1

Listening to our patients

Partners in Healthcare

Patient Experience Highlight Report

January – March 2016

This report provides information on the different ways we collect service

user feedback and experience, what it means, and how we are using it

to improve the service. Included within this report is evidence of

community engagement work, social media activity and our involvement

in public health.

Index

Overview and Summary 2

Patient Stories 3

Community Engagement & Partnerships 4

Views from communities 13

Consultations 14

Surveys 16

Putting things right (complaints and compliments) 18

NHS Direct Wales website 19

Moving forward 22

2

Overview

The following provides an insight into patient experience across the

Trust. We get this information from:

Patient Experience

Community engagement work

Putting Things Right (complaints)

Compliments

People accessing information on our websites

Surveys

Consultation responses

What was good about all of our work?

People gave us really good feedback, saying staff were:

Polite and friendly

Professional attitude

Gave excellent care

Reached a lot of different communities across Wales

Increasing links through social media activity

What could be improved?

Feedback from service users to improve:

Response times

Planning journeys and improved communication for those using non

emergency transport service

Summary

Total number of people engaged with through community

engagement and patient experience 3371

3

Stories... Patient Voices The following patient stories were presented to our Quality, Patient

Experience and Safety Committee and Trust Board. View stories

on our website.

Trust Board, January

We heard from Chad, a young Community First Responder who talked about what it

is like for him as a Responder in the Cwm Taf area. The Board had a conversation

about how we can encourage younger people to volunteer for the organisation, and

recognised all of the great work that volunteers do on behalf of the service.

Quality, Patient Experience and Safety Committee, February

We received 2 stories from Patient Care Service users, who both had visual

impairments. One story highlighted the need for better planning for journeys to and

from hospital, and the need for support from staff to get to and from appointments

and the vehicles. Another story focused on the needs of a service user and her

guide dog. While it took a long time to get the right transport, taking into account the

needs of the guide dog, the member of staff demonstrated excellent customer care

and guiding skills. These stories, as well as many others, are being used to help

influence the new Non Emergency Patient Transport Services Project.

Trust Board, March

Peter, a Paramedic from the Hywel Dda area, was invited to talk about his

experiences working for the service. There was a discussion about delays at

hospitals, working out of area, and making best use of other pathways. This was part

of a wider discussion with other staff and partners from other organisations who were

there, about improvements we could be doing together.

Here are the themes from other stories and experiences we received over this

reporting period.

Themes

What was good?

Caring and professional staff

Prompt response

What could be improved?

Support for patients waiting at length at A&E

4

Engaging with communities

2369 people engaged with

Themes

What was good?

Lots of great feedback about the service

Providing First aid and CPR sessions to groups

Educating people about Defibrillators and how to use them

What could be improved?

Having operational staff and volunteers present at events

Learning

Community Engagement is allowing us to reach communities to talk to them about

our services. While the feedback is mostly positive, there are areas for improvement

and these are fed into the relevant department/s.

Feedback from communities suggest that there is a lack of choice when it comes to

accessing health services, particularly in an emergency. We continue to promote the

Choose Well message and raise awareness of the range of health services available

in communities.

We’ve attended 38 events

5

Strengthening community partnerships

Lesbian, Gay, Bisexual, Transgender

Every February is LGBT History Month. The overall aim of the month is to promote

equality and diversity for the benefit of the public. The theme this year was ‘religion,

belief and philosophy’

During LGBT history month we attended a coffee morning with Rainbow Bridge, a

domestic violence organisation for the LGBT community. We also attended a family

fun day at the Museum of Wales in Cardiff and used a fun, interactive game allowing

people to learn some new facts about LGBT history. The Partners in Healthcare

Team also started attending the LGBT hate crime advocate course at Unity Group

Wales in Swansea. The Welsh Ambulance Service now also holds monthly surgeries

at the Unity Group, giving members of the LGBT community an opportunity to meet

WAST staff, as well as developing engagement opportunities with the LGBT

community.

Mental Health

We held a successful engagement event in partnership with Hafal Carer’s

Participation group in the Aneurin Bevan Health Board area. We were able to talk to

people about our services and answer lots of good questions about Patient Care

Services and escorts, how we use volunteers, and queries about NHS Direct Wales.

The group provided feedback on positive experiences of using 999, what people

expect from using 999, and what dignity means to carers and for people

experiencing mental ill health. The group were keen to see us return with some

operational staff and provide demonstrations and awareness of CPR and using

defibrillators. Further work will be done with the group to let them know how we have

used their feedback in our work.

6

Vision Loss

We have attended vision loss groups with Sight Cymru and RNIB over the last few

months. Overall there has been positive feedback from service users. Patients have

also provided us with great feedback we can learn from in relation to our non

emergency transport service, Patient Care Service (PCS). For example, a service

user has a rare condition that makes her extremely sensitive to light. She cannot be

in daylight for more than two hours as this can result in her blacking out and

becoming extremely unwell. The service user has attempted to use PCS but due to

her condition has stopped using the service due to their prolonged exposure to

daylight. We work closely with the people who give us this feedback to make sure we

are planning their journeys as well as we can be and that we are considering their

needs and requirements.

Other feedback included:

“Due to the waiting area being noisy I would miss my name being called”

“I would be picked up late; this resulted in me missing my appointment”

“The taxi driver parked on the opposite side of the road and I didn’t know

where they were”

All of this feedback is being used to make improvements as part of the Non

Emergency Patient Transport Services Project.

Deaf & Hard of Hearing

We have continued our work

with Deaf and hard of hearing

communities.

We attended the British Deaf

Association (BDA)

International Women’s Day

event and have visited hard of

hearing groups in Llanelli,

Carmarthen, Usk and Spoltt.

We were invited to visit

Wrexham Deaf Club, where

we talked about the Trust’s

clinical response model, what someone who is Deaf should expect from us and what

we have done to try and make it easier for a Deaf person to contact the Welsh

Ambulance Service when they need us.

This work is continuing to identify barriers to communication and access to services

for people who are Deaf and hard of hearing. Looking to the future, we plan to work

with staff to raise awareness of issues faced by Deaf and hard of hearing people.

7

Black Minority Ethnic Groups

We attended a family fun day at the

Ethnic Youth Support Team (EYST)

project in Swansea, engaging with over

100 members of the community. With

support from the CFR training team the

community had the opportunity to learn

some new life saving skills.

Members of the PIH Team, supported

by our Paramedic colleague Dennis

Moss, also attended the annual Minority

Ethnic Communities Health Fair, held in

Cardiff City Hall.

The event was attended by over 500

members of the community and offered

an opportunity for people to participate

in health checks, gather information

about health & well-being and talk to

providers of local health services.

For the Welsh Ambulance Service, the

event provided a chance for us to talk to

members of the BME community about

their experiences of using our services.

We were also able to network with other groups and organisations who work within

the BME community. We hope these networking opportunities will lead to further

partnership projects being undertaken in the future.

8

Engaging with Carers

As part of our Carers Strategy work, we plan partnership events with local and

national organisations to engage with carers. We capture their experiences of our

services as well as educating them about our Trust, and ensure they are signposted

and connected with the appropriate local services to support them. We have been in

North and South Wales holding events over the last few months.

“Thank you so much for

enabling us to offer the recent

event to Carers. There was

definitely a positive feeling on

the day and some fantastic

feedback from both Carers

and organisations. We really

appreciate your support and

would welcome an opportunity

to work together in the future”.

Marie Gibson, Carers Information Support Service Co-ordinator, Association of Voluntary Organisations in Wrexham.

During these events we provided information, exercise opportunities, alternative

therapies, massage & nail treatments, cake decorating, singing, cookery

demonstrations, CPR demonstrations, blood pressure checks, lunch, tea, coffee and

lots more …….

“Well done for

organising such a great

event. I was able to talk

to quite a number of

people about screening

and many were keen to

refer themselves for

screening”.

Screening Officer

Public Health Wales

From January – March 2016, we engaged with nearly 100 Carers!

9

Learning Disability Community

The team continues to work

with the learning disability

community and visited a

number of groups throughout

Wales including Caerphilly

People First and Conwy

Connect for Learning

Disabilities. These visits gave

people the opportunity to give

their feedback about using our

services and to tell us what

matters to them to make their

experience a better one.

We also hosted an information stand at Cardiff People First ‘Standing Up, Speaking

Out’ Health Fair where we talked to people about our services and we filmed four

representatives talking about what they would need to make their experience of

using a 999 ambulance a good one. This film will be shared with staff to share

experiences of those with learning disabilities.

Comments from our visits included:

“I would want somebody with me in an ambulance”

Member of Pembrokeshire People First

“Ambulance called after accident. Staff very good. Were lady staff”

Chelle, Conwy Connect for Learning Disabilities

“Called an ambulance for myself after legs went dead. Only had men staff.

Went on my own. Had to find my own way back”

Sheila, Conwy Connect for Learning Disabilities

During our visits, we took the

opportunity to talk about the role of

Learning Disability Community

Champion, which many people were

keen to become. We are currently

arranging training sessions to

enable the champions to go out to

other learning disability groups and

talk about the Welsh Ambulance

Service. We will also be organising

presentation ceremonies for the

champions to be presented with a

certificate in recognition of their role.

10

Older People & Dementia

We have been visiting groups and asking them about their experiences with the

Welsh Ambulance Service. Some of this work has been recorded on video so that

we can share with senior staff to have a discussion about the needs and

requirements of older people when accessing our services.

We have visited a number of social groups at Newport, Aberdare, Haverfordwest,

Abergavenny, Caldicot and Ammanford to talk to people living with dementia and

their carers. Each group was very well attended and generated a lot of questions

about our services. Members also talked a lot about what ‘Dignity’ meant to them

and comments included:

“To be listened to in a friendly and compassionate manner”

“Someone who talks to you face to face not like you’re not there”

“Tells you what’s going on and you know how it is going”

The Trust is supporting Dementia

Friends, an Alzheimer’s Society initiative,

to help people develop an understanding

of dementia and turn it into action to

support service users and employees

who are affected by the condition. The

Alzheimer’s Society’s Dementia Friends

programme is the biggest ever initiative to change people’s perceptions of dementia.

It aims to transform the way the nation thinks, talks and acts about the condition.

It is believed that over 45,000 people in Wales live with some form of dementia, with

many others that haven’t been diagnosed. We are promoting different ways for staff

and volunteers to become Dementia Friends, and will be supporting staff to get

involved with local training and awareness activities.

11

Defibuary

On 1 February 2016, we launched a

‘Defibuary’ campaign. The aim of the

campaign was to raise public awareness

of the location of Automated External

Defibrillators (AEDs) as well as educating

people that defibrillators can be used by

an untrained person.

Using various engagement methods we

reached over 301,000 people,

which involved the public, private and

third sector and allowed the pubic to take ownership of life saving equipment in their

community. Through Defibuary we also developed a directory of AEDs and their

locations across Wales. The campaign identified 150 new AED locations

which was great news!

A huge thank you to our partners

who donated prizes for best tweet

and most locations tweeted.

Jane who identified numerous defibrillators won ‘best selfie’ and was given a prize by our partners Cariad.

Gary identified the most defibrillator locations and was given a prize by Welsh Hearts.

12

Using Dignity Programme to Strengthen Community Relationships

As part of the Dignity in Care programme, Dignity Champions were asked to lead an

Easter egg appeal and donate the eggs to a charity of their choice. We were

overwhelmed by the generosity of staff who donated so willingly, putting a smile on

many children’s faces this Easter.

The Easter eggs were donated to:

Swansea Young Carers

BAWSO

Women’s Refuge

Royal Gwent Hospital Children’s Ward

Brecon War memorial Hospital Children’s Centre

Over 150 Eggs were donated

13

Getting views from communities

We have asked people the following questions when we have been out and about

with communities.

What does dignity mean to you?

Being treated as a person whose needs are thought of and valued, even

(especially) if they differ from yours.

Being treated with respect as I treat others. Feeling my opinions are valued and

listened to.

Dignity means to respect my values, beliefs and opinion with no special treatment

but equality and acceptance.

How was your experience using 999?

Excellent. Ambulance came very quickly. Paramedics were brilliant –

professional, calm and friendly. Well done!

NHS Direct Wales called ambulance for me. Ambulance arrived very quickly.

Staff were great, very reassuring and kept me calm. They used humour to keep

me calm.

The response was very quick. My mother had peritonitis and she was taken into

hospital straight away. She made a good recovery. Had it not been for their

quick response she could have died, so I am grateful for our ambulance service.

When I call 999 I expect....

I expect to talk to someone quickly who can help and is knowledgeable. I want

them to be calm and authoritative.

Guidance, idea of timescale.

Rapid response, care, knowledge of illness and person, to be seen when taken to

A&E.

We are using this feedback to influence the way we engage with communities and

how we use feedback to improve our services. By capturing information in this way,

we have a good picture of what peoples experiences are and what they expect from

us. Monitoring what we are doing with this feedback is really important to us because

we want to see things change for the better as a result of what people tell us.

What does dignity

mean to you?

How was your

experience using 999?

When I call 999 I

expect...

14

Consultations

Bereavement Leaflet Consultation

We have recently undertaken a review and re-designed our Patient Information

leaflet for people who have experienced bereavement.

A final draft version was sent out for public consultation, using our Partners in

Healthcare Network Readers Panel. The leaflet was also shared with a range of staff

groups and networks to ensure clinical/procedural details included in the leaflet were

accurate. The leaflet is has been developed in line with the Joint Royal Colleges

Ambulance Liaison Committee recommendations for our staff to provide appropriate

information to bereaved relatives.

The consultation process generated a good response, with the majority of

responders saying that they felt the leaflet was well laid out, was easy to understand

and contained useful and appropriate information.

All comments that suggested

changes or amendments were

considered and where

appropriate changes have been

made. This will be available for

use within the next few months.

“I think it has been very

sensitively done, it will

be a great help to a

grieving person after

their loss”

“A lovely well thought

out leaflet, answers

many questions in an

easy to understand

format”

15

7 Vital Signs

When we respond to 999 calls,

for us to assess patients and

decide what needs to happen

next, we carry out assessments

or ‘observations’ on the 7 vital

signs.

To help inform patients what

happens during the assessment,

what equipment we use and

why, we have developed a

poster explaining this.

To ensure it is easy to read,

understand and the images we

use are appropriate, the poster

is being reviewed by our public

Readers Panel.

Getting your views on our Equality work

The Trust consulted with the public and colleagues to review our Strategic Equality

Objectives, so we would like to thank everyone for their comments and suggestions.

We have pleasure in presenting our Strategic Equality Plan Treating People Fairly,

which sets out our plans to continue to create an environment where, regardless of

background or circumstances:

- Each patient and carer is provided with a high quality service which meets their needs as an individual

- Every colleague has the opportunity to achieve their full potential

16

Surveys

Alternative Care Pathways

Pathways aim to reduce the number of unnecessary conveyances to hospital and

increase the number of patients cared for in their homes by the appropriate health

and social care professionals (this includes people who have fallen but are not

injured; diabetic patients who have had a hypo and epileptic patients who have a

seizure).

This survey captured the patients experience for these pathway referrals (please

note figures refer to January and February only).

Themes

What was good?

Excellent service

Prompt service by paramedics

What could be improved?

Long wait for a response

Staff attitude

Learning

Details of regular callers are passed on to the appropriate staff in order for a review

of each patient’s 999 call history. Work is being done with local staff and teams to

identify the reason for this and what can be done to support people if they need

additional care and treatment from different healthcare providers e.g. General

Practitioners and Community Resource/Frailty Teams.

137 surveys sent out

35 returned (26% return rate)

100% of respondents said they felt

involved in decisions about their

care.

97% of respondents said staff acted

in a professional manner.

We have used the ambulance service many times and have always been very impressed by the service.

An excellent first response service. Wales should be proud of its modern, well equipped ambulance service. People in Wales have an excellent service.

17

Twitter Summary

Tweets

698

Tweet impressions (how many

people our tweets have reached)

646,000

Profile visits (number of times

people have clicked on our profile)

20,553

Mentions (people who included

@WelshAmbPIH in their tweet)

532

New followers

751

Social Media – Patient Experience & Engagement

We continue to use social media channels to raise awareness

of specific messages we want to share in an open and instant

way.

Using social media is a great

way for us to share messages

and pictures about our work.

We have continued to increase

our reach to different people

and communities.

We share compliments and

experiences we get and

encourage people to feedback

to us.

18

Putting Things Right

Complaints

436 complaints were received (January – March)

Compliments

193 Compliments were received (January – March)

The majority of compliments were about:

the care and attention provided by staff

the professional attitude of staff

polite, cheerful, friendly staff

0 50 100 150 200

Jan

Feb

March

0 10 20 30 40 50

Aneurin Bevan

ABMU

Betsi Cadwaladr

Cardiff & Vale

Cwm Taf

Hywel Dda

NHSDW

Powys

The call taker was great - gave me all the

information and arranged for an

ambulance. The crew did everything for

my sister. They are two of the nicest

people who have ever come to the house

Thank you both so much for transferring baby

H to Cardiff Heath when he was very ill. You

both made me feel at ease during what was a

stressful time. Thank you both for being so

kind and considerate, it is much appreciated.

Learning

Themes and trends from complaints are presented to the relevant committees and the

Organisational Learning Group. This group seeks assurances that lessons are identified and

actioned.

The majority of complaints continue to be

about:

Timeliness of the Emergency

Medical Service – delay in vehicle

arrival

19

NHS Direct Wales Website

The website continues to be a popular source of information, particularly with mobile

technology as visitor numbers remain high.

Following a positive meeting with Stonewall Cymru and a public consultation through

social media about adding Lesbian Gay Bisexual and Transgender (LGBT)

information onto the website, we are in the process of developing this content which

we hope to have available before the Summer.

Themes

Learning

As visitors were searching for local services in their area using only the first part

of their postcode, we have made it clearer that a full postcode is required.

Wales will pilot a free phone number for access to urgent care later in 2016 with

the aim of making it available across Wales.

Visits

January 390,236

February 377,183

March 388,185

Total 1,155,604

Top pages viewed

Stomach Pain symptom

checker

Stomach Ache & Abdominal

pain topic

Symptom checker homepage

What was good?

Informative & reassuring

Easy to read & well laid out

What could be improved?

0845 costs too much to call

Hospital postcode search

Between January and March, 105 web visitors left feedback about their website visit. Out of these 71

rated their experience as a positive one.

“Beautifully clear and

informative”

Academic feedback

“Informative and useful”

Carer feedback

“All the information I

needed was in one place.

Thank you. Great site!”

Patient feedback

20

Symptom Checkers

Our online symptom checkers continue to grow in popularity, allowing website users

to assess their symptoms in their own time, gaining useful information and

signposting advice on what to do next to help with their problem. These include

contacting your GP, A&E, Pharmacy, NHS Direct Wales or Self Care.

During this period, the most popular Symptom Checkers were:

Stomach Pain 49, 583 visits

Cold and Flu 21, 475 visits

Generally Unwell 14, 622 visits

To assess the effectiveness of symptom checkers, we asked users for feedback on

their usefulness and asked if users intended to follow the advice given. During this

period 92 users completed the survey.

Themes

Learning

We are currently strengthening the disclaimer that will explain that symptom

checkers are there to help signpost people to the most appropriate health

professional on what to do next, and not to diagnose conditions online.

63% Found them useful 76% Intended to follow advice given

Reasons why people didn’t

follow advice

Will not attend A&E due to waiting

time

Will not contact GP for further

advice as can expect to wait up to

3 weeks for appointment.

Reasons why the symptom checkers were not seen as useful

Questions too general Does not diagnose

21

Social Media – NHS Direct Wales

We continue to use social media to promote the

NHS Direct Wales website and signpost the public

to the tools and information available through the

website. Encouraging self care, supporting

‘Choose Well’ and raising awareness of health

promotion campaigns and public health issues,

continues to be the primary aim.

Twitter Summary

Tweets

277

Tweet impressions (how

many people our tweets

have reached)

123.7K

Profile visits (number of

times people have clicked

on our profile)

4,618

Mentions (people who

included

@NHSDirectWales in their

tweet)

248

New followers

408

Social media allows us to engage and respond to the public & organisations in real time

and keep the NHS Direct Wales service in the minds of the user’s.

It’s also a great way to capture feedback, share compliments and demonstrate how users

feedback can influence service delivery and website content.

22

Moving Forward

Jack is Back!

As part of our commitment to

engage and educate the younger

generation about the role of the

Welsh Ambulance Service and

appropriate use of 999, we are

keen to continue developing a

range of Children’s resources.

Following on from the success of

our first school booklet ‘Jack tells

you all about the Welsh

Ambulance Service’ aimed at 6-8

year olds; we will shortly be going

out for public consultation to

capture feedback on our latest

version, which will target 9-11 year

olds.

‘Jack tells you more’ is in a comic

style to get across in a simple way

the range of services/support

available other than the Welsh Ambulance. If you would like to get involved, please

let us know by contacting ppi.team@wales.nhs.uk

Random Act of Kindness

Our Dignity Champions have been leading a Random Act of Kindness campaign. By

using evidence gathered in the UK government’s Foresight Project on Mental Capital

and Wellbeing, we have been thinking of projects to improve wellbeing.

This was an idea of one of our dignity champions and will be running from 1-30 April

2016.

#RandomActofKindnes

s

23

Get involved – give us your feedback

If you want to join our

Partners in Healthcare

Network, please visit our

website, call 01792 311773

or email

ppi.team@wales.nhs.uk.

Follow us on Twitter

@WelshAmbPIH

@NHSDirectWales

‘Like’ us on Facebook

www.facebook/welshambulanceservice

www.facebook/NHSDirectWales