Acting on feedback

About the colposcopy clinic

Our colposcopy clinic sees women who have had an abnormal cervical screening (smear test) result. GPs can also refer patients for other reasons.

Our team aims to give safe, kind, and effective care. To help us do this, we ask patients to tell us what they think of the care they received.

Why we did a patient survey

Colposcopy is an important part of the NHS cervical screening programme. It helps us spot and manage changes to cells in the cervix.

We gave a short survey to patients who had a first visit to the colposcopy clinic. We asked about:

• The information they got before and after their visit.
• How long they waited.
• How they were treated.
• What the staff were like.
• Their overall experience.

What patients told us

• 100% of patients rated the service as ‘good’ or ‘excellent’.
• 96% were seen within 30 minutes of arriving.
• 100% felt welcome on arrival.
• 98% said the colposcopist introduced themselves.
• 100% said we explained the reason for their appointment.
• Over 98% felt communication during the appointment was clear.

What we can do better

• 77% of patients with an abnormal smear result said they received information about their appointment.
  • Of those who got the information, 85% found it very helpful. The rest said it was somewhat helpful.
• Only 67% of patients said they were given contact details when they left the clinic.
  • This may be because their results were normal, and they were discharged back to their GP.
  • We send a summary letter with contact details to every patient.

What we’ve changed

We shared the survey results with the whole colposcopy team.

We have:

• added key information to the end of appointment letters.
• improved how we show information in the MyChart app, so it's easier to see.
• started sending all patients an information letter by post.

We will repeat the survey next year to check if these changes helped.

Systemic Anti-Cancer Therapy (SACT) includes chemotherapy, immunotherapy, and hormone therapy. The SACT Patient Experience Survey was created by patients and staff to gather feedback on how we can improve the information given to patients receiving SACT treatment at CUH. The survey gave patients the chance to share what information was most useful or what they wish they had known before and during treatment.

We will use the survey results to improve written information, create patient videos and leaflets, and update the cancer pages on the CUH website and information available to patients on MyChart.

How do patients receive information?

The survey responses came from patients being treated in the Oncology and Haematology Day Units.

• 60% of patients said they received the ‘blue folder’ pack at the start of treatment, while the rest didn’t receive it or couldn’t remember it.
• 82% said they were told about local cancer information and support services, but 18% didn’t or couldn’t remember receiving this information.
• 36% of patients wanted written information (handed to them or sent to them), and 18% preferred receiving the information on MyChart before starting their treatment.
• 10% of patients looked for information about SACT on the CUH website, and 18% looked for it on other websites. Patients said the most useful information on the CUH website would be about where to get further help, who to contact at the hospital if they felt unwell, where to go, and how to prepare for treatment.

Is the information useful?

• 73% of patients found receiving written information in the Day Units very helpful, 22% found it somewhat helpful, and only 6% said the information was hard to understand.
• Overall, 64% of patients said the SACT information helped them with their treatment, and 32% agreed that the information met their needs.

The main issue for improvement is making sure patients know where to find information. Some patients didn’t know where to look for information or weren’t aware that SACT information was available online. Written comments gave staff useful ideas on what information could be added or improved to give patients a better experience.

Next steps

We shared the results with the Cancer Patient Partnership Group and other CUH staff. Some changes to improve the information given to patients before and during treatment have already been made. We plan to include more information in MyChart, so patients can access what they need before and during treatment.

We will also use the results to improve the cancer information on the CUH website.

The survey results helped create a focus group to review, create, and update the information in the patient ‘blue folder’ pack. This group will also focus on producing patient information films for the CUH website. The films will give new patients important information at the start of their treatment and when attending for follow-up sessions.

The children’s cardiology team wanted to learn about patients' experiences and areas for improvement. They asked patients and families to complete a survey, either on paper or online.

Most surveys were filled in by parents or carers, with 8% completed by patients.

The results were positive. 91% of people rated the overall care as excellent. Most families were happy with waiting times, felt reassured by the consultant, had the chance to ask questions, and had enough privacy.

Two thirds of families knew who to contact after their appointment. To improve this, staff have updated information on the website and in clinic letters.

16% of respondents said their children had additional needs and suggested better information before and during visits. In response, the team created a Playmobil animation to explain the clinic visit in a child-friendly way, available on the Clinic 6 web page.

The team is also offering the hospital passport to more families and working with the play team and specialist learning disability nurse to provide extra support.

The outpatient survey is done each year to gather feedback from patients and improve services. Since the Covid-19 pandemic, many patients have had virtual (telephone or video) appointments. The survey compares experiences of patients with both types of appointments.

Results

Overall, the 2021 survey results were positive. Most patients rated their experience with both appointment types as 90% or higher. The combined scores of 8-10 were 85% in both 2020 and 2021.

Face-to-face vs virtual appointments

In-person appointments received a higher rating. 91% of patients rated face-to-face visits 8-10, compared to 77% for virtual appointments. While scores for face-to-face appointments were similar to pre-pandemic levels, patients suggested improving communication about medication, side effects, and follow-up care. Virtual appointment feedback also highlighted the need for better communication and privacy during sessions.

Future appointments

When asked about future preferences, 44% of virtual appointment patients wanted face-to-face visits, while 70% of face-to-face patients preferred in-person appointments. There was a 4% increase in patients preferring face-to-face visits from 2020 to 2021.

Sharing learning

The results were shared with the Outpatient Experience Group and staff. Key actions include:

• Using feedback to develop a virtual clinic call centre.
• Identifying virtual clinics that would benefit from dedicated rooms.
• Reassuring staff about the popularity of virtual appointments.
• Improving video appointment technology.

Staff in the children's recovery team wanted to understand how children and their families feel about the care given after general anaesthesia. They gave a questionnaire to parents, carers, and children asking what was good and what could be improved.

The team was particularly interested in how different staffing levels and skills affected care. By looking at the experiences of families who had used the recovery areas more than once, staff hoped to identify any areas for improvement and any staff training needs. The goal is to provide consistent, high-quality care across all recovery areas.

The questionnaire was filled out by families while they were still in the hospital. No names were asked for.

Survey results:

• Parents, carers, and children were very pleased with the care in the recovery areas, with many praising the staff’s positivity and kindness.
• Families mentioned the need for clearer communication about wait times outside recovery and when the child would be seen in recovery.
• Staff will remind parents and carers about the limited food and drink options in recovery and suggest bringing a child’s favourite snack.

The main points from the survey are displayed on the children’s recovery notice board. A presentation was also given to relevant teams and managers.

Staff will continue to ask for feedback to ensure that children and families always receive high-quality care.

You said

You didn’t know the name or role of the staff member caring for you, and that badges were hard to see.

We did

We gave staff new name badges. Staff names are in black on a yellow background, so they’re easier to read, even for people with poor vision.

The #hellomynameis badges remind staff to introduce themselves.

The Cancer Patient Partnership Group (CPPG) highlighted that staff should ask patients, "What name do you prefer?" In the last National Cancer Patient Experience Survey, only 63% of CUH patients said staff asked this, compared to 71% nationally.

To improve this, staff suggested adding the preferred name to Epic, the electronic system.

We also learned from another NHS Trust about putting the preferred name on the wristband. Following this, the Epic 2020 update added a ‘Known as’ field, shown next to the legal name and on wristbands.

We know that hospitals can be busy and noisy, and patient feedback shows that noise can make it hard to sleep well. The Sleep Sound Sleep Safe working group introduced sleep well packs on all wards to help.

They also made these improvements:

• Identified noisy equipment, like telephones, and reduced the noise levels.
• Fitted quieter door closures.
• Added foam pads to bin lids to reduce noise.
• Made call bell volumes adjustable when old systems are replaced
• Made call bell volumes adjustable when old systems are replaced.
• Asked staff to prevent keys from jangling on lanyards.
• Reminded staff to speak quietly at night.
• Displayed sleep promotion posters on wards.
• Encouraged staff to close blinds and dim lights at night.
• Delivered presentations to raise awareness of the impact of night-time noise.
• Installed noise warning systems in intensive care.
• Silenced keypads on doors.
• Set Hospedia TVs to turn on at 7am instead of 5am.

We take all feedback seriously and use it to make changes that benefit patients, families, and carers.

Here are some examples of improvements we’ve made after receiving complaints:

Communicating with families

A patient’s family complained that they weren’t updated before discharge. Investigation revealed poor communication with the next of kin on the discharge day.

Action: We reminded staff to keep the next of kin informed and provided training on discharge processes.

Improving appointment booking

A patient continued receiving appointment reminders after miscarrying.

Action: We found a duplicate booking in the system, apologised, and are reviewing the system to prevent this from happening again.

Changes to infusion procedures

A patient complained that their infusion started without the right staff present and they weren’t shown how to monitor it.

Action: We now start infusions only when trained staff are available and provide patients with scales and instructions.

Improving care for diabetic patients

A diabetic patient complained about pain not being addressed and food that didn’t meet their needs.

Action: We trained staff on diabetic care and updated patient information leaflets.

Managing pain in the emergency department

A patient complained of inadequate pain management in the Emergency Department.

Action: We trained staff on pain relief and reviewed staffing levels to ensure faster response.

Communicating with families during restricted visits

A patient’s family had trouble getting updates due to Covid-19 restrictions.

Action: We improved communication, including video calls for therapy sessions and training on record-keeping.

Improving care for patients with learning disabilities

A patient with a learning disability didn’t have their hospital passport, affecting communication with staff.

Action: We trained staff on supporting patients with learning disabilities and appointed a learning disability champion.

Improving communication before treatment

A patient didn’t understand who would perform their procedure, causing distress.

Action: We trained staff on clear communication and provided a checklist to ensure patients understand who will carry out their treatment.