Category: Setting the Stage – Measuring/Reporting and Acting and Setting the Stage – Staff Engagement / Improving Staff Experience
Staffordshire and Lancashire Commissioning Support Unit
Insight and Involvement – Measuring, Reporting and Acting
Organisation – Staffordshire and Lancashire Commissioning Support Unit (SLCSU) is one of the largest the country delivering a range of transformational and transactional services across Shropshire, Telford and Wrekin, Staffordshire Herefordshire and Lancashire. SLCSU employs over 750 people and covers population of over 3.5 million people.
Aim – Our objectives were to provide one single place for all patient experience, clinical and incident intelligence to provide a holistic view of areas for improvement. Triangulation of the three elements of quality to see the bigger picture
To prevent the likelihood of a recurrence of Mid Staffs by allowing all staff to view relevant data in order to take action on the findings
To gain the greatest amount of intelligence from local data by using the national recognised domains of patient experience to record data and to triangulation local and national data to identify themes and trends
To capture clinical feedback via a real-time system with ease of access and ability to view all data in real time.
To provide opportunities for action based on multi stranded quality data
The work has its genesis in the David-Colin-Thome report into Mid Staffs where the need for a single place for patient feedback, clinical feedback and incidents with real time reporting was highlighted as a requirement to prevent recurrence of the issues. There was a clear need to encourage a culture of openness and transparency the staff engagement element of the project was to ensure that practice managers, GPs and others were comfortable sharing incidents, clinical feedback and patient experience feedback. There was a history of practices being very reluctant to share incidents and feedback from patients and this initiative had a clear objective to encourage the entry and sharing of data. The project was extended to include clinical feedback and safety information this creating a safety system this was to ensure that all data could aggregated and themes via standardised data set. The data aggregation was set up in such a way to allow data to be aggregated at a provider level across multiple locations and organisations/CCGs to ensure that a true picture of provider performance could be seen.
Outcomes – The Insight model has been transformed into a quality system by entering clinical feedback from GPs and by reporting incidents in primary care settings. All data comes together and is reported in real time to identify themes and trends across the quality spectrum. This holistic approach has been pioneered by Stoke on Trent CCG and has been rolled out to all 54 GP practices. Work is now underway to rollout to the GP practices in Telford and Wrekin and Shropshire with the other 6 CCGs to follow, this will see 260 practices using the system to improve services for patients and the public.
As a result of the system we have been able to respond to patient experience feedback real time with monitoring visits to our provider wards, we have been able to identify key themes and trends from multiple sources and have put actions in place to resolve. It has changed the organisational culture as staff now appreciate they are part of feeding in formation that aces up a big picture that one group or location can create without collaboration. Patients are now at the heart of what we do as they drive the requirements for change supported by the evidence form clinical feedback and incidents. The clinical and patient feedback has highlighted issue with our community nursing team and has directly led to a clinical review of services. Work has also been undertaken to resolve issues with cancer referrals and delays to the confirmation of appointments
The communications and engagement team at SLCSU has worked with our emergent CCGs and we have developed a systematic approach to public and patient involvement that has its roots in systemic review of cause and effect. This approach is achieved by using an Insight database which collates, aggregates, analyses and reports quality data in real time to CCG staff based on their commissioning portfolio.
Over 9000 records entered to the system, 2000 small changes in practices, 3 major service reviews
400 incidents at primary care
50 changes in practice, 150 in progress and review 100 with no changes required and 100 currently in review
Changes to clinical practice for surgery
Procedures put in place to identify fax errors
Procedures reiterated about shredding confidential information
Changes to clinical practice and follow up on surgical procedures
Issues raised at CQRM about 111 service
Sub group established to discuss prescription issues Changes in practice for clinical staff. More open culture for the implementation of learning.