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All too often user experience and engagement programmes are created in a response to a mandatory requirement for measurement, or an organisation’s response to particular set of results and or complaints. To deliver a consistently positive user experience it is vital that an organisation’s user experience and engagement programmes form part of its strategic priorities.

A person centred approach to strategy setting

In 2014 Bristol Community Health released their patient and public empowerment strategy ‘Your Healthcare, Your Way’

Bristol Community Health is a Community Interest Company and part of the growing social enterprise movement. They employ over 1,100 staff, the majority of whom are highly skilled frontline clinicians. They provide a range of over 30 community healthcare services commissioned by the NHS in and around Bristol. The services cover a diverse range of specialist clinical care, from dermatology nursing to district nursing, physiotherapy to podiatry, walk-in centres to wound care and much more.

Bristol Community Health’s approach to developing their patient and public empowerment strategy marks them out a provider committed to the delivery of person centred care.

Their approach started with the provider engaging with their care users and the public in the local area. Culminating in a community engagement event in June where 70 delegates including public, care users, carers and the voluntary community gave their views on what they needed from their care provider, alongside how their views aligned to the provider’s current and intended approach to care delivery.

Matthew Areskog, Bristol Community Health’s Patient and Public Empowerment Lead, said;

“Engaging with patients and voluntary organisations in a constructive and beneficial way is really important to Bristol Community Health. This event has seen all of our delegates participate in lively discussion which has resulted in some excellent ideas for us to use within our strategy, and ensure that this strategy is a working document to help us achieve more for patients.”

Local voluntary organisations, including Alzheimer’s UK and the British Lung Foundation, as well as some of Bristol’s own services attended the event. Patients were invited to take free health checks, as well as being able to check their hand-washing routine with Bristol Community Health’s Infection Prevention and Control Team.

Using the insight gained the team at Bristol went on to draft their PPE strategy. However to ensure that strategy was still in line with the feedback, members of the local health community were re-engaged and invited to comment prior to its publication. The strategy will remain a working document where patients and public constantly inform local care delivery.

Bristol Community Health have further committed to embedding this person centred approach to care delivery through their plans to release a community pledge which covers their ‘Social value strategy’ and a refreshed equality and diversity strategy.

Embedding the care experiences, needs and aspirations of local communities in the development of care provider strategies is a fundamental step towards ensuring those services then go on to provide the highest quality care, of the work at Bristol Community Health Dr Andrew McCulloch comments:

“It is great to see a social enterprise committing to a person centred approach in the delivery of high quality community care. Bristol Community Health’s recently released Patient and Public Empowerment Strategy represents a clear commitment to putting the needs of their care users at the heart of both the structure and the delivery of their care services. Bristol’s ‘Your Healthcare, Your Way’ event, coupled with subsequent rounds of engagement and feedback from the public and care users has ensured this strategy truly represents what matters to those using Bristol Community Health’s care services. We also welcome their commitment to collect regular feedback focusing on the experiences of care users and to use this intelligence to improve care quality”

A strategy rooted in evidence

In 2011/12 Salford Royal NHS foundation trust agreed to work with Picker to develop an evidence based Patient, Family and Carer Experience Strategy.

The work initially analysed all of the trust existing patient and staff experience data as well as complaints and PALS information to develop a strategy based on the experiences of staff and care users.

This understanding was then supplemented by a range of engagement activity with their local population. The trusts “What Matters Most To You” initiative developed a set of 6 trust wide Always EventsTM to define the interactions and aspects of care that must always occur when patients and families interact care professionals and trust staff. These always events were aligned to the trust values underpinning a strong link to their organisational culture.

  • Staff will always communicate with, inform and respect the patient and/or carers, ensuring appropriate communications methods are in place for diverse groups
  • Patients and/or carers will always know who is in charge of their care
  • Patients and/or carers are always listened to.
  • Patients’ physical, social, spiritual and emotional needs will always be reviewed.
  • Patients and/or carers will always receive information and education to facilitate self-care, ensuring that they can be accessed by all patients.
  • Patients and/or carers will always be included in the discharge process

An implementation programme was developed to ensure the strategy become a natural way of working for staff, with each Always Event having a dedicated work stream which included; staff training and communications support, information support, dedicated time for family access to ward managers, the introduction of a patient experience champion to each division, the production of the ideal patient journey shared with all staff (both clinical and non-clinical), and the creation and regular hosting of a patient and family collaborative event.

The trust combined this with a complete review of their patient experience measurement activity, investing in a ward/service level real time feedback solution which allowed them to integrate the use of all available technology, including bedside televisions, to collect and respond to patient feedback. Performance was defined through trust, ward and service level targets that were aligned to both the always events and the wider strategy.

Michele Morgan, then Assistant Director of Nursing at Salford Royal NHS Foundation Trust commented:

“Working closely with Picker to undertake the Patient and Staff Experience Review, alongside Salford’s own review work streams, allowed Salford Royal Foundation Trust to build a detailed picture of what we do well and identify themes for more focused improvement work. Mapping all of this work together in partnership with Picker Institute has underpinned the development of the trust’s ‘Patient, Family and Carer Experience Strategy’”

In 2013/14 Salford Royal NHS Foundation Trust maintained a first quartile performance across key patient experience domains as well as being the top ranked acute trust in terms of staff engagement.

Picker Patient and Staff Experiences Review

One of Picker’s most successful programmes has been the Patient and Staff Experience Review; a tailored programme of work that enables you to take control of your patient experience data and use it more effectively.

Each Patient and Staff Experience Review is a four stage process:

  • Review – Review all patient experience data sources and understand level of awareness, interpretation and use of patient experience data at all organisational levels.
  • Analysis – Understand what your patient experience data is telling you, including staff engagement and buy in. Measure the impact of any existing patient experience initiatives.
  • Staff engagement – Work with staff to understand the challenges faced and the areas of support required, identifying opportunities to use patient experience information effectively.
  • Reporting and implementation – Delivery of a report and onsite presentation of findings at your organisation. We also provide continuing implementation, guidance and support.

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