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MH Inpatient Survey Results 2010. Toni Martin Senior Consultant Quality Health. Context. NHS Plan: Mandatory annual national surveys (patient and staff) Health Check and Vital Signs Patient and Staff surveys continue to be major source of data for CQC evaluating Trust declarations
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MH Inpatient Survey Results2010 Toni Martin Senior Consultant Quality Health
Context • NHS Plan: • Mandatory annual national surveys (patient and staff) • Health Check and Vital Signs • Patient and Staff surveys continue to be major source of data for CQC evaluating Trust declarations • Care Quality Commission’s Role: • Organise and run the national surveys • Publish comparative data for each Trust to inform public and guide funding • Review of CQC role n running national surveys likely. BUT White Paper, “Information Revolution” and “Outcomes Framework” consultation documents indicate strongly that patient experience and PROMs will be more widely used, higher volumes
Key Points • Establish: differences between patients and managers / clinicians views of service • National Service User Surveys 2003 - 2010 used essentially same methodology: postal, two reminders • Second time IP survey has been run – voluntarily in 2010. Comparison with previous data from 2009 compulsory survey, in report and presentation • Comparison here with 3,845 Service User respondents in 33 MH function Trusts (51% of the total number of Trusts). 14,064 service users surveyed by QH • Methodology: Service Users taken from live discharges from acute IP wards January-June 2010. Complicated criteria. Different “sample” sizes in Trusts depending on size of IP population: sample sizes varied by Trust • Monthly samples undertaken from live discharges to maximise relevance of survey to service users • National Response Rate: mean 29% (Spread 37% -22%, heavily influenced by social deprivation and ethnicity)
Key National Findings, all QH Trusts • 7 in 10 respondents said staff made them feel welcomed when they arrived on the ward • Only 1 in 4 said that staff definitely knew about the treatment and care they had previously received • On the environment that the service user was in: • Very few said they shared sleeping areas with service users of the opposite gender • 1 in 6 said they did not feel safe on the ward, and in addition 4 in 10 said they felt safe only sometimes • A clear majority rated the food as very good or good • A majority (54%) said the ward or room they were in was very clean • 4 in 10 said they received all the help they needed from hospital staff with organising their home situation • Ratings for staff are lower than those for staff in the community MH survey • 1 in 5 said that they did not receive an explanation of the purposes of their medication and almost half (47%) said they did not receive information on medication side effects
Key National Findings, all QH Trusts • Only 1 in 3 said they were as involved as they wanted to be in decisions about their care and treatment • A majority of service users (54%) wanted talking therapy, but only 28% received it • A substantial majority of service users (58%) said that there was not enough to do on the ward in the evenings and at weekends • Just over 1 in 3 who had been sectioned said that their rights were explained to them completely • When discharged, more than 6 in 10 had an out of office MH service number they could phone if needed, but more than 1 in 4 did not • More than 8 in 10 had been contacted by a member of the MH team since leaving hospital, mainly in the first week after being discharged • 50% rated their care received in hospital as excellent or very good. Very wide range of scores from Trust to Trust
Issues for Action • Ensure that previous knowledge on the condition/care given to the service user is available to staff on admission • Orient the service user to the ward daily routine: clear majority are not fully oriented • Review arrangements for safety and security on the ward: majority did not feel safe at all or only did so sometimes • Nurses score substantially lower than psychiatrists in terms of the service users feelings of respect and dignity, and time available to talk to them. Review training for Nurses on the ward • Ensure that there is enough time for service users to discuss their condition with nurses on the ward • Ensure that all service users are given information on the purposes of medication and the side effects of meds • Review availability of talking therapies, given the gap between “demand” and provision • Make further activities streams available to service users, especially at weekends and in the evenings • Ensure that all service users who are sectioned are given information about their rights • Review methods of speeding discharge in relation to waiting for discharge meds and other factors • Ensure that all service users have an out of hours contact number • Ensure that all service users are given information about how to get help in a crisis
The Next Steps • Specific action plans in place to deal with top patient related issues. • Build a performance management system which makes managers accountable; top improving Trusts pick 3-4 issues at most and rigorously performance manage them from the top. • Lead the process within the Trust. Keep the pressure up, don’t stop. Repeat messages. • Ensure data is placed in Quality Accounts • Publicise achievements.
