1. What actions will the Trust take to improve its accountability to patients and public?
Enhanced Public and Patient Involvement (PPI)
- Public Consultation and Feedback Mechanisms: Regular consultations, public meetings, and surveys to gather feedback from patients and the public.
- Patient Panels/Advisory Groups: Establishment of patient and public involvement panels to advise on service delivery and Trust policies.
- Community Engagement: Strengthening relationships with local communities through outreach programs to ensure their needs and concerns are heard.
- Accessible Complaints Processes: Ensuring that patients can easily make complaints and providing clear, timely responses, along with lessons learned from complaints.
Patient-Centred Care Improvements
- Co-Design of Services: Involving patients in the design and development of healthcare services to ensure they meet the real-world needs of those using them.
- Accessible Information: Providing patients with clear, accessible information about their healthcare options, treatment plans, and the Trust’s performance.
Collaboration with External Oversight Bodies
- Work with Regulatory Bodies: Collaborating with external bodies such as the Care Quality Commission (CQC) to undergo regular inspections and audits to ensure compliance with healthcare standards.
- Action Plans for Improvement: Implementing action plans based on inspection results, with timelines and measurable outcomes that are shared with the public.
- We work increasingly closely with our political stakeholders including HOSC members, local and county Councillors and our MPs to ensure proper scrutiny of our services and developments and to ensure we are meeting the needs of the communities they serve.
2. What improvements have been made for those with long term conditions/chronic illnesses across your services over the last year?
We know how important it is to make best use of our outpatient capacity for people with long term conditions:
- We are using Deep Medical (an AI system) to ensure optimum booking of outpatient clinics and two-way text messaging to reduce missed appointments and improve waiting lists in outpatients.
- Centralising outpatient bookings means it is easier for patients to contact the right place if they want to change or cancel an appointment.
- We can now access electronic records for patients in general practice and community settings to reduce repeated investigations and improve prescribing decisions.
- More patients are being enabled to choose for themselves whether they want to be regularly followed up or see us only when they need to.
- The new eye diagnostic hubs will address the 20000 overdue follow up patients over the next 18 months to ensure we safely manage chronic eye conditions such as Age-Related Macular Degeneration (AMD) and glaucoma - and will allow us to see 7000 more new patients to ensure faster treatment of new onset chronic eye conditions.
In neurology we are excited to have appointed a new nurse co-ordinator for motor neurone disease across our MSE hospitals. Her work will span primary and secondary care and link in with our local hospices and charity/support organisations. She starts next week and is funded through Challenging MND.
In Southend we have established a joint anaesthetic / geriatric clinic which won the national HSJ patient safety award 2023) for making major cancer surgery safer for frail patients and those with significant chronic conditions.
In rheumatology we have launched a fracture liaison service across all three sites, which will reduce the risk of repeated fractures and preserve patients independence and mobility for longer.
We have started specialised clinic for ‘women of childbearing age suffering from Autoimmune/arthritic disorders’ at Basildon, open to all three sites
For patients with newly diagnosed inflammatory arthritis we now see 70% within three weeks whereas previously it was 30%
In cardiology we provide a wider range of specialist clinics which means that patients do not need to travel into London - for example patient with inherited cardiac conditions. We also offer a wider range of specialised treatments eg injectable drugs for high cholesterol and keyhole surgery.
There have been many exciting developments in stroke services including access to advanced imaging and the use of artificial intelligence to improve the speed of decision making as faster treatment improves outcomes. We are working with the community to redesign stroke rehabilitation and we are the first trust in the UK to pilot an ambulatory stroke pathway enabling patients to avoid hospital admission.
3. How can members of the public thank MSE staff and how public thanks can be part of the reward package?
Members of the public have several ways to express their gratitude to MSE staff. The primary platform for public thanks is the Friends and Family surveys, which collect feedback from patients and their families. Monthly reports, including positive feedback from these surveys, are provided to all areas of the organisation. Additionally, patients can leave compliments on the Trust’s website and Care Opinion platform, which the for employees? How registered “thanks” can be collectively fed into MSE’s determination on how departments perform so that MSE management would not have to rely on national comparisons to decide on local departmental performance. Patient Experience Team shares with the relevant teams or individual staff members. Other expressions of thanks, such as thank-you cards and letters, are also given directly to staff, particularly on the wards. Staff are encouraged to share these compliments with their line managers during appraisals and check-ins, ensuring that their efforts are recognised.
We are in the process of improving how compliments and thanks are collected and shared across the Trust. This data can be included in the overall quality measures for each department, allowing MSE to assess performance based on local feedback rather than solely relying on national comparisons. By integrating positive feedback into departmental evaluations, we can create a more accurate and holistic picture of the care provided. This approach not only acknowledges the hard work of our staff but also highlights areas of excellence.
The public can and do nominate staff for the annual Shine Awards. This is a powerful and meaningful feedback with the winners receiving a prize and their stories being featured in the media. The staff newsletter also features a “thank you” message from a member of the public to staff every week.
4. What is the trust doing to improve the performance in Cancer Care? Are there any plans for the Broomfield Hospital cancer patients to have a dedicated inpatient cancer ward.
We are aware that there are no specialised in-patient beds for patients with cancer at Broomfield and this is highlighted in oncology future planning. A cancer strategy for the Trust will be produced for 2025 and this will address the direction of the hub and spoke organisation of oncology inpatient and cancer clinic capacity across the Trust. Palliative care services and beds are present on each Trust site. The dedicated cancer ward at the Southend site is the hub.
To improve cancer performance, the plan is to deliver the 77 % faster diagnostic standard this year and improve 62-day compliance to 70% by March 2025. There are plans to see improvement in the skin pathway now the community tele-dermatology service is in place; improvements in colorectal cancer as a result of the rapid diagnostic service, and the expansion in endoscopy activity. These interventions will improve performance. The Trust also planning the right capacity for oncology which is a key risk to improve waiting times in oncology for the 31-day standard and this will link to the cancer strategy. Other tumour sites are expected to deliver their plan and planning will ensure the right capacity is in place for each speciality.
5. With regards to the A&E at Basildon, what is being done to make the processes before you are seen by a doctor more efficient, has anyone looked at the patient journey from the start to finish at A&E.
There is an urgent care improvement programme for each hospital led by the Managing Director. The biggest driver of improved waiting time in ED and the total time a patient is in ED is the flow through to beds in the hospital for patients requiring admission. For Basildon this has been a challenge in matching discharge with bed capacity which can led to congestion in ED. Interventions are in hand with regard to better use of community facilities and more direct input of community nurses on to the wards to increase discharge. Length of stay has improved at Basildon and the 4-hour standard is holding at 72 %. Capacity will need to be agreed with the ICB for this winter to reduce risk on flow and admission pressure consistent with the financial plan.
The non-admitted pathway is also regularly reviewed and 85 % of patients are now triaged within 15 minutes of arrival with an average time of 8 minutes. This ensures a patient is directed to the right service for treatment – including same day emergency care services outside of ED. Much still needs to be done with system partners to get more patients seen within the 4 hours – a challenge is the high attendance from walk in patients particularly on a Monday following the weekend. The ICB is looking for more community interventions – for the care of regular attenders for example. The improvement plan will look to all best practice , such as GIRFT for example, on the admitted and non-admitted pathway.
