north west health self assessment process 2011
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North West Health North West Health Self Assessment Self Assessment Process 2011Process 2011
Sue SmithProject Manager for the
Health Equality Group and Health Self Assessment Lead
Health Self Assessment
4 Top targets Ensuring everyone has a
person centred plan Equal access to all health
services Ensuring people using health
services are safe Valuing People targets are met
Overall Ratings
Target 2011 2010
1
2
3
4
Target One
2011 2010 2
elements
Green 11 11
Amber
12 12
Red 1 1
15 same
1 improved
8 rated lower
Target Two
2011 2010
9 elemen
ts
Green 3 2
Amber
18 20
Red 3 2
2 same
14 improved
8 rated lower
Target Three
2011 2010
4 elemen
ts
GreenAmbe
r24 24
Red
3 same
10 improved
11 rated lower
Target Four
2011 2010
11 elemen
ts
Green 7 12
Amber
14 9
Red 3 3
3 same13 improved8 rated lower
Issues
Targets changed slightly from last year
Target 1 re % PCP/health action plan
% for some targets mean ratings changed
Issues about Joint Strategic Needs Assessments- many areas did not have detailed JSNA in place-(red)
Overall
Many areas improved Data collection improved More self advocates involved
in training More people had health checks People felt things were getting
better
Target 2
Reminder texts for appointments
Information shared in referral letters
Wheels for all- cycling project Care pathway for parents with
learning disability Cancer screening improved
Target 2
A protocol is in place to follow up non attendance at health check appointments
Healthy lifestyles course Appointed a postural care
physio specialist to deliver postural care
Health action plan audited completed across all services
Target 3
Acute network Patient satisfaction survey Individualised pathways Thumbs Up Hate Crime DVD E learning safeguarding People involved in training
Target 4
Health action plans in prison Accessible custody information Prison staff training Prison health staff shadowing CTLD
and doing training Specialist Forensic Practitioner and
specialist provider to support people with forensic needs
Target 4
Dementia cafes Complex care teams Autism e learning tool Short break services Transition plans Patient stories Advocacy Hub developed
CQUINS commissioning for quality improvement
Mental health services - flagging, HAPs & communication needs
Re use of patient passports Re reasonable adjustment 12 staff trained for autism
assessment Acute hospitals to improve quality of
care
Accessible information
Accessible information-pathwaysassociates.co.uk Reader panels Pictorial pathways DVD patient journeys Websites NWAS communication book
Acute self assessment
1. Self-assessment Questionnaires based around 7 themes
2. Hospital visits Hospital visits based around exploring the themes
3. Sharing and learning event
Areas looked at
Information Reasonable adjustments to services Involvement of people with a learning disability
and their carers Capacity, consent, safeguarding and the law Leadership Organisational learning Fundamental care
Self assessment summary
1. Information for patients and carers
Theme with most scope for improvement across Acute and MH Trusts
Good things going on:
Range of easy read information Pre-admission visits for elective patients Flagging system Hospital passport system.
What can be better!
Easy read medication information Picture food menus Accessible information in A&E
2.Reasonable adjustments &service delivery
Theme with significant scope for improvement, especially for Acute Trusts
Good things going on
Liaison Nurse – 3 Trusts have these Individualised care plans Staff training and awareness
What can be better!
Basic training/awareness Counting number of readmissions
0%
20%
40%
60%
80%
100%
North West Acute Trusts MH Trusts
3.Involvement in development of services Theme with significant learning opportunities from
MH Trusts
Good practice Carers involved in decision making Individual care planning Monitoring of complaints and incidents
What can be better Pre-admission information Easy read admissions booklet Patient feedback mechanisms Carer surgeries
0%
20%
40%
60%
80%
100%
North West Acute Trusts MH Trusts
4.Capacity, consent & safeguarding
Theme with lowest number of red ratings from self-assessment
Good practice Compliance with Mental Capacity Act and Deprivation of Liberty Equality and Diversity awareness
What can be better! Advocacy for patients Staff training
0%
20%
40%
60%
80%
100%
North West Acute Trusts MH Trusts
Theme with significant scope for improvement
Good practice Managers are Learning Disability champions Nurses are Learning Disability champions
What can be better!
Learning disability awareness across the whole Hospital Working with services in the community
5.Leadership & management
0%
20%
40%
60%
80%
100%
North West Acute Trusts MH Trusts
Lots of room for improvement!
Good things going on:
Lessons learned from complaints
What can be better!
Patient and carer feedback sharedwith Managers Learning Disability champions to raise awareness
6.Organisational learning
0%
20%
40%
60%
80%
100%
North West Acute Trusts MH Trusts
7.Fundamental care
Good things Hospital passport system Individualised care plans Learning Disability champions Mental capacity assessments
What we can learn from Mental Health Trusts!
Reasonable adjustments to all aspects of care
0%
20%
40%
60%
80%
100%
North West Acute Trusts MH Trusts
Summary
Quick wins:Hospital Passport Accessible information Flagging systems Individualised care plans
Most impact: Raising awarenessInvolvement of patients and carers
Must dos: Engagement with patient group and their carersPartnership working and sharing good things happening
Next Steps
All areas developing action plans Regional report Review of Health Self Assessment
for 2012 Repeat process later this year HEG work plan Get more acute hospitals to do
assessment
Thank you
Any questions?
Sue Smith susan.smith@northwest.nhs.uk
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