Patient experience and feedback
Although not mandated to report on patient experience, as a Trust we feel that it is really important to tell people how we are continually improving our services as a result of our patient's experiences. Patients are at the heart of everything we do, and we understand the importance of learning from their voices. The following pages provide information on what our patients and their families have told us through complaints, concerns, compliments and surveys, what steps we have taken to improve and how we intend to improve further in the future.
The Patient Experience Team co-ordinate all complaints, concerns, compliments and comments for the Trust, in line with the NHS Complaints Regulations 2009 and local policy. All feedback, both positive and negative, is managed by the department and enquirers. Communication with patients or their families is maintained throughout the process and they are informed of the outcome of their feedback.
Compliments
Compliments always far outweigh the number of complaints received, and in 2021/22, 2,558 compliments were received regarding the service. -an average of 213 a month..
Compliments are reported to the Trust Board and also emailed to the individual staff members with the local management teams copied in so that they can be acknowledged and recorded on the staff members’ personnel file.
Complaints
As a Trust we closely monitor the volume of complaints coming through, seeking any trends and themes to support service improvement and early intervention.
Although complaints and concerns account for less than 1% of the contacts we have with patients, throughout 2021-2022 we have seen clear themes through the complaints and concerns received by members of the public and their representatives. This has had a focus on delays in sending an ambulance and times when we have asked patients to make their own way to hospital. This has been as a result of escalatory measures put into place by the Trust during sustained extreme pressures in the wider system. The Trust has developed a clear action plan and has been working with our system partners across the region to support patients safely.
Following the release of our fully revised Complaints and Compliments Policy at the end of 2020/21, consent is now requested and must be received before the investigation can be started. Once consent has been received, this allows our investigators to telephone the complainant/patient to discuss their concerns openly without the worry of breaching data protection regulations.
Patient Advice and Liaison Service
The Patient Advice and Liaison Service (PALS) is in place to support patients, their relatives or carers to comment on services, give compliments or raise a concern. They are able to support with signposting of the public to the correct department and are able to do this via the phone, email or in writing.
The Trust PALS team aim to deal with all comments received with similar standards of responsiveness and thoroughness as put into place for formal complaints.
A concern can be described as negative feedback which has not been, or is not required to be, dealt with as a formal complaint. It does not necessarily require a written response and can be resolved verbally if appropriate.
The PALS team support patients or relatives where an item of property has been lost in transit. They liaise with the local teams to ensure a quick turnaround where possible to reunite patients with their items.
Patient Advice and Liaison Service
The Patient Advice and Liaison Service (PALS) is in place to support patients, their relatives or carers to comment on services, give compliments or raise a concern. They are able to support with signposting of the public to the correct department and are able to do this via the phone, email or in writing.
The Trust PALS team aim to deal with all comments received with similar standards of responsiveness and thoroughness as put into place for formal complaints.
A concern can be described as negative feedback which has not been, or is not required to be, dealt with as a formal complaint. It does not necessarily require a written response and can be resolved verbally if appropriate.
The PALS team support patients or relatives where an item of property has been lost in transit. They liaise with the local teams to ensure a quick turnaround where possible to reunite patients with their items.
Parliamentary and Health Service Ombudsman (PHSO)
Although most complaints are successfully resolved through the Trust’s complaints process, complainants are able to refer their complaint to the Parliamentary and Health Services Ombudsman (PHSO) if they feel their complaint has not been resolved and the Trust has exhausted all avenues of resolution. This provides complainants with an impartial, independent review of their complaint and gives clear guidance to the Trust on how to improve our investigations and responses.
In 2021/22 the Trust received two referrals to PHSO compared to four referrals the previous year. Both referrals received in 2021/2022 are at the initial investigation stage due to delays with Ombudsman investigations.
Patient surveys
The annual patient survey programme includes continuous surveys for Emergency Service (ES)/Emergency Clinical Advice and Triage Service (ECAT) and the Patient Transport Service (PTS), along with planned survey projects in line with the Trust’s priorities and strategies. Planned survey projects are designed in collaboration with the service/clinical leads and/or co-produced with Experts by Experience to ensure the patient voice is heard across different patient groups.
The continuous patient surveys are available on the Trust’s public website, allowing patients to provide valuable feedback at any time. Listening to patient feedback enables the Trust to identify what is working well but also highlights areas for learning and potential service improvement. The online patient surveys are signposted using a range of methods, including the Trust’s social media channels, patient information cards (which include a QR code and link to the survey) and invitation to feedback letters, which are posted to random samples of ES and PTS patients each month.
Patient comments are actively encouraged, with all qualitative feedback included within the analysis, thematic review and reporting process. Patient comments received are overwhelmingly positive about the staff and services provided and highlight areas of good practice, but also areas for potential service improvement. The feedback received through surveys is continually monitored and triangulated with the themes identified through complaints, patient engagement and patient safety to ensure appropriate governance and learning.
All patient surveys include the national Friends and Family Test (FFT) question, ‘Overall, how was your experience of our service?’ as standard good practice. The FFT is a method of calculating the overall satisfaction of the patient and is used as a benchmark across the Trust. The FFT result is calculated by dividing the proportion of ‘very good’ and ‘good’ responses (numerator), by the overall number of responses (denominator). The FFT is a national directive, and the Trust is required to provide all PTS patients with the opportunity to respond to the FFT question, with these results reported to NHS England each month.
The table below includes the rolling overall satisfaction results for ES/ECAT and PTS:
| Trust patient experience results (April 2021 to March 2022) | Overall satisfaction (Friends and Family test) | |
|---|---|---|
| Number of patients | Overall satisfaction | |
| Emergency service / emergency clinical advice and triage service | 993/1095 | 90.7% |
| Patient transport service | 629/677 | 92.9% |
| All services | 1622/1772 | 91.5% |
Since April, 1,772 patients have responded to the overall satisfaction question. 91.5% of these patients have rated their experience as ‘good’ or ‘very good.’ Patient feedback has continued to be overwhelmingly positive, highlighting the professionalism, kindness, and care delivered by staff and demonstrating that patients are treated with dignity, respect, privacy, and compassion.
Patient survey reports are available on the Trust’s public website.
Safeguarding
A survey was designed to obtain feedback from patients who had consented to a safeguarding referral (e.g., mental health services, falls team or GP for additional support).
Overall satisfaction of 88.0%, with 68.2% of patients included to at least ‘some extent’ in the referral discussions undertaken. 68.8% of the patients went on to receive additional support.
The patient comments received were mostly positive, although staff attitude/explanation of care were identified as areas for improvement.
Maternity
A survey was designed to obtain feedback from patients who had called 999 due to a maternity related concern, linking in with the World Patient Safety Day global campaign theme of ‘Safe Maternal and Newborn Care’ and maternity masterclasses delivered by the Trust.
Overall satisfaction of 94.7%, with patients generally satisfied with all aspects of care. Positively, ambulance service staff were rated by patients as ‘good’ or ‘excellent.’
Confidence/training of ambulance service staff when attending maternity patients was identified as an area for potential improvement.
Mental Health
A survey was co-produced with the SUN Network Experts by Experience to obtain feedback from patients who had called 999 when experiencing a mental health crisis. The survey ran alongside the call handler engagement sessions undertaken by the mental health team and Experts by Experience.
A number of positive comments were received in relation to the service and staff, but the overall satisfaction levels (76.5%) were lower than expected, with 26.7% of patients rating the handling of their emergency call as ‘poor’ or ‘very poor.’ This will support future developments in the service.
Young Patient Mental Health
A pilot Instagram survey was designed in collaboration with the Youth in Mind group, and received 1,825 views in 24 hours, highlighting the benefit of using social media as a feedback mechanism.
Overall satisfaction and staff were rated between ‘good’ and ‘excellent.’
30.2% of patients did not feel that they were listened to, or that their needs were understood when they had called 999 during a mental health crisis. This will support future improvements in training and development.
Easy Read
During 2021, the patient surveys were reviewed to become more user friendly. The continuous surveys are now available online and in different formats, including ReachDeck Toolbar Everything.
The Trust has been in liaison with Norfolk and Norwich SEND Association in relation to patient engagement and the co-production of an easy read survey with Experts by Experience during 2022/23.
The patient feedback received for all of these projects has been shared and discussed to ensure learning going forward. The safeguarding, maternity and mental health survey projects will be included on the 2022/23 survey programme.
Next steps:
The Trust is committed to developing its patient experience and engagement activity and continually explores new methods to obtain feedback and to hear the experience of patients. The co-produced Patient and Public Involvement (PPI) Strategy was led by our patients, the public, stakeholders, and experts by experience and will directly feed into the Patient Experience department workstreams to ensure the patient voice directly influences improvements and service delivery. The success of the co-produced strategy has emphasised the value of co-production, with further co-produced patient experience projects planned for 2022/23. An overview of this piece of work is provided on the next page.
The 2022/23 patient survey programme will include the continuous patient experience surveys and a number of planned patient survey projects, ensuring incorporation of the Trust priorities and the PPI strategic objectives. Overall satisfaction levels will continue to be included as part of the Trust’s dashboard, with the monthly PTS Friends and Family Test figures reported to NHS England.
Emergency services/ECAT and Patient Transport Services
- The ES/ECAT and PTS surveys will continue as online surveys, enabling patients to feedback at any time. The option of paper or telephone surveys will remain available, along with alternative survey formats as required.
- Random samples of ES and PTS patients will continue to be collated each month, with these patients sent an invitation to feedback letter (with a QR code and link to the survey). The surveys will also continue to be promoted via patient information cards and the Trust’s social media channels.
- Survey results will continue to be monitored as part of the Trust’s quality reporting and included within the Trust’s dashboard.
- Patient feedback received through surveys will continue to be triangulated with other sources of patient experience, with survey results analysed and collated into report form.
Planned survey projects
- A number of bespoke, planned survey projects will be undertaken during 2022/23, including projects in relation to: young patients, mental health, learning disabilities, maternity care, safeguarding and intelligent conveyance.
- During 2022/23, there will be a focus on accessibility to ensure the patient voice can be heard across patient groups, with a co-produced easy read survey planned as a priority.
- The Birmingham Community Healthcare Call handling survey will continue to monitor patient satisfaction in relation to the call handling service provided by the CallEEAST.
- Following the implementation of the revised Complaints Policy, a complaint handling survey is planned to measure patient satisfaction in relation to the Trust’s complaints handling process.
Next Page: Patient and Public Involvement (PPI)