There are a number of things that are never far from my mind on a day to day, week to week basis, but one of them which perpetually pervades above most others is patient experience and how people find us when they come in for care.
There are many ways that we can and do track this and we have a specific team who’s job it is to listen to our patients and their families, to hear their compliments, complaints and suggestions for improvement – and to ensure we acknowledge all of them equally and act as appropriate, sharing information right across the Trust in the myriad of services and settings we provide.
An important – and independent – source of information on this is the annual survey of adult inpatients that has been carried out by the regulator the Care Quality Commission (CQC) each year since 2002.
Published on Wednesday, the team sought views from more than 63,000 patients nationally in November 2023 and about 400 of those were inpatients at ELHT at the time, for at least one night.
That is a significant number of people for a hospital with a total of around 1,000 beds and so it’s right that we take on board the feedback and interrogate the results, as I know every other Trust in England will have done too.
Among the most important and valuable information that the survey asks patients to give is an opinion on the overall care they received, including the quality of information provided to them and communication with colleagues, as well as whether they were given enough privacy, the amount of support to eat and drink and how discharge arrangements were managed.
We always learn a lot from this type of information, but I knew this year more than ever was going to provide critical insight following some of the most challenging circumstances we have ever faced in the NHS.
We have been managing record numbers of people coming into hospital for treatment through urgent and emergency care pathways – A&E at Blackburn, our urgent care centre in Burnley and the minor injuries unit in Accrington for some time and we know this has led to long waits to be seen, as well as putting huge pressure on the whole system to admit and discharge people in equal measure.
Where this isn’t achievable, we have cared for people on temporary trollies instead of permanent beds in our wards and had patients and their families on corridors. This is necessary and deliberate to allow us to keep treating people even when we run out of clinical space, but there can be no doubt that this experience is not what anyone would aspire to in terms of safe, personal and effective care.
At times, it can be heartening – life reaffirming – to hear people accept and mentally process these arrangements pragmatically in their minds. Some even graciously recognise, even at times of great personal and emotional distress, that we were doing our best in very difficult circumstances and for this we are always grateful.
Our scores, whilst reasonably comparative with other Trusts in many ways, are disappointing and show a decline in our overall experience rating.
For an organisation that is full of brilliant people, who work so hard and pride ourselves on continual improvement, these results are tough to take and, for this reason, it’s important to recognise positive areas and ratings as much as those we need to improve.
We scored highly on both themes of kindness and compassion and respect and dignity and this chimes with feedback I have received and shared previously around how colleagues care for patients and their families when they need it.
I am put in mind here of the man who messaged me about his wife’s care on the corridor on A&E and, as I said at the time, I appreciated his honest appraisal of the team on duty, who he said worked so hard despite the very difficult circumstances. He described being cared for by amazing people who openly recognised the environment was far from ideal and apologised to him and his wife as part of their care.
I am reminded also of the feedback we have heard from families of those at the end of their lives, who find themselves in hospital but can recount how their experience was steeped in compassion and care and helped them to create positive and lasting memories at the most difficult of times. This is important, as there is only one chance to get it right.
You’ll remember also that I took a shift with the Patient Services Team (PSA) just last month and spoke to a number of patients and was so buoyed to hear their feedback about the fantastic care they had received. Indeed, one used the phrase ‘it’s a five star hospital’ and I felt so proud of everyone here at the Trust.
But whilst it’s right to recognise where things have gone right, it is clear from this survey that we also got things wrong and, in places, we simply should have been better.
Some of this we are already aware of and have a number of key and critical improvement plans in place, but it is my wish that we accept all feedback openly and without being defensive. That we welcome and learn from it and then move forward, together, to make progress.
I believe we are well on with this and – as just one example – already have well developed plans to eradicate corridor care for the winter ahead. We have also recently developed a Patient Experience Strategy which has explored a range of feedback we have received and taken best practice from other organisations, to create a really important improvement plan for the Trust.
I am both confident and determined that this will have an impact on scores and ratings for future surveys but, more importantly, on how people experience care here at ELHT.
To this point, the patient experience team receive a lot of feedback separate to this survey as patients and their families tell us directly of their experience through feedback on wards and departments, through things like the ‘Friends and Family Test’, as well as sending me messages and information personally.
All of this is hugely welcomed and, more to the point, important and valuable as we strive to improve in the ways that are most important to local people. Please, take the time in whichever way you prefer to let us know about your experience, where we could do better and where we got it right.
There are lots of great things to celebrate here at ELHT and I am grateful to colleagues for everything they do each day and night.
One I can personally vouch for is August’s Employee of the Month, Data and Digital Project Manager Elena Mortimer, who is in one of those teams that is behind the scenes and non-clinical but makes a huge difference to the patients experience too.
Elena’s nomination said she shows all the values of the Trust, conducts herself with professionalism, and has an approach that is kind and caring, whilst still getting the job done. She will do anything for anyone and works long hours to make sure she lets no-one down.
Her nominator added that it was difficult to put into words the amount of work Elena has done – she has logged long hours, gone well above and beyond her job role and has been a rock of inspiration for most of the team, including those senior to her. What amazing feedback, well done Elena and thanks not just for everything you do, but the way you do it too.
I was delighted to bob in and present Elena with her award and thank her personally. She is a credit to the Trust and I know this spirit is indicative of the vast majority of colleagues here at ELHT.
On this note let me end by saying please enjoy the Bank Holiday weekend if you’re off and thanks if you’re picking up shifts as ever to ensure our services continue to operate effectively. It’s valued and appreciated by everyone, including all the people who are inpatients this weekend.
Martin