A dearth of good practice and numerous competing priorities has led many boards to do nothing with the patient intelligence they have at their fingertips
A belief that few boards routinely incorporate information about patients’ experiences into their discussions made improving patient experience a clear choice of topic for this year’s Intelligent Board report.
A review of board papers and surveys of chairs, non-executive directors and chief executives revealed many trusts felt they were in the early stages of the journey and could do a lot better.
The report, prepared by an independent reference group supported by Dr Foster Intelligence, showed that 72 per cent of NEDs felt informed or well informed about patient experience, but more than half said they spent less than 10 per cent of board time and attention on patient experience matters. Just 43 per cent of NEDs said that patient experience was always an integral part of quality discussions at board meetings.
Jocelyn Cornwell, director of the Point of Care programme at the King’s Fund and chair of the report’s reference group, says the survey showed a genuine appetite from NEDs to do something in this area, but at the same time there was a dearth of good practice.
“I think it is a priority for boards,” she says. “The problem is that they have so many competing priorities.”
The report includes a checklist outlining three main points on what boards should be doing on patient experience.
First, they need to show leadership, which means using a variety of ways to hear patient stories, such as walkabouts. The survey showed that 85 per cent of provider boards use reports from walkabouts as part of their patient experience reporting. But Ms Cornwell warns they are only useful if they’re structured. “Just walking about for its own sake is not particularly useful.”
Second, boards also need intelligent reporting and meetings. Information must be analysed and interpreted, rather than appearing as floods of tables or a set of stories from complaints. Decisions should be informed by solid information.
Finally, boards need to act on the intelligence received. For more than 95 per cent of items on patient experience in the agenda, the minuted action was to note the report. “We don’t expect the board to take the actions, the board’s job is to ask for the action to be taken and then to get a report [on the progress],” says Ms Cornwell.
She hopes the report will fundamentally change the practice of provider boards, so they are better informed and develop strategies to improve problem areas. l
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Telling stories: salford
Salford Royal Hospital Foundation Trust opens every board meeting with a patient story as a way of establishing the mindset that patients should be at the centre of every decision.
“It’s easy to lose sight of the fact that you’re there to provide a service to your patients, rather than to balance the books,” says trust chair Jim Potter.
“The pressures you get externally are so great that you really don’t want to be seen to be a failing trust in terms of finances.”
Different methods are used to present the story; a written statement, often delivered by a board member; a story told by nursing staff; videos of patients recounting their experiences. It was felt that it would be too daunting for most patients to come to a board meeting, but board members do walkabouts on a scheduled basis and hear stories face to face.
The challenge is translating stories into concrete decisions on finance, quality initiatives, capital programmes and so on. Mr Potter says regular contact with patients can prevent an ivory tower situation when boards are taking strategic decisions, and ensure that patients remain the focus.
Ward level feedback
The board of Northumbria Healthcare Foundation Trust appointed a patient experience director and a service improvement lead to help individual wards make improvements based on patient feedback.
The trust was already gathering patient views, but it was at trust level. Now patients are surveyed when they leave the wards and the results are reported at ward level. Backfill is funded so that teams can be released to focus on areas for improvement. The board receives quarterly reports on progress.
“This is about supporting our teams to make the changes that they want to see,” says Anne-Marie Laverty, director of patient experience. “We’ve had incredible support from the board to do that.”