This year PEN introduced a new judging category – Patient Experience Professional of the Year. The entrants are nominated by colleagues or patients and are judged on the submissions and testimonials made on their behalf by those around them, from within and without the organisation. The inaugural winner was Sally Ryan of Ipswich Hospital Trust – here are some excerpts from the entry submission explaining why Sally was deserving of such an Award.
Name: Sally RyanPosition: Learning Disabilities Liaison Nurse
Sally started her lifelong quest for improving the experience of people with learning disabilities over 20 years ago. She started with volunteer roles which inspired and galvanised her to become a champion in her field. She describes as ‘the best job ever’ her role as a teaching assistant taking clients through their paces within a specially designed life skills flat. Early on she began honing her particular skill of tuning in to an individual’s specific way of communicating and learning and over the years she has developed her empathic abilities to an exceptionally high degree showing time and again an uncanny ability to get under people’s skin to enable them to communicate more clearly their needs and wishes. She also began to formulate her understanding of the wider social impact of this empathic approach – her clients were able to develop practical skills enhanced by the extra effort made by Sally to help them to develop their social and emotional skills. Sally describes this early part of her career as transformative – realising that people with learning disabilities do not see life as the challenge others perceive and by aligning herself with this view she has been able to create relationships of greater depth than ‘worker:client’ thus enhancing the quality of the care provided.
An epiphany of equal importance in formulating Sally’s approach was carved out of an altogether less pleasant work experience at a day centre where she witnessed and was encouraged to adopt an approach with little or no personalisation of care, no freedom for the clients, a high level of boredom (clients and staff) and an attitude of ‘maintaining’ or ‘containing’ people. A great of example of everything sally found to be an anathema.
Sally ploughed this experience into earning a first in her Specialist Practice Degree in LD ten years ago and established herself within the community services before deciding to make the leap to be a champion of LD patients’ experience within Ipswich Hospital – a busy acute district general hospital.
Sally came to the Trust in 2011 with a solid reputation for her work within the community and immediately her passion and dedication and approach stood out as exemplary. Sally had clarity of vision for improving the experience of patients with a learning disability. She understood that we faced challenges – she knew of these from her contacts within the community of some patients whose experience had not been good enough and she came with clear ambitions for us as an organisation.
Coming into a busy, acute environment and being the lone dedicated voice for a marginalised and perceived as ‘difficult’ group required Sally to stand out and stand up – potentially daunting for anyone!
Sally’s skills and experience in communicating and giving voice to a challenging and difficult topic enabled her quickly to build a network of supportive colleagues and gain the support of key Board and other senior staff – all necessary for taking forward such a big agenda.
Sally has a ‘big’ personality to go with the ‘big’ agenda and this has stood her in good stead to keep focussed and galvanise a whole organisation and its culture.
Sally arrived at Ipswich Hospital at a time when they had recently completed a short piece of work with a patient with a Learning Disability (LD) and her family carer following their raising of a complaint about the patient’s care and the lack of engagement with the family. This had resulted in the organisation focussing on some key issues eg; lack of basic care, fear/lack of understanding of LD, poor liaison with the family carer. The Trust had been privileged that the patient and carer concerned had wanted to make a difference and had talked to the Board of Directors, taken part in educating staff and the development of a DVD to share their experience and our response.
Sally joined us and took this catalyst to learning and ran with it. She identified key areas to target for improvement and has led the way across the organisation:
- Access to services
- Correct diagnosis
- Support with treatment
- People feeling safe and heard
- Ensuring individualised care – getting needs recognised, understood and met
Taking a systematic and pragmatic approach Sally developed a strategy for working towards a greater standard of care for patients with a learning disability. Sally identified that we had to deal with both the simple and the complex and she has tackled each with the same optimism and enthusiasm.
A key to improving LD patient experience has been training staff – something which is a challenge for all organisations struggling to keep the frontline covered and costs down. Sally has provided formal training for over 1,000 staff since joining us but Sally’s approach is to educate, challenge and promote great care at every opportunity.
Typically for Sally she has been creative in her approach to training – building an army of 40 ‘link professionals’ enables on the job, informal training opportunities provided by people with a passion for LD issues on their own wards reducing the need for staff to leave the ward to attend training sessions. Sally also walks the wards – chatting and explaining as she goes – this personal approach enables staff to learn in a straightforward, practical way enabling staff to ‘just do it’. This approach has enabled staff to ‘join the dots’ and realise the fat handled cutlery can be really useful for patients with a LD as well as enabling staff to recognise the clues from patients when they need the toilet or are in pain.
Sally’s army of link professionals are often people touched by LD through their own lives as family members or carers/friends. Encouraging champions with this personal understanding can require some challenge and support but reaps rewards through their dedication and inherent understanding and empathy. Sally has developed their skills to enable them to support others in understanding mental capacity and facilitating consent; best ways to support people and make reasonable adjustments; enabling communication and understanding of people as individuals; ensuring family carers are involved.
Sally’s approach is to enable and encourage patients with a LD to have a say over what happens – however small or limited that ability might be – and encouraging/enabling staff to likewise.
This belief in personal empowerment and opportunity extends to Sally having created a learning disabilities (LD) expert patient support network who have undertaken the Expert Patient Support Programme training. This group is now fully involved in the development and progress of hospital services and proposed changes which also positively impact on services for all patients and carers. The group provide feedback on their own and others’ experiences of accessing the hospital and have advocated for patients and carers at training and development events. In particular they advised on the redesign of Central Outpatients providing insight into the signage and way-finding project whereby a mixture of coloured corridors, improved maps and signage using symbols as well as words was introduced.
In August they undertook an access audit of this completed work in Central Outpatients and gave a thumbs up to most of the signage whilst identifying further work needed on the maps and also the disabled access toilets. Without Sally’s support and championing this group would not have the gravitas it does nor would the voice of those with an LD be heard so loudly.
Sally has also led the way in creating a more seamless service – she facilitated Ipswich being the first hospital regionally to establish information sharing protocols with GPs and the Local Authority to ensure the early identification of people with LD via an alert across all patient administration systems. This has recently been recognised nationally as best practice and ensures potential barriers to accessing services are removed.
People with an LD are thus identified early, pre appointment assessments can be made, adjustments identified and patients/their carers are enabled to be actively involved in their care and treatment, with the hospital making the necessary reasonable adjustments to support individualised care.
This specific care is supported by the introduction of the LD patient passport and use of a purple dot symbol to be a visual reminder for staff on the Patient Needs at a Glance board above the bed.
Sally has supported 328 elective attendees on various pathways ensuring the highest quality of person centred care is provided.
Sally has ensured we have introduced access to easy read literature and is always finding creative tools for engaging and communicating with LD patients.
Ensuring the LD voice is heard is central to Sally’s tenet and as well as the expert patient group she has developed an ‘easy read’ feedback form although much of the feedback comes back via personal anecdote collected in conversation with patients and their carers. The grapevine is a very strong conduit for information and feedback within the local LD community. Before Sally started working with us the grapevine talked about how frightening hospital was and the few poor experiences coloured all. To ensure we learn from mistakes Sally instigated an alert system whereby all incidents, complaints and compliments involving a person with LD are reviewed by Sally who ensures that if there is a risk or area of concern, the necessary changes are made.
The grapevine now talks about the changes made and the ‘good stuff’ instigated by Sally and there has been a gradual shift in the ‘collective memory’ of the LD community. There can be no better illustration of the esteem Sally is held in and the impact of her work than the very recent LD community event held in September – Sally attended to talk about the changes at the hospital and she was treated to a standing ovation as she walked into the hall.