Quality account 2011-2012

Medway Community Healthcare CIC Registered office: Unit 5 Ambley Green, Bailey Drive, Gillingham Business Park, Gillingham, Kent ME8 0NJ Tel: 01634 382777 Registered in England and Wales, Company Number: 07275637

Quality account

2011-2012

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…leading the way in excellent healthcare

…we are caring and compassionate …we deliver quality and value …we work in partnership

Welcome

We are pleased to publish our first quality account as Medway Community Healthcare Community Interest Company (CIC) - a type of social enterprise providing NHS services. As a social enterprise, our social purpose is central to everything we do and enables us to do things differently. Being different means we can reinvest any surplus for the benefit of the community, not to maximise profit for shareholders. This year, through Medway Cares - our own charity, we are making £30,000 available to local charities and voluntary agencies. We are also able to focus on working more closely with local businesses and suppliers and in the past year we have put in place contracts with local companies for catering, maintenance work and cleaning.

Staff have described their excitement about making a difference being the reason they came to work for a healthcare organisation in the first place; of the freedom to make changes and of the ability to be more flexible and responsive to the needs of patients.

Over time, we hope our community will feel it has a real and meaningful say in how our services are designed and delivered. Patients, carers and the wider community can be part of making a difference through our community forum. Working together with our community forum and our staff we have begun to explore ways we can work together using co-production methods - working with a local school and creating their student survey in return for use of their business facilities for our monthly governance forum is an early example of this way of working.

Our apprenticeship programme attracts local young people, giving them hands on experience in clinical and non-clinical work. This year, all our apprentices have been successful in securing employment.

Our quality account statutory report looks back over the past year and sets out our quality priorities for the coming year. We describe the importance of quality and safety and how we have been working to make improvements in our new organisation. There is a real need to work to ensure our services are high quality and value for money during a period of financial constraint and major change in the provision of health services.

Over the last year we have worked with our staff to streamline services, making them more efficient and ensuring that front line staff are where patients need them. We have developed quality indicators across all services to ensure that any areas of potential weakness are identified early and appropriate support put in place.

Our vision for the next year is to continue to raise standards in all our services, working with our staff, patients, our community and commissioners to ensure we provide the best possible care for local people.

Martin Riley Managing director

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Quality measures – our performance in 2011/12

In our previous quality account we outlined a number of areas that our patients had said were important to them. We then broke these down into some key objectives that would identify how we performed in these areas. The table below gives an overview of our performance through the year, more detail follows the table: -

Indicator Target Q1 Q2 Q3 Q4

1. Delivering high quality safe and effective care

Implementation of NICE guidance

100% within our

scope

Achieved Achieved Achieved Achieved

Implementation of Productive series

60% by March 12

Partially achieved

Partially achieved

Partially achieved

Partially achieved

Development of outcome measures

3 per service byMarch 12

Partially achieved

Partially achieved

Partially achieved

Partially achieved

2. Services responsive to need and expectation

Completion of patient experience collection across all services Q1, those needing action Q3

100% Achieved

n/a Achieved

n/a

Implementation of action plans

100% n/a Achieved n/a Achieved

Staff being bare below the elbow

100% Fully compliant

Fully compliant

Fully compliant

Fully compliant

Compliance with hand hygiene requirements

95% Fully compliant

Fully compliant

Fully compliant

Fully compliant

Cleaning audits 88% Fully compliant

Partial compliance

Fully compliant

Partial compliance

Compliance with MRSA screening in St Bartholomew’s Hospital

100% 90% Fully compliant

Fully compliant

Fully compliant

RCA completion for MRSA bacteraemia or C. diff infection

100% No infection One C.diff No infection

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3. Patients are treated with dignity and respect

Provision of inpatient care in single sex accommodation


Fully compliant

Fully compliant

Fully compliant

4. Apply the principles of Being Open in relation to incidents and complaints

Investigation of incidents and lessons learnt disseminated

90% Achieved Achieved Achieved Achieved

Satisfactory closure of complaints

90% Achieved Achieved Achieved Achieved

5. Deliver on our equality and diversity strategy

Service developments take into account equality and diversity strands


Fully compliant

Fully compliant

Fully compliant

Respond to issues identified in patient enquiries and experience surveys related to equality

100% Nil reported

1. Delivering high quality, safe and effective care Implementing NICE guidance Throughout the year we continued to ensure our clinicians were provided with evidence based clinical guidance to enable them to provide safe and effective care that takes into account national best practice. This has been tested by a clinical audit programme (assessment against evidence based criteria and/or the outcome of care by comparison).

The National Institute for Health and Clinical Excellence (NICE) produce evidence based guidance and standards to ensure best practice. During 2011/12 a full review was completed on how we ensure that we comply with NICE guidelines. The responsibility for ensuring our services put the guidance into practice sits with our pathway leads (clinical managers) to ensure each piece of guidance is fully reviewed, audited and embedded. We are fully compliant with guidance that is relevant to our services and we are working with commissioners to look at ways of developing services to be able to deliver in areas we historically have not provided. Every piece of NICE and other national guidance is reviewed and where needed, action plans are developed to ensure the recommendations are implemented by the services.

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Productive implementation All of our services are implementing new and more efficient ways of working, in-line with the productive approach, to enable high quality patient care to be continually delivered despite continuing reductions in budgets. Services are utilising tools developed following Lean principles, service redesign and project management. Outcome measures Each of our services has been working toward developing outcome measures that really identify the experience for patients. All services have identified a question they use in their surveys to ascertain the patient’s view; many services have nationally recognised assessment tools they use to measure the impact of a treatment or intervention. However, where this is not the case we are working to develop suitable tools for their patients.

2. Services responsive to needs and expectations Patient surveys We believe that listening to patients is crucial to providing high quality care. Knowing what works and what does not is vital to our approach of ensuring our patients have a good experience.

We proactively gather and use patient feedback by providing a structured programme that is tailored to the specific service and the needs of their users. Recent results show that patients rated their overall experience of our services as 96% positive.

The patient experience programme is designed to use the feedback obtained to make improvements. In 2011/12, improvements achieved include: -

increased numbers of patients saying they had a good or very good experience

provision of patient information leaflets

provision of contact details and improved appointment systems

improved clinic facilities and increased availability of appointments

reduction in waiting times

supermarket-style ticket machines installed

Protecting patients from infection Part of ensuring a good experience for our patients means we have to reduce the risk of infection whilst in our care. Through 2011/12 we have continued to work with Medway Hospital and GPs to continue the things that work, including: -

clinical staff wearing short sleeves clinical staff not wearing any jewellery on their arms and hands, other than a plain

wedding ring ensuring staff have good hand hygiene either by using alcohol gel or washing their

hands continually working to ensure patient treatment areas are kept clean and well

maintained

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At St Bartholomew’s Hospital every patient being admitted is screened and, if necessary, swabbed to identify if they have MRSA on their skin. If they have, they are then treated to eradicate the bacteria. As a direct result of the attention paid by staff to protecting patients from infection we had very few patients with infections. However, when this did happen we undertook an investigation to see what, if anything, we could do differently to prevent the same happening to another patient.

Each year, our inpatient units, Wisdom Hospice, Darland House and St Bartholomew’s Hospital, are inspected by a Patient Environment Action Team (PEAT), of internal and external people including patients. The areas inspected include the environment and cleaning, quality of food and privacy and dignity. Our staff have continued to improve scores and have achieved an ‘excellent’ rating for food and privacy and dignity, with good and acceptable environment scores. Due to the age of some of the buildings we use we have challenges that sometimes mean our scores are not as high as we would expect. For example, the environment and cleaning score is based on the standards of cleaning and the environment and this includes the condition of the flooring and paintwork.

3. Patients are treated with dignity and respect

It is extremely important that anyone being treated by any of our services is treated with respect and cared for in an environment that meets their needs. We have ensured every inpatient is cared for in an area with people of the same gender, with nearby access to single sex toilet and bathroom facilities. This helps safeguard privacy and dignity when people are at their most vulnerable. Sharing with patients of the opposite sex will only happen in exceptional circumstances.

In 2011/12 there were no reports of patients of the opposite sex sharing sleeping areas.

4. Apply the principles of being open in relation to incidents and complaints

Being open with our patients is part of everything we do and is promoted through our organisational values. We have made a public commitment to being open - for more information visit our website.

Our approach supports staff to apologise if something has gone wrong and encourages managers to speak directly to people who are not happy with the care or service they receive. Every incident is investigated and if something has gone wrong, the people

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affected are given full and frank information and the opportunity to have any questions answered.

We share the things we have learnt across the organisation and our training includes extracts from situations that have happened.

5. Deliver on our equality and diversity strategy

We have made good progress on achieving our equality objectives over the last year. As part of our work we have reviewed our approach to equality and diversity ensuring that our aims and objectives are clear. These will be published on our website and a formal review of progress undertaken by our Board each year.

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What our patients say about our services

(Above shows a word cloud of the adjectives used by patients in recent surveys – the larger the word appears the more frequently it has been used.)

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Priorities for quality improvement in 2012-13 Using feedback from patients and the wider community has informed our quality committee what the important areas for the organisation to concentrate on this year should be, to ensure we strive to continually improve quality of care. The committee proposed nine areas for consideration as our clinical priorities. Following consultation with our patients, our community forum and our staff to identify those that were important to them we will be focusing on: -

Priorities for 2012-13

Patient safety

Reducing the number of patients acquiring a pressure ulcer whilst in the care of our nursing services.

Continue to provide environments and care where the risk of infection is minimal.

Clinical effectiveness

Developing personalised care plans for patients with long-term conditions. A number of key conditions will be identified and we will work with other local health and social care services.

Report on patient outcome measures across our services.

Patient experience

Real time patient satisfaction feedback - to find out more about patient’s experiences of care as they are receiving it. We would like to expand the use of our systems to do this and to highlight the importance of patient feedback on the services they are using.

The use of ‘intentional rounding’ (regular timed patient checks) in our wards, recent work in the United States on this approach has been shown to reduce falls, dehydration and incontinence and provide better pain control.

Continue to work to reduce waiting times for patients in services where there are challenges.

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Assuring our Board We have a number of contracts to provide 36 NHS services. These range from health visiting to hospice care (Wisdom); physiotherapy to out of hours GP services (MedOCC) and a care home for people with dementia (Darland House) to providing community equipment (CELS). Clinical improvement programme There were no National Enquiries that we were required to participate in, however, we participated in seven national clinical audits, the: -

National programme for stroke improvement National audit of depression and screening of staff on long term sickness Vital signs Improvements to the TIA (transient ischaemic attack) service combined national audit of falls and bone health in older people 2011-12: older people's experiences of exercise programmes Patient Environment Action Teams (PEAT) Mental Capacity Act HTM01 dental decontamination

We have an annual clinical improvement programme that is developed with our service leads and agreed by and reported to our quality committee and commissioners. In 2011-12, 100 different audits were conducted across 42 services, including non-clinical services, these ranged from outcomes for dysphonic patients in voice therapy to injection outcomes for patients being treated by the clinical assessment service;

infection control compliance to effective record keeping and medicine administration and cleaning standards.

Some key results of the programme are: improvements in clinic location and facilities for dental services development of an open access clinic for patients with a TIA (transient ischaemic attack) improved training programme established for nursing and domestic staff regarding

food choices for patients with coeliac disease improved access to therapy services for patients who have had a stroke improved provision of swallowing screening within 24 hours of admission in stroke

services

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Taking part in research As a social enterprise, we are keen to enhance the quality of patient care through involvement in and use of clinical research. We are a member of the Comprehensive Local Research Network and Kent and Europe Centre Boards, both of which encourage and facilitate research. We are keen for staff to be involved in research, whether as recruiters, investigators or identifying research through academic study. Examples of the research staff have recruited patients to and/or been involved in includes: -

Awareness of palliative care in UK, Nigeria and Portugal Study into whether psychosocial-existential and spiritual training for healthcare

workers improves patient care and reduces burnout

Assessment of care needs of chronic obstructive pulmonary disease patients and their carers

Emotional processing and social cognition in Amyotrophic Lateral Sclerosis & Motor Neurone Disease

Chronic fatigue syndrome at Burrswood Hospital

The Calories Study – parenteral versus enteral nutrition

The Hemispatial Neglect trial The 3rd International Stroke Trial (IST3)

Thrombolysis The Stroke Oxygen Study A DNA Resource for Lacunar Stroke

In 2011-12, all patients recruited by our services to participate in research approved by a research ethics committee were incorporated in NHS Medway or figures for other providers. From April this year, it is anticipated that all recruitment at our sites will be attributed to us. Commissioning for Quality and Innovation (CQUIN) In 2011-12 a proportion of our income was conditional on achieving targets agreed with NHS Medway through the CQUIN framework. The following table shows our achievement: -

CQUINs 2011-12 Achievement

The delivery of a patient experience programme Achieved

Supporting mothers to breastfeed until the 6 - 8 week baby check, target 80%

Achieved 74%

Having no patient transfers at St Bartholomew’s Hospital delayed due to our services

Achieved

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The delivery of a public awareness campaign about the risk of pressure damage

Achieved

Offering patients access to the stop smoking service Achieved

Undertaking risk assessment and treatment of patients at risk of clots at St Bartholomew’s Hospital

Achieved

Providing interventions for patients identified as having frequent use of accident and emergency services as a result of falls or diabetes

Achieved

Participation in the regional heart failure improvement programme (Enhancing Quality)

Achieved

Data quality Reliable information is essential for safe and effective treatment and care of our patients. A data quality improvement plan, agreed with our commissioners, identifies our plans, actions and initiatives for the year.

Maximising the amount of time clinicians have to see patients is an on-going priority for us; by improving our processes staff are now able to monitor and manage diaries more effectively and increase time with patients.

Patients are sometimes referred to the wrong service. A piece of work is being completed that is ensuring the appropriate service for the patient’s condition or treatment; this will prevent patients waiting unnecessarily for their appointment and reduce our administration workload.

Information governance toolkit In 2011-12 Medway Community Healthcare made their first independent submission of compliance against a series of standards known as the Information Governance Toolkit. The standards cover a range of areas such as data quality, use of the NHS number and validation of national dataset submissions to the Department of Health.

We met the nationally defined standards of compliance in information governance. Our overall performance provided a final score of 69%, which meant we achieved Level 2 overall, with Level 3 being achieved in three of the requirements:

information governance awareness accuracy of service user information consistent and comprehensive use of the NHS Number

We are working towards achieving Level 3 in all areas for 2012-13.

Incidents As an NHS provider we have a reporting system that identifies when a patient has been involved in a potentially harmful situation, for example, having a fall or not getting a dose of medication. Every such incident is scrutinised to identify what happened and, if possible, why. When necessary action is taken such as retraining for a member of staff; a change in the way things are done or, in some cases, disciplinary action. All incidents are reported to

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our Board and quality committee, as well as sharing the findings and improvements with other services to prevent the same thing happening again.

Where incidents are classified as serious (nationally defined criteria) we are required to report these to the Department of Health via the service commissioner. In 2011-12 we had six incidents that met these criteria, none of which involved a patient being harmed and all categorised as the lowest risk. Four involved potentially patient identifiable information being sent to the wrong place. Of these, three involved information being sent to another NHS organisation, this meant that it was kept safe and returned to us without it getting into the public arena. The other involved a number of organisations and a failure to ensure patients’ addresses were checked, resulting in some information on test results being sent to incorrect addresses.

The sixth serious incident was reported following receipt of a letter of complaint that had been sent to the local media. The complaint referred to care received from our services and another provider of healthcare. We worked with the other provider as well as the relative and family to investigate the complaint and are currently reviewing staffing levels across a number of services.

NHS organisations are required to report and fully investigate any incidents classified by the Department of Health as a Never Event. These are serious, largely preventable patient safety incidents that should not occur in a modern health service. In 2011-12, 11 of the Never Events had the potential to happen in the type of services we provide. We are pleased to report that no Never Event incidents occurred in any of our services

Safety Thermometer The Safety Thermometer is a national tool intended to reduce ‘avoidable harms’ some people experience in health services. These include falls, pressure ulcers, blood clots (venous thromboembolism) and urine infections. Over the past few years our staff have reported on these and other areas to ensure that our care is safe and effective and, where necessary, lessons learnt. Throughout this year we have worked with our continence team to reduce the numbers of patients who have a catheter thereby reducing the risk of infection. We have reviewed the care of every patient with a pressure ulcer whilst in our care to understand what caused it and if it could have been prevented and we report on those patients who have a fall in our inpatient units. All these areas, along with venous thromboembolism prevention, make up the Safety Thermometer that all our nursing services will be reporting every month by the end of 2013. This will inform part of next year’s quality account. Through piloting the tool over the last 18 months and reporting the incident data already we have a wealth of information that, whilst improvements can still be made, shows patients are, in the main, protected from harm within our services.

Appraisal and supervision Ensuring our staff are supported to deliver high quality care for our patients is vital, we regard appraisals as key to recognising an individual’s performance: feeding back on competence, supporting them in their work and embedding our values. Supervision for clinical staff ensures best practice is achieved and clinicians are able to discuss and reflect

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on complex clinical situations. Our staff and managers have told us that supervision and appraisal are highly valued and we have made great strides in implementing supervision in clinical services and ensuring all our staff have an annual appraisal.

Education and training Medway Community Healthcare is committed to ensuring all our staff are appropriately equipped to do their jobs. Certain training is delivered as a rolling programme, eg infection control, safeguarding and manual handling. Attendance is monitored and compliance remains high. All our staff have access to a variety of other training and development opportunities. We have staff studying on a wide range of courses from NVQ to degree and masters programmes. We offer apprenticeships in clinical and administrative services and secondments for staff to undertake professional qualifications.

Transfer of care As a provider of community services we have many patients referred to our services by other providers of health care. On occasions we identify shortfalls in the care that was provided prior to our service being involved. When these are reported we inform the referring organisation of the concern and our staff work to ensure the patient’s care is not compromised. Our senior pharmacist has worked with the chief pharmacist in the local hospital to enable patients to be discharged with the relevant medication and information.

Development of health visiting in Medway The Government has pledged to increase the number of health visitors by April 2015. This commitment will deliver a new service model bringing improved access and support for families. We have plans in place to continue to recruit more health visitors over the next few years to meet the target including training qualified nurses to be our future health visitors. By doing this we will be able to provide the full range of these services to local families meeting five key areas: -

improving health outcomes and delivering the healthy child programme building relationships with mothers during pregnancy and the early weeks providing additional services, eg support for mother’s mental health or toddler sleep

problems providing services for families requiring additional support, eg families at social

disadvantage or families with a child with a disability supporting high intensity services for families where there are safeguarding concerns

The first steps in a child’s development are crucial to their life chances; this is an exciting time to be a health visitor, they are central to support parents improve the quality of a child’s early life. Qualified nurses interested in becoming a health visitor can find our more on our website.

Providing a Flying Start Preceptorship is a term that refers to a period of time (usually 12 months) where newly registered healthcare professionals (eg nurses, physiotherapists) are given support to help them build their confidence in their new roles. Medway Community Healthcare has been involved in leading the way and influencing the development of a new preceptorship programme called Flying Start England (adapted from Flying Start Scotland). This programme provides on the job support through a structured approach, allowing the

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individual needs of the health care professional to be considered. The programme has been implemented over the last year and is already showing dramatic improvements in confidence levels of not only the newly registered staff but also the established staff that support them. It has also helped us to retain the new staff within their first year and beyond.

Pressure ulcer awareness campaign Pressure ulcers, also known as pressure sores or bed sores, can be a problem to people of all ages. Skin damage can occur as a result of sudden or prolonged illness or injury that prevents a person being able to move freely without help. Injury or illness may also prevent the person receiving signals from the brain to the skin, which would normally warn them to change position.

It had been noted that many patients had the first signs of skin damage before being seen by a community nurse and before being sent to hospital for surgery or treatment.

To improve awareness of this risk we developed the Change your skin campaign to provide advice to carers, relatives and care agencies on how to detect the early signs of skin damage. The campaign publicises how to identify what to look for, action to take and how to get advice and support from our services.

We have produced posters and leaflets that are displayed in pharmacies, clinic and GP waiting rooms. Through this campaign we hope to see a reduction in the numbers of patients we have referred to our services suffering unnecessarily with pressure ulcers.

Volunteers at St Bartholomew’s Hospital Volunteers at St Bartholomew’s Hospital provide one-to-one daily visits to patients in Andrew, Merton and William Wards and the anti-coagulation clinic held on the site. Our volunteers come from diverse, multicultural backgrounds including, student doctors and midwives, retired people and patients. The initiative originally started with volunteers helping to provide tea and coffee services. This developed into volunteers sitting and talking with the patients thus providing informal communication channel, enabling us to find out what the patient experiences during their stay. The volunteers capture and record comments, positive and negative and, where needed, action is taken. Our volunteers have the available time to chat with patients and play games, thus helping their rehabilitation and releasing time for the nurses to care. In the future, we hope to be able to provide a volunteer at reception on a during visiting hours to escort patients and visitors and we would like to extend the patients’ trolley service to twice daily, although we would need many more volunteers to cover this service. Anyone interested in joining Medway Community Healthcare as a volunteer can register their interest on our website.

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Practice development unit accreditation Our stroke team were again awarded practice development unit accreditation. This is a unique programme in partnership with the University of Bournemouth to develop and improve a quality service that is patient focused and uses processes based on teamwork and collaboration. The University had this to say about our stroke team:-

“It is clear, due to the support and enthusiasm of staff that you continue to improve and develop the service. Evidence for this is well presented and includes the: -

weekly patient groups at St Bartholomew’s Hospital to enhance patient involvement

strengthening of interdisciplinary working and the exchange of knowledge and skills with the interdisciplinary team

introduction of outcome measures, increased access, and improving the process for providing timely discharge summaries

development of the knowledge and skills of others involved in support for people who have had a stroke such as new carers and the recently appointed gym instructors

blending of new roles and the introduction of an interdisciplinary assessment and review tool is also clearly important

To achieve this with changes to roles, the structure or basis of the service and especially in the financial constraints that are present is deeply impressive. It could not happen without dedicated and committed members of the team. It has been a pleasure to read this report especially as I was part of the original accreditation team when you first became a Practice Development Unit in 2006.”

Nursing students on placement Students are our workforce of the future. Good quality clinical placements are successfully completed throughout the organisation (assured by student evaluation and professional regulatory review). We are continually looking to improve the quality further and the way in which we provide placements.

We work with the teams that support students on placement to learn from student feedback and plan improvements.

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Care Quality Commission Medway Community Healthcare has unconditional Care Quality Commission (CQC) registration since April 2011.

Our children’s services were assessed by the CQC and OFSTED in conjunction with other healthcare providers and Medway Council. As a result of all the excellent work to support clinicians who support families with children on a child protection plan we had no required actions. However, we are working with the Medway Safeguarding Children Board as we are keen to ensure lessons are learnt and implemented across all agencies.

Our stroke service team achieved the position of best performing in the recent CQC review of stroke services.

As part of the process of publishing our quality account we are required to seek comment from a number of organisations that scrutinise our care provision. This year we were pleased to share the account with staff and our community forum.

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What our stakeholders say Elected members’ forum Our elected members’ forum, who represent staff within the organisation made the following comments on this report: - The report was very interesting to read; it highlighted and addressed many relevant areas and mutual concerns.....pensions, work force, changes ahead. It clearly linked the organisational plan and vision. The layout was clear and easy to follow … the information is very comprehensive it focuses on achievements by services as individual units. I wonder if patient experience of moving between services or being seen by multiple services at the same time has been missed. …it would be beneficial for staff to know the objectives for next year, have these really promoted. NHS Kent and Medway The main commissioner of our NHS services: - Our organisations are working closely together to ensure all aspects of patient safety and care quality are consistently meeting high standards of care and sustain improvements. As far as NHS Kent and Medway can comment the information contained in the quality account is an accurate and honest reflection of progress made in many aspects of service improvement. The quality account sets out how Medway Community Healthcare has been working to make improvements to its organisation and reiterates the importance of quality and patient safety. However, the PCT would like to see further information on performance against quality measures as this is not clearly stated. Medway Community Healthcare has seen positive outcomes during the last year by involving patients in setting priorities to improve clinical and patient reported outcomes. The PCT considers that the relationship has been strengthened through Clinical Quality Review meetings and the Deep Dive process. The PCT will continue to work closely with Medway Community Healthcare to assure the quality of local health services and ensure the culture of continuous improvement. Medway LINk (Local Involvement Network) Seventy people were asked about their experience of services, Medway Community

Healthcare’s performance against last year’s priorities and what they felt this year’s priorities should be. Responses were gathered through online and paper surveys and interviews with service users and visitors in outpatient areas of Medway Maritime Hospital where Medway

Community Healthcare provides services and at St Bartholomew’s Hospital. The quality account is short, well structured and the style is easy to read. There is a very limited use of jargon and where it appears there is a clear explanation, for example the

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section on Preceptorship. Use of acronyms is avoided, and where they are necessary are spelt out. Tables are clear and simple. Avoidance of complicated data also helps to make the document accessible to the lay reader; however, there were some areas where more detailed information would aid understanding, eg where the document talks about ‘increased numbers of patients saying

they had a good or very good experience’ it would be useful to know what this level has increased from and to. Respondent were asked how they felt the organisation had met the quality priorities. 83% of respondents felt that the priorities had been met well, with 4.5% feeling they had been met badly. Positive comments praised responsiveness to individual needs, staff being well trained and friendly and being treated with dignity and respect. A limited number of negative comments were made at Medway Maritime asking for parking to be improved which are is outside of the control of Medway Community Healthcare. However, there were Comments about St Bartholomew’s, one concerned with parking on the other a ‘shortage of staff and beds. Respondents were asked to suggest what they thought Medway Community Healthcare’s priorities for the coming year should be. Just over 50% of respondents answered, mostly with positive comments, however there were 5 mentions of the need to improve parking at

St Bartholomew’s Hospital. Respondents were asked to rate their experiences in the following areas (1 being poor and 4 very good): - Safety – 66 responses of which 92.5% gave the highest rating, with a further 6% giving a rating of 3. Only one person (1.5%) gave the lowest rating with the cryptic comment ‘video entry system in view of reception’. Communications with staff – 66 responses of which 92.4% gave the highest rating with the remainder giving a rating of 3. Comments were mostly around the staff being quick, friendly, helpful, efficient and caring. Dignity and respect – 68 responses of which 89.7% rated their experience as 4, with the remainder all giving a rating of 3. In summary, the Medway LINk feel Medway Community Healthcare should be commended on the excellent feedback received regarding patient experience. The overwhelming majority of respondents were extremely positive about their experiences, reflected in 98.5% of respondents rating their overall experience as excellent or very good. On this occasion the Community Forum and the Medway Health Overview and Scrutiny Committee did not put forward any comments to be included in the account.

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More Visit www.medwaycommunityhealthcare.nhs.uk to find out more about us and the services we provide. Get involved To become a member of our community forum join in here > Your feedback For further information or to request a hard copy of this report please contact the communications team or call 01634 382211. Other languages This information can be made available in other formats or languages please contact the communications team or call 01634 382211

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Quality account 2011-2012

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