Case study: South London and Maudsley NHS Foundation Trust

Patrick Gillespie leads the Clinical Academic Group for Psychosis who are using Patient Opinion to identify the ways in which they could improve local services. We asked him how it was going.

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What is your role at South London and Maudsley NHS Foundation Trust?

I am a Service Director at the trust. I have responsibility for the strategic leadership and management of health and social care services delivered to a deprived inner city population.

As an organisation, we are part of something called an Academic Health Sciences Centre (AHSC), along with two other NHS Foundation Trusts and a University.

The aim of the AHSC is to improve NHS care for patients by putting research findings into practice as quickly and effectively as possible. We have set up Clinical Academic Groups (CAGs) to bring people together who are experts in their field - whether that's cancer care or dementia - so that we offer patients the very best care and treatment. This involves clinical staff working alongside academic researchers much more closely than has sometimes been the case in the past.

There are 21 CAGs in total and I am Service Director for the one relating to Psychosis. The Psychosis CAG provides services for approximately 10,000 patients.

How does Patient Opinion add to the ways you receive feedback from service users and carers?

Patient Opinion certainly adds to the feedback we receive in other ways. Although we have extensive service user involvement within the Trust and collect regular patient experience and satisfaction data from people in survey form, this allows us to hear actual stories about people’s particular experiences of how they have received our services. We welcome the unique insight it gives us.

It can also be an early warning system, alerting us to things that may be going wrong in someone’s care or obstacles and problems for service users and carers which we may not have appreciated. It also helps us to solve minor issues at an informal stage rather than the patient or carer having to make a formal complaint. It can also alert us to good practice that we have not really appreciated.

How have staff felt about the feedback you've had and how do you involve them?

Staff have at times found the feedback difficult and some can feel temporarily demoralised. Nevertheless, when issues have been resolved informally or changes have been implemented, this is very positive for everyone.

We involve staff in looking at the issues and trying to resolve them before a final response is written to the person who posted the opinion. However, we want to do more work with staff to explain to them that the feedback is someone saying what the experience was like for them so that we can understand what it feels like to be on the receiving end of that particular service. It helps us improve the experience of care we give to our patients.

How does it feel to encourage people to give your services honest and public feedback?

On the one hand, it can feel quite challenging and adds an extra dimension to our work. We are a very large and complex Trust and we never know what sort of issues may prompt a posting. On the other hand, it feels good to be responsive to individuals. We are committed to continually improving how our care is experienced.

We are very committed to involving services users and carers in the current trust restructuring and committed to continually improving all aspects of quality. This will enable us to provide patients with clearer information about what they can expect at every stage in the process of care and what treatment options are available to them.

How have you found responding so far?

I have found reading and responding to the opinions that have been posted thought provoking and interesting. I have always felt humbled by the effort that it takes for someone to post an opinion or to write a complaint so it is really important that we respond to whatever has been posted as openly and honestly as possible.

We have a system in place for responding to postings which has worked quite well. A holding response is often posted and the final response is usually posted by the Service Director responsible for the specific service that is talked about in the posting.

Have you learnt anything through using Patient Opinion?

We have learnt just how many things within services can affect people’s experiences, from the very minor to very major details and how important they can be in a care situation. It makes us look at the way things are done which often makes a big difference to how service users and carers experience our care.