IMPROVING the Patient & Client experience

This Statement has been produced for DHSSPS by NIPEC in partnership with theRCN. The Department would like to acknowledge the contribution of the stakeholder

groups in the development of this Statement.

PREFACE 04

FOREWORD 05

Introduction 07

Patient and Client Experience Standards 08• Respect 09• Attitude 10• Behaviour 11• Communication 12• Privacy and dignity 13

Stakeholder Involvement 14

Monitoring and improving standards 16

Appendices 18Appendix 1 Patient and Client Experience: Northern Ireland 18

related policy, legislation, documents and initiatives

Patient and Client Experience: Other initiatives and 19information UK level

Appendix 2 Examples of Monitoring Activities 23

References 25

Contents

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Good quality care is everyone’s business; it requires champions in the board roomand at the bedside. Leaders of health and social care organisations mustdemonstrate behaviours which are consistent with high standards of care andcompassion. The five standards relating to: respect, attitude, behaviour,communication and privacy and dignity clearly state what people can expect fromthe health and social care service. The Department will want to see servicescommissioned that embrace the five standards, and health and social careproviders monitoring and continually improving them.

We will ensure that:

• Patient and client experience has a clear focus within our priorities • Patient experience standards are embedded in commissioning processes• Health and Social Care providers have the patient and client experience

integrated across all policy and strategy documents • Trust boards should receive an annual report of the outcome of the evaluation

of the Patient and Client Experience Standards and associated improvements.

DHSSPS will review performance management information annually whichillustrates that these standards are being monitored effectively and continuousimprovements are being made. I will want to see that lessons are learned andexperience of care is continually improving.

The Department will ask the Regulation and Quality Improvement Authority toensure that these standards are actively monitored and continual improvementmade as part of its system of regulation and improvement.

Martin BradleyChief Nursing Officer

Preface

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All of us, whether as patients or staff, want to be treated courteously, with dignity,respect and sensitivity.

I want to ensure that appropriate systems are put in place to enable theachievement of the standards outlined in “Improving the Patient and ClientExperience” and commit ourselves to a service that integrates these standards intoall that we do.

A good understanding of what makes the public satisfied with our service will bethe difference between a successful and an unsuccessful organisation.

We can have a real impact upon the experience of those who use our service byhow we communicate, by how we co-operate and support colleagues, and bycreating a friendly environment where we can all take pride in the services that we offer.

Michael McGimpsey, MLAMinister for Health, Social Services and Public Safety

Foreword

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When we are in need of care, we can beat our most vulnerable. During this timeour experience of health and social careservices should be as positive aspossible. Therefore all those involved inproviding care should be continuallyimproving standards to ensure a highquality of patient and client experience.However, the complex and highlypressurised world of health and socialcare delivery can make maintaining thatfocus difficult.

Policy drivers and service arrangementsare currently in place to ensure safety,quality and access. In addition, a varietyof UK level initiatives and activitiesprovide evidence of the types of issuesthat people say are important to them.

This information, along with previouswork undertaken by DHSSPS, hashelped identify five standards relating torespect, attitude, behaviour,communication, privacy and dignity.Stakeholder groups in Northern Irelandhave also been involved in thedevelopment of these standards andthe ways in which organisations shouldensure they achieve them. Theirfeedback is summarised later in thisdocument.

Organisations may employ a number of

different activities to objectively monitorand continuously improve theexperience of patients and clients. Thisincludes the development oforganisational policies and codes ofpractice which support the patient andclient experience outlined in the fivestandards. Appendix 2 gives a fewexamples of activities that could beused to support monitoring processes.

IntroductionSecuring a positive patient and client experience is theresponsibility of all involved in providing health and social care.

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See Appendix 1

*

*

Patients and clients have a right toexperience respectful and professionalcare, in a considerate and supportiveenvironment, where their privacy isprotected and dignity maintained. Thisprinciple should be promoted andsupported by all health and social careorganisations and professional bodies,enabling staff to provide a qualityservice.

There are many complex factorsrelevant to the quality of patient andclient experience. The following fiveareas have been identified as importanttowards ensuring a positive patient orclient experience.

RespectAttitudeBehaviourCommunicationPrivacy and dignity

This is not an exhaustive list and theremay be overlap between the areas,however, all five relate to aspectsidentified by patients and clients asimportant to their experience.

Any aspect of the patient and clientexperience will, by its nature, require a

variety of measurement approaches inorder to appropriately capture thequality of the actual experience ofpatients and clients. Continuous,objective and systematic monitoring andimprovement against the standardsdescribed in this document will helpgive confidence to patients and clientsacross Northern Ireland.

Standards of patient andclient experience*

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Whilst the focus of these standards is on patient and client experience, they should be taken to

refer to carers where appropriate.

*

This standard will be recognised whenall members of staff display a personcentred approach in their care andtreatment, or in their contacts withpatients or clients.

This is demonstrated by:

• Patients’ and clients’ wishes beingrespected

• Respect for diversity and difference • Patients and clients being actively

involved in decisions regarding theircare

• Members of staff providing care thatis personalised

• Patients’ and clients’ interests beinggiven priority by members of staffand teams

• An organisational culture whererespect for the individual is valued.

This standard is achieved when:

Patients and clients report experienceof being respected and involved indecision making regarding their careand treatment.

Patient and client representative groups report a patient and client focus in their involvement in servicedevelopment and improvementactivities.

Evidence shows that the organisationvalues people.

Staff members report that induction,ongoing learning and developmentactivities promote respect for patientsand clients and a person centredapproach.

Patients and clients report thatunavoidable interruptions during careprocesses are managed sensitively.

Respect

Feeling respectedmeans beingvalued as a

uniqueindividual

All health and social care staff show respect in all contactswith patients and clients.

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development activities aimed atimproving and maintaining positivestaff attitudes.

There is evidence of well organised andmanaged environments with dedicated,compassionate and professional staff.

AttitudeAll health and social care staff show positive attitudestowards patients and clients.

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Experiencingpositive

attitudes fromstaff means

feeling cared for as an

individual

This standard will be recognised whenpersonal approaches and responses topatients and clients by all members ofstaff show care and compassion.

This is demonstrated by:

• Welcoming and approachable staffwho demonstrate a willingnessto help

• Staff understanding the effect theirverbal and non-verbal communicationhas on others

• Staff demonstrating a non-judgemental attitude towardspatients and clients

• Staff being open-minded towardsnew or better ways of caring andworking

• Organisational structures andprocesses that enable staff to takesufficient time to show positiveattitudes to patient and clients.

This standard is achieved when:

Patients and clients report experiencesof positive attitudes towards them.

Patients, clients and staff membersreport that the organisational cultureis conducive to positive attitudes atindividual and team levels.

Staff members report high levels ofsatisfaction with learning and

This standard will be recognised whenall members of staff involve patientsand clients in their care, respecting theirwishes and showing professional andappropriate behaviour.

This is demonstrated by:

• Staff seeking patient and clientconsent when appropriate

• All staff being polite, courteous andprofessional

• Staff being open and receptive tofeedback and challenge

• Patients and clients being called bytheir preferred name

• Staff respecting the personal spaceof patients and clients.

This standard is achieved when:

Patient and clients report that theywere asked for their consent whereappropriate.

Patients and clients report that theyhave been called by their preferredname.

Patients and clients report beingtreated in a polite, courteous andprofessional manner.

Evidence shows that the organisationhas implemented local policies thatoutline what is expected in thebehaviour of all staff.

Evidence demonstrates responsivenessto expressed views and challenges.

Behaviour

Experiencingprofessional and

consideratebehaviour

means feelingvalued

and safe

All health and social care staff show professional andconsiderate behaviour towards patients and clients.

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This standard will be recognised whenall staff members engage in effectiveverbal and non-verbal communicationleading to clear information beingexchanged between staff and patients/clients.

This is demonstrated by:

• Staff adapting their verbal and non-verbal communication to be sensitiveto individual needs

• Staff giving clear, correct information,using appropriate language

• Staff using effective communicationskills such as active listening tocheck the patients’ or clients’expectation and understanding

• Staff undertaking learning anddevelopment activities relevant tocommunication

• Important elements ofcommunication exchange beingrecorded accurately

• Staff involving carers and familymembers where appropriate.

This standard is achieved when:

Patients and clients report thatcommunication has been sensitive totheir needs and respectful of theirpreferences.

Patients and clients report that theyhave been provided with clear, correct

information using language theyunderstand.

Patient and client documentationdemonstrates that the importantelements of communication exchangehave been recorded appropriately.

Staff members report that respectfuland sensitive communications are partof the organisational values.

CommunicationAll health and social care staff communicate in a waywhich is sensitive to the needs and preferences ofpatients and clients.

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Clearcommunication

meansunderstanding

and feelingunderstood

This standard will be recognised whenstaff members ensure that allenvironments where care is providedprotect the privacy and dignity ofpatients and clients.

This is demonstrated by:

• Staff ensuring that the modesty ofpatients and clients is protected,respecting cultural diversity

• Staff receiving training anddevelopment relevant to their needsto support the maintenance ofpatients’ and clients’ privacy anddignity

• Effective use of available resourcesin all health and social careenvironments to secure privacy anddignity for patients and clients

• Staff ensuring that patients’ andclients’ personal information iscollected, utilised and stored in a waythat maintains confidentiality.

This standard is achieved when:

Patients and clients report that theirprivacy and dignity has been protectedthroughout their health and social careexperience.

Patients and clients report thatdiscussions relating to their personalinformation were held in a way thatmaintained their privacy and dignity.

Evidence shows organisationalarrangements exist which are aimed atprotecting privacy and dignity forpatients and clients.

Staff report that maintaining patientand client privacy and dignity isencouraged and supported by theorganisation.

Privacy and Dignity

Means feeling that your private

moments areprotected and

you are treatedwith due

respect andconsideration

All health and social care staff protect the privacy anddignity of patients and clients at all times.

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IntroductionIt was agreed to hold a series ofstakeholder workshops forrepresentatives from the voluntaryagencies and service providerorganisations to test the patient andclient experience standards as theywere being developed. This was toensure the standards were clear,unambiguous and took account ofthe views of these importantstakeholder groups.

A draft version of the ‘Patient and ClientExperience Statement’ was distributedto the voluntary stakeholder groupsalong with an invitation to attend aworkshop. In addition, individualsessions with voluntary agencystakeholder groups were facilitated forthose groups who were unable to attendthe workshop.

Letters outlining the purpose of theworkshops and requesting nominationsfor individuals to representorganisations, together with a copy ofthe draft paper, were sent to the ChiefExecutives / Directors of HSC Boards,Trusts, Family Practitioner Units,Northern Ireland Social Care Council, NIMedical and Dental Training Agency,Prison Services, Ambulance Service,Hospices, and Independent Health CareProviders. The Chief Executives/Directors were asked to consider their

nominations from a multi-professional/multi-disciplinary aspect, the patientexperience being the responsibility of allinvolved in health and social care. Thepatient and client experience draftpaper was then distributed to theirnominated delegates in advance of theworkshops.

A second concluding workshop washosted for the service providerdelegates who attended the first, toconsult on the final draft of thedocument and discuss implications forimplementation and evaluation.

Consultation FeedbackAll of the events encouraged livelydiscussion and debate with thestakeholder groups. Feedback wasprovided regarding the relevance, clarityand applicability of the standards.Comments received were mainlyregarding the clarity and simplicity oflanguage, strengthening the standardstatements; and ensuring that a patient-centred approach was included.Alternative wording was suggested formany parts of the document by bothstakeholder groups. An idea was offeredthat two separate documents might beprepared, one including thebackground, development andmonitoring of the standards; the otherpresenting a shortened version of the

Stakeholder Involvement

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standards document for general use byall levels of health and social care staff.The concluding event offered theopportunity to the service providers’stakeholder group to comment onimplementation and evaluationprocesses, giving examples of good

practice where relevant. A final draft of the document wasagreed at this workshop.

For a full list of participants whoattended the workshops, please go towww.nipec.n-i.nhs.uk

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The assurance and continualimprovement of patient and clientexperience is the responsibility of allorganisations and members of staffinvolved in delivering health and socialcare. Patient and client experiencestandards should be embedded incommissioning processes and allproviders must have a PatientExperience Strategy in place with anExecutive level lead driving delivery.Ongoing monitoring should bemainstreamed across the organisationand where necessary improvementmade against the five patient and clientexperience standards.

Monitoring these standards requires avariety of measurement approaches inorder to appropriately capture the actualexperience of patients and clients.These approaches must be systematicand objective, include the patient, clientand their carers where appropriate andutilise a number of tools in order toidentify patient and client experienceconsistently.

There are many quality monitoring andimprovement activities which can helpan organisation identify if they areachieving these standards effectively;bench marking, audit, practicedevelopment, quality improvementinitiatives and so on.

All of these activities should involve thepatient and client or theirrepresentatives, organisational leaderscharged with the quality of patient andclient experience as well as members ofstaff and teams charged with ensuring apositive patient and client experience inthe delivery of health and social care.

Various tools such as current andretrospective patient and client surveys,patient and client structured interviews,staff surveys, analysis of patient andclient stories, observational techniquesand use of indicators can all helpillustrate if the organisation is achievingthe five standards outlined in thisStatement.

Continual improvement should also besystematic and robust, involve therelevant staff and result in evidence oftangible improvements.

Aspects for improvement identified fromthe organisation’s monitoring activityshould result in dedicated action plans.These action plans should beimplemented and evaluated to ensureimprovement has taken place. Patientand client involvement should be utilisedwhere appropriate. These activities must be recorded and communicatedthroughout the organisation and form part of the performancemanagement requirements.

Monitoring and improvingstandards

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Organisational achievement of the fivepatient and client experience standardsmust be monitored and wherenecessary improved on an ongoingbasis if the public is to be assured of

consistent positive patient and clientexperience.

See Appendix 2 for examples ofmonitoring activities.

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In 2001, Best Practice – Best Care1 setout the detail of a framework to improvethe quality of care in Northern Ireland.This included links to national standardsetting bodies such as the NationalInstitute for Clinical Excellence (NICE)and the Social Care Institute for ClinicalExcellence (SCIE) as well as the variouscodes of conduct for the regulatedprofessions such as Medicine, Nursingand Social Work.

In 2002, DHSSPS guidance HSS (PPM)10 (2002)2 asked health and social carebodies to formally develop andimplement clinical and social caregovernance arrangements with a view toimproving quality in the HPSS. Thiscircular also stated the wide range ofactivities relating to the delivery of highquality care and treatment, and statedthat clinical and social care governancearrangements must involve users inways that are meaningful, appropriateand acceptable.

In 2003, the Health and Personal SocialServices (Quality, Improvement andRegulation) (Northern Ireland) Order20033 applied the “statutory duty ofquality” on HSS Boards and Trusts,which means that each organisationhas a legal responsibility to satisfy itself that the quality of care itcommissions and/or provides meets a required standard.

In March 2006, the Quality Standardsfor Health and Social Care - SupportingGood Governance and Best Practice inthe HPSS4 set out the quality standardsDHSSPS considered people shouldexpect from the HPSS. The standardsidentified five key quality themes:corporate leadership and accountability;safe and effective care; accessible,flexible and responsive services;promoting, protecting and improvinghealth and social well-being; andeffective communication andinformation. It represented a significantstep in placing the needs of serviceusers and carers at the centre of healthand social services.

Also in March 2006, DHSSPS in SafetyFirst: A Framework for SustainableImprovement in the HPSS5 set out apolicy statement on safety. It stated thatDHSSPS was committed to the ongoingdevelopment of a safer service as partof the Department’s drive to improveclinical and social care, service userexperience and outcomes.

In 2007, the Department produced thecircular: Guidance on StrengtheningPersonal and Public Involvement inHealth and Social Care6, promoting theinvolvement of people in plans anddecisions about their care or treatmentas well as plans and decisions aboutservice provision. The guidance wasbased on a set of core values and

Patient and Client Experience: Northern Ireland relatedpolicy, legislation, documents and initiatives

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Appendix 1

guiding principles and provided aframework for good practice in theinvolvement of people at all levels inhealth and social care.

In June 2008, Health Minister MichaelMcGimpsey said in the Preface to thecross departmental documentDelivering the Bamford Vision - theResponse of Northern Ireland Executiveto the Bamford Review of Mental Healthand Learning Disability that promotingindividual dignity and privacy, alongsideindividual responsibility and selfdetermination, were the key principlesdriving the Review’s proposals7. Theresponse to the consultation concludedin October 2008.

There are a number of otherdocuments and initiatives relevant topatient and client experience. Theyinclude:

In 2004-2005, in keeping with the drivetowards provision of a quality service,the Nursing and Midwifery Group atDHSSPS in partnership with theNorthern Ireland Practice and EducationCouncil for Nursing and Midwifery(NIPEC) took forward the regionalEssence of Care project which involvedthe facilitation, implementation andevaluation of benchmarking projectsacross the HSC sector, independentsector, hospice care and in prisonhealth8. This followed on from the 2001Department of Health (England) releaseof Essence of Care,9 a tool-kit of ninepatient-focused benchmarks for clinicalgovernance, developed to reinforce theimportance of “getting the basics right”

and improving the patient/clientexperience.

In June 2007, NIPEC reviewed thecontinued impact of the Essence ofCare projects. This demonstrated theimprovements that had been madeacross many benchmarks, includingPrivacy and Dignity and the challengesthat organisations appear to face whentrying to sustain and further developEssence of Care benchmarks.10

In July 2007, NIPEC published theOrganisational Guide to Practice andQuality Improvement Activity11 whichoutlined the type of people,infrastructure and systemsrequirements in order to ensure practiceand quality improvement activity atorganisational level. The guide wasdeveloped to support and influencepractice and quality improvement workacross all sectors of health and socialcare. It identified that activities such asaudit, benchmarking, research, practicedevelopment, or service improvementhad the shared aim of improving thequality of care provided to patients andclients. The guide supports a selfassessment for organisations in terms of their readiness to facilitatesuch activity.

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Appendix 1

In September 2006, “Who Cares, WinsLeadership and the Business ofCaring”12 was published by the Office forPublic Management and the BurdettTrust for Nursing. Sir William Wellscomments in the Foreword thatleadership and influence must bebrought to bear at senior levels withregard to the dignity and care ofpatients. He says that ‘this is not justabout the odd satisfaction survey butrather the competence, credibility andauthority to performance manage on anongoing basis the whole patientexperience, wherever it is located.’ Thestudy was commissioned by the BurdettTrust for Nursing about the businessaspects of patient care and theimplications for nurse leaders and theirboards. Designed to trigger the actionsthat would take patient care from‘bedside to the boardroom’, the reportargues that if a more market drivenhealth system is going to deliver ‘a newNHS’, then patient satisfaction andcustomer care need equal ranking with finance, targets and outputs onboard agendas.

In 2006, the NHS Confederationpublished Lost in Translation in which itillustrated a gap in what the public andpatients think about the NHS. Itreported the outcome of differentsurveys relating to varying aspects ofpatient and client experience,particularly around respect and dignity.

It also identifies that nursing has a keyrole to play in improving patientexperience.

In 200613, the Social Care Institute forExcellence (SCIE), which aims toimprove the experience of people whouse social care by developing andpromoting knowledge about goodpractice, published (updates 2008) SCIEPractice Guide 09: Dignity in Care. Itprovided information for service userson what they could expect from healthand social care services, and a wealthof resources and practical guidance tohelp service providers and practitionersin developing their practice, with theaim of ensuring that all people whoreceive health and social care servicesare treated with dignity and respect.

In October 2006, the Department ofHealth (England) published the Dignityin Care Public Survey October 2006 –Report of the Survey14. It reported onpeople’s views from an online surveycarried out in June 2006, the purposeof which was to hear directly from thepublic their own experience about beingtreated with dignity by care services, orabout care they had seen provided toothers. Over 400 people responded tothe survey, including both members ofthe public and health and social carestaff. In summary, the most commonissues raised were: making it easier tocomplain; improve the inspection andregulation of the service; and raise

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Appendix 1

Patient and Client Experience: Other initiatives andinformation UK level.

awareness and understanding of dignityin care (including in the training andinduction of staff).

In November 2006, the Department ofHealth (England) launched the Dignity ofCare campaign. The Dignity Challenge15

promotes respect and dignity in care ofolder people which supports andpromotes the individual.

In September 2007, the Picker Institutereport16 Is the NHS becoming morePatient-Centred? Trends from theNational Surveys of NHS Patients inEngland 2002-07 draws on the resultsof 26 national patient surveys carriedout under the auspices of the NHSpatient survey programme in England toassess the quality of NHS care throughpatients’ eyes. The Picker Institute is anapproved provider of surveys for thenational programme. Their reportidentifies that NHS care had improvedsignificantly in some important respectsand most patients are highlyappreciative of the care they receive.But despite pockets of excellence, theysay the service is still far from patient-centred with the most significantproblem a failure in relation to patientengagement. The Picker Institute17 havealso produced a series of fact sheetsover the last five years on ImprovingPatients’ Experience.

In 2007, the Health Care Commission,which is an independent bodyresponsible for reviewing the quality ofhealthcare and public health in England,and Wales and responsible forassessing and reporting on theperformance of the NHS in England,

published The State of HealthcareReport 200718. This included a specialchapter on providing a better experiencefor patients. They recommend thathealthcare organisations need to placemore emphasis on listening to patients,providing them with accessibleinformation, and understanding andaddressing their individual needs.People with a particular need forpersonalised care must be involved indrawing up their care plans and beoffered the best possible support tolive independently.

In June 2007, Frances Blunden fromWhich? (consumer organisation)delivered a lecture, Can regulation helpto improve the patient’s experience?19

at the Nursing and Midwifery Council’sannual lecture in Cardiff. In her speech,she said that many of the messagesfrom the work ‘Which?’ had carried out,were not about complaints of seriousprofessional misconduct orincompetence but more often instancesof mildly incompetent care, orcompetent care delivered badly or withattitude. She identified four clear areasof need and expectation that togethercontribute to a good patient experience:the ward environment; organisation ofcare; being kept informed; and attentionfrom caring staff.

In September 2007, the HealthcareCommission also published Caring forDignity A National Report on Dignity inCare for Older People while inHospital20, which highlighted their keyfindings of the programme ofassessment and inspection and set outrecommendations for action to improve

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Appendix 1

the care and overall experience of olderpeople in hospitals. A number of keythemes are identified, includinginvolving people in their care anddelivering personal care in a way thatensures dignity for the patient.

In May 2008, Robin Youngson, a UKtrained anaesthetist and clinical leaderworking in New Zealand, reflected oncompassion in healthcare as part of theFutures Debate series run by the NHSConfederation. He defined compassionas ‘the humane quality ofunderstanding suffering in others andwanting to do something about it’. In hisreflection he comments that fewhospital patients ever remember whatwas said to them, or what was done, but the emotional experience is lived a lifetime.

In May 2008, DOH (England) publisheda study Public Perceptions of Privacyand Dignity in Hospitals, undertaken inMarch 200721 on their behalf. Itindicated that cleanliness and staffattitudes were the most importantfactors for patients to feel they aretreated with privacy and dignity inhospital. The research, conducted byIpsos MORI, involved 2,000 interviewswith members of the public across thecountry. It was designed to exploreperceptions towards privacy and dignityin hospitals, with particular emphasison the importance of single-sexaccommodation.

In June 2008, the Royal College ofNursing published Defending Dignity –Challenges and Opportunities forNursing22. The report describes the

findings from the RCN Dignity Surveycompleted by over 2,000 nurses fromacross the UK. The RCN define dignityas being concerned with how peoplefeel, think and behave in relation to theworth or value of themselves andothers. To treat someone with dignity isto treat them as being of worth, in a waythat is respectful of them as valuedindividuals. The survey results pointedto three main factors that maintain ordiminish dignity in care: the physicalenvironment and the culture of theorganisation (place); the nature andconduct of care activities (processes);and the attitudes and behaviour of staffand others (people). The survey is oneof a range of initiatives that underpinthe RCN’s Dignity Campaign.

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Appendix 1

How the activity supportsquality patient experience

Measures current practicesagainst standards andidentifies areas forimprovement, encouragingthe production of actionplans and enabling regularreview.

How the activity supportsquality patient experience

Provides a qualitativeaccount of a patient’s/client’s journey through thehealth and social careservice.Recurrent themes providepractical examples of howthe standards have notbeen met or achieved.

How the activity supportsquality patient experience

Provides an account ofpositive aspects of thepatient’s/ client’s journeythrough the health andsocial care service. Thisprovides practicalexamples of how thestandards have been metor achieved.

What could be achieved?

• Identification of areasfor improvement

• Engages individuals andteams in serviceimprovements

What could be achieved?

• Can inform theorganisational trainingand developmentagenda

• Highlights areas forimprovement

• Encourages a reflectiveculture among staff

What could be achieved?

• Identification andacknowledgement ofareas of good practice

• Sharing of good practiceareas between teams

• Could contribute toincreased staff morale

Evidence produced

• Records of auditprocesses/ auditreports

• Action plans for serviceimprovement

Evidence produced

• Report of themesproduced

• Action plans for serviceimprovement

• Training anddevelopment plans

Evidence produced

• Reports of goodpractice themes

• Records of serviceimprovements as adirect result of sharinggood practice

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Appendix 2Activity: AUDIT

Activity: COMPLAINTS REVIEW

Activity: COMPLIMENTS REVIEW

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How the activity supportsquality patient experience

Provides quantitative andqualitative feedback fromthe patient/client relativeto the standards for patientexperience.

How the activity supportsquality patient experience

Provides opportunities todevelop the knowledge,skills and attitudesrequired to support theachievement of thepatient/client experiencestandards. This may beaccomplished throughexisting professionalsupervision or appraisalsystems.

How the activity supportsquality patient experience

Provides an opportunity toincorporate the fivestandards into inductionprocesses for all healthand social care staff.

What could be achieved?

• Can inform theorganisational trainingand developmentagenda

• Highlights areas forimprovement

• Encouragesengagement withpatients and clients to actively seek theirviews

What could be achieved?

• Training needs analysis• Can inform the

organisational trainingand developmentagenda in a targetedmanner

• Encourages a reflectiveculture among staff

What could be achieved?

• Raising awarenessamongst staff inrelation to the fivestandard areas

• Standards arepromoted andsupported by all healthand social care staff

Evidence produced

• Analysis data from survey• Narrative reports• Action plans for service

improvement

Evidence produced

• Training anddevelopment plans

• Annual organisationalprofessional supervisionreports

• Training needs analysisreporting

• Organisational policydocuments forsupervision andappraisal

Evidence produced

• Organisational inductionpolicy

• Training anddevelopment plans

• Records of evaluationsfrom induction processes

• Numbers of staffinducted

Activity: PATIENT/CLIENT SURVEY

Activity: PERSONAL/PROFESSIONAL SUPPORT OR SUPERVISION

Activity: STAFF INDUCTION

Appendix 2

1 DHSSPS Best Practice – Best Care April 2001http://www.dhsspsni.gov.uk/4161contentsintro.pdf

2 DHSSPS Governance in the HPSS – Clinical and Social Care Governance:Guidelines for Implementation HSS (PPM) 10/2003 Jan 2003

3 Health and Personal Social Services (Quality Improvement and Regulation)(Northern Ireland) Order 2003 No. 431 (N.I.9)

4 DHSSPS Quality Standards for Health and Social Care – Supporting goodgovernance and best practice in the HPSS March 2006http://www.dhsspsni.gov.uk/qpi_quality_standards_for_health___social_care.pdf

5 DHSSPS Safety First: A Framework for Sustainable Improvement in the HPSSMarch 2006 http://www.dhsspsni.gov.uk/safety_first_-_a_framework_for_sustainable_improvement_on_the_hpss-2.pdf

6 DHSSPS Guidance on strengthening personal and public involvement inhealth and social care HSC (SQSD) 29/07

7 Delivering the Bamford Vision - the response of Northern Ireland Executive tothe Bamford Review of Mental Health and Learning Disability June 2008http://www.dhsspsni.gov.uk/bamford_consultation_document.pdf

8 NIPEC Northern Ireland Essence of Care Project Evaluation Report May 2005http://www.nipec.n-i.nhs.uk/pub/Essence%20of%20Care%20Report.pdf

9 DOH (2001), The Essence of Care: Patient-focused benchmarking for healthcare practitioners.http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4005475

10 NIPEC Review of Essence of Care June 2007 http://www.nipec.n-i.nhs.uk/pub/revieweocfinalreport.pdf

11 NIPEC Organisational Guide to Practice and Quality Improvement Activity July2007 http://www.nipec.n-i.nhs.uk/pub/doporgguide.pdf

12 The Burdett Trust for Nursing Who Cares, Wins Leadership and the businessof caring September 2006 ISBN: 978-1-898531-95-1http://www.burdettnursingtrust.org.uk/docs/5719_burdett_trust_who_cares_wins_031006.pdf

13 SCIE Practice Guide 09: Dignity in Care. 2006 First published in Great Britainin November 2006, updated August 2007 and February 2008http://www.scie.org.uk/publications/practiceguides/practiceguide09/files/pg09.pdf

14 DOH Dignity in Care public survey October 2006 – report of the survey Oct2006http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_413955 2

References

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15 DOH The dignity of care campaign: the dignity challenge Nov 2006http://www.dh.gov.uk/en/SocialCare/Socialcarereform/Dignityincare/index.htm

16 Richards, Nick and Coulter, Angela Is the NHS becoming more Patient-Centred? Trends from the national surveys of NHS patients in England 2002-07 Picker Institute Europe September 2007http://www.pickereurope.org/Filestore/Publications/Trends_2007_final.pdf

17 Picker Institute Improving the Patients Experience Fact Sheetshttp://www.pickereurope.org/page.php?id=6

18 Healthcare Commission State of Healthcare 2007Improvements andchallenges in services in England and Wales December 2007http://www.healthcarecommission.org.uk/_db/_documents/State_of_Healthcare-2007.pdf

19 Nursing and Midwifery Council, Cardiff Can regulation help to improve thepatient’s experience? Frances Blunden, Which? Annual Lecture 6 June 2007 http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=2853

20 Healthcare Commission Caring for Dignity A national report on dignity in carefor older people while in hospital Commission for Healthcare Audit andInspection September 2007http://www.healthcarecommission.org.uk/_db/_documents/Caring_for_dignity.pdf

21 DOH Public Perceptions of Privacy and Dignity in Hospitals Research StudyConducted for the Department of Health March 2007 Published May 2008http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_084763

22 Royal College of Nursing Defending Dignity – Challenges and opportunities fornursing June 2008http://www.rcn.org.uk/__data/assets/pdf_file/0011/166655/003257.pdf

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Produced by:Department of Health, Social Services and Public Safety,

Castle Buildings, Belfast BT4 3SQ

Telephone: (028) 9052 0627

Textphone: (028) 9052 7668

www.dhsspsni.gov.uk

November 2008

Ref: 131/08