data from patients about their experience (both qualitative and quantitative), we analyse it (turn it into a format that helps us see patterns, trends) and then review our service in the light of this intelligence. In other words the data we have gathered help use make better decisions about how to move the service forward.

18. Why Improve Patient Experience? The importance of organisational culture

19. The journey of culture change

20. Themes for organisations to focus on A Board that is accountable for and committed to patient experience and its continual pro-active improvement. An organisation engaged with patient experience that understands the value of it to the organisation, its staff and patients. Patient Experience is built into the organisation’s short and long-term business plan The organisation has a clear vision (together with values and standards) for patient experience – known and understood by everyone in the organisation – including staff and patients Patient Experience is considered an equal partner in Quality, alongside Clinical Effectiveness and Safety

21. Themes for organisations to focus on The link between staff experience and patient experience is recognised; staff experience is also captured and linked into patient experience. The role of teams is recognised. The organisations maximises and values the value of hearing the patient voice. A resource (budget, staff, systems) is dedicated for the capture of feedback, analysis of data and implementation of quality improvement to services as a result of that measurement activity. The organisation knows what it costs them to improve patient experience and can measure the impact resulting from that investment

22. How to Improve Patient Experience Helping leaders to Improve Patient Experience

23. Helping leaders to improve patient experience “The two main attributes of the organisations that were collecting experience data and using it to make changes were visible leadership and an organisational culture in which staff know that Patient Experience was a priority” King’s College London and The King’s Fund, What Matters to Patients, 2011

24. Key features of organisations who are successfully delivering patient experience Committed board members – with nominated Board Experience Champions Strong direction and leadership from the top Grass roots/front line involvement – backed by top level support Individual leaders can make a significant impact in enabling services that have not been in the forefront of gathering Patient Experience feedback data to embrace a more modern approach to doing so.”

25. The role of the board/management team The board should support the development of the patient experience improvement priorities, vision and strategy for patient experience. By linking patient experience with clinical effectiveness and safety the board has the opportunity to develop a clear picture of quality in the organisation In addition, the board members can ensure that patient experience is always on the agenda and by playing a positive role in gathering feedback, “walking the floor” regularly, talking to staff and patients.

26. Top Ten Things the board can do

27. Why Improve Patient Experience? Commissioning for a Positive Patient Experience

28. “You have the right to expect your local NHS to assess the health requirements of the local community and to commission and put in place the services to meet those needs as considered necessary”. NHS Constitution

29. The critical list - Commissioners Commissioners need to ensure that their decisions are informed by knowledge of the patient experience. Providers and commissioners need to develop share patient experience goals as part of developing good working relationships Incentive systems need to be aligned so that they recognise and reward innovative patient experience measurement and improvement in local organisations

30. Key themes from the research Work in partnership Consider patient experience as a key dimension of Quality Provide personalised care Ensure continuity of care and track experience along patient pathways as well as individual service Understand the challenge and scope for improving patient experience in individual organisations Evaluate and support provider organisations to deliver a positive patient experience

31. Top Ten Things commissioners can do