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Dr Ify Okocha, Medical Director

Good afternoon everyone. For those who don’t know me, I‘m Dr Okocha. I’m the Medial Director and the trust lead for quality.

I’m going to spend the next 10 minutes or so just sharing with you some aspects of quality report, the detail of which you can find in the annual report at the very back.

Lord Darzi in 2008 in the NHS Next Stage Review quite eloquently described high quality care. He said it is care which is clinically effective, personal and safe.

And in Oxleas we’ve pretty much adopted the three main strands of quality, which is that the care we provide must be effective. It has to be safe, and safe as a doctor who prescribes medication I’ve got to be absolutely certain that it is safe, having considered  the health and other things regarding the individual and that the experience of whoever would provide that care to has got to be quite positive. The challenge however is how do you evidence that you provide good quality care. Certainly in Oxleas we do that in a number of ways. We rely heavily on feedback, and one of the most significant sources of feedback is obviously from the patients that we care for. And so Steven has touched on the National Patients’ Survey which is about mental health service users. We listen to what they say. But we also have some local sorts  of feedback. We have electronic  tools that we use right across our services  and many would have seen at the back there (points to back of room) the Oxleas patient experience visit which is quite an innovative approach which my colleague Dr Keith Millar has managed to start in Oxleas. They’ve managed so far over 15 site visits, and conducted   questionnaires with about 600 service users and we use all of that information to see how people judge the quality of our services and that of course has to continue.

Where we have feedback from one of our sources talked about the CQC who regulate us and license us and from whom we receive monthly feedback based on the sources of intelligence that they have at their disposal.  GPs also give us feedback and when we don’t get things right and there are complaints and incidents, we’ll learn the lessons and use those to further improve our services.

Another really important  source is audits. When we audit our practice and the quality of our care, either against national guidelines such as the NICE guidelines or indeed against local protocols or policies. And all of that information we’ve put together in our quality report . As I said, you can get a copy of our Annual Report at the back.

One of the things we did last year and which we are going to do again this year is to emphasise the need to stick to what has now become the for ‘must dos’ in Oxleas and these are four key things that we thought we ought to improve year on year, starting as far back as 2008 following one of the national patient survey results.  And the first of them is to increase support to families and carers of service users. And the second of course is to provide better information, information about people’s conditions, information about their treatment and information about our services. Not just to users of services but also to their carers and families. And quite importantly, to enhance assessments to ensure that the service user, the patient, is at the heart of the assessment and that we take on board what they think their difficulties are and consider also XXXXX their treatment plan, what they views are about what will help them. And lastly that we continue to improve the way we relate to patients, their carers and families.

To that end we published Our Promise, a copy of which was sent to every single service user over the last two years and that’s currently being reviewed. Stephen has talked about our service users have grown and the content of this may not be entirely appropriate for community services nor would it be appropriate for the extremes of ages, either younger people and older people or indeed some of our learning disability colleagues. And we review this to make sure that we have a more appropriate promise for the services that we provide now.

Thinking now about how we’ve evidenced improvement in those areas. We sought to increase the number of carers who have been offered an assessment, and achieved that. We also undertook an inpatients’ survey asking service users in hospital at the time, whether they had enough information about their medication, did they have enough information about side effects of their medication., and did they feel that they were involved in their treatment. And I am pleased to say that a significant proportion felt that they had enough information. We sought to make sure that those who have the most complex of needs, and whom we treat under the care programme approach have a crisis plan so they know what to do if things aren’t going quite so well. And lastly we decided that we’re going to reduce the number of complaints relating to staff attitude and continue to strive to do so.

And in our Bexley community service in our intermediate care unit we carried out a survey over a three month period up to December that involved nearly 200 people, asking them questions about did they feel they were treated with dignity and respect, did they receive assistance as they saw necessary and I am pleased to say that many said they did. Were they given information about their care and treatment, were they given information about the choices that they can make such as their choice of food, and many said they were.  And we also asked the question whether they felt involved in the decisions about their care and many said they did. But I am particularly pleased that nearly 99% of people, when asked if they were happy to come back to the unit, said they would. And I think that must say something about the quality of care the staff were providing.

As required, we had to share our quality report with our local stakeholders. And here I have some extracts from the comments that they made. So the three PCTs, Bexley, Bromley and Greenwich when asked to comment said they were quite pleased with the quality and improvements and they saw the improvements as a solid building block for further improvements. The three LINks were pleased with the improvements we made and were particularly pleased about some of the quality things that I’ll come on to next.  And Greenwich Overview and Scrutiny Committee were also pleased with the improved performance and were particularly delighted about the use of the four ‘must dos’ and they hope that we can build on those.

Thinking therefore towards 2011/2012. At the beginning of the year we had three focus groups across Bexley, Bromley and Greenwich which were attended by a little over 100 people. We received well over 160 comments about ways that people thought we should improve our services and I’ve just put those into nine themes. Many of the comments really capture the essence of the four ‘must dos’, such as listening to service users, ensuring that we use them as experts, making sure that we work more closely with our partners and comments about staff increasing their skills, start being more proactive. They talked about the involvement and support of carers and making available to service users things that would enable them to be part of society. There were comments about our services in psychological therapies, CAMHs, but also health promotion and the use of newer technologies and I am pleased to say that we’re actually doing many of the things on the list.

Thinking therefore towards 2011/2012, w certainly would like to continue our focus on the four priority areas, our four ‘must dos’, across mental health, learning disability and community health services.  We also have incorporated many of the themes that I shared with you a moment ago, not just into our quality plan and the work of our quality focus groups but also into our annual plan. And we plan to focus our energies on achieving the quality targets we’ve been set on the Commissioning for Quality and Innovation framework by NHS London and Bexley, Bromley and Greenwich.

Thank you.