Mid Cheshire Hospitals NHS Foundation Trust
Mid Cheshire Hospitals Endoscopy Team – Withdrawal of Consent
Category – Turning it Around
The Endoscopy department received a complaint from a patient who had undergone an endoscopy procedure and were concerned and distressed that they felt that they were unable to withdraw consent during the procedure. This complaint went through the formal complaint procedure process and staff met with the patient and patient’s relatives to address the issues and concerns raised.
In response to and following the resolution of this complaint, a team led by Maureen Brown have implemented numerous local and national interventions to ensure patients fully understand the process around withdrawal of consent during an endoscopy procedure and to ensure high levels of patient satisfaction and safety going forward. Learning from this incident has been shared both nationally and locally. There has been a real focus on education and spreading awareness, both through patient consultation and patient information.
By educating patients on how to withdraw consent, and making this information as accessible as possible via national information leaflets, locally displayed information and discussions with healthcare professionals whilst taking consent prior to the endoscopy procedure, similar circumstances should be avoided going forward. There is an ethos, in Endoscopy, of taking proactive steps to continually improve the service provided to users of the service and their relatives and carers.
The nurses in the Unit are passionate about the quality of care delivered, and the senior nurses endeavour to create an environment in which this is encouraged. The patient is always at the centre of the service, and although receiving complaints can be unpleasant, the Unit strives to turn any negativity into a positive outcome going forward.
Barking, Havering and Redbridge University Hospitals NHS Trust
Learning Disability Communication Flashcards
Communication difficulty is a significant problem for children with learning disabilities or autism and their families. This can become a considerable contributing factor in the presentation of challenging behaviours. It is therefore important that parents and carers are effectively supported to meet their child’s communication needs. It is estimated that 20% to 30% of people diagnosed with autism will never develop speech. It is therefore essential that alternative functional communication is developed for these children. The Pictorial Exchange Communication System (PECS) was developed in 2002. Benefits have been found to include reducing behaviours that challenge, encouraging speech and increasing social communication. PECS focuses on school and home environment but does not have pictures explaining what may happen in hospital which we know is an environment and experience which can cause increased anxiety and difficulty for children with LD and for their families.
Global Initiative Ltd
Hetty’s Hospital was conceived by two paediatricians, Drs Ria Evans and Rebecca Duncombe. They won runner-up in the TVWLA 2023 Challenge. The project was awarded funding to complete a releasable trial version of the app. Global Initiative translated and developed the idea into an app for tablets and mobiles. They also funded half of the project through their Initiative £100k Fund for socially impactful digital projects.
Global Initiative is a digital agency in the heart of Oxford. Founded in 1999, it is directed by Gareth Nixon and Chris Sinclair and now comprises 14 staff. Specialising in start-up and enterprise software, Global Initiative supports various projects through its Initiative 100k Fund for those that will have a positive social impact. More information about the fund: https://www.global-initiative.com/social-fund
Hetty’s Hospital began as a solution to the turmoil that any parent taking their child into hospital faces: how can we reduce the anxiety for our children going into hospital and make the experience as worry-free as possible? The solution is the brainchild of two pediatricians: a storybook app with games teaching kids all about the hospital experience. Through the narrative of the eponymous Hetty and her three friends, the app mixes key, informative messages with wacky, mess-galore games such as the sick-bucket and wee-in-the-pot games. As graphic as these games might seem to grown-ups, it was demonstrated as the most effective way of captivating our target audience. The app, which is freely available on iTunes and Play Store, has received nearly 1,000 downloads in the time since release. Designed to be played before or during a child’s hospital visit, allowing for unscheduled appointments and parental involvement. The team has been approached by other organisations to contribute ideas and funding for new stories. It is optimised for tablets but works on smartphones.
Plymouth Hospitals NHS Trust
(Now University Hospitals Plymouth NHS Trust)
Patient Diaries in Intensive Care
Intensive care patients frequently experience memory loss, nightmares and delusional memories. Some may also develop symptoms of anxiety, depression and post-traumatic stress disorder (PSTD). The use of Patient Diaries in this population has emerged as a valuable tool to fill in memory gaps and to promote psychological recovery. Majority of reported diary usage has been within Europe, however there is little evidence of use of diaries as standard practice within the UK. Following publication of the ‘Rehabilitation after Critical Illness’ NICE Guidelines, it recommended services should be developed to meet the psychological care needs of patients following critical illness. In December 2016, our ICU introduced Patient Diaries following a 3-month trial. It was recognised we needed to try and reduce the impact of psychological trauma following a stay in ICU. Diaries offer a simple yet very effective way of helping patients understand and come to terms with what has happened to them whilst they have been critically ill. Equipping patients with a better understanding of what has happened to them whilst in ICU may help them to set realistic goals for recovery and minimise the risk of adverse long-term problems.
Cardiff & Vale University Health Board
Developing a Patient-centred Service for Neuroendocrine Cancer across South Wales through Commissioning and Co-production
Dr Mohid Khan – firstname.lastname@example.org
Care for patients with Neuroendocrine Cancer across South Wales has been transformed since September 2017 by developing a nationally commissioned patient-centred service across Welsh NHS organisations. Historically, a fragmented service received significant negative feedback. Led by a Gastroenterology NET expert, working with commissioners and patient groups through co-production, options of the model of care were appraised and implemented at a central and local level. Two cancer nurse specialists have been trained and provide support and education regardless of geography. There is more effective communication from the NET multidisciplinary meeting with equality of access to specialist expertise, diagnostics and treatments. The new service has gained the confidence of patient groups with overall satisfaction rate increasing from 19% to 99%. Using patient reported outcome measures (PROMS), there is a statistically significant reduced burden of gastrointestinal symptoms with 93% of patients feeling their symptoms are being addressed. To achieve sustainability, activity is recorded to guide devolvement of resource. Working with local clinicians has provided education to provide some local follow up for simple cases, guided centrally, which encourages sustainability. The success has been shared with national Wales commissioners, other NET centres in the UK and Europe through conference presentations and social media.
Mid Cheshire Hospitals
MCHFT Surgical Ambulatory Care Unit
Contact: Helen Williamson – email@example.com
The Surgical Ambulatory Care Unit (SACU) was introduced with the ambitious aim of radically challenging the traditional management of emergency surgical patients. This was in response to a number of issues:
- Rising numbers of emergency surgical admissions.
- Increased demand on the Emergency Department.
- Unnecessary overnight stays & prolonged length of stay.
- Negative impact on patient experience.
- Positive introduction of Ambulatory Care Service within Division of Medicine and Emergency Care.
In collaboration with National Surgical Ambulatory Emergency Care Network, Mid Cheshire Hospitals implemented a Surgical Ambulatory Care Unit based at Leighton Hospital. The SACU team was established, and the location tied in with the ward refurbishment programme which facilitated SACU to be co-located with the Surgical Admissions Unit. SACU is a same day emergency service for GP referred surgical patients providing rapid assessment, diagnosis and treatment in a timely manner without admission to a hospital bed. This service was introduced to improve the experience of surgical patients, to avoid unnecessary waiting and delays and reduce unnecessary overnights stays. This in turn reduces the pressure on the emergency department and has cost saving benefits to the organisation in reductions in average length of stay and more timely discharges. The success of this project is a result of strong leadership and teamwork, with patient experience as a primary driver throughout. We have seen improvements in reported levels of patients experience and significant improvements in organisational measures such as reductions in length of stay. By reviewing current practice and thinking innovatively about how we can do things differently to improve patient experience, the team have successfully implemented a project which offers real sustainable benefits.
Building a Carer Friendly Organisation
Nottinghamshire Healthcare NHS Foundation Trust
Contact: Paul Sanguinazzi – firstname.lastname@example.org
Nottinghamshire Healthcare is a major provider of mental health, intellectual disability and community healthcare services for the people of Nottinghamshire. These services are provided from community settings through to acute wards as well as low, medium and high secure settings. It employs 9000 staff from over 100 sites. It has an income of over £400 million.
We have developed and implemented an ambitious, transformational and comprehensive programme in partnership with our carers to build a carer friendly trust. With the collective commitment of Trust staff, carers and local organisations we have:
- changed culture and practice through staff induction and development programmes
- raised awareness through innovative films, the carers section on our website and increased social media presence
- tackled issues that carers raised (e.g. information sharing)
- supported and informed carers through guides, information, support groups and forums
- ensured that all our 100 plus mental health teams have evidenced that they have improved their involvement of, support for and communication with carers. This was backed by Trust leaders who proactively enabled the aim of supporting and involving carers.
As a result we were awarded two gold stars from the Carers Trust as part of their national Triangle of Care (ToC) programme in recognition of our work, which we have shared widely. One of our carers said: “The impact of the work Notts Healthcare has done and continues to do is immense and has made a huge difference to the way carers’ needs are recognised and addressed. It has made me, as a carer feel valued. Thank you.”
Case Study Summaries
Others to be uploaded shortly. If you are looking for a specific case study please contact us.
- Case Study – Oct 2019 – Royal Cornwall Hospitals Trust The Successes of Take Over Day in Child Health at The Royal Cornwall Hospitals Trust
- Case Study – June 2019 – Whittington Health
- Case Study May 2019 – Serco Health Limited Nobody is ‘just a ….’. Empowering Support Staff Strengthening the Foundation Category Winner
- Case Study – April 2019 – PENNA 2018 – Nottingham University Hospitals NHS Trust (NUH) – The Chief Nurse Excellence in Care Fellowship Programme
- Case Study – Mar 2019 – PENNA 2018 – Overall Winner – Nottingham University Hospitals NHS Trust
- Case Study – Feb 19 – Investing in Children – Type 1 Kidz
- Case Study – Jan 19 – Mid Cheshire – TTO Medications
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- Case Study – Healthwatch Essex is an independent voice for the people of Essex.
- Case Study – Global Initiative Ltd – Hetty’s Hospital
- Case Study – Public Health Wales – Listening and Learning from Children and Young People
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- PREVENTION: THE DDES EXPERIENCE
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- NHS INSTITUTE FOR INNOVATION & IMPROVEMENT – CHILDREN AND YOUNG PEOPLE
- Insight for Improvement Regional Roadshows – 2017