Case study: Surrey and Sussex Healthcare NHS Trust

Ian Mackenzie, Director of Information and Facilities at Surrey and Sussex Healthcare NHS Trust discusses how staff at the trust have reacted to Patient Opinion and how patient stories (positive and negative) are helping them to continually improve what they do

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You share all the stories we publish about your services, good and bad, on the Trust website homepage through our widget. Why did you think it was important to do this?

It's about being open. All NHS organisations receive positive and negative comments, that’s just the reality. Being honest about the comments we’re getting, and showing that we’re listening and taking people’s feedback seriously, is the right thing to do. Some people might think it’s a brave move, to have negative comments about our organisation published on our homepage, but we have nothing to hide – and there are as many positives as there are negatives. We have a responsibility to be open and honest in everything we do.

I also think that admitting that we don’t always get it right, and being honest with people, will always be the best way to deal with issues. It’s about being transparent, and saying ‘We know we’re not perfect but we’re listening to you, and when you tell us something is wrong – we’ll try to make it better.’

You often respond directly to people’s stories, and then take personal ownership for making changes in your services. That’s quite a commitment from a Director.

I feel a real sense of personal responsibility for making sure our services, particularly those that I look after, are the best they can be. So when someone shares feedback with us, I take it personally – and I will try and do whatever I can to improve what we’re doing.

More personally, at the time I got involved with Patient Opinion my father was ill in hospital so I had my own experiences of the NHS. His care was generally very good, but there were things I noticed that could be done better and would have made a difference to us. It’s really difficult to know how to get into dialogue with a big Trust to share your feedback. Patient Opinion is a really quick and easy way for someone to do that, and if someone takes the time to share their story, it’s right that I should take the time to listen and respond to them.

Does responding to people’s stories represent a big time commitment for you?

It takes very little time at all.. I try to respond immediately, from the heart and entirely honestly. The alerts come to me by email, I’m responding to emails all day so it’s just an extension of that. Sometimes, where something more serious has been shared it requires a bit more thought and time – but then so it should,if it’s something serious that we should be taking the time to resolve.

The feedback comes through, I read it, I share it, I respond to it and I see if there’s anything we can do. It’s not complicated – and it’s how I would want and expect to be responded to if I was giving my feedback to an organisation.

With some of the stories about SASH on Patient Opinion, you’ve responded and changed something within the same day. That’s really impressive. What drives you to be so responsive?

I’m impatient. If I know something isn’t right, I want to fix it. But it’s more about a frame of mind. I like immediacy, that’s why I’m such a fan of social media - I like the anarchy of it all (the positive side of anarchy!). Everyone is equal, and no one is more or less important than any other. We ask people to tell us what they think, the least we can do is listen. If someone uses Patient Opinion to tell us that something isn’t right, I can respond there and then, in minutes, and I can often make changes very quickly. Most of the time, people just want something small to change – they’re not asking for the world. If you delay responding, spend a long time constructing your response or drag your heels in getting something done, you’re ruining the relationship with your patients even more. Doing things a lot better isn’t that much more difficult than doing things a bit better.

You have an opportunity to make things right, and to improve your services – why wouldn’t you take it?

What do you think working with Patient Opinion in the way you do says about your organisation?

It says that we’re open and honest, that we have nothing to hide and that we take people, and their feedback, seriously. We love the positives, but we welcome the negatives too – they both help make our organisation better.

What do you value most about reading people’s stories?

My favourite story was about a porter, who was highly praised by one of our patients. People in roles like this are not often mentioned, so it was great to see that his hard work had been recognised. I replied to the patient immediately, but what I couldn’t say was that entirely coincidentally, we had our annual staff awards that night and he was being awarded joint employee of the year. It was great to be able to share this story with everyone, and the next day I went back onto Patient Opinion to tell the patient about the porter’s award.

If I’m honest, I also relish the chance to make things better. Our stories say a lot about us, and how we respond and react says as much, if not more. When I went down onto the wards following a comment about cold food being served, I spent time with our catering staff, tasted the food, and found out that the catering staff hadn’t been allowed to taste the food they were serving – that just seemed mad. That’s all changed now because of that feedback

Do you feel Patient Opinion, and the feedback people are sharing on the site, is having an impact on SASH?

Yes, it definitely is. It’s quite hard to measure – but as an example, when I spoke to a new member of staff earlier this year, I asked why they had wanted to come and work for us. They said that they’d seen the way we respond to people on Patient Opinion and had been really impressed at how open and honest we were, and how far we go to improve our services using people’s stories. I thought that was great. Another example is that last week I was on one of our wards and they had printed a story and my response from PO and put it on the wall. When I arrived they said how great they thought it was and how proudly they displayed it.

The other thing I’ve noticed is that I think we’re becoming a more confident organisation. We’ve had our problems, quite publicly, and I’m sure staff have felt in the past quite disheartened. But now, staff take such pride in their work – they are happy to put their names and faces to their work (with the Your Care Matters work we are doing for example) and they take responsibility for their services and feedback in a different way. Patient Opinion isn’t solely responsible for that, but is definitely a big part of our culture now.

How do staff feel about Patient Opinion?

Worried at first. When we put the widget on our Trust homepage, which showed negative comments, they thought we were mad – I thought we were mad!

But I was very happy to soon be proved wrong, and so were they. I only hear positives things about it now, almost everyone shares my view that it’s a really good thing to be honest and open about our feedback. People feel good about it, from cleaners to consultants.

Does working with Patient Opinion have any impact on how you think about your work?

My overwhelming feeling is "Why didn’t I do this before?". Over the last year or so, I felt much more personally responsible for what my staff and I do. I’m not saying that wasn’t there before, but it’s now there in a different kind of way.

What would you say to a Trust who were thinking of "taking the plunge"?

You have absolutely nothing to lose. If you’re frightened of people saying negative things about you, which is what I imagine most people are worried about, then it’s already happening; patients are already talking about you in social media and in other public ways – working with Patient Opinion makes it possible for you to be involved in what is being said. This can’t possibly make anything worse. Most people will respect you for your openness.

People are talking about your organisation publicly all the time. If you’re providing ways for people to tell you what they think, but you’re not listening to them, what does that say about you?

Working with Patient Opinion says that you have the confidence in your organisation to talk about it honestly, and allow other people to talk about it in the same way. But if you don’t respond to the comments its almost worse than not signing up to Patient Opinion at all.

Stories about Surrey and Sussex on Patient Opinion