agenda - king's college hospital nhs foundation trust - 479.1 - bod agenda and papers ju… ·...

Key: FE: For Endorsement; FA: For Approval; FR: For Report; FI: For Information

AGENDA Meeting Public Board of Directors Time of meeting 09:30-12:20 Date of meeting Wednesday, 1 June 2016 Meeting Room Boardroom, Trust Headquarters, PRUH Site King’s College Hospital, PRUH

Encl. Lead Time

1. STANDING ITEMS Chair 09:30

1.1. Apologies 1.2. Declarations of Interest 1.3. Chair’s Action 1.4. Minutes of Previous Meeting – 04/05/2016 FA Enc. 1.4 1.5. Action Tracker & Matters Arising FE Enc. 1.5 2. BEST QUALITY OF CARE 2.1. Patient Story FR Presentation D Marshall

K McDowall 09:35

2.2. Quarterly Patient Experience Report FR Enc. 2.2 J Seddon 10:00

3. Chief Executive’s Report FR Enc. 3 N Moberly 10:15

4. TOP PRODUCTIVITY 4.1. Performance Report (Month 1) FA Enc. 4.1 J Farrell 10:25 5. SKILLED, CAN DO TEAMS 5.1. Monthly Nurse Staffing Levels Report FE Enc. 5.1 G Walters 10:40 5.2. Nursing & Midwifery Staffing Levels Report FE Enc. 5.2 G Walters 10:55 5.3. Staff Pay Awards FE Enc. 5.3 D Brodrick 11:10 6. FIRM FOUNDATIONS Sound Finances

6.1. Finance Report (Month 1) FE Enc. 6.1 C Gentile 11:25 6.2. Finance & Performance Committee Chair Update FI Enc. 6.2 C Stooke 11:40 Rigorous Governance

6.3. Board Assurance Framework FE Enc. 6.3 J Seddon 11:45 6.4. Council of Governors Report FR Verbal C North 12:00

6.5. Chair & Non-Executive Directors’ Activity Report FI Enc. 6.5 Chair 12:10

6.6. Board Committee Minutes FI Chair

6.6.1. Finance & Performance Committee – 26/04/16 Enc. 6.6.1

7. ANY OTHER BUSINESS Chair 12:15

8. DATE OF NEXT MEETING: Wednesday, 06 July 2016, 09:30 in the Dulwich Room, Hambleden Wing.

Members:

Lord Kerslake (BK) Trust Chair

Sue Slipman (SS) Non-Executive Director, Vice Chair

Christopher Stooke (CS) Non-Executive Director

Faith Boardman (FB) Non-Executive Director

Prof. Ghulam Mufti (GM) Non-Executive Director

Prof. Jonathan Cohen (JC) Non-Executive Director

Dr Alix Pryde (AP) Non-Executive Director

Erik Nordkamp (EN) Non-Executive Director

Nick Moberly (NM) Chief Executive Officer

Dawn Brodrick (DB) Director of Workforce Development

Colin Gentile (CG) Chief Financial Officer

Toby Lambert (TB) – Non-voting Director Interim Director of Strategy Ahmad Toumadj (AT) – Non-voting Director Interim Director of Capital, Estates and Facilities

Jane Farrell (JF) Chief Operating Officer

Judith Seddon (JS) – Non-voting Director Acting Director of Corporate Affairs Dr. Geraldine Walters (GW) Director of Nursing & Midwifery

Prof. Julia Wendon (JW) Medical Director

Attendees:

Tamara Cowan (TC) Board Secretary (Minutes) Sally Lingard (SL) Associate Director of Communications Chris North (CN) Lead Governor Dorothy Marshall (DM) Sister, Ontario Ward, Orpington Kay McDowall (KM) Team Lead Physiotherapist, Orpington

Apologies:

Trudi Kemp (TK) – Non-voting Director Director of Strategy

Circulation List:

Board of Directors & Attendees

Enc. 1.4 Subject to Chair's Approval

1

King’s College Hospital NHS Foundation Trust Board of Directors - PUBLIC Minutes of the Meeting of the Board of Directors held at 10:00 on 04 May 2016 in the Large Hall, 4th Floor, Bromley Central Library, High Street Bromley, BR1 1EX Members: Lord Kerslake (BK) Trust Chair Sue Slipman (SS) Non-Executive Director, Vice Chair Faith Boardman (FB) Non-Executive Director Chris Stooke (CS) Non-Executive Director Prof. Ghulam Mufti (GM1) Non-Executive Director Dr Alix Pryde (AP) Non-Executive Director Erik Nordkamp (EN) Non-Executive Director Nick Moberly (NM) Acting Chief Executive Officer Dawn Brodrick (DB) Director of Workforce Development Colin Gentile (CG) Chief Financial Officer Jane Farrell (JF) Chief Operating Officer Toby Lambert (TL) Interim Director of Strategic Development Judith Seddon (JS) – Non-voting Director Acting Director of Corporate Affairs Ahmad Toumadj (AT) – Non-voting Director Interim Director of Capital, Estates & Facilities Jeremy Tozer (JT) Interim Chief Operating Officer Geraldine Walters (GW) Director of Nursing & Midwifery Julia Wendon (JW) Medical Director In attendance: Tamara Cowan (TC) Board Secretary (Minutes) Alan Goldsman (AG) – Non-voting Director Outgoing Acting Director of Strategy Rose Sweeney (RS) Volunteer Petula Storey (PS) Head of Volunteering Council of Governors Members Various (15 Governors) Paul Brown (PB) Healthwatch (OHSEL) Apologies: Prof. Jonathon Cohen Non-Executive Director Sally Lingard (SL) Associate Director of Communications Trudi Kemp (TK) – Non-voting Director Director of Strategic Development

Item Subject Action

16/41 Apologies Apologies for absence were noted. The Board welcomed Toby Lambert (JF) in his new role as Interim Director of Strategic Development and thanked Alan Goldsman (AG) for his support and services provided to the Trust over the past year.


2

Item Subject Action

16/42 Declarations of Interest There were no declarations of interest reported.

16/43 Chair’s Action There were no Chair’s actions to report.

16/44 Minutes of Previous Meeting The minutes of the meeting held on 06 April 2016 was approved as a correct record subject to correcting some minor typographical errors and removing duplicated sections.

16/45 Matters Arising/Action Tracking The action tracker was noted and it was agreed JF would speak to Ann Wood about the data on cancellation of patient which it was agreed would be circulated to the Board.

JF

16/46 BEST QUALITY OF CARE

16/46.1 Patient Story The Board welcomed patient volunteer Rose Sweeney (RS) and Petula Storey (PS) the Head of Volunteering. RS outlined the details of the particular recipient volunteer programme 'hospital to home'. The following key points were reported • The 'hospital to home' (H2H) programme is run by the volunteer team;

• It was established to help vulnerable patients go back home;

• The programme has a core team of 6 trained volunteers and a staff member

who coordinates the service;

• At present it only operates on the Denmark Hill site with plans to extend t the PRUH and Orpington sites in due course;

• The team work closely with the British Red Cross and strong links with other local community support networks;

• The patient story focuses on the support given to a couple. The husband was

admitted to the hospital and his wife was struggling to cope with managing with her unwell husband and the household bills;

• The H2H service helped the wife manage bills and administration following the death of her husband;

• H2H also supported the wife connect with social care networks for the support she needed; and


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Item Subject Action

• It was evident from this case that there were lots of issues for this patient such as the fact that she may have been on the brink of dementia which may have explained why she kept falling behind on her bills and that she was in need to specialist care services for instance she wore slippers in the midst of winter because she could not cut her toenails and found it impossible to wear normal shoes.

The following key points were raised and noted by the Board: • This patient story is a very powerful reminder of how the Trust goes way

beyond what is its responsibility;

• It is a shocking story of failures in the system and the H2H programme has to be applauded;

• The story raises questions about whether or not the Trust provides enough support to its volunteers. There seems the Trust puts a lot on the volunteers and care need to be taken to manage their remit and exposure;

• Volunteers are given training and guidance on what they can and cannot do for instance they are not allowed to handle money and cannot provide care;

• This patient story is a perfect illustration of the types of typical issues which

arise in the community;

• The story illustrates the importance of holistic health care and the Trust needs to flag how lack of holistic approach impact on the hospitals on the front line;

• There are big policy issues with lack of social care which is a local government

issue;

• The practicalities need to be picked up by the system and through the transformation programme. This is especially true about the creation of local care delivery. The Trust needs to support the process for getting health care on sound care structure that support these types of patients and their families. This is similarly the case in the Bromley area and the Trust needs to work with partners to help these patients. This is going to be hard work and the Trust has to be clear about what the role and remit of its volunteers are because this situation is not sustainable;

• The Trust should look at an award scheme for its volunteers;

• The Trust works close with Age UK and SAIL;

• The Trust should conduct a research project into the volunteer H2H programme and what are the key measures which can be used to inform linkages and what can be learnt from it to help patients further;


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Item Subject Action

• Before the patients are referred to the H2H service a risk assessment is undertaken as part of the discharge process. Higher risk cases go straight to the British Red Cross;

• Cases such as these should feed into the work the Trust is doing with partners; and

• This is a powerful and enlightening story and the issues will be picked up and used as examples for wider partnership working.

16/46.2 Quarterly Outcomes Report The Board received the quarterly patient outcomes report. The following key points were reported: • The Trust missed the target for screening and full assessment of patients for

dementia at the Princess Royal University Hospital (PRUH);

• There has been significant improvement in the mortality of patients with hip fracture. Mortality of these patients are high nationally but the Trust's has made strides to improve its performance especially at its PRUH site which was previously underperforming;

• The Trust did not perform well in previous laparotomy audit as a result of data issues however the improvements have been made and it is hoped the result due to be published in June 2016;

• Both sites submitted data to the trauma audit and research network (TARN) and it was shown that more patients are surviving major trauma; and

• Overall patient outcomes are improving.

The Board raised the following key points in discussion: • It would be good to understand how the Trust benchmarks against other

Shelford trusts;

• The Trust is topping the stroke and trauma audit performance targets compared with other trusts; and

• It is disappointing to see that the PRUH is performing below target for screening

and assessment of patients for dementia. The dementia services and processes at the Denmark Hill site are well developed and resourced. This is less true at the PRUH and the Trust plans to address this imbalance given the patient population in the Bromley area. The Board would be provided with the data from the audit and the Trust's plans to make improvements in due course.


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Item Subject Action

16/47 Chief Executive's Report The Board received and noted the report from the chief executive officer (CEO). The following key points were noted in discussion with the Board: • The Trust is moving in the right direction on quality but more needs to be done.

There is good news on SHMI but there remains more to do on infection control;

• Patient experience is improving with good feedback;

• The Trust's access target is the most problematic issue. A&E is very challenged and where the most important work needs to be done;

• Referral to treatment (RTT) backlogs are coming down and the Trust has systems in place to address the key issues. The Trust went back to reporting its RTT data and is currently one of the worst performers but the Trust is confident it has good data which can be relied on and systems and plans in place to address the backlog;

• This planning round had been very comprehensive and much more detailed;

• The Trust is keeping its stakeholders informed and updated on its progress in meeting its operational targets;

• The Trust needs to make headway on its finances and the key to moving forward is maintaining grip and delivering on the money; and

• The Trust has delivered the £65m for year end and is now focusing on developing a cost improvement programme which will underpin sustainability.

The Board raised the following points in discussion: • It is good to see emphasis on customer care and delivering on the

transformation programme will support further improvements;

• The executive is thinking about the how it will communicate the transformation programme initiatives and will provide a communications plan to the Board in due course; and

• The Trust needs to explore with KCL, investment in research, particularly the in relation to discovery science. These conversations are under way and will tie into the Trust's research strategy.

16/48 TOP PRODUCTIVITY

16/48.1 Performance Report (M12)

The Board received and discussed the month 12 performance report which was also discussed at the Finance & Performance Committee meeting held on 26 April 2016.


6

Item Subject Action

The following key points were reported • Operational performance is varied but the Trust is broadly in line with trajectory;

• Emergency department (ED) performance deteriorated in March to 81%. This is

due in part to the significant increase in attendances by 9%;

• The Trust has plans in place to improve the ED performance for both sites attaining 95% by the end of 2015/16;

• The Trust is working closely with commissioners to improve the performance

against referral to treatment targets;

• The Trust ended the year off trajectory with its diagnostics target at 5.8%. The Trust has a detailed recovery plan which will deliver 1% by the quarter 2;

• The Trust is pleased to have delivered all cancer targets with the exception of breast which ended at 92.2% as opposed to the 93% target;

• The Trust is tightening up its governance process which has been informed by lessons learned. The Trust has critically evaluated it position and putting in place structures to manage the risks; and

• The size of the task to get the Trust back to sustainability cannot be underestimated but it is deliverable with strong leadership and governance processes which will be embedded in the new organisation structure.

The Board noted and raised the following key points in discussion: • The Finance and Performance Committee discussed the plans for recovery in

detail;

• Running daily patient tracking lists (PTL) is providing increased oversight which enable the Trust to make necessary improvements;

• The Trust recognise the need to improve its business intelligence services to

facilitate better evaluation; • The Trust has had its RTT numbers externally validate hence there is significant

certainty about the current backlog numbers. The Trust will now give effect to its plans to bring down the backlog and deliver 88% by the end of the year. The Trust is moving quickly to address the backlog and working in conjunction with commissioners;

• The Trust needs to better communicate about the indicators that are on track.

The Trust needs to be clear about the milestones for achieving these key indicators. To do this work needs to be done on improve tracking and its scorecard reporting;

• The Board needs a deep dive into the ED performance and give the issue urgent focus;


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Item Subject Action

• The ED performance for month 12 is not too far away from what is expected at this point in the year but the Trust needs to get into the detail about what the drivers are for the increased activity levels;

• The increased activity cannot be categorised as a blip and similar activity levels can be seen across the sector at other hospitals;

• A review will be conducted in the utilisation of the theatre resources. There are

multiple contributing factors;

• The Trust is firmly signed up to improving performance trajectories and will communicate the current position regularly.

It was agreed that the Board, through the finance and performance committee, would give urgent focus to the ED performance. It was also agreed that JF would include comparative data in future performance reports.

FPC/JF

16/49 SKILLED, CAN DO TEAMS

16/49.1 Monthly Nurse Staffing Levels Report The Board received and noted the monthly nurse staffing levels report. The following key points were reported: • The Trust's increased number of red shifts relate in part to the decrease in fill

rates. The Trust has to use healthcare assistants (HCA) to provide additional cover;

• The staffing issues at the Princess Royal University Hospital (PRUH) relate to high levels of vacancies; and

• The Trust needs to improve staff rostering and sickness management. The Board raised the following key points in discussion: • Shortage of staff is a long standing issue which is system-wide. The challenge

particularly lay with retaining band 5 nurses

• The Trust is developing recruitment strategies to ensure it has the right numbers of staff in place. It should be noted that even with a strategy nurse shortage is a perennial system wide issue. The Trust will have to apply other proactive measures to retain staff such as conducting stay interviews;

• The Trust has a set a ratio of 70% registered nurses to 30% HCAs on each ward at any given time. This ratio ensures that there is sufficient cover and expertise on each ward; and

• The Trust recognises there is more to be done with staff retention and the key points from the recent survey will be taken forward with the internal survey.

It was agreed that the Board would pick up staff retention issues in the July.

DB


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Item Subject Action

16/49.2 Maternity Patient Story Update GW reported that this item will be picked up at the Quality & Governance Committee as Maxine Spencer could not make it to this meeting to provide an update.

16/50 FIRM FOUNDATIONS

Sound Finance

16/50.1 Finance Report (M12) The Board received and discussed the month 12 finance report which was also discussed at the Finance & Performance Committee (FPC) meeting held on 26 April 2016. The following key points were reported and raised in discussion: • At month 12 the Trust has an actual deficit of £65.4m which was achieved

through non-recurrent funding;

• The Trust has worked hard to achieve this position but the challenge remains to remain sustainable; and

• The Trust did achieve a surplus in March; however, whilst there are no income

issues, work needs to be done on improving demand capacity going into next year.

The Board noted the m12 finance report and the following key points: • The FPC reviewed the financial position and whilst it applauded the

achievement of the forecast position the underlying position needs lots of attention; and

• The Trust is not complacent about the challenge ahead and focus is turned now to identifying savings target of not exceeding the forecast £30m deficit for 16/17.

16/50.2 Finance & Performance Committee Chair Update The Board received and noted the report from the Committee Chair.

Strong Partnerships

16/51 Integrated Care (Local Care Networks - Southwark & Lambeth) The Board received and discussed the report on local care networks in Southwark and Lambeth. The following key points were reported • The Southwark and Lambeth Integrated Care (SLIC) programme formally

ended on 31 March 2016;


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Item Subject Action

• The emerging programme of work for integrated care in Lambeth & Southwark will be conducted though a Local Care Network (LCN) managed by the Southwark & Lambeth Strategic Partnership (SLSP);

• A separate programme is being developed for Bromley; • The SLSP Board had decided to focus on co-design and implementation in

16/17;

• The SLSP recognise that most of its work will be focused on widespread culture change across the local system not just the technical process of design and roll-out;

• To support this process the Trust will need to provide executive resources; • Partners will have to work together to move the key issues up the national

agenda and share data to inform the programme of work; and

• KHP's expertise will be a key contribution to this process. The Board raised the following key points in discussion: • It is good news to note the new focus and mobilisation of the integrated care

agenda and work through the LCN and the codification of the operating model;

• There is good data and existing studies which will support the work of LCN. Accountabilities, deliverability and monitoring will be embedded in next phase of work;

• The work of this group could go as far as changing the commissioning framework;

• Councils have expertise in giving effect to this type of working and using informatics and the LCN should use this as a good source of learning;

• Tower Hamlets and Surrey are areas where LCN's can be seen to be working well;

• The partners spent a lot of money on SLIC with very little progress. This must be avoided and more must be achieved under this structure. The work for the sustainable transformation programme (STP) is driving joined-up forward planning with commissioners which will support the work of the LCN. This work has fostered good leadership and relationships; and

• KHP should be leading this work and drive for system change. It was agreed that the Board would receive a further update in 6 months and that site visit would be conducted to establish LCN's which are working well.


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Item Subject Action

Rigorous Governance

16/52 Council of Governors Report The Board received an update on the activities of the Council of Governors from Lead Governor, Chris North. On behalf of the governors he relayed the following key matters: • The Council is keen to hear more about the Trust Transformation programme;

and

• It is important that the Trust keep staff engaged and share plans early so that staff takes ownership and feel empowered to deliver these plans.

16/52.1 Chair's and Non-Executive Director's (NEDs) Activity Report The Board noted the report on the Chair and NED's activity.

16/52.2 Monitor Quarter 4 Submission The Board noted the submission made to Monitor for quarter 4.

16/52.3 Confirmed Board Committee Minutes The Board noted and received the confirmed minutes of the Finance & Performance Committee held on 22 March 2016.

16/53 ANY OTHER BUSINESS

There were no matters of any other business raised for discussion.

16/54 DATE OF NEXT MEETING

Board Public Session (Annual Report & Accounts) on Thursday, 26 May 2016 from 13:15-14:15 in the Dulwich Room, Hambleden Wing

Enc. 1.5

Action Status as at: 01/06/2016 1

BOARD OF DIRECTORS (PUBLIC MEETING) ACTION TRACKER

Date Item Action Who Due Update DUE

24/11/2015 15/116 Patient Cancellation Data - It was agreed JF would speak to Ann Wood about the data on cancellation of patient which it was agreed would be circulated to the Board. Patient Story - It was agreed that data on appointment cancellations would be circulated to the Board.

AW/JF 01/06/2016 Update to be provided at the meeting

NOT DUE 06/04/2016 16/34 Chief Executive's Report - It was agreed that the Trust

would start to promote its Orthopaedics outcomes and the merits of the Trust hosting one of the centres in the interim.

NM 06/07/2016

06/04/2016 16/34 Chief Executive's Report - It was also agreed that FB, BK and JF would have a side meeting about hitting the 50% response to complaints.

JF/BK/FB 06/07/2016

06/04/2016 16/35.1 Performance Report (M11) – It was agreed that the recruitment plan for next year will be presented at the May Board meeting.

DB 06/07/2016

04/05/2016 16/49.1 Monthly Nurse Staffing Levels Report - It was agreed that the Board would pick up staff retention issues in the July.

DB 06/07/2016

02/02/2016 16/8.2 Adult Safeguarding Report - It was agreed that the Trust would look at DoLs benchmarking data across the Shelford Group and get some qualitative data about the process being used elsewhere.

GW 05/10/2016

02/02/2016 16/8.3 Children Safeguarding Report - It was agreed that a progress report on the safeguarding training and the implementation of the new system would be presented to

DB/GW 05/10/2016

2

Date Item Action Who Due Update the Board in 6 months.

06/04/2016 16/33.2 Quarterly Patient Safety Report – The following was agreed:

1) The Board noted that whilst it is reassured people are not getting complacent and use to the current level of never events the Trust should test out its current position against other hospitals and garner any learning;

2) The Board also noted and endorsed the commitment from management to improve the position by quarter 3/4.

JW/NM 02/11/2016

COMPLETED

04/05/2016 16/48.1 Performance Report (M12) - It was agreed that the Board, through the finance and performance committee, would give urgent focus to the ED performance. It was also agreed that JF would include comparative data in future performance reports.

FPC/JF 01/06/2016 This item has been moved to the FPC Work Plan.

Patient Experience Report

Board of Directors 01 June 2016

1

Enc. 2.2

Patient Experience Report Board of Directors 1 June 2016

2

Report to: Board of Directors Date of meeting: 1 June 2016 Subject: Patient Experience Report Author(s): Jessica Bush, Head of Engagement and Patient Experience, Sophie Dalton, Head of Patient

Relations and Complaints, Cathy Varley, PALS and Support Services Manager

Presented by: Judith Seddon, Acting Director of Corporate Affairs Sponsor: Judith Seddon, Acting Director of Corporate Affairs History: N/A Status: Information

1. Summary of Report This quarterly report to the Quality and Governance Committee about patient experience presents data and qualitative feedback from patients for Quarter 2 2015/16. 2. Action required The Board is asked to note this report and offer comments and recommendations. 3. Key implications

Legal: N/A Financial:

Reputational risk

Assurance:

CQC Fundamental Standards – Caring and Responsiveness. Delivery of mandated Friends and Family Test

Clinical: N/A Equality & Diversity:

The Equality Delivery System seeks to ensure that all patient groups receive the same quality patient experience

Performance:

Performance against CQC Fundamental Standards Friends and Family Test Complaints performance CQC National Patient Survey performance Delivery of Quality Account Priorities

Strategy:

Patient Experience is a key deliverable of the King’s Strategy and forms a part of the Trust Quality Account

Workforce: Links to Staff Friends and Family Estates: Quality of estate from a patient perspective Reputation: Poor patient experience is a reputational risk. Other:

Enc. 2.2

King's Corporate Strategy seeks to provide 'Best Care Globally' and one of the key strategies underpinning this goal is 'Best Quality Care' which encompasses our desire to treat our patients with courtesy and compassion, to listen to the views of patients, carers and the community to improve what we do and to provide accessible and user friendly services.

Executive Summary

3

• The picture at year end for patient experience is varied. • There are many services which are providing an excellent patient

experience, such as our Child Health wards, services at Orpington and from our TEAM outpatient clinics. However, there are also areas which require significant improvement if we are to achieve our aspiration to be amongst the top 10% of hospitals nationally for patient satisfaction

• For the Friends and Family Tests, inpatient performance continues to be generally strong but there are key wards where satisfaction is poor. Our Emergency Departments are significantly challenged in terms of the volume of patients coming through the doors and this is evidenced by variable satisfaction which has fallen over the last quarter as activity has continued to rise. Satisfaction with outpatient and maternity services is also lower than nationally

• Overall complaints reduced by 17% this year compared to last year • Responsiveness to complaints is a continuing challenge and,

although we have improved performance over the year to end with 45% of complaints being responded to within our target of 25 working days, we still have much work to do to achieve our internal goal of 70%

• PALS enquiries have risen by 9% compared to last year with the largest activity in the specialties where capacity has become a significant problem

• Positive Enter and View visits by Southwark Healthwatch to the Denmark Hill ED

• Work to improve patient experience for our two quality priority areas – outpatients and accessible information is progressing well

Enc. 2.2

• In line with other Trusts in London and England, performance has declined over the last six months

• Poor performance in March for King's – off target against trust nationally and Shelford Group

• Feedback continues to focus on waiting times, staff attitude and aspects of the environment

• Performance at PRUH ED has improved over Q4 but for DH there was a fall

Friends and Family Test A&E – target to be in top 10% of trusts nationally natiobally

Always friendly and staff always explained what is happening caring considerate and wonderful staff

I really hated the staff treatment. They were impatient and extremely rude.

(%) Positive

(%) Negative

(%) Positive

(%) Negative

(%) Positive

82 10 82 11 7886 7 85 8 8486 8 84 9 83London Area Team 10

King's A&E and Acute Dental 13England 9

March

Location/Trust (%) Negative

2016Month January February

4

Enc. 2.2

Sheet1

Inpatients

MonthJanuaryFebruaryMarch

Location/Trust(%) Positive(%) Negative(%) Positive(%) Negative(%) Positive(%) NegativeEngland average95

King's Inpatient and Day Cases93.92.692.61.995.92.0London average95

England952952952

London Area Team952952952

Shelford Group – March FFT Inpatients+ FFT

England average95

London average95

Newcastle upon Tyne 98

Imperial 97

University College Hospitals London 97

University Hospitals Birmingham 97

Guy’s and St Thomas’ 97

Oxford University Hospitals 96

King’s College Hospital96

Cambridge University Hospitals 95

Sheffield Teaching 95

Central Manchester 92

Sheet2

Outpatient Q 1


Location/Trust(%) Positive(%) Negative(%) Positive(%) Negative(%) Positive(%) Negative

King's Outpatient and Day Case867887886

England923923923



England average92

London average92



Imperial 94








Sheet3

A&E

2016



King's A&E and Acute Dental821082117813

England867858849


• Although King’s exceeded the national average score for March, to be amongst the best 10% of Trusts nationally, the percentage of patients recommending the trust would need to be 98% (excluding private patients)

• Within the clinical divisions, Child Health scored 98% over the quarter with Neurosciences on 97% and Cardiac and Liver on 96%. Performance for TEAM and Renal was disappointing with Renal (84%) and TEAM (92%)

• Top Shelford group Trust is Newcastle with a 98% recommend score • Excellent improvement for Orpington wards over Q4

Friends and Family Test Inpatient – target to be in top 10% of trusts nationally

I was always treated with kindness and understanding by all the nursing staff and also treated with respect and dignity on the ward by all the nursing staff as well. I would always recommend Byron Ward to anyone. My stay on this ward is always special and I will always remember my stay with a great fondness. May God Bless all the working staff, nurses and the doctors on Byron Ward. Thanking you all for getting me better I am so grateful.

Shelford Group – March FFT Inpatients

+ FFT

England average 95London average 95Newcastle upon Tyne 98Imperial 97University College Hospitals London

97

University Hospitals Birmingham 97Guy’s and St Thomas’ 97Oxford University Hospitals 96King’s College Hospital 96Cambridge University Hospitals 95Sheffield Teaching 95Central Manchester 92

Month

Location/Trust (%) Positive(%)

Negative(%)

Negative(%)

PositiveKing's Inpatient and Day Cases 94 3 2 96

England 95 2 2 95London Area Team 95 2 2 9595 2

93 2

95 2

February March(%)

Positive(%)

Negative

January

5

Enc. 2.2

Sheet1

Inpatients




England952952952



England average95

London average95


Imperial 97









5

6

7

8

9

10

5.9

Sheet2

Sheet3

Sheet1

Inpatients



King's Inpatient and Day Cases943932962London average95

England952952952



England average95

London average95


Imperial 97









Sheet2

Outpatient Q 1




England923923923


Sheet3

• Outpatient performance remains disappointing though, after a dip last quarter, improved over Q4

• Trending well below the London and national average scores • Within the divisions, Cardiovascular (98%), Haematology (97%) and Renal (94%) all

score above national and London hospitals. Performance from Liver over the quarter was poor with an average recommend score of 75%

• Negative feedback continues to focus on waiting times and staff attitude • King’s recommendation score trending well below top Shelford hospital – UHB • Little variation in satisfaction at DH – response rates for PRUH remain low

Friends and Family Test Outpatients and Day case – target to be in top 10% of trusts nationally

March(%)

Positive(%)

Negative(%)

Negative(%)

Positive(%)

Negative86 7 7 88 692 3 3 92 393 3 3 92 3

Location/Trust (%) Positive

Month January

London Area Team 93

February

King's Outpatient and Day Case 88England 92

Shelford Group – March FFT Inpatients + FFTEngland average 92London average 92University Hospitals Birmingham 97

Newcastle upon Tyne 94Imperial 94Guy’s and St Thomas’ 93Oxford University Hospitals 93



King’s College Hospital 88

Cambridge University Hospitals 88Central Manchester 87

I arrived in time for my 2.45 appointment. I waited until 5.15pm for a x-ray. When seen I was told this was normal - so why was I not asked to arrive at 5pm.

The service by staff is good but the waiting time for an appointment are ridiculous.

6

Enc. 2.2

Sheet1

Inpatients




England952952952



England average95

London average95


Imperial 97









Sheet2

Outpatient Q 1




England923923923



England average92

London average92



Imperial 94








Sheet3

Sheet1

Inpatients




England952952952



England average95

London average95


Imperial 97









Sheet2

Outpatient Q 1




England923923923



England average92

London average92



Imperial 94








Sheet3

• The table provides the average rating over the four maternity FFT touchpoints – ante natal, labour and birth, post natal and post natal in the community

• Trending below the London and national average scores • Highest satisfaction ratings received for care during labour and birth • Continuing low responses for post natal community • National combined recommend percentage was 96% over the quarter

Friends and Family Test Maternity – target to be in top 10% of trusts nationally

Amazing facilities, friendly welcoming staff including reception, special care by sonographer and assistants, felt very privileged to be a patient at the Harris Birthright Centre.

I have felt really supported throughout the post-natal process for the first couple weeks after giving birth. For the birth itself I was was so impressed by the support from my midwife. She was amazing. No complaints at all - just so grateful, thank you! Antenatal support was also excellent.

A bit poor, I understand that the midwives are busy, but frustrating when they say that they will sort something out and you never see them again.

(%) Positive

(%) Negative

(%) Positive

(%) Negative

(%) Positive

90 3 86 7 8896 1 96 2 9695 2 94 3 95London Area Team 2

King's Maternity – Combined 6England 2

March

Location/Trust (%) Negative

Month January February

Location/Trust Ante NatalLabour and

BirthPost Natal

Post Natal Community

King's College Hospital 89% 93% 93% 96%London average 94% 95% 91% 98%National average 95% 96% 96% 98%

7

Enc. 2.2

Sheet1

Inpatients




England952952952



England average95

London average95


Imperial 97









Sheet2

Outpatient Q 1




England923923923



England average92

London average92



Imperial 94








Sheet3

A&E

2016




England867858849


Sheet4

Maternity

2016



King's Maternity – Combined903867886

England961962962


Sheet1

Inpatients




England952952952



England average95

London average95


Imperial 97









Sheet2

Outpatient Q 1




England923923923



England average92

London average92



Imperial 94








Sheet3

A&E

2016




England867858849


Sheet4

Maternity

2016



King's Maternity – Combined903867886

England961962962


Location/TrustAnte NatalLabour and BirthPost NatalPost Natal Community

King's College Hospital89%93%93%96%

London average94%95%91%98%

National average95%96%96%98%

• Performance against our internal benchmarks is generally good across the divisions with just TEAM and Renal falling one point short of the target satisfaction score of 89

• Child Health continue to score very highly with an average satisfaction score over Q4 of 97

• Involving patients in decisions about their discharge is green across the board which is positive as this is an area where performance struggled in the last CQC national inpatient survey

• 47 wards met or exceeded the benchmark with 10 falling short

• Medial 2, Boddington, PRUH Children’s Ward and Paediatric Short Stay top score for the Quarter with very impressive patient satisfaction scores

How are we doing? Inpatients performance Q4

8

Enc. 2.2

• Overall, the Trust satisfaction score was 82 for the quarter, one point below target • Some good performance from the Divisions with five meeting or exceeding the current HRWD target satisfaction score of 83 • Liver, Child Health and Women’s all scored under 70 which is disappointing with Liver rated red across all metrics • Process issues including appointments, delays in clinic and information on waiting remain a significant issue with lack of information

for patients in clinic about whether there are delays is rated very poorly • Work is underway to improve information about delays through the Trust’s Improving Outpatient Experience quality priority for this

year – focus will be on ophthalmology on both sites and clinics in one of our specialist areas • Performance is better for caring aspects of the service including involving patients in their care, treating them with respect and dignity

and kindness • Response rates continue to be an issue in some areas and the PRUH. Plans to introduce tablets / iPads are delayed due to technical

issues with Wifi at the PRUH which need to be resolved • Introduction of texting for Friends and Family at the PRUH has also been delayed due to capacity issues within BIU

How are we doing? Outpatients performance Q4

Question / Overall Site & Divisions

Trust

Am

bulatory

Cardiovascular

Dental

Haem

atology

Neurosciences

Renal

Surgery

Trauma, E

mergency an

Wom

ens Services

Benchm

ark

1 . Friends and Family Test 88 89 98 89 97 85 94 84 99 88 873 . Service from Appointment Centre 74 74 80 70 89 69 80 76 85 68 804 . Seen on time 64 64 78 66 44 62 59 58 81 61 705 . Information on Waiting 37 31 33 29 37 37 55 39 66 17 606 . Involvement in Care 87 86 90 84 100 85 85 85 91 86 857 . Dignity and Respect 95 95 99 92 100 96 98 94 99 91 948 . Kindness & understanding – reception staff 92 94 94 86 98 93 96 90 98 80 949 . Kindness & understanding – clinical staff 95 95 98 95 100 95 97 94 98 94 94

Overall 82 81 87 80 85 80 84 80 90 77 83Respondents 2069 343 87 193 30 153 120 585 94 92100 58 53

83 74 7095 93 8794 89 8594 93 9187 89 7832 21 2462 51 4366 53 6285 83 75

CC

TD

Child H

ealth

Liver

9

Enc. 2.2

Sheet1

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM

Showing: Survey results broken down by chosen Site and Division, compared against the Trust overall and displayed as a heat map. For the date period specified in filters.

End Date31/03/2016 11:59:59 PM

Question / Overall Site & DivisionsTrustAmbulatoryCardiovascularCCTDChild HealthDentalHaematologyLiverNeurosciencesRenalSurgeryTrauma, Emergency anWomens Services Benchmark

1 . Friends and Family Test8889988583899775859484998887

3 . Service from Appointment Centre7474806653708962698076856880

4 . Seen on time6464786251664443625958816170

5 . Information on Waiting3731333221293724375539661760

6 . Involvement in Care87869087898410078858585918685

7 . Dignity and Respect95959994939210091969894999194

8 . Kindness & understanding – reception staff9294949489869885939690988094

9 . Kindness & understanding – clinical staff95959895939510087959794989494

Overall8281878374808570808480907783

Respondents2069343871005819330531531205859492

&"Arial"&8Report Generated: &BPage:&B &P of &N

Sheet2

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM


End Date31/03/2016 11:59:59 PM

Question / Overall Site & DivisionsDenmark HillAmbulatoryCardiovascularCCTDChild HealthDentalHaematologyLiverNeurosciencesRenalSurgeryTEAMTherapiesTrauma, Emergency anWomens ServicesWomens Services Benchmark

1 . Friends and Family Test8788987984899775859674-96991008887

889879848997758596740969910088

111111111101111

3 . Service from Appointment Centre7374806454708962698171-79851006880

1621771431381591851381541771440174184200156

222222222202222

4 . Seen on time6160795651664443626040-90811006170

2222561991892252301812162371850264265300217

333333333303333

5 . Information on Waiting3733313521293924375735-5066-1860

2552882342102542682042532942190314331300235

444444444404434

6 . Involvement in Care85858978908410078858779-95911008685

3393773123003383682823383812980409421400321

555555555505545

7 . Dignity and Respect94949990949210091969887-99991009094

4334754023944304683744344793850508521500411

666666666606656

8 . Kindness & understanding – reception staff8992938892869885939680-94981007894

5255694894865155664595275754660602618600489

777777777707767

9 . Kindness & understanding – clinical staff94949891939510087959889-98981009394

6196675805796106665466226735540700717700582

888888888808878

Overall8077837372768368788469-88901007383

Respondents15612698333571932953153113277011894386


Sheet3

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM


End Date31/03/2016 11:59:59 PM

Question / Overall Site & DivisionsOrpingtonAmbulatoryCardiovascularCCTDDentalNeurosciencesSurgeryTherapiesTrauma, Emergency anWomens Services Benchmark

1 . Friends and Family Test9110010060--88100-10087

1001006000881000100

111001101

3 . Service from Appointment Centre665050---5883--80

15015060001461830100

221002201

4 . Seen on time8179083--79100-10070

229150143002242830200

332003302

5 . Information on Waiting3025-33--33---60

254150177002582830200

433004302

6 . Involvement in Care9496-100--86100-10085

350150277003433830300

534005403

7 . Dignity and Respect93100-70--93100-10094

450150347004364830400

635006504

8 . Kindness & understanding – reception staff95100-80--93100-10094

550150427005295830500

736007605

9 . Kindness & understanding – clinical staff93100-70--93100-10094

650150497006226830600

837008706

Overall87815071--7898-10083

Respondents321215008501


Sheet4

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM


End Date31/03/2016 11:59:59 PM

Question / Overall Site & DivisionsPRUHAmbulatoryCardiovascularCCTDChild HealthDentalHaematologyLiverNeurosciencesRenalSurgeryTEAMTrauma, Emergency anWomens Services Benchmark

1 . Friends and Family Test8378100900-100--5782--6787

7810090001000057820067

1111010011001

3 . Service from Appointment Centre611001008125----3850--10080

178200171250100009513200167

2222010022002

4 . Seen on time5561836650-50--5051--1770

2392832377501500014518200183

3333020033003

5 . Information on Waiting3175100230-0--2533--060

3143832607501500017021500183

4444030044004

6 . Involvement in Care85811009050-100--6783--8385

39548335012502500023629700267

5555040055005

7 . Dignity and Respect97881009850-100--9298--10094

48358344817503500032839500367

6666050066006

8 . Kindness & understanding – reception staff9594100980-100--9294--10094

57768354717504500042048900467

7777060077007

9 . Kindness & understanding – clinical staff978910099100-100--8097--10094

66678364627505500050058500567

8888070088008

Overall8283988134-79--6273--7183

Respondents152936110100766004


Sheet5

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM


End Date31/03/2016 11:59:59 PM

Question / Overall Site & DivisionsQueen Marys SidcupAmbulatoryDentalSurgeryBenchmark

1 . Friends and Family Test9793-9787

93097

101

3 . Service from Appointment Centre8171-8380

1630180

202

4 . Seen on time7876-7870

2390259

303

5 . Information on Waiting4415-4960

2540308

404

6 . Involvement in Care9190-9185

3440399

505

7 . Dignity and Respect100100-10094

4440499

606

8 . Kindness & understanding – reception staff10099-10094

5430599

707

9 . Kindness & understanding – clinical staff9998-10094

6400699

808

Overall8980-8783



Sheet6

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM


End Date31/03/2016 11:59:59 PM

Question / Overall Site & DivisionsDulwich TherapiesBenchmark

1 . Friends and Family Test929287

92

1

3 . Service from Appointment Centre656580

158

2

4 . Seen on time919170

249

3

5 . Information on Waiting565660

304

4

6 . Involvement in Care959585

399

5

7 . Dignity and Respect10010094

499

6

8 . Kindness & understanding – reception staff10010094

599

7

9 . Kindness & understanding – clinical staff10010094

699

8

Overall908783

Respondents2626


Sheet7

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM


End Date31/03/2016 11:59:59 PM

Question / Overall Site & DivisionsBeckenham BeaconACLNAmbulatoryCardiovascularCCTDChild HealthSurgeryTherapiesTrauma, Emergency anWomens Services Benchmark

1 . Friends and Family Test95100100-100-80--10087

100100010008000100

110101001

3 . Service from Appointment Centre----------80

100100010008000100

110101001

4 . Seen on time8478100-50-80--10070

1782000150016000200

220202002

5 . Information on Waiting250--100-0---60

1782000250016000200

320303002

6 . Involvement in Care9810092---100--10085

2782920250026000300

430304003

7 . Dignity and Respect100100100-100-100--10094

3783920350036000400

540405004

8 . Kindness & understanding – reception staff9810092-100-100--10094

4784830450046000500

650506005

9 . Kindness & understanding – clinical staff100100100-100-100--10094

5785830550056000600

760607006

Overall948397-92-80--10083



Sheet8

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM


End Date31/03/2016 11:59:59 PM

Question / Overall Site & DivisionsErithAmbulatoryCCTDBenchmark

1 . Friends and Family Test---87

00

00

3 . Service from Appointment Centre---80

00

00

4 . Seen on time---70

00

00

5 . Information on Waiting---60

00

00

6 . Involvement in Care---85

00

00

7 . Dignity and Respect---94

00

00

8 . Kindness & understanding – reception staff---94

00

00

9 . Kindness & understanding – clinical staff---94

00

00

Overall---83

Respondents000


Sheet9

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM


End Date31/03/2016 11:59:59 PM

Question / Overall Site & DivisionsSevenoaksAmbulatorySurgeryBenchmark

1 . Friends and Family Test---87

00

00

3 . Service from Appointment Centre---80

00

00

4 . Seen on time---70

00

00

5 . Information on Waiting---60

00

00

6 . Involvement in Care---85

00

00

7 . Dignity and Respect---94

00

00

8 . Kindness & understanding – reception staff---94

00

00

9 . Kindness & understanding – clinical staff---94

00

00

Overall---83

Respondents000


Sheet10

Divisional Heat Map

Start Date01/01/2016 12:00:00 AM


End Date31/03/2016 11:59:59 PM

Questions

1How likely are you to recommend our outpatient department to friends and family if they needed similar care or treatment?

3How would you rate your experience of booking your appointment/time slot

4How long after the stated appointment time did your appointment start?

5If you had to wait for your appointment, were you told how long you would have to wait?

6Were you involved as much as you wanted to be in decisions about your child’s care?

Were you involved as much as you wanted in decisions about your care and treatment?

7Overall, were you treated with respect and dignity in the outpatient department?

8During your visit were you treated with kindness and understanding by reception staff?

9During your visit were you treated with kindness and understanding by clinical staff?

Selected Filters:

Note: The available filter selection is dependent on the report that is being generated.

Filter OptionSelection

Trust SiteBeckenham Beacon,Denmark Hill,Dulwich ,Erith,Orpington,PRUH,Queen Marys Sidcup,Sevenoaks

ServiceDay Case,Outpatient

Speciality / WardAllergy and immunology ,Assisted conception unit ,Audiology (BB) ,Audiology (PRUH),Bariatrics,Blood tests/Phlebotomy (BB),Blood tests/Phlebotomy (DH),Blood tests/Phlebotomy (ORP),Blood tests/Phlebotomy (PRUH),Bone marrow transplant,Breast Care (DH),Breast Care (PRUH),Breast Screening (104 Denmark Hill) ,Breast Screening (Cheyne Wing),Breast Screening (Screening van) ,Cardiac Catheter Laboratory (DH),Cardiac Catheter Laboratory (PRUH),Cardiac Outpatients ,Cardiology (BB),Cardiology (DH),Cardiology (ORP),Cardiology (PRUH),Cardiology (SO),Cardiothoracic surgery (DH),Cardiothoracic surgery (PRUH),Chartwell Unit,Chemotherapy unit (DH),Chemotherapy unit (PRUH),Chest Unit (DH),Chest Unit (PRUH),Child Liver ,Colorectal (DH),Colorectal (ORP),Colorectal (PRUH),Colorectal (SO),Colposcopy and Vulvoscopy (BB),Colposcopy and Vulvoscopy (DH),Community Services,CT Scan (DH),CT Scan (neuroimaging) (DH),CT Scan (neuroimaging) (PRUH),CT Scan (PRUH),Cystic Fibrosis ,Deep Brain Stimulation,Dental – Community Special Care,Dental - Maxillofacial (DH),Dental - Maxillofacial (PRUH),Dental - Oral Surgery (DH),Dental - Oral Surgery (ORP),Dental - Oral Surgery (PRUH),Dental - Orthodontics (DH),Dental - Orthodontics (QM),Dental - Restorative,Dental Hygiene & Therapy – Adults,Dental Hygiene & Therapy – Children,Dermatology (BB),Dermatology (DH),Dermatology (ORP),Dermatology (SO),Diabetic clinic (DH),Diabetic clinic (PRUH),Diabetic eye clinic,Diabetic foot clinic ,Dialysis Satellite Unit - Bromley,Dialysis Satellite Unit - Dartford,Dialysis Satellite Unit - Dulwich ,Dialysis Satellite Unit - Sydenham,Dialysis Satellite Unit - Woolwich,Endocrinology (BB),Endocrinology (DH),Endocrinology (PRUH),Endoscopy,ENT,Epilepsy,Fracture clinic (DH),Fracture clinic (PRUH),Gastroenterology,Gastroenterology (PRUH),General Clinics ,General Neurology (DH),General Neurology (ORP),General Neurology (PRUH),General surgery (BB),General surgery (DH),General surgery (ORP),General surgery (PRUH),General surgery (SO),Gerontology (BB TEAM),Gerontology (DH Surgery),Gerontology (OP TEAM),Gerontology (PRUH Surgery),Gerontology (PRUH TEAM),Gerontology (SO),Gynae Endocrine Clinic ,Gynae oncology ,Gynaecology (BB) ,Gynaecology (DH),Gynaecology (ORP),Gynaecology (PRUH),Haematology medicine (DH),Haematology medicine (PRUH),Haematology Outpatients,Headache (Bessemer Road),Headache (Suite 5),Health and ageing Unit,Hepathology ,Hepatobiliary,Hospital at Home,Huntingtons Clinic,Integrated Respiratory Team ,Interventional Radiology (DH),Interventional Radiology (PRUH),Kings Dialysis (Main Unit) ,Lipids ,Liver Outpatients ,Liver Pathology,Maxillofacial,Medical oncology,MND Clinic ,Movement Disorder ,MRI Scan (DH),MRI Scan (neuroimaging) (DH),MRI Scan (neuroimaging) (PRUH),MRI Scan (PRUH),MSK (Pain, Rheumatology, Ortho),MSK Pain,MSK Rheumatology,Multiple Sclerosis ,Muscle Clinics ,Neonatal Outpatients (DH),Neonatal Outpatients (PRUH),Nephrology Clinic (DH),Nephrology Clinic (PRUH),Neuro Admissions Lounge,Neuro Pain Clinic ,Neuro Surgery (Spinal) ,Neuro Surgery ,Neurology,Neurology/Neuro Surgery,Neuro-Ophthalmic ,Neuropsychology ,Neurovascular,Nuclear medicine ,Nuclear medicine (DH),Nuclear medicine (ORP),Occupational Therapy (General) (BB),Occupational Therapy (General) (DH),Occupational Therapy (General) (ORP),Occupational Therapy (Hand),Occupational Therapy (Neuro) ,Oncology Clinics ,Ophthalmology (DH),Ophthalmology (PRUH),Ophthalmology (QM),Ophthalmology (SO),Oral Medicine,Orthodontics,Orthopaedics,Orthopaedics (BB),Paediatric Allergy (DH),Paediatric Allergy (PRUH),Paediatric Blood tests/Phlebotomy (DH),Paediatric Blood tests/Phlebotomy (PRUH),Paediatric Cardiology,Paediatric Dentistry,Paediatric Dermatology/Skin (DH),Paediatric Dermatology/Skin (PRUH),Paediatric Diabetes (DH),Paediatric Diabetes (PRUH),Paediatric endocrine/dieticians (DH),Paediatric endocrine/dieticians (PRUH),Paediatric ENT,Paediatric Gastroenterology (DH),Paediatric Gastroenterology (PRUH),Paediatric General Medicine (DH),Paediatric General Medicine (PRUH),Paediatric Haematology/Sickle Cell/Oncology ,Paediatric Respiratory/Asthma/CF,Paediatric surgery (DH),Paediatric surgery (PRUH),Paediatrics,Paediatrics (DH),Paediatrics (PRUH),Pain clinic (BB),Pain clinic (DH),Pain clinic (ER),Pain clinic (ORP),Pain clinic (SO),Parkinsons Clinic ,Peripheral Nerve,Physiotherapy (General) (BB),Physiotherapy (General) (DH),Physiotherapy (General) (ORP),Physiotherapy (Neuro),Physiotherapy (Paediatrics),Physiotherapy (Respiratory),Physiotherapy Musculoskeletal (DH),Physiotherapy Musculoskeletal (DUL),Pituitary,Planned Investigation Unit (DH),Planned Investigation Unit (PRUH,Plastic surgery (ORP),Plastic surgery (PRUH),Plastic surgery (SO),Podiatry,Pre Assessment ,Psychological medicine ,Pulmonary Rehab Team ,Radiology (BB),Radiology (DH),Radiology (ORP),Radiology (PRUH) ,Rapid Access ,Rapid Access Chest Pain Clinic,Renal Outpatients,Respiratory ,Restorative Dentistry,Rheumatology (BB),Rheumatology (DH),Rheumatology (ER),Rheumatology (ORP),Rheumatology (PRUH),Sarcoid ,Sexual Health Centre (BB),Sexual Health Centre (DH),Skull Base ,Sleep Clinic,Spasticity Clinic,Speech and Language Therapy,Stroke medicine (DH),Stroke medicine (PRUH),Surgical Appliances,Therapy Gym,Thyroid ,TIA Clinic,TOP,Trauma and Orthopaedics (ORP),Trauma and Orthopaedics (PRUH),Trauma and Orthopaedics (SO),Trigeminal Neuralgia,Ultrasound (BB),Ultrasound (DH),Ultrasound (ORP),Ultrasound (PRUH),Urogynaecology ,Urogynaecology Physiotherapy,Urology (BB),Urology (DH),Urology (ORP),Urology (PRUH),Urology (SO),Vascular Clinic ,Vascular Lab,Vascular surgery (BB),Vascular surgery (DH),Vascular surgery (PRUH),X-ray (BB),X-ray (DH),X-ray (ORP),X-ray (PRUH)

Location104 Denmark Hill,1st Floor,1st Floor, Cheyne Wing,1st Floor, Cheyne Wing Opposite Matthew Whiting,1st Floor, Denmark Wing,2nd Floor,2nd floor Denmark Wing,2nd floor Hambledon central ,2nd Floor, Cheyne Wing,2nd Floor, Golden Jubilee Wing,2nd Floor, Ruskin Wing,3rd Floor Bessemer Wing ,9th Floor Ruskin Wing ,Alan Cumming Building,Bariatrics ,Basement , Golden Jubilee Wing,Basement Hambledon,Betty Alexander Suite, Golden Jubilee Wing,Cardiac Cath Lab, 1st Floor Cheyne Wing,Chartwell Unit - Basement,Clinical Measurements - Basement,Denmark Hill,Dental Building,Dialysis Satellite Unit - Bromley,Dialysis Satellite Unit - Dartford,Dialysis Satellite Unit - Sydenham,Dialysis Satellite Unit - Woolwich,Dulwich Hospital,Ground Floor,Ground Floor, Cheyne Wing,Ground Floor, Golden Jubilee Wing,Level 0, PRUH North Wing,Level 1, PRUH South Wing,Normanby Building,OP B, Level 1 South Wing,OP C - Level 1, PRUH South Wing,OP D - Level 1, PRUH South Wing,Outpatients B, Level 1 South Wing,Outpatients C, Level 1 South Wing,Outpatients D, Level 1 South Wing,Paediatric Outpatients, 3rd Floor, Hambledon Wing,Pre Assessment,Radiology - Ground Floor,Radiology - Level 1,Screening Van ,Suite 1, Golden Jubilee Wing,Suite 3, Golden Jubilee Wing,Suite 4, Golden Jubilee Wing,Suite 5,Suite 5, Golden Jubilee Wing,Suite 6, Golden Jubilee Wing,Suite 7, Golden Jubilee Wing,Suite 8, Golden Jubilee Wing,Therapy Suite Golden Jubilee Wing 1st Floor,Unit 6, KCH Business Park,West Kent Eye Centre - level 2 South Wing

DivisionACLN,Ambulatory,Cardiovascular,CCTD,Child Health,Dental,Haematology,Liver,Neurosciences,Renal,Surgery,TEAM,Therapies,Trauma, Emergency and Acute Medicine (TEAM),Womens Services

SurveyOutpatient Survey including Dental

QuestionAll Questions Selected

ResponseAll Responses Selected

CategoryEasy Read,Standard,Parents / Carers,Child (8-16 years)

Start Date01/01/2016 12:00:00 AM

End Date31/03/2016 11:59:59 PM


• Work on track to launch new appointment letters in June

• Pre-assessment on track • Initial meetings have taken place with key staff and

working group set up to develop accessible feedback tools to include speech and language, stroke and LD expertise

• Initial phase will be to develop online survey capability with easy read and photos

• Initial work underway to develop training for volunteers about learning disability and communication to enable supported feedback

• Initial baseline data analysis completed identifying key areas for improvement at DH and PRUH

• First clinics for improvement work identified and agreed with Divisional Manager as Ophthalmology at both DH and PRUH where satisfaction rates are very low

• Second specialist area to be identified and agreed • Work to commence with staff groups June 2016

Patient Experience Quality Priorities – progress to-date

Accessible information: Improve access to information for patients, carers , service users and parents where those needs relate to a disability, impairment or sensory loss.

Improving Outpatient Experience: Improving information about waiting times for patients in clinic

10

Enc. 2.2

KEY FINDINGS

• Patient feedback on staff was generally positive – they are friendly and supportive.

• Patients weren’t aware of services available out of the hospital, or had much confidence in using them. People told us they struggled to get an appointment with their GP and therefore used A&E instead.

• Patients weren’t clear about where to go or what to do when first arriving in the department.

• Patients found the waiting area uncomfortable and gloomy. • Patients weren’t given much information about how long

they could expect to wait. • Staff generally felt well supported in their role, and were

satisfied with the training they had received. • Staff said that space and capacity was an issue in the

department, and care of mental health patients was mentioned as a challenge.

• Staff told us that patients often spoke of issues getting an appointment with their GP.

RECOMMENDATIONS

1. The Trust improves clarity for patients on what to do and where to go upon arriving.

2. The Trust improves the appearance of the waiting area. 3. The Trust improves triage and re-direction of patients. 4. The Trust improves how it communicates information about

the expected waiting time. 5. The Trust improves the way patients are called to see staff. 6. The Trust reviews how volunteers could support the

department. 7. The Trust regularly reviews the staffing levels and skills mix in

A&E. 8. Southwark CCG initiates further research to understand why

people choose A&E over other services. 9. GP Federations extensively promote the Extended Primary

Care Services. 10. Southwark CCG works with acute providers to ensure there is

clear messaging about how to use services appropriately. 11. Southwark CCG works with acute providers to address care of

people with mental health problems in the A&E department.

Focus on the front line – Healthwatch Enter and View Denmark Hill Emergency Department

As part of a regular programme of engagement with King’s, Southwark Healthwatch carried out 4 formal Enter and View visits to the Denmark Hill Emergency Department over the winter

The Trust and CCG have provided written responses to the recommendations and associated actions will be monitored quarterly with Healthwatch. Full report available at http://healthwatchsouthwark.co.uk/reports

11

Enc. 2.2

http://healthwatchsouthwark.co.uk/reports

Patient Complaints Q4 15/16

The Trust received 206 complaints in Q4 compared to 219 in Q3; 110 (128) at DH and 97 (90) at the Bromley sites. The ratio of complaints received during the quarter to patient activity (per 1000 patient attendances) was 0.6 compared to 0.5 in Q3. Overall, the downward trend continues in complaints received with a total of 811 in 15/16 compared to 974 in 14/15 – a 17% reduction. In Q4, 215 potential complaints were resolved locally. Performance in responding to complaints improved with 50% closed in Q4 within 25 working days with an overall YTD 15/16 performance of 45%. Just over half of the complaints investigated were upheld.

Inpatient complaints represents 61% of the overall total of complaints received in Q4 (127) which is an increase of 14 complaints from Q3 (113) – DH, 72 and Bromley sites, 55. Maternity - increased marginally to 15 from 8 in Q3; DH 11 and PRUH 4. Overall DH has received the most complaints about maternity care with an average 2 cases per month compared to 0.9 at the PRUH. Outpatients (including ED) – have significantly decreased in Q4 (79) from 111 in Q3 (37 DH, 42 Bromley). PRUH ED complaints notably reducing in Q4. 12

Enc. 2.2

Complaints - Responsiveness

First receivedNo. Responded Within 25 Days

% Response Rate Within 25 Days

No. Responded Late

15/16 Quarter 4 206 102 50% 37Ambulatory 13 4 31% 4Cardiovascular 12 8 67% 2Child Health 10 8 80% 1Corporate Affairs 1 1 100% 0Critical Care & Theatres 4 4 100% 0Clinical, Scientific & Diagnostic Services 1 1 100% 0Dental 5 2 40% 0Facilities 6 5 83% 1Clinical Haematology 4 3 75% 0Liver 20 6 30% 2TEaM 38 15 39% 10Neurosciences 13 9 69% 1Maternity 15 11 73% 3Renal 3 0 0% 1Sexual Health 1 1 100% 0Surgery 28 10 36% 6Therapies 1 0 0% 0Emergency Department & Major Trauma 21 8 38% 5Women's Services - Gynaecology 10 6 60% 1Totals: 206 102 50% 37

Responding to complaints improved in the second half of 15/16 with 49% and 50% of complaints closing within 25 working days in Q3 and Q4. This fell short of our internal target but demonstrates an overall % improvement since October 15 which is ongoing. Activity by Division for Q4 demonstrates areas achieving the 70% target and those where improvement is still required. Continuous dialogue and support is given to the Divisions and early signs suggest YTD 15/16 response rate is 56%. Overall the response rate in 15/16 was 45% The trust’s 5-year Quality Strategy sets an aspirational target of responding to 95% of complaints within 25 working days.

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Complaint themes

53.5% (68) of inpatient complaints relate to clinical treatment (doctor led). Cardiology, General Medicine and Labour received the most complaints of this type. Concerns about patient care (nursing) represent 37% of the inpatient complaints (47) – of these 22% reflect concerns that care needs were not met or were felt inadequate. Most complaints of this type were made about a general medical ward (DH) or the Nightingale Birth Centre (DH).

Significant decrease (29%) of outpatient complaints in Q4 – the reduction being at DH where complaints fell to 37 compared to 68 in Q3. We continue to look for opportunities to locally defuse outpatient enquiries which is reflected in these figures overall. Clinical treatment (doctor led) concerned 70% of the Bromley site outpatient complaints (29). They are varied in area and theme with 70% (20) relating to Surgery, ED, Ambulatory and Gynaecology.

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Complaints - Divisional Activity

Bromley sites: Overall, Surgery has a high level of complaints on the Bromley sites in 15/16 (85), 25% of the total number of complaints received in 15/16. However, related to patient activity, the ratio of complaints is low at 0.6 per 1000 patient attendances. Half of all Surgery complaints in 15/16 related to clinical treatment and 20% related to an admission/discharge. Medicine has the second largest level (67), 19% of the total complaints. Related to activity this is a ratio of 2 complaints per 1000 patient attendances. Approximately a third relate to clinical treatment and 19% relate to discharge. ED had their second lowest rate of complaints in Q4 (9) following 15 in Q3. Denmark Hill: Networked Services (Cardiovascular, Haematology and Neurosciences) have the highest profile of complaints in 15/16 (98) but a low ratio of 0.7 complaints per 1000 patient attendances. Surgery complaints were at their lowest level reported in Q4 (9). In 15/16 Surgery received 63 complaints compared to 81 in 14/15 (20% lower), and 104 in 13/14. Gynaecology/Child Health increase in Child Health complaints in Q4 (8) up from 4 in Q3. Liver (including HPB, Endoscopy) have maintained high levels of complaints in Q3 and Q4 (15, 16). Issues in the main concern clinical treatment, communication and admissions/discharges.

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When investigation and responding to complaints, we continually identify areas of our service that we can improve on, which may also include individual performance and personal development. As part of our approach to resolving complaints, we invite patients, their families and/or advocates to meet with us, as listening first hand to experiences, enables us all to reflect and ensure changes are made when we have not got things right. During Q4 we have used complaints to contribute towards a range of general improvements across the organisation. Below is one case which has resulted in a number of actions being identified which have been completed or remain ongoing.

Learning from complaints

Elderly patient was admitted to King’s following a fall at home. She had vascular dementia, previous stroke, diabetes and a heart condition. The family were concerned that she was insufficiently monitored within the Emergency Department as she went on to experience a seizure. Once moved to a medical ward, the family remained concerned with the level of care the patient was receiving, both in terms of the timeliness of the clinical assessments and the nursing led care. The patient was moved to another medical ward where the family again found staff were not responsive to their mother’s care needs and felt that she was inadequately monitored. A delay in the patient receiving a sedative infusion caused distress. In response to the complaint, the Trust acknowledged firstly that the monitoring of the patient within the Emergency Department had been appropriate but staff had failed to communicate and share information with the family to alleviate their stress and worry. The Trust confirmed that the monitoring of the patient on the ward had also been appropriate, with several different specialty teams reviewing the patient through the day and night. It was accepted that sharing information with the family during these investigations had not been adequate. It was also acknowledged that in hindsight the ward nurses did not respond to the family’s concerns in a supportive way. The following are some key learning actions arising from the case: 1. Complaint was shared with teams involved in the patient’s care. 2. Specific feedback was given to individual nurses identified, with objectives for improving practice set and monitored for these

staff. 3. Additional stocks to be ordered for any high dose medications being prescribed so that an appropriate ward stock level can be

maintained. 4. Projects on medication administration and dignity and continence are being completed on the medical ward. 5. Senior nursing staff are leading on care at the bedside to demonstrate, develop and monitor best practice of the fundaments

of care. 16

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Patient Advice and Liaison Service Overview of activity - Q4 PALS 15/16

Inpatient activity across sites remains stable. Outpatient activity has increased on both sites this quarter. ED contacts at PRUH increased this quarter despite remaining stable at Denmark Hill.

Overall PALS activity has increased by 9% in 15/16 compared to the previous year.

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Bromley Sites Denmark Hill Division Total Number I/P O/P Total Number I/P O/P Ambulatory 461 7 454 211 16 195 LRS 326 142 184 287 115 172

Network Services 113 46 67 407 96 311

TEaM 195 163 32 146 105 41 W&C 60 31 29 109 27 82 CCTD 52 3 49 87 13 74

Total number of PALS cases by Division 1 Jan to 31 March 2016

PALS outpatient activity is greatest in the specialties where capacity has become a significant problem. The relative numbers in TEAM are low despite the numbers of attendances.

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PALS activity for Q4 by division and site

Site Month LRS Ambulatory TEaM Network Services W&C CCTDPRUH January 65 21 54 30 16 12

February 72 23 70 29 23 8March 78 37 64 45 19 22Total 215 81 188 104 58 42

ORP January 13 5 1 1 1 1February 16 3 1 1 0 3March 16 6 2 5 1 1Total 45 14 4 7 2 5

QM January 3 113 0 0 0 0February 8 148 0 0 0 1March 1 105 0 0 0 1Total 12 366 0 0 0 2

BB January 6 0 0 1 0 2February 6 0 2 1 0 1March 5 0 1 0 0 0Total 17 0 3 2 0 3

DMH January 83 61 39 137 38 27February 103 86 54 132 40 39March 101 64 53 138 31 21Total 287 211 146 407 109 87

Total 576 672 341 520 169 139

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Activity for Liver Renal and Surgery all sites 1 January – 31 March 2016 Bromley

Sites Audiology Colo

rectal ENT Gastro General Surgery

Ortho paedic Urology Total

Jan 0 9 5 6 28 35 13 87

Feb 0 9 2 11 32 43 17 102

Mar 1 6 2 20 26 46 15 100

Total 1 24 9 37 86 124 45 326

Denmark Hill

Colo rectal

General Surgery Liver

Ortho paedic Renal Urology Total

January 13 7 25 25 5 8 83

February 11 17 35 23 4 13 103

March 10 12 31 33 9 6 101

Total 34 36 91 81 18 27 287

Cancellation of elective surgery and increase in length of surgical waiting lists was significant this quarter with bed capacity limited for some groups such as Orthopaedics at Denmark Hill and infection control restrictions to admissions at Princess Royal. There are continuing patient issues relating to theatre availability for Orthopaedic patients requiring surgery on the Princess Royal site. Outpatient appointments were also rescheduled because of industrial action but the key theme of dissatisfaction for patients was their difficulty in communication, telephone accessibility, receiving adequate explanations and agreeing rescheduled dates. This was cited in 50% of the cases as the key issue.

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Activity for Ophthalmology and ED all sites 1 January – 31 March 2016

ED

Emergency Medicine PRUH

Emergency Medicine DMH Total

January 35 16 51 February 38 13 51 March 34 12 46 Total 107 41 148

This specialty has now stabilised in the numbers of contacts on the Princess Royal site. At QMS there are site specific problems this quarter relating to the reconfiguration of outpatient administration support, appointment capacity and significant alteration to the infrastructure of Oxleas switchboard services. This has created high numbers of PALS contacts for simple appointment and clinical enquiries.

An increase in PALS contacts at Princess Royal relates to dissatisfaction with clinical care. It is however also linked to increased waiting times in the department and clinical decision making when inpatient bed capacity is limited.

Ophthalmology Ophthalmology

PRUH Ophthalmology

QM Ophthalmology

DMH Total January 12 77 20 109 February 7 110 34 151 March 19 78 26 123 Total 38 265 80 383

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Enc. 2.2

Activity for Neurosciences all sites 1 January – 31 March 2016

Neurosciences Neurology Bromley Neurology DMH

Neurosurgery DMH Total

January 3 26 88 117

February 8 25 83 116

March 16 41 68 125

Total 27 92 239 358

Delays in the administration processes for Neurosurgical spinal referrals, waiting times for new appointments and difficulties for patients in accessing information have been significant this quarter.

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Enc. 3

1

Report To: Board of Directors Date of Meeting: 01 June 2016 By: Nick Moberly, Chief Executive Officer Presented By: Nick Moberly, Chief Executive Officer Subject: Chief Executive’s Board Report OVERVIEW As we move into the early part of the new FY, our focus has been threefold:

• First, maintaining a tight grip on performance, in line with the trajectories that the Trust has proposed for the year. Clinically, performance remains generally strong. Operationally, we are performing in line with our proposed trajectories, but have significant improvements still to deliver as the year unfolds. Financially, Month 1 was behind plan owing to income weakness; and we need to maintain an intensive focus on firming up and delivering our £50m cost improvement programme for the year.

• Secondly, starting to drive the longer transformation of our services. Under

this broad heading, the last month has seen good progress in driving through our organisational restructure – described below. Very positively, our business case to launch a major programme of clinical transfo

agenda - king's college hospital nhs foundation trust - 479.1 - bod agenda and papers ju… ·...

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