Finding the best ways to capture and exploit patient feedback is something most clinical commissioning groups want to target.
For a group of CCGs, in the Midlands that task is already well underway thanks to an innovative project from NHS Staffordshire Commissioning Support Unit.
The CSU won the ‘most promising IT to support clinical commissioning’ category of the EHI Awards 2012 in association with BT for its Model of Insight project; which will also be featured at EHI’s latest conference, Information for Commissioning, on 15 May.
The project has created a database to collect patient feedback from a huge range of sources. This is then presented to GP practices and commissioners in real time via patient experience dashboards and used to make commissioning decisions.
Data included in the repository includes feedback gathered reactively from complaints, PALS contacts and 18 week contacts, plus letters to newspapers and comments from social media, as well as proactively gathered information from workshops, focus groups, deliberative events and patient experience stories.
From reports to insight
Lesley Goodburn, head of community relations, says: “Before, people were getting reports on a quarterly basis saying something like ‘there were 46 complaints, two training sessions were held and a policy was changed’. It was very dry and it didn’t really mean anything.”
Goodburn says the CSU now inputs all the information into its database, where it is aggregated and analysed and then triangulated against information from risks, incidents and nationally collected data.
The project used a standard Datix database and created bespoke coding and protocols to support the aggregation of the data. The CSU estimates a saving of more than £9,000 a year in staff time due to the use of automated reporting.
The information is collected using the Department of Health’s five domains of patient experience which cover ‘safe, high quality care’, ‘building better relationships’, ‘better information more choice’, ‘access and waiting’ and ‘clean and comfortable place to be’.
Data can be mined by GP/speciality, by provider for use in contracting and quality meetings as well as by the patient experience domains and sub-subjects.
The data is to be presented to GP practices across the nine CCGs using a dashboard. At the moment, the CSU is rolling out the dashboard to the 54 practices in Stoke. It will cover 260 practices once roll-out is complete to all GPs in the nine CCGs that are now using the system.
Finding the hot issues for patients
For commissioners, the database is providing invaluable intelligence on the services they are buying for local populations and enables them to monitor the impact of changes in terms of patient feedback.
Goodburn adds: “This approach has led to reviews of services such as podiatry, continence and orthotics, changing the dynamic of patient and public involvement to the bottom up rather than commissioner led from the top down.”
The kind of services which have been changed as a result of the project shed further light on its usefulness to commissioners.
Goodburn adds: “It’s not saying that diabetes and cardiac are unimportant but its showing what the hot issues for patients are. It gives patients a voice for them to say this is what is important to us.”
For example, the focus on podiatry led to changes a service that had long waiting times. Goodburn says: “There were a lot of people in the system who were effectively being seen for life.
“Following the patient feedback, the service was reviewed and a lot of those people were discharged on the basis that a fast track system was set up so they could be seen again if needed, without having to go through the whole assessment process.”
The Model of Insight project is being supported by a Model of Involvement initiative which aims to increase patient and public involvement in decision making.
This is working closely with the Model of Insight so that, for example, information from a patient congress set up under the Model of Involvement is fed back into the database.
Goodburn says the two projects together are proving a powerful force for amplifying patients’ voice in a systematic way which is leading to systematic changes to service provision.
The two projects were initially developed in partnership with NHS North Staffordshire CCG and were then rolled out to NHS Stoke CCG before being implemented in five other CCGs in the south of the county.
The popularity of the initiative has also led to demand further afield. NHS Staffordshire CSU is also starting to work on the project with Telford and Wrekin and Shropshire and Hereford CCGs, which are buying their commissioning support from Staffordshire.
Goodburn says the team has also had talks with Bedfordshire and Derby County CCGs about working with them on the project.
The acute, mental health and community hospitals in North Staffordshire have also signed up to explore the possibility of standardising data collection and aggregation. In addition, the CSU is looking at adding clinical feedback to the system from both the consultant and GP ends.
Goodburn says the impetus for much of the scheme has come from the demand from clinical commissioners for information from patients as they enter a new era of commissioning and believes it could not have happened without the NHS reorganisation.
She adds: “In the past the reports that were being produced were providing limited intelligence but now CCGs are enthused by the data and see a purpose to it.”