FAB – Frailty Assessment Base – The Ipswich Hospital NHS Trust

ip

General Summary

The service – FAB – Frailty Assessment Base – brings together the whole system to address the frailty needs of older people in once place by a multi-disciplinary team; reducing admissions, increasing confidence, enabling patients to go home. FAB has proved to be successful in its ambitions to make an impact on individuals and the system.

Based on evaluation of evidence, best practice; involving key stakeholders and led by senior clinicians, specialists in their fields, FAB enables the pooling of expertise within a clear framework and objectives to improve the patients experience, reduce admissions and increase the system’s ability to manage frailty.

FAB was piloted and has been so successful it is now (12 months later) being relocated to a specially designed and refurbished area with increased capacity. Recognised at the HSJ Awards, the project has communicated its ethos and success widely which provides evidence and ideas for others to use.

The positive outcomes for patients and across the system has demonstrated its sustainability which will now continue to grow.

 photo 1

Impact

The Frailty Assessment Base opened in October 2015 and the data below is for the first six months

Patient experience was a key outcome for the service:

  • 100% of patients or their relatives were asked to complete a patient satisfaction feedback form. 85% response rate and 100% would recommend the service (94% rate extremely likely to recommend the service and 6% rate as likely to recommend).

 

Other measurements:

Patient destination following assessment; whether an admission was successfully avoided; how onward care was supported:

  • 88% of patients assessed avoided immediate admission and were discharged to the community with 58% returning home, a further 24% returning home with increased support and 6% transferring to an intermediate care bed.
  • 12% required acute admission following assessment but had received a front loaded geriatric assessment and the average length of stay for these individuals was 1.35 days below the average length of stay for age matched individuals admitted through existing pathways.

 

Staff satisfaction (in recognition of the role it plays in patient experience):

82% of staff involved in the FAB across the system reported being satisfied with the quality of care they were able to give with most also being happy to recommend working in the FAB

 

System wide improved outcomes (in recognition that frailty and inappropriate admissions is a system wide issue with system wide consequences):

  • Support for self-management – Explanation, advice, Shared Care Plans
  • Patient empowerment
  • Falls assessment waiting time – reduced from 3 months to 3 days

 

The service also aims to raise the awareness of frailty in the local healthcare community. Each patient is scored on the Rockwood Clinical Frailty Scale and this is communicated to GPs.

 

System wide efficiencies:

  • Best use of GP time – easy access
  • Consultant telephone advice and triage
  • No waiting lists
  • Front loaded CGA for those admitted – saves time
  • Reduction in admissions 274
  • Reduction in bed days 1,918
  • Cost of service £225k
  • Net saving to CCG £500k
  • Net saving to Trust £300k

 

Case study example 1 – patient via ED

  • 88 year-old man attending ED with “funny turns”
  • 12 months before FAB

–             27 ED attendances

–             8 acute admissions

  • Seen in FAB October 2015
  • 6 months after FAB

–             Attended ED once

Case study example 2 – from a GP

  • 90 year-old female
  • Frailty score 4
  • Complex medical problems
  • Experienced a loss in confidence and abdominal symptoms
  • GP was asked to arrange admission by family but instead referred to FAB
  • Seen within 48 hours
  • Admission avoided
  • Patient reassured and provided with advice on self-management
  • Onward referral and sharing of care plan with LHCT
  • Patient greatly reassured, went home and has been managing well.
  • GP felt this to be a very successful outcome

 

Reflecting on the last 12 months in total:

931 patients in our first year, 840 of which we were able to get home (with or without a change in care / support) this is 90%. The breakdown is similar to the pilot with 58% home, 32% returning home with increased support.

3% were transferred to another supportive environment eg. rehab hospital or respite care placement whilst 7% were admitted to acute hospital for medical input.

Over 50% of the patients seen were in the mild to moderate frailty groups on the Rockwood clinical frailty scale. 14% were severely frail or above.

 

Rationale

The issue:

Research recognises that 60–70% of acute admissions are in people with long term conditions and/or frailty with only a mild to moderate illness – the Trust recognised the growing number of emergency department attendances and increased attendance to admission conversion rates in those over 85 years (75%)

This was not a good patient experience, likely to be an unnecessary admission and could lead to delays in discharge due to changing circumstances.

 

The Proposal:

In the Autumn of 2015, with winter approaching and expectations of growing numbers arriving with no bed capacity to play with, we embarked on an innovative initiative to:

 

  • Provide an alternative assessment pathway for frailer individuals
  • Prevent deconditioning and support onward care in the patient’s own home or community setting where possible
  • Raise the awareness of frailty in the local healthcare community
  • Support a system-wide response”

 

Planning

Prior to establishing our service model a survey monkey questionnaire was sent out to the local practices to establish what local GPs looked for in a frailty assessment service. One of the key findings from this was easy accessibility.

Feedback from patients and carers was reviewed and engagement with the Older People’s User Group enabled two-way feedback and ideas for the initiative; enabling an understanding of what really matters to older, frail patients and what worried their carers.

The project is multi-disciplinary – led by specialist elderly care doctors with a multi-disciplinary team of senior physiotherapist, occupational therapist, dietitian, pharmacist and a doctor specialising in elderly care.

 

October 2015 – A pilot Frailty Assessment Base (FAB) was created to provide an assessment locality for individuals with complex co-morbidities who may otherwise have been admitted for assessment and ongoing care

  • Located within Ipswich hospital but it is a community orientated service
  • Physically consisting of a waiting area and three assessment areas
  • Accessed via GP referral, community healthcare professional referral or the emergency department
  • FAB can assess up to 6 patients a day and following assessment a shared care plan is provided to the patient and a copy provided to their GP and any involved community healthcare teams
  • Assessment is tailored to the needs of the patient with a maximum of 4 hours spent on FAB

 

Standing Out

The FAB is a one stop shop pulling together a range of people and services with the sole aim of ensuring the needs of frail, elderly patients are addressed without the need to resort to a lengthy stay or repeated visits.

FAB speaks for itself in terms of its results (outlined above) and especially in the feedback from patients and carers:

“All members of the department are very friendly and helpful”

“It was good to have some explanations for a possible cause rather than being discussed just as elderly”

“I have been so impressed with the wonderful treatment I have received. Nothing could possibly improve all the help and advice I have been given.”

Consultant geriatrician Julie Brache said: “The proactive approach of the new Frailty Assessment Base aims to provide a friendly and comprehensive assessment in a day which helps to maximise independence and avoid the risk of harm from an overnight admission if this is not required.”

Learning Points

  • Collection and review of evidence base to enable formulation of plan and service that genuinely responds to the issues, needs and wishes of patients, carers AND referrers such as GPs, care homes etc.
  • Involve key stakeholders in the design and review – patients, carers and referrers
    Ensure the creation of a solid multi-disciplinary team that covers all aspects needed (including carers)
  • Clear access points to the service, clearly communicated
  • Prompt response to patient need across the system
  • Create an appropriate environment – comfortable, welcoming, warm and friendly staff

 

photo 2

National Council For Palliative Care in partnership with Pancreatic Cancer UK, St Giles Hospice, Leeds Teaching Hospitals NHS Trust’ NHS England , Lesley Goodburn – Patient Leader and Brian Daniels – Playwright

Homeward Bound – A Play and Educational Package about Relationships, Love, Empathy and Compassion at End of Life

case study dec pic

 

The National Council for Palliative Care (NCPC) is the umbrella charity for all those involved in palliative, end of life and hospice care in England, Wales and Northern Ireland.

Since 2009 NCPC has led the Dying Matters coalition. Dying Matters is a coalition of 30,000 members across England and Wales which aims to help people talk more openly about dying, death and bereavement, and to make plans for the end of life. Its membership includes hospices, care homes, NHS organisations and staff, GPs, funeral directors, the legal sector, charities, faith groups and many more.

General Summary

Homeward Bound is an initiative driven by Lesley Goodburn a patient leader who wanted to share the journey that she and her husband Seth made through devastating diagnosis of pancreatic cancer. Seth died just 33 short and heart-breaking days after his diagnosis.

Lesley promised Seth before he died that she would work to raise awareness of the signs and symptoms of pancreatic cancer and raise awareness of the gap between the person centred aspirations of the NHS and the reality of end of life care in an acute hospital.

Lesley wrote letters after Seth died to various healthcare professionals explaining what it felt like to be the person who is dying or the family supporting them and these letters were shared with National Council for Palliative Care (NCPC)

NCPC then commissioned playwright Brian Daniels to work with Lesley to develop a play about compassion at end of life. The play was launched in March 2016 and from there a partnership was developed between NCPC, Pancreatic Cancer UK (PCUK) and Leeds Teaching Hospitals NHS Trust (LTHNT) to develop a package of educational resources to accompany the play.  NHSE and St Giles Hospice have now also entered the partnership to produce a film of the play to accompany the educational package.

Impact

The play has been seen by over 1000 healthcare professional and based on the feedback we are clear that it has a huge emotional and thought-provoking impact as shown by the world cloud below based on the feedback from 8 performances

At each performance a postcard in the form of a Homeward Bound railway ticket is handed out asking the for three actions that a person will take when they are back in their organisation along with their details.

These are databased and then followed up at 3, 6 and 12 months in the form of a ticket check towards a destination.

So far we have 500 actions that are databased and we are just coming up to our first three months check in a flavour of the changes pledged are outlined below

  • Community palliative care nurse will never be late for an onward appointment and if she is late she will always phone to explain
  • Nurse – will always think about what it’s like to be the person who is dying and change her practice
  • Consultant – will make sure that all the people involved in end of life care from cleaners and catering staff to OTs, physios, and medical staff all join up their communication so that the person and the family are at the centre of their practice
  • Nurse – will always empathise with families and imagine what it might feel like to get a diagnosis with the short prognosis

We are currently working with academics to develop a measurement and evaluation approach to the both the play and the educational resources.

Rationale

The development of the play came from Lesley’s promise to Seth to share their journey through pancreatic cancer and this has now developed further in the development of an educational package with the primary objectives :-

  • to raise awareness about the signs and symptoms of pancreatic cancer
  • understand the human impact of late diagnosis of disease on an individual and those important to them
  • to improve communication between professionals and individuals with life-limiting illness and their families and ensuring involvement and shared decision making
  • to improve the quality and experience of palliative and end of life care for people affected by pancreatic cancer

The partnership approach has developed to ensure that the objectives can be maximised by getting the support the organisations that have expertise in the relevant areas.

Planning

Initially the work to develop the play was with Lesley Goodburn, Brian Daniels the playwright and NCPC and this culminated with the launch of the play in March 2016.

Work then started with PCUK who were keen to work with NCPC to develop resources that could be used with their Clinical Nurse Specialists (CNS) and clinical support networks. Working together on the package we then enlisted the help of the palliative care, organisational development and educational team at Leeds Teaching Hospital who worked with the charities to map the national end of life competencies, the on line learning modules, the PCUK Patient Charter, the person centred National Voices I statements and the Macmillan Values standard to the scenes within the play.

To support the educational resources it was decided to film and an abridged version of the play and St Giles Hospice and NHS England came in as partners to develop the approach.

In the meantime the play Homeward Bound has been performed 12 times to over 1000 healthcare professionals at End of Life conferences and NHS Improvement events and has been supported by the Health Foundation and the Q Initiative.

The educational first draft resources as enclosed were launched at the PCUK healthcare study day in October and the package has been further developed by CNSs who volunteered to input into the process. The Film is being made in December and the final educational resource and the film will be launched in January 2017.

The educational package in still in development and the submitted draft only relates to one scene within the play, the remaining five sections are in development and will be branded and printed for launch.

What Makes It Special?

This initiative has been driven from the patient and carer perspective and is an example of the determination of one person to share a thought provoking, emotive, emotional and immensely personal story in memory of the man she loved. This is a story driven by love, exploring relationships and with a clear focus on improving the empathy and compassion of health care professionals through the sharing of the story supported by educational packages.

The play Homeward Bound is an example of using the arts to portray a true and personal story of the 33 days from diagnosis of terminal disease to the death of a husband, soul mate, partner and friend. The play uses humour to explore a deep and meaningful love to give a glimpse of the devastation that a terminal diagnosis can bring. It brings forward the need for coordinated person and family centred care at end of life and how that is a partnership between all involved

The partnership approach of bringing together the people and organisations to organically grow the potential of what originally was the idea of play which has now been turned into a play, supported by educational resources and a film.

This is truly unique partnership between a person who has experienced deep and profound grief, a playwright who has turned that story into a drama that allows people to image what it is like to be Seth or Lesley. Along with professional charities that specialise in end of life care and pancreatic cancer, joining with palliative care, educational and organisational development staff and culminating with the support of a hospice and NHSE to bring together the play and the educational resources to support a film that will promulgate the messages of compassion and empathy amongst healthcare professional is unique.

Given that the play was commissioned in January 2016 we have come a long way in to realise the ambitions set out at the start of the process with development, implementation and launch of full supported package within 12 months supported by six strategic partners.

Key Learning Points

  • Let patients and carers lead the way they know what needs to improve they just need to support to turn their stories into something that will engender action
  • Use the power of personal story telling to engage people and allow them to discard their professional personas.
  • Use drama to help reinforce the need for compassionate at end of life by sharing feelings, emotions,  aspirations and the little things that mean a lot to people
  • There is only one chance to get things right at the end of a person’s life and what happens lives on in the memory of the loved ones forever.
  • Partnerships can evolve as long as you are prepared to remain flexible in your thinking and that the organic approach can achieve more in a shorter period of time.
  • The multi-disciplinary approach to the project has bought diversity of thinking and changes of approach that have accelerated the outputs and the quality of the product
  • Charities, large teaching trusts, hospices, individuals and NHSE can all contribute to a project as long as everyone is signed up the ultimate goal of improving end of life care.

 

NOVEMBER 2017 NEWSLETTER

Welcome to the Patient Experience Network Newsletter
PENLetter November 2017
Issue 49
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Welcome to this month’s PENLetter

We have collated all the current and inspirational patient experience news into one place.

Welcome to the October edition of our PENLetter! 

Welcome to the November edition of our PENLetter! Don’t forget our closing date for submission to our awards is Friday 24th November!   Do let the team know if you have any questions – all details are later in the newsletter.

This month it seems communication is the buzzword with articles in this month’s edition about coaching apps, huddles and training days – all designed to improve the patient experience through improved communication.

We also include a call from NICE looking for a Chair or Topic Advisor for the NICE guideline committee on Rehabilitation in people with severe and enduring mental illness – you need to act quickly as the deadline for applications is 10:00 on 24th November.

Enjoy the read.

Ruth

PENNA 2017 AWARDS
As we enter the last few days for entries, do get in touch if you have any questions – the team can be reached on 033 33 44 7060 or info@patientexperiencenetwork.org.  We are looking forward to reading all about your amazing work to improve the patient experience.

Deadline for entries is Friday 24th November.

We have some wonderful news for students who may be considering submitting an entry –  we are now able to offer bursaries to some individual students.  With this in mind we have also extended the deadline for the two student categories until January 12th 2018.  These categories will be judged outside the regular judging process – all other entries must be with us over the next couple of days!

Our awards conference and ceremony will be on 1st March 2018 in Birmingham. 

 


A few words from our partner – the Picker Institute Europe

Picker is a charity with an ambitious vision; the highest quality of health and social care for all, always.

We strive to realise this vision through our day-to-day work, building upon the Picker Principles of Patient Centred Care.  Developed over 20 years ago by Picker in the USA, the principles are the definition of what a positive patient experience should include, no matter who the person is or the nature of the care that they are receiving.
As an internationally renowned charity we influence policy and practice so that health and social care systems are always centred around people’s needs and preferences. We empower staff working in health and social care to improve patient experience by effectively measuring, and acting upon people’s feedback, and we aim to inspire the delivery of the highest quality healthcare, by developing tools and services which enable all patient’s experiences to be better understood

We couldn’t achieve all of this without collaborating with other like-minded charities and organisations operating in the health and social care sectors.

Picker has collaborated with the Patient Experience Network because we share a similar philosophy; we both have a person-centred approach to healthcare at our very core, and we believe strongly in a balanced conversation around quality improvement that puts equal emphasis on both celebrating success and learning from mistakes.

The Patient Experience Network National Awards are a prime example of what this collaboration and balanced approach looks like in practice.

The awards are truly unique in that they are the first and only awards programme to recognise best-practice in patient experience of care across all facets of health and social care in the UK.

The clever premise for the event also sets it aside from other quality improvement awards.  All shortlisted entries exhibit their patient experience initiatives so that other attendees can learn from their hard work.

The format also contributes to the inclusive and collaborative atmosphere of the awards, and is something that Picker wholeheartedly endorses. The awards programme inspires the attendees, and celebrates the success of the hard-working and creative healthcare workers in the room.

As a trusted and respected charity working in the field, Picker sits on the judging panel and our CEO, Chris Graham, attends to congratulate the shortlisted entries and present the winners with their awards.
The entries are a demonstration of some of the most cutting edge thinking and practice on person-centred care, and we are always impressed with the passion, creativity and energy that is evident in the entries.  We are continuing our support of these ground-breaking awards this year, and we’re very much looking forward to reviewing the entries over the coming months and participating in the awards day in Birmingham on 1st March 2018.

This Month’s Case Study

FAB – Frailty Assessment Base

Organisation

Acute district general hospital + 3 community hospitals and some community health services. Catchment of more than 330,000 people living in and around urban Ipswich. Remainder of the population is rural and quite isolated. 500+ beds + community beds; annual turnover £200+ million; 3,500 whole time equivalent staff; typically older catchment population than the England average with a greater proportion over 55.

Population served is an aging one (one of the fasted growth rates of very elderly people – over 80s – in the country), increasing levels of complexity of care including dementia, learning and other disabilities, co-morbidities; increasing population non-English reading/speaking; alongside older patients there are older family carers.

READ MORE HERE…..

 

PEN News

Ruth Evans at PEN

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Articles from Members
I am writing to invite you and your network of contacts to consider applying for the role of Chair or Topic Advisor for the NICE guideline committee on Rehabilitation in people with severe and enduring mental illness.  The deadline for sending an application is 10am Friday 24 November 2017.

Committee roles

At this stage we are looking for a Chair and Topic Advisor and the details can be found on the NICE website using the links below:

1.Committee Chair
https://www.nice.org.uk/get-involved/join-a-committee/chair-rehabilitation-in-people-with-severe-and-enduring-mental-illness-guideline-committee

1.Committee Topic Advisor
https://www.nice.org.uk/get-involved/join-a-committee/topic-expert-rehabilitation-in-people-with-severe-and-enduring-mental-illness-guideline-committee

How to apply for professional roles
Please send a short CV and cover letter before the deadline of 10am on Friday 24 November 2017  to NGAapplications@rcog.org.uk for my attention.  The following documents should be included:

1.A cover letter, explaining how you meet the criteria in the person specification and your motivation for applying for the post
2.A short CV
3.Applicant information form – with details of 2 referees
4.Declaration of interests form
5.Equality monitoring form

Guideline update
More details on this guideline can be found here: https://www.nice.org.uk/guidance/indevelopment/gid-ng10092

Interviews
Interviews will be held in person at the RCOG in London on 18 or 19 January 2018.

Spread the word
Please encourage your network of contacts to apply to be part of this committee.

Thank you for your help in finding committee members for this NICE guideline.

Kind regards

Eleanor

Eleanor Howat
Project Manager National Guideline Alliance (NGA)

 

 

 

 

Events
PALS and Patient Experience Conference 2017

Monday 27th November 2017, Derby

The 2017 PALS Conference will be held in Derby this year, courtesy of Derbyshire Healthcare Foundation. It will be on Monday 27 November 2017. The Agenda is coming together. We have confirmed special speaker from The Academy of Fabulous Stuff in the form of Roy Lilly so this will be a highlight of our events that we have so far provided. We also have somebody from the Learning Disability Programme of NHS England and a visit from medical Protection Dogs to explain what they are doing with dogs not only preventing patients have illness episodes but detection of cancers at a very early stage.

 

Implementing Criteria to Assist Patient Discharge from Hospital

Monday 4 December 2017, De Vere West One Conference Centre, London

The masterclass offers a practical guide to setting up and implementing Criteria led discharge. The use of Criteria in the process of patient discharge will be debated to dispel the common myth that this approach is restricted to Nurses doing what was traditionally Doctor’s work. The stand point adopted is that Criteria can be developed to assist patient discharge from hospital and implemented at multiple points in the discharge process to reduce length of patient stay, improve quality of care and does not compromise patient safety.

Our 20% discount is available by quoting ref: hcuk20pen  when booking.(*Cannot be used in conjunction with any other offer.  Full T&Cs available upon request.)

For further information and to book your place visit

http://www.healthcareconferencesuk.co.uk/criteria-to-assist-patient-discharge-from-hospital or email hanisha@hc-uk.org.uk

 

National PROMs Summit 2017

Monday 11 December 2017
De Vere West One, London

Developed in association with Mr Bibhas Roy, Consultant Orthopaedic Surgeon & Virtual Orthopaedic Clinic Lead, Central Manchester University Hospitals NHS Foundation Trust and chaired by Prof W Angus Wallace, Division of Orthopaedic and Accident Surgery, University of Nottingham/Nottingham University Hospitals NHS, this national conference will open with an update from NHS England on developments in Patient Reported Outcome Measures (PROMs) and will then focus on PROMs in clinical practice; using case studies of PROMs changing clinical practice alongside expert sessions on subjects such as using PROMs for decision making, to change practice, and auditing and analysis of outlines.

Our 20% discount is available by quoting ref: hcuk20pen  when booking.(*Cannot be used in conjunction with any other offer.  Full T&Cs available upon request.)

For further information and to book your place visit

http://www.healthcareconferencesuk.co.uk/proms-training or email kerry@hc-uk.org.uk

Follow the conference on Twitter #PROMs2017

 

Masterclass: Complaints Handling & Response Letters

Monday 11 December 2017,

De Vere West One Conference Centre

This interactive and practical workshop will provide a structured approach to complaints handling and response writing.  Delegates will be taken through a methodology that will ensure that all complaints are properly investigated and that responses will stand up to scrutiny. There will be a complaint and letter writing case study during which delegates will receive feedback from the trainer.  All techniques will be tested through role-play based on an actual complaint. The course will be facilitated by Kate Hill Solicitor InPractice. Our 20% discount is available by quoting ref: hcuk20pen  when booking.(*Cannot be used in conjunction with any other offer.  Full T&Cs available upon request.)

For further information and to book your place visit: http://www.healthcareconferencesuk.co.uk/complaints-handling-and-response-letters-masterclass or email hanisha@hc-uk.org.uk

In-depth legal masterclass: Informed Consent After Lanarkshire

Wednesday 13 December 2017, De Vere West One Conference Centre, London

This one-day course will cover all elements of informed consent as well as the law relating to treatment of those who lack capacity and who are unable to give informed consent.

Our 20% discount is available by quoting ref: hcuk20pen  when booking.(*Cannot be used in conjunction with any other offer.  Full T&Cs available upon request.)

For further information and to book your place visit: http://www.healthcareconferencesuk.co.uk/informed-consent-masterclass-training  or email hanisha@hc-uk.org.uk

 

Patient Leadership Summit

Friday 15 December 2017
De Vere West One Conference Centre, London

This national summit chaired and co-produced with Jonathon Hope Patient and Co-chair, Realising the Value of Individuals – Increasing Participation in CKDUK Renal Registry will focus on the important issue of Patient Leadership and enabling patient leaders to work collaboratively with the NHS through co-production.  You will hear from a range of leaders in the field of co-design and co-production including Fiona Carey C4CC Co-Chair Coalition for Collaborative Care and representatives from NHS England, The King’s Fund and Nesta.  You will also have the opportunity to start to consider how your organisation can began to plan a co-designed event to start to utilise the renewable energy of your patients, carers and patient leaders.

For further information and to book your place visit

http://www.healthcareconferencesuk.co.uk/patient-leadership or email nicki@hc-uk.org.uk

Follow this event on Twitter #patientleadership

 

Priorities for improving sepsis outcomes: early diagnosis, treatment and education

Morning, Thursday, 18th January 2018, Central London

THIS EVENT IS CPD CERTIFIED.  This seminar will be an opportunity to discuss the policy priorities for improving sepsis outcomes.

It takes place in light of NHS England’s Sepsis Action Plan, expected in autumn 2017, which will reflect current work on safety netting, standards, reporting, education and training. It also follows the progress made on Improving outcomes for patients with sepsis, which looked at supporting healthcare professionals to recognise and treat sepsis promptly, with the aim of improving patient outcomes and reducing mortality.

Delegates will assess what more can be done to ensure symptoms of sepsis are identified and patients are diagnosed earlier, especially in the context of recent NICE guidance to treat people with life-threatening sepsis symptoms within one hour. They will also consider the potential impact of the 2017 Antimicrobial Resistance and Sepsis CQUIN and NHS England’s proposal to introduce a sepsis specific indicator to the Clinical Commissioning Group Improvement and Assessment Framework in 17/18.

The conference is expected to bring together key policymakers with a range of stakeholders, including Members of both Houses of Parliament, senior government officials involved in this area of public policy, together with health and social care professionals, healthcare lawyers, representatives of consumer health organisations, trade unions, local government, as well as representatives of healthcare and pharmaceutical industries, academia, interested and affected charities and user groups, and reporters from the trade and national media.

+44 (0)1344 864796 or jessica.street@westminsterforumprojects.co.uk

 

National NICE Quality Standard for Chronic Kidney Disease in Adults

Friday 19 January 2018
De Vere West One Conference Centre, London

Chaired by Jonathan Hope CHD Patient and Patient Co-Chair Think Kidneys, this conference focuses on improving care and outcomes for people with Chronic Kidney Disease and implementing the Updated NICE Quality Standard released in July 2017. Dr Robert Lewis Specialist Committee Member Quality Standard for Chronic Kidney Disease NICE opens the conference with an extended session on implementing the National quality standard for chronic kidney disease including challenges for renal services. Our 20% discount is available by quoting ref: hcuk20pen  when booking.(*Cannot be used in conjunction with any other offer.  Full T&Cs available upon request.)

For further information and to book your place visit:

http://www.healthcareconferencesuk.co.uk/national-nice-quality-standard-chronic-kidney-disease-adults or email nicki@hc-uk.org.uk

Follow the conference on twittter #CKD2018
Patient Experience Insight Summit

Thursday 22 February 2018
The Studio Conference Centre, Birmingham

The National Patient Experience Insight Summit will focus on measuring, understanding and acting on patient experience insight, and demonstrating responsiveness to that insight to improve care. Through national updates and case study presentations the conference will support you to measure, monitor and improve patient experience in your service, and demonstrate responsiveness to the feedback you receive.

For further information and to book your place visit

http://www.healthcareconferencesuk.co.uk/patient-experience-and-experiences-of-care or email kate@hc-uk.org.uk

Follow the conference on Twitter #PatientExp

Our 20% discount is available by quoting ref: hcuk20pen  when booking.(*Cannot be used in conjunction with any other offer.  Full T&Cs available upon request.)

 

Transforming Outpatient Services National Summit

Monday 26 February 2018
De Vere West One Conference Centre, London

Outpatient clinics can be demanding environments. This national summit aims to bring together leaders of outpatient services to focus on improvement and the delivery of outstanding outpatient care and experience.

For further information and to book your place visit

http://www.healthcareconferencesuk.co.uk/improving-outpatient-services or email kate@hc-uk.org.uk

Follow this conference on Twitter #Outpatients

Our 20% discount is available by quoting ref: hcuk20pen  when booking.(*Cannot be used in conjunction with any other offer.  Full T&Cs available upon request.)

 

PEN National Awards 2017

Thursday 1st March 2018

The REP Birmingham

An incredible day showcasing and celebrating what is working well to improve the experience of care.  A day not to be missed.
The Point of Care Foundation’s upcoming conference: Making healthcare more human

Wednesday 28 March 2018 ,Wellcome Collection, London

In July we published a briefing entitled ‘Behind Closed Doors: Can we expect NHS staff to be the shock absorbers of a system under pressure?’, which highlights the extent of the pressure NHS staff are facing, and the consequences for patients, if more is not done to support staff.  Other recent surveys have revealed similar concerns among both the consultant workforce and junior doctors.

The CPD-accredited conference will provide an opportunity for delegates to learn from experts and to network with peers who share these concerns, in innovative and challenging sessions.  In line with our mission to ‘humanise healthcare’, delegates will learn:

•how to practice collaborative leadership between managers, staff, and patients;
•how to recognise drivers for staff engagement, how to improve staff experience, and how to enable staff to care for themselves and colleagues;
•how to understand what conditions enable staff to be at their best with patients.

The conference aims to encourage new learning and to challenge traditional ideas about the role of staff and patients.

The morning sessions will include a patient discussion panel followed by forum theatre performed by Performing Medicine, which will draw on themes from the patient panel to perform scenarios where staff can provide more human care.

The afternoon will provide the opportunity for a conversation between staff and patients, encouraging both to think about what difference it makes when relationships between them are strong, as well as what enables/prevents these relationships from building. This will be followed by a session in which clinical and non-clinical staff will make their voices heard about what conditions make them feel enabled and ‘at their best’.

If you want to be part of the movement for a healthcare system which is more human, book now to attend this unique and progressive conference. The audience will be drawn from a wide range of professions but will be of particular interest to consultants and junior doctors, as well as academics and researchers.

Early bird tickets are now available and cost just £150 – you can book your place by visiting the event page: https://goo.gl/dNxSwi    

PEW Patient Experience Week
23-27 April 2018
More to follow! 

In case you missed it
Doctor Communication of a Different Kind
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Velindre Cancer Centre, Communicating Effectively – Caring for my Family with Cancer 

Case Study – June 2017

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Velindre Cancer Centre

Communicating Effectively – Caring for my Family with Cancer

Velindre Cancer Centre in Whitchurch, Cardiff, provides specialist cancer services to people living in South East Wales and is one of the 10 largest cancer centres in the UK. The Cancer Centre is a specialist treatment, teaching and research and development centre for non-surgical oncology, treating patients with chemotherapy, radiotherapy and related treatments, and caring for patients with specialist palliative care needs. We provide services to over 1.5 million people across South East Wales and beyond. each year we treat over 5,000 new referrals and around 50,000 new outpatients. Our dedicated staff of over 670 work as a close knit team. Our aim is to provide patients & families with the best possible care and treatment.

Inspiration

Inspired by experiences of families, cancer nurse Michele Pengelly was concerned about the paucity of resources helping newly diagnosed cancer patients talk to their children about cancer and the impact on families. Resources were limited, mostly using heteronormative images, questionable for the diversity of modern-day.

Demonstrating a collaborative partnership with Equality Manger Ceri Harris, the idea followed to write a series of books which are fully diverse, accessible and fit for purpose including audio/BSL. Following consultation with patients, children and professionals the first “Caring for my family with Cancer” book was successfully launched in 2015. 150 have now been issued.

The series of 6 books is innovative as a completely diverse, accessible resource aiming to support cancer patients to talk to their children about cancer. Utilising modern technology and computer graphics, the books have provided positive outcomes to families’ experiences, have longevity, are cost effective and include single parent and same sex families. This use of technology and charitable funding to support costs has meant that the series of books is fully sustainable. The simplicity of the family story has contributed to a project with transferability. The dissemination of this work has been through professional, public and third sector events.

Rationale

Michele Pengelly, a cancer nurse with 30 years’ experience has worked with numerous parents who made decisions not to talk to their children about their cancer. Sometimes the parents’ health deteriorates and they sadly die with their children still unaware of the cancer and no understanding of what has happened.

Michele facilitates a children’s bereavement group; listening to these children’s stories and observing their pictures and memory jars she felt passionately that we could do better and take a more proactive approach. For parents who did want to explain cancer and their treatment the current resources were not always appropriate. Resources were limited, mostly using heteronormative images, questionable for the diversity of modern-day families (single parents, same sex) – to give a father a story book about breast cancer because there was nothing else available was not good enough!

Michele had the idea of writing a book to mirror the families we were meeting in clinical practice. In 2014 meeting with Trust Equality manager, Ceri Harris, 20 years’ experience in equality, both felt passionately there was a need to create a resource that not only looked at gender concerns, but to develop a series of books; fully diverse, accessible and fit for purpose, including BSL and audio versions in several languages that would meet the needs of families who used the services at Velindre. The aim was to meet a gap in resources and enable safe and open conversation about cancer within families so that children were part of the experiences in a positive way.

Planning

From the outset engaging & involving stakeholders was hugely important; equality groups, parents, clinical psychologists and nursing staff, to ensure the books met everyone’s expectations and needs. Ensuring the language used was fit for purpose and that support was provided to parents in how to use the books effectively.

An internal governance group was established as well as a stakeholder group, so we were confident that the books met all obligations. Michele and Ceri worked closely with the artist and digital colourist to develop the characters within the books to reflect diversity.

Velindre fundraising were involved in the funding of the printing and additional costs. Clinical and nursing staff received training on how to use the books with parents and support them with any difficult questions and situations. We were fortunate that Cardiff born Hollywood actor Matthew Rhys, patron of fundraising, provided bilingual audio versions of the book, professionally recorded in a studio in LA, and sent for the launch. Matthew’s beautiful tone and animated approach brings to life the story of the little girl Lucy and her family’s experience of cancer.

The final version of the first book was agreed by the stakeholder group, prior to printing, so everyone involved was aware and agreed on the final product.

This year we have evaluated and revised the books following comments from staff, patients and their families and produced the British Sign language Version which we launched in November as part of Sensory Loss Awareness Month in Wales.

Books are issued to families together with a set of cuddly lions (one for the child & one for the parent) to reduce separation anxiety if the parent needs to come into hospital – the lions feature in the books too!

Impact

The impact has been so positive using both quantitative and qualitative methodologies including patient experience digital stories. We have attached as part of our application a video of Vincent, a little boy who received the book and cuddly lions when his mother was a patient with us. He speaks so eloquently about how useful and important the book was to him; how he recognised himself within the book and that he even though he looked like the little boy, Jack.

We asked each family who received a copy to provide comments and feedback, this helped us evaluate and revise future versions. We spoke to clinicians, asking if they found it a useful resource. We keep data on numbers of families using the resource, ages of children and which type of book is most used.

What surprised us is that we are now seeing the lions appear in the children’s memory boxes when they attend the children’s bereavement group. This demonstrates how important the lions were as part of their own journeys, how they found comfort in the books and lions and the positivity they must have given during a very upsetting time.

An additional outcome is that the Trust has been approached by a number of health organisations not just from Wales but across the UK asking about the project and wanting to purchase copies of the books.

As identified throughout this application, the project has involved and seeks to involve more internal and external stakeholders. We realised the value of the books and how they have helped families and hope to develop future resources that can be used externally, whether for cancer or modified to be used for other conditions.

Key Learning

Engagement – It is essential to involve the parents and families from the outset and to keep their involvement throughout the pilot study and change management process. This gives a greater integrity and heart to the project.

Training – Collaborate with training departments and staff personal development reviews to help identify the training needs for those delivering care with the new resource. What additional support and advice they may need to deliver this service and build this into training programmes.

Technology – How can you best use current and future technology? For example by using a digital colourist and artist we are able to create picture layers, so characters, and elements of the story can be easily added or taken away to develop further books.

Adaptability – The methodology could be used in other fields, for example “Caring for my family with motor neurone disease”. The use of modern technology means it can be adapted and updated if cancer treatments change.

Sharing Best Practice – don’t keep it to yourself. There will be lots of other organisations with similar challenges struggling to develop solutions. Through events, conferences and publications take every opportunity to share.

 

 

May Newsletter 2017

Welcome to the Patient Experience Network Newsletter
PENLetter May 2017
Issue 44
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Welcome to this month’s PENLetterWe have collated all the current and inspirational patient experience news into one place.
Welcome Note from Ruth Evans, PEN Founder

Welcome to the May edition of our PENLetter!

Another newsletter packed with interesting patient experience news!  We have some great articles to read in Leadership news.

Where an executive shares their learning from shadowing a member of the frontline team, another looks at the importance of patient experience n the C-suite, and a third explores compassionate leadership.  Loads of great reads in our Patient Experience news section with two looking at the difference sitting down makes. 

We are finalising the regional events where we plan to bring some of the excitement of the awards to four regional events – more to follow soon!

 

Enjoy the read.

Ruth

PENNA 2016 AWARDS
PENNA2016:Following our successful Awards we are planning to bring some of the best practice to a series of regional events.  We are finalising the details for four events and so far have fixed two dates: 21st June in Leeds and 11th July in London.  More details will be issued soon, but please make a note of these dates in your diary.

 

If you have any questions please contact the team on 033 33 44 7060 or info@patientexperiencenetwork.org

 

This Month’s Case Study
Nottingham University Hospitals – Think Drink Project
About the ProjectThink Drink initiative was established in 2015 at NUH. The cause and extent of the problem was identified through audit data of fasting times for patients’ waiting for surgery and valuable Patient Public Involvement feedback from patients about their experiences. The audit data indicated excessive fasting times for patients across the trust, an average of nine hours; this coupled with some negative feedback from patient, saying they were very thirsty and kept without fluid for long periods prior to their surgery. The overall aim of the initiative is to minimising fasting times for patients across the trust thus improving patient outcomes and experience, reducing dehydration and morbidity.

READ MORE HERE

PEN News

Ruth Evans at PEN

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Leadership News
Hospital Impact: What one health system executive learned from shadowing frontline staff
The newest faces in hospital C-suites are focusing on patient engagement
Caring to change: How compassionate leadership can stimulate innovation in health care
Patient Experience News
Ireland launches first ever patient experience survey
Geisinger’s nursing bundle improves consistency, quality of patient experience
Nurses sitting at the bedside linked to higher patient experience scores
Is Sitting the New Patient Communication Strategy for Nurses?
Hospital Impact: For a better patient experience, focus on the outcomes that matter most
6 Steps to Improving the Patient, Family Engagement Process
Local News
Scheme where patients dine with their family at Norfolk and Norwich Hospital recognised at national awards
Technology News
Do caregivers need a Parkinson’s disease simulation device to experience empathy?
How to master patient onboarding in 3 steps
Events
Masterclass: Complaints Handling & Response LettersTuesday 23 May 2017
De Vere West One Conference Centre

This interactive and practical workshop will provide a structured approach to complaints handling and response writing.  Delegates will be taken through a methodology that will ensure that all complaints are properly investigated and that responses will stand up to scrutiny. There will be a complaint and letter writing case study during which delegates will receive feedback from the trainer.

For further information and to book your place visit

http://www.healthcareconferencesuk.co.uk/complaints-handling-and-response-letters-masterclass or email   hanisha@hc-uk.org.uk

 

 

Me first Masterclasses 2017

Upcoming training dates:

London:  5th June 2017

London:  7th July 2017

Birmingham:  26th July 2017

Me first is an education and training resource that helps health and social care professionals to develop their knowledge, skills and confidence in communicating with children and young people.

The Me first masterclasses, which are co-delivered with young people, support healthcare professionals to apply the Me first communication model to their practice. The training builds on attendee’s existing skills and expertise, and utilises quality improvement techniques to enable healthcare staff to embed learning in their clinical practice.

Please visit www.mefirst.org.uk or email us at info@mefirst.org.uk to sign up for training.

 

 

The future for medical technologies, devices and diagnostics: accelerating access, self care, and early indications from Innovation Test Beds

Morning, Thursday, 29th June 2017

Central London

THIS EVENT IS CPD CERTIFIED

Following the launch of the NHS Innovation Accelerator, this seminar will be a timely opportunity to assess indications from the test bed sites, and next steps for developing the role of technology in healthcare to support new models of care.

Discussion will be informed by the publication of the Accelerated Access Review, particularly in respect of its recommended establishment of a digital health technology catalyst, and advice to NICE to review its health technology assessment processes.

Further sessions will focus on utilising technology to promote self care, the growth of wearable technology, and the next steps and challenges for industry following Brexit.

 

Patient Leadership Summit

Friday 7 July 2017
De Vere West One Conference Centre, London

This national summit chaired and co-produced with Jonathan Hope Patient & Co-Chair ‘Realising the Value of Individuals’ NHS England will focus on the important issue of Patient Leadership and how you can support patients in your organization to co-design and improve services, how you can help patients to develop patient leadership skills and how to effectively work with patient leaders.

For further information and to book your place visit

http://www.healthcareconferencesuk.co.uk/patient-leadership or email nicki@hc-uk.org.uk

Follow the conference on Twitter #patientleadership

Our 20% discount is available by quoting ref: hcuk20pen  when booking.(*Cannot be used in conjunction with any other offer.  Full T&Cs available upon request.)

 

Measuring, Understanding and Acting on Patient Experience Insight

Monday 18 September 2017

London

The CQC State of Hospitals Report, 2 March 2017 states that “Changes to improve pathways of care, patient experience, and outcomes can also have significant cost savings”
By attending this conference delegates will focus on measuring, understanding and acting on patient experience insight, and demonstrating responsiveness to that insight to improve care. Through national updates and case study presentations the conference will support you to measure, monitor and improve patient experience in your service, and demonstrate responsiveness to the feedback you receive

For further information and to book your place visit email: carolyn@hc-uk.org.uk or call Carolyn Goodbody on 01932 429933

A 20% discount is available which can be claimed by quoting ref: hcuk20spkr

 

Useful Resources 
Negotiating the Care Maze in poetry
Caring to change: How compassionate leadership can stimulate innovation in health care
What? Why? Children in Hospital
SPEAK -It’s a two way thing  An NHS East and North Hertfordshire video to raise awareness for effective communication between healthcare professionals and young people. SPEAK – S = Slowly, P = Politely, E = Easily, A = Adapt, K = Kindly
In case you missed it
Soapbox: The Power of Emotional Contagion
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