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Dorset CCG Patient Insight Final Report

A report prepared for Dorset CCG

Date: 03 October 2019

Authors:

Megan Bilas

Alan Poots

Amy Tallett

Juan Abad Madroñero

www.picker.org

Picker Picker is an international charity dedicated to ensuring the highest quality health and social

care for all, always. We are here to:

Influence policy and practice so that health and social care systems are always centred

around people’s needs and preferences.

Inspire the delivery of the highest quality care, developing tools and services which

enable all experiences to be better understood.

Empower those working in health and social care to improve experiences by effectively

measuring, and acting upon, people’s feedback.

© Picker 2019

Published by and available from:

Picker Institute Europe

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3 West Way

Oxford,

OX2 0JB

England

Tel: 01865 208100

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Email: [email protected]

Website: www.picker.org

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Company Limited by Registered Guarantee No 3908160

Picker Institute Europe has UKAS accredited certification for ISO20252: 2012 (GB08/74322)

and ISO27001:2013 (GB10/80275). We comply with Data Protection Laws including the

General Data Protection Regulation, the Data Protection Act 2018 and the Market Research

Society's (MRS) Code of Conduct.

mailto:[email protected]

http://www.picker.org/

Contents

Background 1

Methods 1

Topic Development 2

Round One Rating Survey 3

Overview 3

Responses 3

Results: Questionnaire Administration 4

Results: Rating Items 5

PPI Advisory Group 6

Demographics 6

Meeting Structure and Activities 7

Results 8

Eliminated statements 8

Combined Statements 10

Highly Rated Statements 11

Discussion 11

Round Two Rating Survey 12

Overview 12

Responses 14

Demographics 15

Results: Questionnaire Administration 17

Results: Rating Items 19

Patient Insight Survey Development 20

Cognitive Interviews 20

Cognitive Testing Changes 22

Sub-Sections 23

Administration 24

Recommendations for Survey Implementation 24

Format/ Mode of Administration 24

Frequency of Feedback Collection 24

Survey Distribution 24

Balancing generalisability with service specificity 25

Other considerations 25

Appendix A: Round One Survey Topics 26

Appendix B: Round One Rating Items Results 29

Appendix C: PPI Ranking Results 32

Appendix D: Round Two Demographic Results 37

Appendix E: Round Two Questionnaire Administration Results 41

Appendix F: Round Two Rating Items Results 44

Appendix G: Topic to Question Conversion 46

Appendix H: Draft Patient Insight Questionnaire 51

Appendix I: Final Patient Insight Questionnaire 61

Appendix J: Online Questionnaire Routing 71

©2019 Picker. All Rights Reserved. 1

P3261 | Dorset CCG Patient Insight | MB AJP JAM AT | 03 October 2019 | v2.0 FINAL [Protect]

Background

This project was conducted by Picker, an independent health research charity with expertise

in understanding patient experiences of care, on behalf of NHS Dorset Clinical

Commissioning Group (CCG). The goal was to develop and explore new tools for generating

and utilising insight from patients across the Dorset Integrated Care System (ICS) to support

system transformation, service design, service evaluation, and quality improvement.

This final report provides details on the results of the Patient and Public Involvement (PPI)

Advisory Group meeting, the round two rating survey, questionnaire development, and

cognitive testing. A brief review of topic development and the results of the round one rating

survey are also provided, which are covered in more detail in an interim report provided at

an earlier stage. Recommendations for questionnaire administration are provided at the end.

Methods

To address the requirements of developing and testing a set of questions to gather feedback

from patients and service users across the ICS in Dorset, Picker used an approach that

combined stakeholder engagement, patient and public involvement, question development,

and cognitive testing.

A modified two-stage Delphi technique was used to incorporate a large number and broad

range of stakeholders in a cost-effective way (articulated in subsequent sections,

summarised in Figure 1: Process Flow Diagram).

1. Core set of topics developed

2. First round survey sent to stakeholders

3. Results collated from first round

stakeholder survey

4. PPI Advisory Group

consultation

5. Second round stakeholder survey sent

6. Consensus on core topics

7. Development of patient experience

questionnaire

Figure 1: Process Flow Diagram



Topic Development

Picker created a core set of topics concerning quality of health and social care based on the

Picker Principles of Person Centred Care and insights gathered from previous exploratory

work. The Picker Principles of Person Centred Care are eight primary dimensions that are

key to positive patient experience and achieving person-centred care (Figure 2: Picker

Principles of Person Centred Care). These Principles derive from extensive empirical work

with patients that Picker has conducted since its founding.

Other prominent research that informed that creation of the topics included:

o National Voices I Statements o Dorset ICS Discovery workshop analysis o The Big Ask Research Project 2013/14 o Improving Dorset’s Healthcare Consultation 2016/17

The final set of 81 topics was organised by eight themes based on the Picker Principles of

Person Centred Care for ease of presentation (see Table 1). The Principle of “Attention to

physical and environmental needs” was amended to “Community-facing services and

physical and environmental needs” based on feedback from Dorset CCG. The complete list

of topics can be found in Appendix A: Round One Survey Topics.

Figure 2: Picker Principles of Person Centred Care



Table 1: Count of Topics by Theme

Theme Topic Count

Community-facing services and physical and environmental needs 9

Clear information and support for self-care 11

Emotional support, empathy and respect 12

Involvement of, and support for, family and carers (unpaid carers) 10

Fast access to reliable health advice 9

Effective treatment delivered by trusted professionals 9

Continuity of care and smooth transitions 13

Involvement in decisions and respect for preferences 8

Total 81

Round One Rating Survey

Overview

The final list of 81 topics was entered into an online questionnaire that was open for

completion by Dorset staff, patients and members of the public from mid-April to early May

2019. People were invited to take part in the survey via an open access link shared with

Dorset networks and groups, as well as publicising on social media sites such as Twitter.

Each topic had a nine-point scale. A rating of one indicated that an item was not useful or

important for measuring the quality of care while a rating of nine indicated that an item was

highly useful or important for measuring the quality of care. Participants were provided with

an image for additional guidance (Figure 3: Rating Scale). Topics were grouped by theme

and participants could provide optional comments on each theme.

Responses

In total, 183 fully or partially completed questionnaires were received (127 completed and 56

partially completed). Following data cleaning, there were 135 useable cases (109 completed

questionnaires and 26 partially completed questionnaires). Some responses were eliminated

due to eligibility while others were eliminated to ensure high data quality.

The majority of those who participated in the round one rating survey were either patients or

members of the public, including carers (79%). Most were female (77%) and 55 years of age

and older (54%).

Figure 3: Rating Scale



In a multi-response question, most staff members worked in Mid-Dorset (52%), West Dorset

(43%) and Weymouth and Portland (38%). Meanwhile, in a multi-response question, most

patients and members of the public accessed services within Poole (33%), Bournemouth

(21%) and Mid-Dorset (21%).

Figures comparing round one and round two responses can be found in the Round Two

Rating Survey section.

Results: Questionnaire Administration

In addition to demographic questions and rating scale questions, participants were asked

questions regarding the optimum length of a new patient survey, when the survey should be

completed, and how the survey should be administered. The majority of participants (68%)

thought that a survey should contain between 6 and 20 questions: 33% of participants stated

that the survey should be between 6 and 10 questions long and 35% stated that the survey

should be between 11 and 20 questions long, 17% did not provide a response.

In a multi-response question, most participants thought that a feedback questionnaire should

be administered to those who have accessed health or care services recently or within the

past year, and that it should ask about experiences as a whole, as opposed to evaluating a

single service. Just over a half of respondents (56%) preferred a feedback questionnaire

being completed after contact with a health or care service, in which respondents would be

asked about their experiences in the last couple of months (e.g. after a hospital visit, asking

about all healthcare).

Regarding mode of administration, in a multi-response question, the majority of responders

(88%) felt that a patient questionnaire should be administered via a survey link emailed to

people for online completion. More than half (56%) thought that the questionnaire should be

administered via paper copies given out within the services. Comments indicated that

considerations should be made towards those with limited eyesight (easy read options) and

that digital methods might be more amenable towards those with busy lifestyles who could

complete it on the move. Some participants suggested a mixed approach, whereby

respondents have the choice of completing a survey either online or a hardcopy version.



Results: Rating Items

Few items were rated as not being useful or important for measuring the quality of care as

shown by Figure 4: Median Rating Scores. Picker, therefore, applied stringent exclusion

criteria, whereby only those items that received a median (middle value when scores are

arranged in order from least to greatest) score of nine proceeded to the next round PPI

Advisory Group meeting (n=50).

Picker conducted further analysis to see if there were any differences between what patients

and members of the public reported as being highly useful and important versus what staff

reported. Staff results revealed that only nine items out of the total 81 met the inclusion

criteria of having a median score of nine:

People are treated with compassion and empathy

Health and social care staff treat people fairly

Carers’ opinions and experience are valued by health and social care staff

Health and social services help the patient live the life they want

Health and social care staff understand that physical and mental health interact

The confidentiality of an individual's record is protected

All the people involved in an individual's care communicate well with each other

There is a clear protocol in place should people have an emergency

When a person moves in between services or settings, there is a plan in place for what

happens next that is known to this person

0

10

20

30

40

50

6 7 8 8.5 9

Co

un

t

Median Score

Figure 4: Median Rating Scores



In total, 31 items were excluded following the round one survey. Many of these items fell into

the theme of “Community-facing services and physical and environmental needs” and

included statements concerning logistics (e.g. access to parking and travel time to services).

Analysis revealed differences between those residing in the Poole and Bournemouth areas

versus those residing in other areas of Dorset, with slightly higher median scores on

logistical items reported from those living outside of Poole and Bournemouth. However, this

did not warrant inclusion into the refined list as the median score differences were usually

eight (non-Poole/Bournemouth) versus seven (Poole/Bournemouth).

The lowest scoring item (receiving a median score of six) was “People can choose the

gender of the health or social care professional they see,” which fell under the theme of

“Involvement in decisions and respect for preferences.”

The full list of items chosen for inclusion/exclusion following round one survey results can be

found in Appendix B: Round One Rating Items Results.

PPI Advisory Group

Five patients and members of the public within Dorset participated in a Patient and Public

Involvement (PPI) Advisory Group meeting on 10 June 2019 in central Poole. Participants

were recruited through advertisements that Dorset CCG distributed to their patient groups,

newsletters, and social media accounts.

The primary aims of this session were to gather patient and public feedback to further refine

the list of items included in the patient feedback survey and ensure that the topics could be

used across all health and care services. Additional aims included seeking feedback on:

Terminology used to describe those who provide unpaid care to family members and

friends, as these people may not necessarily think of themselves as “carers”

How to include topics that encompass those with special needs while still being broad

enough to apply to the general population

How the new patient survey should be administered (e.g. length, format and

administration method)

Demographics

PPI group participants shared demographic information through screening questions asked

after they had expressed interest in taking part. In addition, participants were invited to share

their experience with Dorset health and social care services during meeting introductions

with the understanding that they could share as much or as little information as they wished.

Therefore, the list of services and institutions accessed by participants may not be fully

comprehensive.

While all five participants were female, there was a spread across rural and urban areas of

Dorset. Participants had experience with a wide range of services in their roles as patients

and carers. Most participants provided care for someone with a long-term condition who



needed access to multiple services, and a few had only accessed primary care for

themselves.

Locations: West Dorset, Dorchester, Christchurch, Poole, Bournemouth

Roles: (some participants overlapped the roles listed): carer of minor children, carer of adult

children, carer of elderly parents, patient, retired NHS employee

Services used: respite care, occupational therapy, physiotherapy, dietician, community

nursing, mental health services (including mental health support workers, adult community

mental health team, crisis and home treatment team, inpatient services, intensive

psychological therapies services, child and adolescent mental health services, psychiatric

intensive care and counselling), specialists team, family parent partnership zone,

paediatrics, GP services, social services, A&E, ophthalmology, dental services,

phlebotomists, elderly living support, community nursing, end of life care, speech and

language pathway, autism pathway, emergency surgery, outpatient care, inpatient care,

cancer testing

Institutions accessed: Dorset County Council, Dorset County Hospital, Southampton

Hospital, Child Development Centre, Poole Hospital, Bournemouth Hospital, St. Ann’s

Hospital, Recovery Education Centre, The Retreat, Bournemouth Day Hospital, Linden Unit,

Forston Clinic, the Red Clinic

Meeting Structure and Activities

Following introductions to each other and to the project, participants were asked to work as a

group to rank the 50 statements that were selected for inclusion following the round one

rating survey. Statements were printed out on cards and presented by theme for ease of

presentation. Participants were asked to follow a “diamond-ranking” model (Figure 5)

whereby they placed the statement that they thought was most useful and important for

evaluating quality of care at the top of the formation. The second, third and fourth rows

consisted of statements ranked with descending priority, with each row having two, three

and two statements respectively. The statement that they thought was least important for

evaluating quality of care was placed at the bottom. The diamond ranking process was

repeated for each of the seven themes. During this process, participants suggested how

statements could be combined with other statements, and discussed the reasons for their

ranking choices.



Following diamond ranking, participants were presented with all of the statements and

instructed to apply green sticker dots to those statements that they considered to be the

most useful for evaluating quality of care and to apply blue sticker dots to those statements

that they considered the least useful for evaluating quality of care. This was done in two

parts for ease of evaluation, with the top two diamond ranked statements evaluated first and

the remaining statements evaluated last.

Results

Based on the results of the PPI group discussion and ranking exercises, five statements

were eliminated for inclusion in the second round rating survey and eight statements were

combined with other statements. A breakdown of all results can be found in Appendix C: PPI

Ranking Results.

Eliminated statements

Criteria for eliminating statements from the second round rating survey were:

If the statement had received a low ranking during the diamond ranking exercise (a

ranking of fourth or fifth)

If the statement had received a blue sticker dot by PPI group members, indicating that it

was one of the least useful statements for evaluating quality of care

In total, five statements were eliminated in the round two rating survey (Table 2).

Figure 5: Diamond Ranking Model



Theme Statement Diamond

Ranking

Count of

Blue

Sticker

Dots

Emotional support, empathy

and respect

Health and social care professionals are

flexible in their support when the needs

of a person change

4 0


and respect

Decisions to refuse treatment are

respected, unless they endanger other

people

5 0

Effective treatment delivered

by trusted professionals

Care teams do not refer people to

services with no therapeutic benefits

4 4

Continuity of care and

smooth transitions

People are informed about the reasons

for their referrals

4 2


smooth transitions

Referral letters contain information that

people can understand

4 0

Members of the PPI group thought that the statements “Care teams do not refer people to

services with no therapeutic benefits” and “People are informed about the reasons for their

referrals” were unrealistic. Instead, they believed that it was more challenging to receive a

referral than it was to be referred without a reason or to a service without any therapeutic

benefits. Meanwhile, the main reason for ranking the other three statements low was due to

relative importance when compared with the other statements within a given theme.

Meanwhile, low ranking statements were retained for inclusion in the second round rating

survey if they met the following conditions:

If the statement had received a green sticker dot by PPI group members, indicating that

it was one of the most useful statements for evaluating quality of care

If the statement was one of the nine items that received a median score of nine by staff

during the round one rating survey

Table 2: Eliminated Statements



Combined Statements

During the ranking exercises, PPI participants suggested that some statements could be

combined with other statements. These suggestions were reviewed and some statements

were merged into a single statement that combined ideas. In other cases, the statement with

the highest ranking and count of green sticker dots was chosen.

Theme(s) Original Statements Combined Statement


and respect

Health and social care

professionals have a positive

and friendly attitude

Health and social care staff treat

each person as an individual

People are treated with

compassion and empathy

Health and social care staff treat

people with compassion and

empathy


and respect

People are treated seriously

Health and social care staff listen

to people's concerns

Health and social care staff

listen to people and take their

concerns seriously

Clear information and

support for self-care

People know who to contact

when they need support

People know where to go to find

out about NHS services in

Dorset

People know who to contact and

where to go when they need

support



A person's care plan results in

them feeling confident in

managing their own health

There is a care plan in place for

people who use health and

social care services

There is a care plan in place that

results in people feeling

confident in managing their own

health



Access to reliable advice

and services

Information is provided in a way

that people can understand

People understand the advice

given to them

Information is provided in a way

that people can understand



Information is available about

any risks linked to treatment


side effects of medications


any risks linked to treatment,

including side effects of

medications

Involvement in decisions

and respect for preferences

An individual's views are taken

into account when deciding on a

care plan and treatment

Health and social care staff

involve the individual in decisions

about care

An individual's views are taken

into account when deciding on a

care plan and treatment

Table 3: Combined Statements



Highly Rated Statements

32 statements received a ranking of one or two during the diamond ranking exercise. The

most highly rated statements (a ranking of one or two, and green sticker dot count of four or

more) are shown in Table 4.


Ranking

Count of

Green

Sticker Dots


and respect

People are treated with compassion

and empathy

1 4

Involvement of, and support

for, family and carers (unpaid

carers)

Discharge planning involves carers 2 4



carers)

Carers' opinions and experience are

valued by health and social care staff

1 5



carers)

The support a carer receives supports

the carer's emotional well-being

2 4

Access to reliable advice and

services

People have systems in place to get

help at an early stage to avoid a crisis

1 5



Staff providing care have the

necessary skills to give the required

treatment

2 4



Health and social care staff understand

that physical and mental health interact

1 4


smooth transitions

Health and social care providers

provide people with consistent advice

2 4


smooth transitions

All the people involved in an

individual's care communicate well with

each other

2 5

Involvement in decisions and

respect for preferences

People are as involved in discussions

and decisions about their care, support

and treatment as they want to be

1 4

Involvement in decisions and

respect for preferences

An individual's views are taken into

account when deciding on a care plan

and treatment

2 4

Discussion

In addition to ranking statements and discussing the reasons around these rankings, PPI

participants were asked to share their thoughts on:

The terminology used to describe those who provide care to family members and

friends

How to ensure that topics encompassed special needs while being broad enough to

apply to the general population

How the new patient survey should be administered

Table 4: Highly Rated Statements



Comments made during the round one rating survey revealed that there was some

confusion over whether the term “carers” applied to those who provide care professionally or

those who provide care on an unpaid basis to family members or friends. Members of the

PPI group agreed that “unpaid carers” better described the role of someone who provided

informal care to a family member or friend although they thought that some refinement of this

term was needed. One suggestion was to use “family carer,” although the point was raised

that this would exclude those who provide care to friends. It was agreed that “unpaid carer”

would be used for the second round rating survey and that cognitive testing would explore

whether further refinement of this term was needed, especially to avoid confusion for those

who provide informal care but receive a carer’s allowance.

Comments that emerged from the round one rating survey demonstrated a concern that

services should consider those with special needs (e.g. those with dyslexia, autism, etc.).

Members of the PPI group thought that an additional question bank of four to five questions

specifically addressing special needs could be added onto a standard questionnaire. This

idea was explored in more depth during the cognitive testing phase of the project.

PPI group members offered valuable insight into the length of the patient insight survey and

how they thought it should be administered. Members agreed with the round one rating

survey results that the core survey should be no longer than 20 questions. However, they

agreed that they would not be opposed to having an additional question bank of four to five

questions asking about special needs and having a similar length question bank asking

specifically about carers. These question banks could be skipped for those who do not have

special needs or provide care for someone else.

PPI members also agreed that an online survey format would be best but that paper copies

should be available for those who are unable or do not wish to complete a survey online,

especially the elderly. Views were more mixed regarding when the patient insight should be

administered. Some participants thought that an annual survey would not capture enough

detail and that a survey should be emailed after individual visits to a service. Others thought

that the survey should be distributed every few weeks. This topic was further explored during

the round two rating survey and during cognitive testing.

Round Two Rating Survey

Overview

37 items were entered into a second round online questionnaire and reflected the

modifications and exclusions made during the PPI Advisory Group phase of the project

(Table 5). This survey was open for completion by Dorset staff, patients and members of the

public from 6-July to 12-August 2019. Dorset CCG publicised the survey via Twitter,

Facebook, email, intranet and the Dorset CCG website. In addition, previous round survey

participants and PPI Advisory group members who had indicated that they would like to

participate in future rounds of research were sent direct links to the survey.



1. There is a care plan in place that results in people feeling confident in managing their own health

2. Information is provided in a way that people can understand

3. Information is available about any risks linked to treatment, including side effects of medications

4. People know who to contact and where to go when they need support

5. People are as involved in discussions and decisions about their care, support and treatment as they want to be

6. People have the information and support to make decisions and choices about their care

7. Information is provided to people at the right time

8. There is a clear protocol in place should people have an emergency

9. If people have urgent needs, the service responds quickly

10. Health and social care needs are quickly identified

11. People have systems in place to get help at an early stage to avoid a crisis

12. People are referred as soon as possible

13. Information is translated into a language that people can understand

14. Health and social care providers provide people with consistent advice

15. The confidentiality of an individual’s record is protected

16. All the people involved in an individual’s care communicate well with each other

17. When a person moves in between services or settings, there is a plan in place for what happens next that is known to this person

18. Health and social care staff treat people with compassion and empathy

19. Health and social care staff listen to people and take their concerns seriously

20. Confidential discussions are held in private

21. People are never made to feel like they are wasting staff time

22. Health and social care staff treat people fairly

23. Health and social care staff understand that physical and mental health interact

24. Health and social services help the patient live the life they want

25. Transfers between care settings are not delayed

26. Unpaid carers’ opinions and experience are valued by health and social care staff

27. Discharge planning involves unpaid carers

28. Unpaid carers are informed about the condition and expected outcome of the person they are caring for as soon as possible with the permission of this person

29. Staff providing care explain information in a way that unpaid carers understand

30. The support an unpaid carer receives supports the carer’s emotional wellbeing

31. People trust the advice given to them by health and social care staff

32. An individual’s views are taken into account when deciding on a care plan and treatment

33. Care teams regularly review an individual’s care plan

34. People are given tailored health and care advice specific to their needs

35. Staff who co-ordinate care understand the individual and their conditions

36. Staff providing care have the necessary skills to give the required treatment

37. People can easily get to the health and care services they need

Aside from the reduction in number of items and combination of some statements, most

other elements of the questionnaire remained the same from the first round questionnaire.

Participants were asked to rank each item on a nine-point scale, with a rating of one

indicating that an item was not useful or important for measuring quality of care and a rating

on nine indicating that an item was highly useful or important for measuring quality of care

(as outlined in Figure 3 presented earlier in this report). Participants were asked the same

questions from the first round regarding their demographic information and how the

questionnaire should be administered.

Table 5. Included items in Round Two



A few modifications were made to reduce confusion on the purpose of the second round

rating survey. The language within the overview of the questionnaire and on the

informational landing page was tightened in order to clarify the exploratory nature of the

questionnaire and the fact that this was not the actual patient feedback questionnaire. In

addition, a reminder was added at the start of the rating items section to refresh participants

on the answer they had provided within the earlier questionnaire administration section on

the number of questions they thought a patient feedback survey should contain. This was in

attempt to encourage them not to rate every single item as highly important if they had only

indicated a specific number of questions to be included in a new patient survey.

Responses

In total, 66 responses to the second round survey were received (55 fully completed and 11

partially completed surveys). Following data cleaning, there were 61 useable cases.

Ineligible cases were removed along with cases in which participants did not complete a

sufficient number of questions in the survey. No cases needed to be removed due to data

quality. Although the total number of useable cases was lower in round two than in round

one (which had 135 useable cases). Possible explanations for the lower response rate

during round two could be due to:

misunderstandings on who could participate in the round two survey (although the

overview section of the questionnaire and informational landing page did explain that

those who participated in the first round could still participate in the second round)

the promotion of two other surveys by Dorset CCG at the same time

summer holiday by potential participants

Participants from round two accessed more services than those in round one (Figure 6).

However, in round one many people did not provide an answer – explaining the low base

size for Round 1 in Figure 6.

Total Respondents Round 1 n=19 Round 2 n=48

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Planned hospital services

Urgent and emergency care

Community health services

Mental health and learning disabilities services

Maternity, children's and family services

NHS continuing healthcare

GP Surgery

Have not accessed any services

What services have you accessed?

Round 1 Round 2

Figure 6: Types of services accessed, percentage of respondents



Demographics

Demographic information was similar across rounds one and two, with the exception of age.

In both rounds, the majority of participants were either patients or members of the public,

including carers (79% in both rounds one and two; Figure 7). Most participants were female

(77% in round one and 73% in round two) (Figure 8). The majority of participants were aged

55 and older in both rounds one and two (54% in round one and 62% in round two) (Figure

9). However, there was a much steeper decline in those aged 54 and younger in round two,

with no participants between the ages of 16-24.



0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Service user

Future service user

Informal carer

Voluntary group representative

Staff member

Are you primarily answering as a...?

Round 1 Round 2

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Female

Male

Prefer not to say

What is your gender?

Round 1 Round 2

Figure 7: Participant Type, percentage of respondents

Figure 8: Gender, percentage of respondents




The largest percentage of staff participants worked in Mid-Dorset in both rounds one and two

(52% in round one and 46% in round two) with fewer numbers working in Christchurch and

East Dorset (Figure 10).


Services accessed by patients and members of the public were similar across rounds, with

the largest fraction accessed in Poole (33% in round one and 45% in round two),

Bournemouth (21% in round one and 28% in round two) and Mid-Dorset (21% in round one

and 21% in round two) (Figure 11).

0% 10% 20% 30% 40% 50%

16-24

25-34

35-44

45-54

55-64

65+

How old are you?

Round 1 Round 2

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Bournemouth

Christchurch

East Dorset

Mid-Dorset

North Dorset

Poole

Purbeck

West Dorset

Weymouth and Portland

In what regions do you work?

Round 1 Round 2

Figure 9: Age, percentage of respondents

Figure 10: Regions in which staff worked, percentage of respondents




Full demographic results can be found in Appendix D: Round Two Demographic Results.

Results: Questionnaire Administration

Questions regarding how long a survey should be, at what point during care provision the

survey should be completed, and how the survey should be administered were carried over

from round one. Most round two participants thought that the survey should contain between

11 and 20 questions (57%), with a smaller fraction (26%) reporting that it should contain

between 6 and 10 questions, 2% did not provide a response. This is in line with round one

results in which 68% of participants thought that a survey should contain between 6 and 20

questions; 33% between 6 and 10; and 35% between 11 and 20, 17% did not provide a

response (Figure 12).


0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Bournemouth

Christchurch

East Dorset

Mid-Dorset

North Dorset

Poole

Purbeck

West Dorset


In what regions have you accessed services?

Round 1 Round 2

Figure 11: Regions in which services were accessed, percentage of respondents

Figure 12: Survey Length, percentage of respondents

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

1 and 5

6 and 10

11 and 20

21 and 30

31 and 40

41+

No response

How many questions should a survey contain?

Round 1 Round 2



When respondents were asked in a multi-response question when a survey should be

administered, nearly a half of respondents (49%) thought that it should be completed on an

annual basis and ask about care experiences as a whole. A smaller percentage thought that

it should be completed after contact with a service, asking only about that service (41%) or

after contact with a service, asking about experiences in the last number of months (41%).

This contrasts slightly with round one results in which 56% thought that the survey should be

completed after contact with a service, asking about experiences in the last number of

months and 44% thought that it should be completed on an annual basis (Figure 13).


Results regarding the mode of questionnaire administration were similar across round one

and round two (Figure 14). In a multi-response question, the largest proportion of

participants from both rounds thought that a survey link should be emailed to people for

online completion (88% and 85% in round one and two). A smaller fraction thought that

paper copies should be given out within services (56% and 58% in round one and two).


Full results can be found in Appendix E: Round Two Questionnaire Administration Results.

Figure 13: Administration, percentage of respondents

Figure 14: Survey Format, percentage of respondents

0% 20% 40% 60% 80% 100%

After contact with a service, asking only…

After contact with a service, asking about…

Annual basis, asking about all experiences

Invites sent to everyone who lives in Dorset

When should the questions be asked?

Round 1 Round 2

0% 20% 40% 60% 80% 100%

Paper copies given out within services

Paper copies posted to homes

Survey link emailed to people for online…

Survey link publicised to people for online…

Telephone Survey

Face to Face survey

Text message (SMS)

What format should be used?

Round 1 Round 2



Results: Rating Items

The exclusion criteria applied in round one was carried over to round two, whereby those

items that received a median (the middle value when scores are arranged from least to

greatest) score of less than nine were removed. In total, four items were excluded by this

criterion:

Information is translated into a language that people can understand

Health and social services help the patient live the life they want

Care teams regularly review an individual’s care plan

People are given tailored health advice specific to their needs

Three items pertaining to support for people who provide informal care received an overall

median score of less than nine. However, these were retained since the median score for

these items was nine in the sub group of people who answered the round two survey as an

informal carer.

The remaining 30 items all received median rating scores of nine and were, thus, retained.

Picker conducted further analysis to see if there were any differences between what patients

and members of the public reported as being highly useful and important versus what staff

reported. Staff results revealed that only six items met the inclusion criteria of having a

median score of nine:

People are as involved in discussions and decisions about their care, support and

treatment as they want to be

There is a clear protocol in place should people have an emergency

If people have urgent needs, the service responds quickly

Health and social care needs are quickly identified

Health and social care staff understand that physical and mental health interact

Staff providing care have the necessary skills to give the required treatment

Full rating results can be found in Appendix F: Round Two Rating Items Results.



Patient Insight Survey Development

The retained items from the round two rating survey were converted into patient experience

survey questions, drawing on Picker’s existing question bank and the questionnaire design

expertise of our researchers. Five of these items fall into a sub-section to be answered by

people who have provided informal care. Following review of the draft survey by Dorset

CCG, a few items were removed due to similarity with other questions. The core question set

consists of 18 items in total.

Full details on topic to question conversion are available in Appendix G: Topic to Question

Conversion.

Additional demographic items were created in the ‘About You’ sections of the questionnaire

to aide in later analysis, including questions concerning:

Services accessed

Regions where services were accessed

Age

Ethnicity

Gender

Time when services were last accessed

Frequency of services accessed

Long-term conditions

A quantitative survey was created to allow for ongoing monitoring, understanding change

over time and benchmarking across different services and patient demographics. Two open-

ended free text questions were included to capture positive and negative experiences with

overall care.

The initial draft survey used in cognitive interviews can be found in Appendix H: Draft Patient

Insight Questionnaire.

Cognitive Interviews

Cognitive interviews were conducted with 16 participants who had accessed health or social

care services in Dorset within the past six months. Cognitive testing involves running through

the questionnaire with members of the target group. Participants are asked to answer the

questions, thinking aloud as they answer to allow the researcher to explore their thought

processes and ask further questions. This allows researchers to understand and ensure

accurate comprehension and retrieval, evaluation and response.

Participant demographic information is provided below in Figure 15.



Figure 17: Services accessed by Cognitive Interview Participants (number/count is displayed)

0 2 4 6 8 10 12 14

Male

Female

Gender

0 1 2 3 4 5

16-19

20-24

25-34

35-44

45-54

55-64

65-74

75-84

85-94

95+

Age

0 2 4 6 8 10 12 14 16

Planned hospital services

Urgent and emergency care

Community health

Mental health and learning disabilities

Maternity, children's and family


GP Surgery

Local Social Care

Other

Services

Figure 15: Gender of Cognitive Interview Participants (number/count is displayed)

Figure 16: Age of Cognitive Interview Participants (number/count is displayed)



Participants varied in the number of services they had accessed within the past six months,

with some accessing only their GP Surgery and others accessing a range of services due to

a long-term condition or injury. Four participants had also provided informal care to a friend

or family member in the past six months.

The 16 cognitive interviews were conducted across three rounds, with evaluation of needed

changes and subsequent edits after every round. Changes made during this process are

noted below.

Cognitive Testing Changes

Round 1:

Front page: Added in pictures depicting how to complete the questionnaire on the front

cover page (e.g. boxes with crosses)

Question 12: Added in answer option “I had problems booking an appointment” to

question “Why have you not always been able to use the services you needed?”

Round 2:

Question 2: Names of major towns added to answer options for question “In what

regions of Dorset were these services accessed?”

Question 9: Answer options at question “Did you know what to do if you had an

emergency?” shortened into “Not applicable,” “Yes,” “No” and “Don’t know/can’t

remember”

Question 13: Deleted “written” from question about care plans

0 1 2 3 4 5 6 7

Bournemouth

Christchurch

East Dorset

Mid-Dorset

North Dorset

Poole

Purbeck

West Dorset


Regions

Figure 18: Locations where services were accessed by Cognitive Interview Participants (number/count is displayed)



Questions 21-23: Prefer not to say options added at questions asking for age, ethnicity

and gender

Questions 22-23: “Write in” replaced by “Please specify” at questions on ethnic

background and gender in order to ensure consistency across the questionnaire

Question 26: Long-standing illness answer option moved up higher in answer choices at

question “Do you have any of the following long-standing conditions?”

Minor grammatical changes made to descriptions at “About you” and “Your experiences

providing informal care to someone who uses services in Dorset”

Round 3:

Question 1:

- “Local social care” added as an option to question asking about services

accessed

Question 9:

- “Did you know what to do if you had an emergency?” changed to “If you had

an emergency in the past 6 months, did you know what to do?”

- Answer option “Not applicable” changed to “Not applicable/I did not have an

emergency in the past 6 months”

Question 26:

- “Do you have any of the following long-standing conditions?” changed to “Do

you have any of the following long-term conditions?”

- Answer options “A long-standing illness” and “A long-standing physical

condition” combined into answer option “A long-term illness or physical

condition (e.g. cancer, HIV, diabetes, chronic heart disease, epilepsy,

asthma, arthritis)”

- Answer option “I do not have a long-standing condition” changed to “I do not

have a long-term condition” to be in line with updated question text

- “A neurological condition” added as an answer choice as one participant

mentioned that those with autism or ADHD typically don’t classify these as

learning disabilities

Sub-Sections

The majority of cognitive testing participants mentioned that they would be open to

answering a subset of 5 questions regarding feedback on a specific service that they had

accessed, provided that these questions were focused. Participants were clear on the

carer’s sub-section of the questionnaire and understood when the section applied to them.



Administration

Most participants thought that the length of the questionnaire was fine, although it could

potentially be burdensome if they needed to complete it every time they accessed a service.

Participants mirrored preferences expressed in the online surveys and PPI group that the

survey should be available in both an online and hard copy format, with younger participants

preferring an online version and older participants preferring a hard copy version. The

majority of participants preferred to complete a patient insight survey either on an annual or

biannual basis.

The final patient insight survey is available in Appendix I: Final Patient Insight Questionnaire.

Suggested online routing instructions are available in Appendix J: Online Questionnaire

Routing.

Recommendations for Survey Implementation

Based on the insights gathered from all stages of this project, Picker make the following

recommendations to Dorset CCG for consideration when planning the implementation of

their new patient feedback survey.

Format/ Mode of Administration

Based on results of the two online surveys, PPI advisory group meeting and cognitive testing

results, Picker recommends that the patient insight survey be available in both online and

paper formats. The online format should be tested to ensure that the questionnaire can

easily be completed on both a web browser and a mobile phone. Dorset CCG may wish to

consider how the online survey interacts with reader apps used by those with limited sight.

Meanwhile, paper copies should be made available for those who prefer a hard copy. This

may be especially relevant for older people.

Frequency of Feedback Collection

In terms of frequency of administration, Picker recommends that the survey be administered

once or twice a year. This allows respondents enough time to fully evaluate aspects of their

integrated care and how their various care teams interacted while balancing respondent

recall of events. Furthermore, sufficient time should be considered for Dorset staff absorbing

results and identifying an initiating improvement activities based on the findings. Dorset CCG

should also consider when the NHS national patient surveys are being run in order to avoid

additional burden on potential survey respondents.

Survey Distribution

In terms of distribution, the majority of survey, PPI and cognitive testing participants

expressed a preference for receiving an email with a link to the online survey. Dorset CCG

could consider adding contact information within the survey invitation email for participants to

request to receive a paper version instead. This option may be the most cost-effective while

balancing respondent preference as printing, mailing and data entry costs would be

minimised. It does however rely on having accurate and up to date email addresses for

patients, and relies on patients regularly reading their emails.



While some concern was expressed during the cognitive interviews that older participants

may not be as responsive to online dissemination methods, Picker did receive the highest

proportion of online survey responses from those who were aged 65 and older. Although we

recognise that this might reflect the higher number of older people residing in Dorset, it does

indicate that older people are willing and able to respond to surveys in an online format.

Another option that was popular among survey and cognitive testing participants was

offering paper copies of the questionnaire within services. While this method may impose the

least burden on respondents since they can complete the questionnaire in the waiting room,

Picker advise that Dorset CCG consider the logistic and cost implications of this distribution

method. In addition, Dorset CCG may miss receiving responses from those with low care

utilisation or those who do not access services at the time that the survey is distributed.

Furthermore, it places some burden on staff or volunteers who are required to ensure

surveys are handed out, without bias, to all patients coming through their services, and that

completed surveys are collated and the data is entered accurately.

Balancing generalisability with service specificity

As previously mentioned, PPI advisory group and cognitive testing participants were open to

completing a small sub-section of service-specific questions in addition to the core

questionnaire asking about experiences across services, provided that they were focussed.

The two open questions in the “Your experiences as a whole” section may also provide

greater information on how certain services are performing. During cognitive testing, results

were mixed on whether more open questions were needed to gather this information. Some

participants thought that optional open questions should be added to end of each section or

at the end of the questionnaire asking about anything else the respondent would like to

share. Other participants thought that people might only express more negative or extreme

viewpoints with the addition of more open questions. Picker advise that Dorset CCG

consider the time and cost implications of adding more open questions due to the analysis

needed to examine them.

Other considerations

Finally, Dorset CCG may wish to consider future development of a carer’s version of the

overall questionnaire. This may be particularly relevant for evaluating paediatric, continuing

health and geriatric services in which there may be a high number of people providing care

for family members or friends.



Appendix A: Round One Survey Topics

Theme: Community-facing services and physical and environmental needs

o People can easily get to the health and care services they need. o People have access to a strong community health service. o A person can see a health or care professional when it works best for the person’s

schedule. o People don’t have to travel more than an hour to get to the service they want to use. o People have access to convenient public transportation options to attend health and

care services. o People have easy access to parking at health and care services. o People who use health and care services do not spend more days away from their

regular place of residence (home, care home, etc.) than they wish. o People who use health and care services feel secure in their living arrangements. o People are referred to appropriate services nearby when services are not available

locally.

Theme: Clear information and support for self-care

o There is a care plan in place for people who use health and social care services. o A person’s care plan results in them feeling confident in managing their own health. o People have the resources needed to help maintain their physical and mental health. o Information is available about any risks linked to treatment. o Information is available about side effects of medications. o Information is provided in a way that people can understand. o People know who to contact when they need support. o People know where to go to find out about NHS services in Dorset. o People know where to go to find out about support groups in Dorset. o Benefits and other social advice (e.g. housing) is available to people. o Patients can see their health and care records at any time, decide who to share them

with and correct any mistakes in the information.

Theme: Emotional support, empathy and respect

o People are treated with compassion and empathy. o People are treated seriously. o Health and social care staff listen to people’s concerns. o Health and social care staff treat each person as an individual. o Confidential discussions are held in private. o Health and social care staff treat people fairly. o Decisions to refuse treatment are respected, unless they endanger other people. o Religious and cultural beliefs are respected and accommodated, unless they violate

UK law. o Waiting rooms are suitable for health and social care needs (are accessible or have

sufficient privacy). o Health and social care professionals are flexible in their support when the needs of a

person change. o Health and social care professionals have a positive and friendly attitude. o People are never made to feel like they are wasting staff time.



Theme: Involvement of, and support for, family and carers (unpaid carers)

o Carers’ opinions and experience are valued by health and social care staff. o Discharge planning involves carers. o Carers are as involved as the person they are caring for wants - in discussions and

decisions about patient care, support, and treatment. o Carers are informed about the condition and expected outcome of the person they

are caring for as soon as possible with the permission of this person. o Services are available specifically for carers. o Carers receive as much support as they need. o Health care staff explain information in a way that carers understand. o A translator is provided for carers if needed. o The support a carer receives supports the carer’s emotional wellbeing. o The support a carer receives supports them in their role as a carer.

Theme: Fast access to reliable health advice

o The service of a person’s choice is available. o People can access the service of their choice in a timely manner. o If people have urgent needs, the service responds quickly. o People understand the advice given to them. o Health and social care needs are quickly identified. o People are referred as soon as possible. o People are given tailored health and care advice specific to their needs. o Information is provided to people at the right time. o People have systems in place to get help at an early stage to avoid a crisis.

Theme: Effective treatment delivered by trusted professionals

o Health and social services help the patient live the life they want. o People trust the advice given to them by health and social care staff. o Staff who co-ordinate care understand the individual and their conditions. o Staff providing care have the necessary skills to give the required treatment. o Health and social care staff understand that physical and mental health interact. o Care teams do not refer people to services with no therapeutic benefits. o Health and social care workers spend as much time with the patient as the patient

would like. o Care teams regularly review an individual’s care plan. o A person has no unmet healthcare needs.

Theme: Continuity of care and smooth transitions

o A single professional co-ordinates a person’s care. o Health and social care providers provide people with consistent advice. o Transfers between care settings are not delayed. o People can rebook with the same care provider for subsequent consultations. o Care providers initiate follow up appointments without people needing to ask. o The confidentiality of an individual’s record is protected. o People are informed about the reasons for their referrals. o Referral letters contain information that people can understand. o All the people involved in an individual’s care communicate well with each other. o There is a clear protocol in place should people have an emergency. o People do not need to repeat their history at each health or social care visit.



o When a person moves in between services or settings, there is a plan in place for what happens next that is known to this person.

o People are able to keep in contact with previous services/professionals.

Theme: Involvement in decisions and respect for preferences

o People are as involved in discussions and decisions about their care, support and treatment as they want to be.

o People have the information and support to make decisions and choices about their care.

o An individual’s views are taken into account when deciding on a care plan and treatment.

o Health and social care staff involve the individual in decisions about care. o People are offered the option of receiving care in their own home. o People can choose the gender of the health or social care professional they see. o Non-medical interventions, such as leisure activities, are provided as treatment

options. o Information is translated into a language that people can understand.



Appendix B: Round One Rating Items Results

Items chosen for inclusion into further rounds of research (n=50):

Clear information and support for self-care: 7 items

o A person's care plan results in them feeling confident in managing their own health. o Information is provided in a way that people can understand. o People know who to contact when they need support. o There is a care plan in place for people who use health and social care services. o Information is available about any risks linked to treatment. o Information is available about side effects of medications. o People know where to go to find out about NHS services in Dorset.

Emotional support, empathy and respect: 10 items

o People are treated with compassion and empathy. o People are treated seriously. o Health and social care staff listen to people's concerns. o Health and social care staff treat each person as an individual. o Confidential discussions are held in private. o Health and social care staff treat people fairly. o Health and social care professionals are flexible in their support when the needs of a

person change. o Health and social care professionals have a positive and friendly attitude. o People are never made to feel like they are wasting staff time. o Decisions to refuse treatment are respected, unless they endanger other people.

Involvement of, and support for, family and carers (unpaid carers): 5 items

o Discharge planning involves carers. o Carers are informed about the condition and expected outcome of the person they

are caring for as soon as possible with the permission of this person. o Health care staff explain information in a way that carers understand. o Carers’ opinions and experience are valued by health and social care staff. o The support a carer receives supports the carer's emotional well-being.

Fast access to reliable health advice: 7 items

o If people have urgent needs, the service responds quickly. o People understand the advice given to them. o Health and social care needs are quickly identified. o People are referred as soon as possible. o People are given tailored health and care advice specific to their needs. o People have systems in place to get help at an early stage to avoid a crisis. o Information is provided to people at the right time.

Effective treatment delivered by trusted professionals: 7 items

o Staff who co-ordinate care understand the individual and their conditions. o Staff providing care have the necessary skills to give the required treatment. o Health and social care staff understand that physical and mental health interact. o Health and social services help the patient live the life they want.



o People trust the advice given to them by health and social care staff. o Care teams do not refer people to services with no therapeutic benefits. o Care teams regularly review an individual's care plan.

Continuity of care and smooth transitions: 8 items

o Health and social care providers provide people with consistent advice. o The confidentiality of an individual's record is protected. o People are informed about the reasons for their referrals. o Referral letters contain information that people can understand. o All the people involved in an individual's care communicate well with each other. o There is a clear protocol in place should people have an emergency. o When a person moves in between services or settings, there is a plan in place for

what happens next that is known to this person. o Transfers between care settings are not delayed.

Involvement in decisions and respect for preferences: 5 items

o People are as involved in discussions and decisions about their care, support and treatment as they want to be.

o People have the information and support to make decisions and choices about their care.

o An individual's views are taken into account when deciding on a care plan and treatment.

o Health and social care staff involve the individual in decisions about care. o Information is translated into a language that people can understand.

Community-facing services and physical and environmental needs: 1 item

o People can easily get to the health and care services they need.

Items chosen for exclusion into further rounds of research (n=31):

Community-facing services and physical and environmental needs: 8 items

o People have access to a strong community health service. o A person can see a health or care professional when it works best for the person's

schedule. o People don't have to travel more than an hour to get to the service they want to use. o People have access to convenient public transportation options to attend health and

care services. o People have easy access to parking at health and care services. o People who use health and care services do not spend more days away from their

regular place of residence (home, care home, etc.) than they wish. o People who use health and care services feel secure in their living arrangements. o People are referred to appropriate services nearby when services are not available

locally.

Clear information and support for self-care: 4 items

o People have the resources needed to help maintain their physical and mental health. o People know where to go to find out about support groups in Dorset. o Benefits and other social advice (e.g. housing) is available to people.



o Patients can see their health and care records at any time, decide who to share them with, and correct any mistakes in the information.

Continuity of care and smooth transitions: 5 items

o A single professional co-ordinates a person's care. o People can rebook with the same care provider for subsequent consultations. o Care providers initiate follow up appointments without people needing to ask. o People do not need to repeat their history at each health or social care visit. o People are able to keep in contact with previous services/professionals.

Effective treatment delivered by trusted professionals: 2 items

o Health and social care workers spend as much time with the patient as the patient would like.

o A person has no unmet healthcare needs.

Emotional support, empathy and respect: 2 items

o Religious and cultural beliefs are respected and accommodated, unless they violate UK law.

o Waiting rooms are suitable for health and social care needs (are accessible or have sufficient privacy).

Fast access to reliable health advice: 2 items

o The service of a person's choice is available. o People can access the service of their choice in a timely manner.

Involvement in decisions and respect for preferences: 3 items

o People are offered the option of receiving care in their own home. o People can choose the gender of the health or social care professional they see. o Non-medical interventions, such as leisure activities, are provided as treatment

options.

Involvement of, and support for, family and carers (unpaid carers): 5 items

o Carers are as involved as the person they are caring for wants - in discussions and decisions about patient care, support, and treatment.

o Services are available specifically for carers. o Carers receive as much support as they need. o A translator is provided for carers if needed. o The support a carer receives supports them in their role as a carer.


P3261 | Dorset CCG Patient Insight | MB AJP JAM AT | 03 October 2019 | V1.8 [Protect]

Appendix C: PPI Ranking Results

Item

#


Ranking

Count of

Green

Dots

Count of

Blue

Dots

Eliminated

for Rd 2

Combined

with…

1 Emotional support,

empathy and respect

Health and social care professionals have a

positive and friendly attitude

1 1 0 1,2,3


empathy and respect

Health and social care staff treat each person

as an individual

1 3 0 1,2,3


empathy and respect

People are treated with compassion and

empathy

1 4 0 1,2,3


empathy and respect

People are treated seriously 1 1 0 4,7


empathy and respect

Confidential discussions are held in private 2 3 0


empathy and respect

People are never made feel like they are

wasting staff time

2 3 0


empathy and respect

Health and social care staff listen to people's

concerns

3 0 0 4,7


empathy and respect

Health and social care staff treat people fairly 3 0 0


empathy and respect

Health and social care professionals are

flexible in their support when the needs of a

person change

4 0 0 Yes


empathy and respect

Decisions to refuse treatment are respected,

unless they endanger other people

5 0 0 Yes

11 Clear information and


People know who to contact when they need

support

1 2 0

11, 14



A person's care plan results in them feeling

confident in managing their own health

2 3 0



Information is provided in a way that people

can understand

2 0 0

13, 27



Item

#


Ranking

Count of

Green

Dots

Count of

Blue

Dots

Eliminated

for Rd 2

Combined

with…



People know where to go to find out about

NHS services in Dorset

1 3 0

11, 14



There is a care plan in place for people who

use health and social care services

2 1 0



Information is available about any risks linked

to treatment

3 2 0

16, 17



Information is available about side effects of

medications

3 1 0

16, 17

18 Involvement of, and

support for, family and

carers (unpaid carers)

Discharge planning involves carers 2 4 0




Health care staff explain information in a way

that carers understand

2 3 0




Carers' opinions and experience are valued

by health and social care staff

1 5 0




Carers are informed about the condition and

expected outcome of the person they are

caring for as soon as possible with the

permission of this person

3 1 0




The support a carer receives supports the

carer's emotional well-being

2 4 0

23 Access to reliable advice

and services

If people have urgent needs, the service

responds quickly

1 1 0


and services

Health and social care needs are quickly

identified

2 1 0



Item

#


Ranking

Count of

Green

Dots

Count of

Blue

Dots

Eliminated

for Rd 2

Combined

with…


and services

People have systems in place to get help at

an early stage to avoid a crisis

1 5 0


and services

People are referred as soon as possible 2 3 0


and services

People understand the advice given to them 2 0 0

13, 27


and services

People are given tailored health and care

advice specific to their needs

2 2 0


and services

Information is provided to people at the right

time

2 1 0


and services

People can easily get to the health and care

services they need

3 0 0

31 Effective treatment

delivered by trusted

professionals

Staff who co-ordinate care understand the

individual and their conditions

3 2 0



professionals

Staff providing care have the necessary skills

to give the required treatment

2 4 0



professionals

Health and social care staff understand that

physical and mental health interact

1 4 0



professionals

Health and social services help the patient

live the life they want

3 0 0



professionals

People trust the advice given to them by

health and social care staff

2 2 0



professionals

Care teams do not refer people to services

with no therapeutic benefits

4 0 4 Yes



Item

#


Ranking

Count of

Green

Dots

Count of

Blue

Dots

Eliminated

for Rd 2

Combined

with…



professionals

Care teams regularly review an individual's

care plan

3 1 0

38 Continuity of care and

smooth transitions

Health and social care providers provide

people with consistent advice

2 4 0


smooth transitions

The confidentiality of an individual's record is

protected

4 1 0


smooth transitions

People are informed about the reasons for

their referrals

4 0 2 Yes


smooth transitions

Referral letters contain information that


4 0 0 Yes


smooth transitions

All the people involved in an individual's care

communicate well with each other

2 5 0


smooth transitions

There is a clear protocol in place should

people have an emergency

1 3 0


smooth transitions

When a person moves in between services

or settings, there is a plan in place for what

happens next that is known to this person

3 0 0


smooth transitions

Transfers between care settings are not

delayed

3 0 0

46 Involvement in decisions

and respect for

preferences

People are as involved in discussions and

decisions about their care, support and

treatment as they want to be

1 4 0


and respect for

preferences

People have the information and support to

make decisions and choices about their care.

1 1 0


and respect for

preferences

An individual's views are taken into account

when deciding on a care plan and treatment

2 4 0

48, 49



Item

#


Ranking

Count of

Green

Dots

Count of

Blue

Dots

Eliminated

for Rd 2

Combined

with…


and respect for

preferences

Health and social care staff involve the

individual in decisions about care

2 1 0

48, 49


and respect for

preferences

Information is translated into a language that


3 0 0



Appendix D: Round Two Demographic Results

(Note: cleaned results are shown below)

Are you primarily answering this as…?

Response N Percent

Someone who uses (or has recently used) health and/or care services in

Dorset

39 63.9

Someone who may use health and/or care services in Dorset in the

future

1 1.6

A carer of someone who uses health and/or care services in Dorset 8 13.1

A representative on behalf of a voluntary group/organisation 3 4.9

A staff member working in the NHS or local authorities in Dorset 10 16.4

Total 61

How old are you?

Response N Percent

Under 16 - -

16-24 years - -

25-34 years 7 11.5

35-44 years 9 14.8

45-54 years 7 11.5

55-64 years 20 32.8

65+ years 18 29.5

Prefer not to say - -

Total 61

What is your gender?

Response N Percent

Female 44 72.1

Male 16 26.2

Prefer not to say - -

Prefer to self-describe - -

Not answered 1 1.6

Total 61



NHS/Local Authority Staff Only:

In what regions of Dorset do you practice/work? (Multi-select)

Response N Percent of

respondents

Bournemouth 4 30.8

Christchurch 2 15.4

East Dorset 5 38.5

Mid-Dorset 6 46.2

North Dorset 3 23.1

Poole 5 38.5

Purbeck 4 30.8

West Dorset 4 30.8

Weymouth and Portland 4 30.8

I do not practice in Dorset - -

Total Respondents 13

What is your profession?

Response N Percent

Allied health professional - -

Ambulance service - -

Commissioning manager/support staff 3 25.0

Doctor - Consultant - -

Doctor - GP - -

Doctor - Junior - -

Dentist - -

General NHS manager/support staff 3 25.0

Healthcare assistant 2 16.7

Nurse 2 16.7

Midwife - -

Public health - -

Practice manger - -

Social care manager/support staff - -

Social worker - -

Other (please state)* 2 16.7


*Other: retired public sector accountant; retired university lecturer

Do you have face-to-face contact with patients?

Response N Percent

Yes, frequently 4 30.8

Yes, occasionally 4 30.8

No 5 38.5




How many years have you been working in Dorset health and/or care services?

Response N Percent

Less than 1 year - -

1-2 years 1 8.3

2-5 years 1 8.3

5-10 years 3 25.0

11 years or more 7 58.3


Patients/Members of the Public Only:

In which county do you live? (If you are an unpaid carer of someone who uses health and/or

care services – please indicate the county that the person you provide care for lives).

Response N Percent

Dorset 48 100.0

Hampshire - -

Wiltshire - -

Somerset - -

Devon - -

None of these - -

Total 48

In what regions of Dorset have you accessed health and/or social care services? (Please

indicate this for the person you care for – if you are an unpaid carer). (Multi-response)

Response N Percent

Bournemouth 13 27.7

Christchurch 4 8.5

East Dorset 5 10.6

Mid-Dorset 10 21.3

North Dorset 8 17.0

Poole 21 44.7

Purbeck 8 17.0

West Dorset 8 17.0

Weymouth and Portland 6 12.8

Have not accessed health or care services in Dorset - -




What services have you accessed in the past year? (Please indicate those services the

person you care for has accessed – if you are an unpaid carer). (Multi-response)

Response N Percent

Planned hospital services (e.g. day surgery, outpatient appointment) 30 62.5

Urgent and emergency care, including 111 service and minor injuries

unit

16 33.3

Community health services (e.g. physiotherapy, podiatry, community

nursing)

16 33.3

Mental health and learning disabilities services 12 25.0

Maternity, children’s and family services 3 6.3

NHS continuing healthcare 6 12.5

GP surgery (GP/family doctor or practice nurse) 45 93.8

Have not accessed any services in the past year 1 2.1

Total 48



Appendix E: Round Two Questionnaire Administration Results


How many questions do you think a survey should contain?

Response N Percent

Between 1 and 5 4 6.6





41 or more 1 1.6

Missing 1 1.6

Total 61

When should we ask people to complete the feedback questionnaire? Please select all that

you think should be used. (Multi-select).

Response N Percent

After contact with a health or care service, asking only about that service

(e.g. after a GP appointment, asking about that appointment)

24 40.7

After contact with a health or care service, asking about experiences in

the last number of months (e.g. after a hospital visit, asking about all

healthcare)

24 40.7

Invites sent to people who have contacted any service in the previous 12

months asking about experience as a whole

29 49.2

Invites sent to people who live in Dorset (regardless of whether they

have used services recently) asking about health or care experiences

7 11.9


Please describe any other option that you think should be considered (free text write-in).

Better after an experience so you can get the whole picture of that intervention

Experience of getting help in an emergency/urgent situation

It may be very difficult to achieve, but an immediate survey followed up 12 months later

would probably be optimum

Options given for those of us using services ourselves as well as in our caring role



What format should be used to ask the questions? Please select all that you think should be

used. (Multi-select)

Response N Percent

Paper copies given out within the services 34 57.6

Paper copies posted to peoples’ homes 14 23.7

Survey link emailed to people for online completion 50 84.7

A survey link publicised (e.g. using leaflets or posters) for online

completion

14 23.7

Telephone survey 7 11.9

Face 9 15.3

SMS 16 27.1


Please describe any other option that you think should be considered (free text write-in).

Depends on age of participant and access to IT

I don’t use/understand social media but I think that SMS would probably catch a lot of

younger people

I think each individual should have a choice

If you wish to achieve the widest coverage a selection of methods would be required

rather than just one

Smart phones easy to use for online completion

Please use this space to suggest other important topics that you think we missed, verbatim

quotes.

There is nowhere to provide details of more than one person who is accessing services

in a household. Yet in my household there are four of us so I never know which one to

answer for.

Written information is always made available before treatment commences and a

summary of outcomes and decisions given to patients post meetings/ discharge is very

important.

Mental Health services given a higher priority and more funding - the service in my area

is very poor and totally over stretched.

Retired nurse working in hospital & community setting, the NHS has had to change &

adapt to meet depends put upon it. Peoples expectations have increased, unfortunately

the funding for everything is not there. Difficult choices & decisions have to be made,

not always what patients & relatives want .Sadly the NHS is not a bottomless pot of

money, perhaps costings of treatment could be made more available to the public,

Audiology services should be boosted with more appointments at Victoria Hospital.

Fortunately I can drive, so if I have a problem with my hearing aids I can go over to the

walk in at Boscombe. Otherwise I would have to wait 4-6 weeks for an appointment at

Victoria Hospital!! How about a walk in centre at Victoria Hospital or somewhere with

easy access in East Dorset?



In your surveys, you have an “age range” questionnaire. It does make anyone over 65

feel valued to be all lumped together in one category, where the younger people’s

categories are subdivided. People over 65 vary just as much in their needs and

requirements as younger ones. Also, “gender” is not, as you should already know, a

posh name for “sex”. Sex is a biological fact, gender a social construct.

Is there any question about what a person can do if they want to complain about the

service/care they have received?

In general, I think it is more likely that people will complete surveys containing 6-10

questions. However, there may be some situations where it is appropriate to ask more

questions - eg when undertaking a survey of patients’ experiences of being discharged

from hospital. Some of the suggested items would need to be directed at the patient’s

carer, rather than the patient (eg where patient is a child or is an older person) - and

perhaps should be part of a separate Carers Survey Some of the items overlap and/or

cover similar issues - and could potentially be combined into one question. Although

important for the quality of the service, I don't think it is appropriate to be asking patients

whether they think staff have the appropriate skills, qualifications, etc.

Questions must be more tailored to the very specific services offered! So many specific

improvements could be made to EPAC but they are so niche.

Maternity services are not linked. So much so you have to take your notes to every

appointment. The midwife or professional cannot prepare for your appointment and you

need to wall around with a pack saying your pregnant when you go to collect it. Some

people may want that information to remain confidential. When I went to my gp to

confirm I was pregnant they didn't know how you picked up the pack. In the end I had to

call a midwife after the receptionist gave me a number. I live in a small community so I

had to then discuss my pregnancy with the receptionist. Everyone in the waiting room

could hear my discussion, someone I know from work was sat in there. Although my

pregnancy was planned I was not ready for the wider community to know about it at that

point. Could the system be made more coherent so you can pick your pack up at the

gp? Or maybe you dont need to carry your notes around for 9 months.

Right care, right time. A joined up health/care service to ensure a clear patient pathway

ensuring key services in the community are developed over time.

Being able to get an appointment to see a practitioner is really important to people.

Plus something about people who do not attend appointments, because these are

“wasted” opportunities for other patients to have one.



Appendix F: Round Two Rating Items Results


Please rate each item, using the scale 1 (not useful and important for quality of care) to 9

(highly useful and important for quality of care).

Topic

There is a care plan in place that results in people feeling

confident in managing their own health 9.00 7.00 9.00

Information is provided in a way that people can understand 9.00 8.00 9.00

Information is available about any risks linked to treatment,

including side effects of medications 9.00 7.00 9.00

People know who to contact and where to go when they need

support 9.00 8.00 9.00

People are as involved in discussions and decisions about

their care, support and treatment as they want to be 9.00 8.00 9.00

People have the information and support to make decisions

and choices about their care 9.00 8.00 9.00

Information is provided to people at the right time 9.00 7.00 9.00

There is a clear protocol in place should people have an

emergency 9.00 9.00 9.00

If people have urgent needs, the service responds quickly 9.00 9.00 9.00

Health and social care needs are quickly identified 9.00 8.00 9.00

People have systems in place to get help at an early stage to

avoid a crisis 9.00 8.00 9.00

People are referred as soon as possible 9.00 8.00 9.00

Information is translated into a language that people can

understand 8.00 7.00 9.00

Health and social care providers provide people with

consistent advice 9.00 7.00 9.00

The confidentiality of an individual’s record is protected 9.00 8.00 9.00

All the people involved in an individual’s care communicate

well with each other 9.00 8.00 9.00

When a person moves in between services or settings, there

is a plan in place for what happens next that is known to this

person

9.00 8.00 9.00

Health and social care staff treat people with compassion and

empathy 9.00 8.00 9.00

Health and social care staff listen to people and take their

concerns seriously 9.00 8.00 9.00

Confidential discussions are held in private 9.00 8.00 9.00

People are never made to feel like they are wasting staff time 9.00 6.00 9.00

Health and social care staff treat people fairly 9.00 7.25 9.00

Health and social care staff understand that physical and

mental health interact 9.00 8.00 9.00

Health and social services help the patient live the life they

want 8.00 7.00 9.00



Topic Median 25th

percentile

75th

percentile

Transfers between care settings are not delayed 9.00 8.00 9.00

Unpaid carers’ opinions and experience are valued by health

and social care staff 8.00 7.00 9.00

Discharge planning involves unpaid carers 9.00 7.00 9.00

Unpaid carers are informed about the condition and expected

outcome of the person they are caring for as soon as possible

with the permission of this person

8.00 7.00 9.00

Health care staff explain information in a way that unpaid

carers understand 9.00 7.00 9.00

The support an unpaid carer receives supports the carer’s

emotional wellbeing 8.00 7.00 9.00

People trust the advice given to them by health and social

care staff 9.00 7.00 9.00

An individual’s views are taken into account when deciding on

a care plan and treatment 9.00 8.00 9.00

Care teams regularly review an individual’s care plan 8.00 8.00 9.00

People are given tailored health and care advice specific to

their needs 8.00 8.00 9.00

Staff who co-ordinate care understand the individual and their

conditions 9.00 8.00 9.00

Staff providing care have the necessary skills to give the

required treatment 9.00 8.00 9.00

People can easily get to the health and care services they

need 9.00 7.00 9.00



Appendix G: Topic to Question Conversion

Information

Topic Question(s) Question Type #

Information is provided in a way that people can understand.

Was information provided to you in a way that you could understand?

Multiple choice, single response

3

Information is available about any risks linked to your treatment, including side effects of medications.

Did you receive enough information about risks linked to your treatment, including the side effects of any medications?


4

People have the information and support to make decisions and choices about their care.

Did you have enough information and support to make decisions and choices about your care?


5



Health and Social Care Staff


Health and social care providers provide people with consistent advice.

How often, if at all, did each of the following happen?

I received conflicting information/advice from care staff.

Grid 6a

Health and social care staff treat people with compassion and empathy.


I was treated with compassion and empathy by staff.

Grid 6b

Health and social care staff listen to people and take their concerns seriously.


My concerns were taken seriously by staff.

Grid 6d

Health and social care staff treat people fairly. How often, if at all, did each of the following happen?

I was treated fairly by staff.

Grid 6e

Health and social care staff understand that physical and mental health interact.

To what extent did staff consider your mental and physical health?


7

Staff providing care have the necessary skills to give the required treatment.


I had confidence and trust in the staff treating me

Grid 6c

People trust the advice given to them by health and social care staff.


I had confidence and trust in the staff treating me

Grid 6c

People are never made to feel like they are wasting staff time.

Question deleted as questions 6e and 6d would already indicate this



Access

Care Plans


People know who to contact and where to go when they need support.

Did you know who to contact and where to go for support? Multiple choice, single response

8

There is a clear protocol in place should people have an emergency.

Did you know what to do if you had an emergency? Multiple choice, single response

9

If people have urgent needs, the service responds quickly.

Did health and/or social care services respond quickly to your urgent needs?


10

Health and social care needs are quickly identified. Question deleted due to similarity with question 10

People have systems in place to get help at an early stage to avoid a crisis.

Question deleted due to similarity with questions 8 and 9

People are referred as soon as possible. Why have you not always been able to use the services you needed?

Multiple choice, multiple response

12

People can easily get to the health and care services they need.

Over the last six months, have you been able to use the services you needed?


11


There is a care plan in place that results in people feeling confident in managing their own health.

Do you have a written care plan?

Does having a care plan leave you feeling confident that you can manage your own health?


13

14

People are as involved in discussions and decisions about their care, support and treatment as they want to be.

Were you involved in discussions and decisions about your care plan?


15

An individual’s views are taken into account when deciding on a care plan and treatment.

Question deleted due to similarity with question 15



Privacy

Integrated Services


The confidentiality of an individual’s record is protected.

Did you feel that your personal details and care records were securely stored?


16

Confidential discussions are held in private. Were you given enough privacy when discussing your condition or treatment?


17


All the people involved in an individual’s care communicate well with each other.


All of the people involved in my care communicated well with each other.

Grid 18a

When a person moved in between services or settings, there is a plan in place for what happens next that is known to this person.


There was a plan in place that I knew about when I moved in between services or settings.

Grid 18b

Staff who co-ordinate care understand the individual and their conditions.


The staff who co-ordinated my care understood me and my conditions.

Grid 18c



Your experiences providing informal care to someone who uses services in Dorset


Unpaid carers’ opinions and experiences are valued by health and social care staff.

Did you feel that your opinion as a carer was valued by staff? Multiple choice, single response

C2

Discharge planning involves unpaid carers. Were you involved in any discharge planning? Multiple choice, single response

C3

Unpaid carers are informed about the condition and expected outcome of the person they are caring for as soon as possible with the permission of this person.

Have you been informed about the condition, treatments and expected outcomes of the person you provide care for in a timely manner?


C4

The support an unpaid carer receives supports the carer’s emotional wellbeing.

Have you been offered support for your emotional wellbeing as a carer?


C5

Staff providing care explain information in a way that unpaid carers understand.

Did staff talk to you about the person you provide care for in a way that you could understand?


C1



Appendix H: Draft Patient Insight Questionnaire

Our Dorset Patient Insight Survey

Your experience matters, please tell us what your care is like.

This questionnaire is about your experiences of care as a patient who has accessed health or

social care services in Dorset.

Results from the survey will be used to support system transformation, service design, service

evaluation, and quality improvement.

How to complete the questionnaire:

The questionnaire should take 15 minutes to complete.

For most questions, please cross clearly inside one box using a black or blue pen.

For some questions, you may be asked to cross more than one box.

If you make a mistake, just fill in the box and put a cross in the correct box.

If you cannot answer a question, or do not want to answer it, just leave it blank and go to

the next question.

Please answer all questions for the time frame indicated at the top of each section (e.g. the past 6

months) and in consideration of all services you have accessed in Dorset during this period.

Please remember not to write your name or address anywhere on the questionnaire.

Taking part in this survey is voluntary. Your answers will be treated in confidence and will not affect

the care you receive.



About you

1. What services have you accessed in Dorset over the past 6 months? (Select all that

apply)

Planned hospital services (e.g. day surgery, outpatient appointment, hospital

admission for one or more nights)

Urgent and emergency care, including the 111 service and minor injuries unit

Community health services (e.g. physiotherapy, podiatry, community nursing)


Maternity, children’s and family services


GP Surgery (GP/family doctor or practice nurse)

Other, Please specify:

2. In what regions of Dorset were these services accessed? (Select all that apply)

Bournemouth

Christchurch

East Dorset

Mid-Dorset

North Dorset

Poole

Purbeck

West Dorset


Information

Thinking about the care you have received over the last 6 months across all Dorset

services (not just your most recent care)…

3. Was information provided to you in a way that you could understand?

Yes, definitely

Yes, to some extent

No

Don’t know/can’t remember



4. Did you receive enough information about risks linked to your treatment, including the

side effects of any medications?

Yes, enough information

Some, but not enough information

No information at all, but I wanted some

I did not want or need any information

Not applicable/I did not receive any treatments or medication


5. Did you have enough information and support to make decisions and choices about

your care?

Yes, definitely

Yes, to some extent

No and I would have liked this

No, but I did not need this





6. How often, if at all, did each of the following happen? (Please select one answer from

each row).

Always Mostly Sometimes Rarely Never Not

applicable

Don’t know/

can’t

remember

a. I received conflicting

information/advice from

care staff.

b. I was treated with

compassion and

empathy by staff.

c. I had confidence and

trust in the staff treating

me.

d. My concerns were

taken seriously by staff.

e. I was treated fairly by

staff.



7. To what extent did staff consider your mental and physical health?

A great deal

To some extent

Not very much

Not at all

I did not want or need this


Access



8. Did you know who to contact and where to go for support?

Yes, definitely

Yes, to some extent


No, but I did not need support


9. Did you know what to do if you had an emergency?

Not applicable

Yes, definitely

Yes, to some extent

No and I wanted this



10. Did health and/or social care services respond quickly to your urgent needs?

Yes, definitely

Yes, to some extent

No

Not applicable/I did not have any urgent care needs


11. Over the last six months, have you been able to use the services you needed?

Yes, always GO TO QUESTION 13

Yes, sometimes GO TO QUESTION 12

No GO TO QUESTION 12



12. Why have you not always been able to use the services you needed? (Select all that

apply).

I did not get referred

I am waiting to be referred

I could not get an appointment at a time that suited me

I had to wait too long to get an appointment

I was not able to travel to the service(s)

I experienced physical access issues (e.g. needing to phone to confirm an

appointment with hearing loss; needing ramps to get into a building; needing

large print to read an appointment letter; etc.)

Other (Please specify)

Care Plans

13. Do you have a written care plan? A care plan is an agreement between you and your

health and care staff to help you manage your health day-to-day. Not everyone may

have a care plan. These are typically issued to patients with complex or long-term

conditions.

Yes GO TO QUESTION 14


Don’t know/not sure GO TO QUESTION 17

14. Does having a care plan leave you feeling confident that you can manage your own

health?

Yes, definitely

Yes, to some extent

No

Don’t know/not sure

15. Were you involved in discussions and decisions about your care plan?

Yes, definitely

Yes, to some extent

No and I would have liked to be involved

No, but I did not want/need to be involved




Privacy



16. Did you feel that your personal details and care records were securely stored?

Yes, definitely

Yes, to some extent

No


17. Were you given enough privacy when discussing your condition or treatment?

Yes, always

Yes, sometimes

No


Integrated Services



18. How often, if at all, did the following happen? (Please select one answer from each

row)


applicable

Don’t

know/

can’t

remember

a. All of the people involved in

my care communicated well

with each other.

b. There was a plan in place

that I knew about when I

moved in between services or

settings.

c. The staff who co-ordinated

my care understood me and

my conditions.



Your experiences as a whole

19. Is there anything particularly good about the care you have received in Dorset that

you wish to share?

20. Is there anything that could be improved about the care you have received in Dorset?

About you

This information will not be used to identify you. We use it monitor whether different people

are having different experiences of NHS services.

21. How old are you?

16-19 years

20-24 years

25-34 years

35-44 years

45-54 years

55-64 years

65-74 years

75-84 years

85-94 years

95+ years



22. Which of these best describes your ethnic background?

White or White British (English, Welsh, Scottish, Northern Irish, Irish, Gypsy

or Irish Traveller, any other White background)

Mixed or multiple ethnic groups (White and Black Caribbean, White and

Black African, White and Asian, any other mixed or multiple ethnic

background)

Asian or Asian British (Indian, Pakistani, Bangladeshi, Chinese, any other

Asian background)

Black or Black British (African, Caribbean, any other Black background)

Any other ethnic group (write in)

23. What is your gender?

Male

Female

Prefer to self-identify (write in)

24. When did you last use health or social care services in Dorset?

In the last week

In the last month

In the last 3 months


More than 6 months ago

Don’t remember

25. How many times did you access services in Dorset over the past 6 months?

1-2 times

3-4 times

5-10 times

11-15 times

Over 15 times

26. Do you have any of the following long-standing conditions? (Select all that apply)

I do not have a long-standing condition

Deafness or severe hearing impairment

Blindness or partially sighted

A long-standing physical condition

A learning disability

A mental health condition

A long-standing illness, such as cancer, HIV, diabetes, chronic heart disease

or epilepsy




Your experiences providing informal care to someone who uses services

in Dorset

Please answer this section if you have provided informal care to someone who has

accessed health and/or social care services in Dorset over the past 6 months. An informal

carer is anyone who provides unpaid care or receives a carer’s allowance for a family

member or friend. This includes care of a child.

If you are not a carer, or the person that you care for has not accessed care in over the past

6 months, please skip this section.

If you provide care to more than one person who has received care over the last 6 months,

please answer based on your overall experience of care services in Dorset during this time.

C1. Did staff talk to you about the person you provide care for in a way that you could

understand?

Yes, definitely

Yes, to some extent




C2. Did you feel that your opinion as a carer was valued by staff?

Yes, definitely

Yes, to some extent




C3. Were you involved in any discharge planning for the person you care for? This could

include discharge from inpatient services or discharge from longer term care (e.g.

services provided in the community).

Yes, definitely

Yes, to some extent

No and I wanted to be involved


Not applicable




C4. Have you been informed about the condition, treatments and expected outcomes of

the person you provide care for in a timely manner?

Yes, definitely

Yes, to some extent




C5. Have you been offered support for your emotional wellbeing as a carer?

Yes, definitely

Yes, to some extent


No, but I did not want/need this


THANK YOU VERY MUCH FOR YOUR HELP

Please check that you answered all the questions that apply to you.

For more information about the Dorset Integrated Care System and your care, please

contact your GP or Our Dorset at:

Tel: 01202 541946 Email: [email protected]

Website: https://ourdorset.nhs.uk/contact/


P3261 | Dorset CCG Patient Insight | MB AJP JAM AT | 03 October 2019 | V1.8 {Protect]

Appendix I: Final Patient Insight Questionnaire

Our Dorset Patient Insight Survey

Your experience matters, please tell us what your care is like.

This questionnaire is about your experiences of care as a patient who has accessed health or

social care services in Dorset.

Results from the survey will be used to support system transformation, service design, service

evaluation, and quality improvement.

How to complete the questionnaire:

The questionnaire should take 15 minutes to complete.

For most questions, please cross clearly inside one box using a black or blue pen.

For some questions, you may be asked to cross more than one box.

If you make a mistake, just fill in the box and put a cross in the correct box

If you cannot answer a question, or do not want to answer it, just leave it blank and go to

the next question.

Please answer all questions for the time frame indicated at the top of each section (e.g. the past 6

months) and in consideration of all services you have accessed in Dorset during this period.

Please remember not to write your name or address anywhere on the questionnaire.

Taking part in this survey is voluntary. Your answers will be treated in confidence and will not affect

the care you receive.



About you

1. What services have you accessed in Dorset over the past 6 months? (Select all that

apply)

Planned hospital services (e.g. day surgery, outpatient appointment, hospital

admission for one or more nights)

Urgent and emergency care, including the 111 service and minor injuries unit

Community health services (e.g. physiotherapy, podiatry, community nursing)


Maternity, children’s and family services


Local social care

GP Surgery (GP/family doctor or practice nurse)


2. In what regions of Dorset were these services accessed? (Select all that apply)

Bournemouth

Christchurch

East Dorset (includes Wimborne Minster)

Mid-Dorset (includes Dorchester)

North Dorset (includes Sherborne, Blandford Forum, Shaftesbury, Gillingham)

Poole

Purbeck (includes Bere Regis, Wareham, Swanage)

West Dorset (includes Lyme Regis, Bridport)


Information



3. Was information provided to you in a way that you could understand?

Yes, definitely

Yes, to some extent

No




4. Did you receive enough information about risks linked to your treatment, including the

side effects of any medications?

Yes, enough information

Some, but not enough information

No information at all, but I wanted some

I did not want or need any information

Not applicable/I did not receive any treatments or medication


5. Did you have enough information and support to make decisions and choices about

your care?

Yes, definitely

Yes, to some extent







6. How often, if at all, did each of the following happen? (Please select one answer from

each row).


applicable

Don’t know/

can’t

remember

a. I received conflicting

information/advice from

care staff.

b. I was treated with

compassion and

empathy by staff.

c. I had confidence and

trust in the staff treating

me.

d. My concerns were

taken seriously by staff.

e. I was treated fairly by

staff.



7. To what extent did staff consider your mental and physical health?

A great deal

To some extent

Not very much

Not at all

I did not want or need this


Access



8. Did you know who to contact and where to go for support?

Yes, definitely

Yes, to some extent


No, but I did not need support


9. If you had an emergency in the past 6 months, did you know what to do?

Not applicable/I did not have an emergency in the past 6 months

Yes

No


10. Did health and/or social care services respond quickly to your urgent needs?

Yes, definitely

Yes, to some extent

No

Not applicable/I did not have any urgent care needs


11. Over the last six months, have you been able to use the services you needed?

Yes, always GO TO QUESTION 13

Yes, sometimes GO TO QUESTION 12




12. Why have you not always been able to use the services you needed? (Select all that

apply).

I did not get referred

I am waiting to be referred

I had problems booking an appointment

I could not get an appointment at a time that suited me

I had to wait too long to get an appointment

I was not able to travel to the service(s)

I experienced physical access issues (e.g. needing to phone to confirm an

appointment with hearing loss; needing ramps to get into a building; needing

large print to read an appointment letter; etc.)


Care Plans

13. Do you have a care plan? A care plan is an agreement between you and your health

and care staff to help you manage your health day-to-day. Not everyone may have a

care plan. These are typically issued to patients with complex or long-term

conditions.

Yes GO TO QUESTION 14


Don’t know/not sure GO TO QUESTION 16

14. Does having a care plan leave you feeling confident that you can manage your own

health?

Yes, definitely

Yes, to some extent

No

Don’t know/not sure

15. Were you involved in discussions and decisions about your care plan?

Yes, definitely

Yes, to some extent

No and I would have liked to be involved





Privacy



16. Did you feel that your personal details and care records were securely stored?

Yes, definitely

Yes, to some extent

No


17. Were you given enough privacy when discussing your condition or treatment?

Yes, always

Yes, sometimes

No


Integrated Services



18. How often, if at all, did the following happen? (Please select one answer from each

row)


applicable

Don’t

know/

can’t

remember

a. All of the people

involved in my care

communicated well

with each other.

b. There was a plan in

place that I knew

about when I moved in

between services or

settings.

c. The staff who co-

ordinated my care

understood me and my

conditions.



Your experiences as a whole

19. Is there anything particularly good about the care you have received in Dorset that

you wish to share?

20. Is there anything that could be improved about the care you have received in Dorset?

About you

This information will not be used to identify you. We use it to monitor whether different

people are having different experiences of NHS services.

21. How old are you?

16-19 years

20-24 years

25-34 years

35-44 years

45-54 years

55-64 years

65-74 years

75-84 years

85-94 years

95+ years

Prefer not to say



22. Which of these best describes your ethnic background?

White or White British (English, Welsh, Scottish, Northern Irish, Irish, Gypsy

or Irish Traveller, any other White background)

Mixed or multiple ethnic groups (White and Black Caribbean, White and

Black African, White and Asian, any other mixed or multiple ethnic

background)

Asian or Asian British (Indian, Pakistani, Bangladeshi, Chinese, any other

Asian background)

Black or Black British (African, Caribbean, any other Black background)

Any other ethnic group (Please specify)

Prefer not to say

23. What is your gender?

Male

Female

Prefer to self-identify (Please specify)

Prefer not to say

24. When did you last use health or social care services in Dorset?

In the last week

In the last month



More than 6 months ago

Don’t remember

25. How many times did you access services in Dorset over the past 6 months?

1-2 times

3-4 times

5-10 times

11-15 times

Over 15 times



26. Do you have any of the following long-term conditions? (Select all that apply)

I do not have a long-term condition

Deafness or severe hearing impairment

Blindness or partially sighted

A long-term illness or physical condition (e.g. cancer, HIV, diabetes, chronic

heart disease, epilepsy, asthma, arthritis)

A learning disability

A neurological condition

A mental health condition


Your experiences providing informal care to someone who uses services

in Dorset

Please answer this section if you have provided informal care to someone who has

accessed health and/or social care services in Dorset over the past 6 months. An informal

carer is anyone who provides unpaid care or receives a carer’s allowance for a family


If you are not a carer, or the person that you care for has not accessed care in the past 6

months, please skip this section.

If you provide care to more than one person who has received care over the last 6 months,

please answer based on your overall experience of care services in Dorset during this time.

C1. Did staff talk to you about the person you provide care for in a way that you could

understand?

Yes, definitely

Yes, to some extent




C2. Did you feel that your opinion as a carer was valued by staff?

Yes, definitely

Yes, to some extent






C3. Were you involved in any discharge planning for the person you care for? This could

include discharge from inpatient services or discharge from longer term care (e.g.

services provided in the community).

Not applicable

Yes, definitely

Yes, to some extent

No and I wanted to be involved



C4. Have you been informed about the condition, treatments and expected outcomes of

the person you provide care for in a timely manner?

Yes, definitely

Yes, to some extent




C5. Have you been offered support for your emotional wellbeing as a carer?

Yes, definitely

Yes, to some extent


No, but I did not want/need this


THANK YOU VERY MUCH FOR YOUR HELP

Please check that you answered all the questions that apply to you.

For more information about the Dorset Integrated Care System and your care, please

contact your GP or Our Dorset at:

Tel: 01202 541946 Email: [email protected]

Website: https://ourdorset.nhs.uk/contact/



Appendix J: Online Questionnaire Routing

Should Dorset CCG wish to create an online survey version of the final questionnaire, Picker

recommends the following instructions to ease completion.

Question Format:

Change answer options at Q2 (In what regions of Dorset were these services

accessed?) to an interactive map in which respondents can click on the regions

displayed

Question Routing:

: Skip (do not display) Q9 if urgent and emergency care is not chosen at Q1.

- Change wording of Q9 to ‘Did you know what to do when you had an

emergency?’

- Change answer options to:

Yes

No


Program routing mentioned at Q11 into online questionnaire

Program routing mentioned at Q13 into online questionnaire

Replace introductory text of carer’s sub-section with question:

- Have you provided informal care for someone who has accessed health or

care services in Dorset in the past 6 months? An informal carer is anyone

who provides unpaid care or receives a carer’s allowance for a family


Answer options: Yes, No, Don’t know/can’t remember

If No or Don’t know/can’t remember – proceed to end of questionnaire

If Yes – continue to questions

Include instruction: ‘If you provide care to more than one

person who had received care over the last 6 months, please

answer based on your overall experience of care services in

Dorset during this time’ at top of question section

Picker Institute Europe

Buxton Court

3 West Way

Oxford, OX2 0JB

England

Tel: 01865 208100

Fax: 01865 208101

[email protected]

www.picker.org

Registered Charity in England and Wales: 1081688

Registered Charity in Scotland: SC045048

Company Limited by Registered Guarantee No 3908160

mailto:[email protected]

http://www.picker.org/

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