Deep-dive review set to be springboard for closer working between health watchdog and Trust
Derby’s independent consumer champion for health and social care services, Healthwatch Derby, has published the findings of an in-depth independent review into our work in the city, following an innovative collaboration between the two organisations that looks set to be continued in the future.
Healthwatch Derby was given exclusive access to our services in the autumn of 2014, to see how we support people with mental health problems, people with learning disabilities and Derby’s children and families. Healthwatch Derby staff were given the opportunity to observe Trust teams first-hand, shadowing the mental health Crisis Resolution and Home Treatment team over a 12-hour shift as well as the school nursing and health visiting teams. They also conducted two ‘enter and view’ sessions at the Radbourne Unit and on Wards 1 and 2 at London Road Community Hospital, to assess the care of adults and older adults experiencing acute mental distress and to collect the views of patients and carers receiving support from each service.
The collaborative 'Think Healthy' review also saw staff from both organisations promoting a questionnaire, and organising and attending face-to-face public feedback events including a trilingual workshop at the Indian Community Centre run in Punjabi, Hindi and Urdu.
In total 1,070 items of individual feedback were collected.
Now, the two organisations hope to build on the close relationship developed during the period of the review and work together to ensure that services are constantly changing and improving to meet people’s needs. The Trust is launching a revised Patient Experience Committee that will act on the recommendations in the Think Healthy review and report back to Healthwatch Derby on its progress.
The report on the Think Healthy review includes the following findings:
- Of those who responded to the Think Healthy survey, 70% rated the services they had accessed as fair to very good, 72% rated safety and care at the Trust as fair to very good and 70% rated the Trust’s effectiveness of care as fair to very good.
- The Trust’s Crisis Resolution and Home Treatment team, which intervenes to support people experiencing acute mental distress, “deals with each patient with empathy, dignity, sensitivity and support” – however because the team operates with handwritten notes, “there is a delay in getting information back to base”; there is also feedback from individuals that there was a “long waiting time for counselling referrals” for patients.
- The Trust’s health visitors “have a good rapport with mothers and babies they are supporting,” “good provision of facilities” and the ability to “speak a variety of languages” – however some consultations “see the mother standing while the health visitor completes assessments and checks,” while improvements could be made in terms of efficiency as “all notes taken are paper based.”
- The Trust’s school nurses “have a good rapport with children they are assessing, and good use of engaging and informative assessment formats.”
- General feedback at the workshops indicated that people using the Trust services felt safe within the Trust, had positive patient experiences and benefited from good facilities – however there was also negative feedback about the use of out-of-area beds (“can be restrictive for carers and family members”), the need for “better cohesion between services” and “continuity of care”, the need to travel to access services (“hinders and affects patient experience”) and the “negative perceptions of the Trust” and of mental health in general.
- The Trust could do better in terms of breaking down “language barriers”, while there is in some cases more work needed to expand and respond to feedback about a “lack of culturally appropriate services.”
'An opportunity to listen'
Carolyn Green, Director of Nursing and Patient Experience at Derbyshire Healthcare NHS Foundation Trust, says: “On behalf of the Trust, I would like to thank Healthwatch Derby for carrying out such a thorough review of the services we provide in the city, and also thank everyone who took the time to give their feedback as part of the review.
“We firmly believe that ‘the patient experience is the patient experience’ and that every single piece of information we receive is an opportunity to listen and reflect on our services and how they are received and experienced. The Think Healthy review has allowed us to hold a mirror to the Trust and enable members of our community to have their voices heard. We fully accept all aspects of the report, and will now begin the hard work of changing and improving to better meet people’s needs.
'Just the start'
“For us, then, this is just the start of the process. We hope that some of the changes we are already making will address some of the report’s concerns – for example, we are currently rolling out phase two of an electronic patient record system across the Trust, which will significantly reduce the need for handwritten notes and allow for better information-sharing and cohesion within and across teams. We are also in the early stages of implementing a new neighbourhood-based approach to the delivery of many of our services, which will see teams working closer with each other and offering better continuity of care. However, we recognise there is more we can and must do.
“We have revised the terms of reference of our Patient Experience Committee so that the Trust can not only act on the recommendations in the Think Healthy review but also continue to listen more closely to those who use our services. In particular, we will listen more closely to those who have had an inpatient admission and find out more about their experience – something that Healthwatch Derby did so well through this review. We will also continue to make cultural adaptations to our services to ensure they meet the needs of our local community.
“We will regularly update Healthwatch Derby on our efforts, to make sure we are properly implementing what the Think Healthy review has told us.”
The full report, recommendations and appendices can be found on the Healthwatch Derby blog and the Healthwatch Derby website.
You can also view our press release following the publication of the Think Healthy report.