CLINICAL EFFECTIVENESS

3.3.1 Care Planning

Care planning is an on-going quality priority of the Trust. In 2010/11, our priority was to ensure that 95% of our patients have a care plan and we

consistently met this target over the last three years (see 1.3). In 2012/13, we shifted our focus on improving the quality of our care plans (see 1.2.1).

We developed the 7Cs standards to clearly define the standards expected of our care plans and implemented a process of monthly self and peer assessments. The scores are reported through our quality dashboards and performance management framework.

Our work on improving the quality of our care plans contributed towards achieving compliance with the CQC standards and improvement in our 2012 national patient survey scores, with the section on

‘care plans’ showing the largest improvement. The graph below shows we scored higher than the

national average around patients understanding their care plan. This was acknowledged by our CQC assessors who praised the improvements we have made in the quality of our care plans during the year.

The 7Cs standards are grouped under the following main headings:

Comprehensive and cross-checked

Collaborative Clear and concise Choices

Crisis/contingency Carried out

Carers and care for The standards are used to assess the quality of the care plans and include a section for patients and/or their carers where appropriate to give feedback on their views about their care plan and their involvement in planning and reviewing their care.

Page 49 of 66 Draft 3.8 20 May2013/WLlaneza Actions for further improvement

We aim to further improve our practice and monitoring arrangements around care planning.

This will include:

Reviewing the questions around care planning in our inpatient and community patient surveys. We will adapt the questions around the specific needs and requirements of individual services and patient groups.

Reviewing our guidelines and policy around care planning to strengthen the links with NICE guidelines and recovery principles.

Rolling our a consistent care plan template through RiO, our electronic patients records system.

3.3.2 Breastfeeding

Our community children’s services were under their targets for breastfeeding at the end of 2012/13 as shown in Table 20 below.

Table 18: Breastfeeding targets and performance

Performance Target

NI 53 (VSB 11) Prevalence of breastfeeding (totally plus partially) at 6-8 weeks from birth (%)

48% 48% 44.5% 38.39%

NI 53 (VSB 11) Percentage of infants for whom breastfeeding status is recorded at 6-8 weeks from birth (%)

No target

set

95% 92.0% 93%

As a Trust we have strongly disputed the target which has been set in regard to breast feeding prevalence within Peterborough. This is for two principle reasons, firstly the target does not take account of the rapidly changing population and demographics of

Peterborough which would indicate reducing prevalence rates given that no new services have been commissioned in this area. Equally, given the service we provide in this area (Health Visiting), we have very limited scope to affect this performance given the

dependency that we have from other commissioned services such as community midwifery and maternity services and in the absence of other support services such as baby cafes.

However, we remain committed to continually improving the effectiveness of our health visiting services through active participation in a range of programmes such as UNICEF Baby Friendly Accreditation, but remain in active debate with our commissioners to establish an appropriate measure to indicate the support we provide to new mothers on breast feeding.

3.3.3 Participation in National Quality Improvement Programmes

National quality accreditation schemes provide a way of assessing the quality of our services and comparing our performance with other Trusts across the country. They provide assurance that our services are meeting the highest standards set by the professional bodies, and also provides us with a framework for quality improvement.

During 2012/13, CPFT participated in the following accreditation schemes run by the Royal College of Psychiatrists.

Table 19: Accreditation Schemes by CPFT Accreditation

Scheme Services Current status Comments

ECTAS

(ECT Accreditation Service)

Addebrookes ECT Clinic,

Cambridge Accredited none

Cavell Centre, Peterborough Accredited

Re-accreditation is

Oak 2 Ward, Cavell Centre,

Peterborough (Adults unit) Accredited none Oak 1 Ward, Cavell Centre,

Peterborough (Adults unit) Deferred A decision will be made in April 2013 Friends Ward, Fulbourn,

Cambridge (Adults unit) Deferred

Ward currently closed for refurbishment IASS, Ida Darwin, Cambridge

(Learning Disability unit) Accredited none Hollies Ward, Cavell Centre,

Peterborough (Learning

The Croft, Ida Darwin,

Cambridge (Children's unit) Accredited none

Darwin Centre, Ida Darwin,

Cambridge (Children's unit) Deferred

Currently going through

accreditation

process and likely to be accredited.

Set to be accredited as excellent for the second time in April

Page 51 of 66 Draft 3.8 20 May2013/WLlaneza 4.0 PERFORMANCE AGAINST KEY NATIONAL PRIORITIES

The Trust is required to achieve a number of key national priorities as outlined within the Department of Health Operating Framework. The Trust continues to perform well against these targets in 2012/13 as shown below.

Table 11: Key national priorities

Target(%) Target

2011/12

Target

2012/13 2011/12 2012/13 LOCAL TARGET

Service users seen within 18 weeks (CPFT target) 100% 100% 100% 100%

NATIONAL TARGETS

CPA patients having formal review within 12

months 95% 95% 99.60% 95.97%

Minimising delayed transfers of care <= 7.5% <= 7.5% 1.42% 3.88%

Meeting commitment to serve new psychosis

cases by early intervention teams 95% 95% 100% 100%

Data completeness: identifiers 99% 99% 99% 99%

Data completeness: outcomes 50% 50% 72% 97.32%

Data completeness: Community services referral to

treatment information 50% 100%

Referral information 50% 98.9%

Treatment activity information 50% 99.6%

Patient identifier information 50% 97.6%

Self-certification against compliance with requirements regarding access to healthcare for people with a learning disability

No threshold

set

No threshold

set

Met Met

MRSA Infection rate (per 1000 bed days) 0.60 0.00 0.00 0.00 C.Difficile Infection Rate (per 1000 bed days) 0.70 0.00 0.01 0.0001 Data has been sourced from the clinical records system

5.0 HIGH QUALITY WORKFORCE