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Our quality priorities 2024/25

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    Share your feedback on our quality priorities for the year

    Each year, we set out our quality priorities and would like to know what you think of these.

    Providers of NHS healthcare are required to produce an annual quality account which describes how we deliver high-quality care to people who use our services. View our reports.

    In our quality account, we have identified 12 priorities for 2024/25 and we would like to hear your views on these. These are projects which span either one or two years and are aligned to KCHFT’s quality strategy objectives, which are:

    1. focus on continuous improvement
    2. make sure information drives continual improvement
    3. promote positive staff experience
    4. improve patient and carer experience
    5. reduce health inequalities
    6. effective use of resources
    7. prioritise patient safety
    8. promote clinical professional leadership.

    The quality account regulations say there must be priorities in the following three areas:

    1. patient safety
    2. clinical effectiveness
    3. patient experience.

    We have added a fourth priority: 4. Staff experience.

    Email your feedback on our priorities to kentchft.qualitymanagement@nhs.net by Friday, 19 April.

    1. Patient safety
    Reduce the number of delayed or omitted doses of medication. (This will be the second year of a two-year priority) In 2024, 100% of omitted doses will have a documented reason. Omitted doses for all prescribed medications will be no greater than 10%. Omitted doses for prescribed critical medicines will be no greater than 5%. Medicine doses are often omitted or delayed in hospital for a number of reasons. For some critical medicines, delays or omissions can cause serious harm. Harm can arise from missing one dose or repeated doses and is determined by a combination of the patient’s condition and prescribed medication. Therefore, it is imperative that patients under the care of KCHFT receive their medication in a timely manner. To prioritise patient safety, improve patient experience and focus on continuous improvement.
    Deliver a joint quality improvement project to implement a positive safety culture in the organisation. We will involve our patient representatives as part of the project implementation. Measure the toolkit, introduce and roll out the toolkit and then measure compliance in March 2025. Following on from the implementation of the National Patient Safety Incident Response Framework (PSIRF) which sets out how we develop effective systems and processes to respond to patient safety incidents in a meaningful way, our next focus is further developing a patient safety culture. Safety culture has been a reoccurring theme in recent reports where poor care was identified such as the Francis Report, Morecombe Bay, East Kent, Ockenden Report and the importance is further highlighted in responses from the Berwick review and Winterbourne view. (NHSE 2023) Following a review of Health and Safety it has been agreed to introduce the use of the Safety Culture toolkit which will strengthen our current safety culture profile. Enabling staff to speak openly about and raise patient safety concerns, without fear of blame, reprimand or intimidation, cultivating the required space to learn from these events to make care safe. Prioritise patient safety and promote positive staff experience.
    Reduce calls to IT regarding EPR (electronic patient record) by 90% post implementation phase and increase staff satisfaction regarding EPR. In the previous 10 months there have been 918 calls to the IT Service Desk regarding our current system. Implement a robust, fit for purpose electronic patient record system. Having a system that is designed by clinicians for clinicians has been shown to improve patient care and staff satisfaction within their role. Improved quality of data to show patient outcomes. Improved data input. Increased efficiencies from system Increased patient / colleague experience. Clinical effectiveness improved due to system design. Promote a positive staff experience and ensure an effective use of resources.

    2. Patient experience
    Develop a programme to make sure that young people with long-term healthcare needs feel prepared when moving from children to adult services. (This will be the second year of a two-year priority). In 2024, all relevant services will have implemented the quality and safety KPIs ensuring that all children identified for the transition pathway have had all necessary actions completed for their transition into adult services. These measurements will be built into Rio. Young people face plenty of challenges when preparing for adult life. Children with complex health needs, have often been looked after by a few teams, however, when they access adult services, care is often provided by several teams, across sectors and in different environments. Developing a robust transition process for children who use our services as well as their families will mean that they will feel supported an understanding what their care will look like once they become an adult. It will provide a framework for our teams to follow to be better able to support their patients as well as to build relationships with adult service partners. Over all this will provide a more integrated and joined up experience for patients and their families. Improve patient and carer experience.
    Use digital technology to improve the number of patient survey responses received by the trust. We will increase the number of patient survey responses by 20%. (This will be the second year of a two-year priority). In 2024, we will increase the number of patient survey responses by 20%. Making sure that people who use our services receive the very best care is essential and being at the centre of the healthcare process they can provide valuable insights into the quality and delivery of our services. Given the nature of our services, it is not always appropriate or easy for patients to complete a feedback survey when they are discharged and often, despite wanting to provide feedback, the opportunity to do this may have passed. Our electronic record system, Rio, has the functionality to send patient surveys and reminders electronically and for those who have the means to use electronic devices for communication this will make the process easier. Traditional means to collate paper feedback will remain to make sure that all patients have the opportunity to feedback their experience of care in a way that is effective for them. Improve patient and carer experience, effective use of resources and information that drives continual quality improvement.
    The East Sussex School Health Team will provide packages of care to children and young people at risk of emotionally based school avoidance. (This will be the second year of a two-year priority). In 2024, we will improve outcomes for children and young people who have a targeted emotional health and wellbeing assessment. Emotionally Based School Avoidance (ESBA) is a significant concern for children and young people in East Sussex. This view correlates with national findings which state that over a fifth of young people have reported to have experienced a high level of emotional problems and difficulties. This highlights the increasing need for the East Sussex School Health Service to engage seldom seen groups who are of school age but may not be attending school due to their emotional health and wellbeing. Improve patient and carer experience and reduce health inequalities.
    Support the health inequalities agenda by recruiting volunteers to represent the population we serve and use their lived experience to support services users from diverse backgrounds and develop our services to meet their needs. Increase the percentage % of new volunteers recruited with protected characteristics - 4% are from ethnic minorities we would like to increase this to 10%, for sexual orientation we have less than 2% who are gay and bi-sexual, this we aim to increase by 10%. 12% of our volunteers have disclosed they have a disability, and we aim to increase this to 20%. Increase percentage % of current volunteer workforce in the top 3 deprived areas within Kent as identified from data already collected – these are the % of active volunteers we have in deprived Kent areas: Swale (4%), Thanet (10%) and Folkestone and Hythe (3%). We would like to increase these % to above 15% for Thanet, over 10% for Swale and Hythe – so these are more in line with our largest population areas where our volunteers reside of Canterbury (18%) and Ashford (14%). The NHS has been cited in its long-term plan as encouraging opportunities at local levels for action on health inequalities. Volunteers as members of the community and service users of the NHS are a key resource for trusts to learn how to improve their services and can be a vital link between services and communities. We have therefore decided to work with volunteers in our priority to support the reduction of health inequalities, to align with current and long-term national NHS agendas. The aim of this quality priority is to utilise volunteers to improve the experience, access and outcomes for people with protected characteristics and from diverse backgrounds. This will be achieved by recruiting volunteers to increase equal representation across our roles, engage with local communities and co-design services to increase equity for those identified groups. In addition, we need to improve equality monitoring for our current cohort of volunteers. Demographic data has identified significant gaps for example, no sexual orientation data has been collected for 70% of volunteers, with only 1.4% who have identified as gay or bisexual. Improve patient and carer experience and reduce health inequalities.

    3. Clinical effectiveness
    Develop a Single Point of Access and Assessment (SPOA) in east and west Kent to ensure the right people, go to the right place at the right time, first time. (This will be the first year of a two-year priority). In year one we will measure – how many people did not go to the right place first time. Using this data, we will agree a reduction target to demonstrate improvement to be delivered in year two. Driving efficiency for same day wrap around care. Providing equity for patients. Simplification of access pathway. Multi-disciplinary cross-organisational working. Anticipatory care planning. To identify system gaps in order to improve services to enable informed decisions when identifying commissioning needs. Defining and using cross-organisational skill sets in order to achieve system goals. This is a system wide project and KCHFT is participating by providing community expertise and capacity. The main metric for the project is a reduction of patients referred to SECAMB conveyed to an emergency department. A better patient experience.
    Standardise and raise the level of quality assurance within the community hospital wards by delivering quality rounds. Every community hospital will undertake a quality round every month for 12 months. These will be delivered by the ward managers who will be looking at a range of safety and quality key performance indicators (KPIs). Target: 100% of quality rounds delivered throughout the year for each community hospital. The community hospitals will develop a governance structure that supports managers to understand where any risks and concerns may be and identify good practice that can be shared with all staff. A ward based standardised assurance tool will be developed and measured at specified intervals to form the basis of the 'quality round'. The quality rounds will be delivered by ward staff and / or managers and the findings of the tool will be used to focus on areas of improvement and to celebrate good practice. Discussions from governance meetings will inform and drive the quality rounds. Promote patient, safety, improve patient experience and promote positive staff experience.
    Implement a screening service for cytomegalovirus (cCMV) for babies identified with potential hearing loss during the New-born hearing test utilising local services. (This will be the first year of a two-year priority). Current practice to date: all babies identified with suspected hearing loss are referred for paediatric assessment to understand the aetiology of their hearing loss. One in 15 babies who are referred to audiology are diagnosed with a permanent hearing loss in one or both ears, although there are many causes for hearing loss in babies, one possible cause is cCMV, it is thought up to one in four babies (25%) diagnosed with a hearing loss have had cCMV. Currently it is only if a baby is seen under Tier 4 medical services for audiology that they will be tested for cCMV and the specimen is sent for testing. It is recommended that a targeted screening programme for cCMV is introduced in north and west Kent and Medway utilising the NHSP workforce (no additional cost) to complete a screen using an oral swab when a positive new born hearing screen indicates further audiological assessment is required (The east and south of Kent is covered by East Kent Hospitals University NHS Foundation Trust where screening for cCMV is already in place). This means that 1 in 4 babies with an identified hearing loss will receive early intervention to slow, halt or even improve the deterioration of their hearing when cCMV is the cause. It will reduce the acuity of their hearing loss and reduce the impact hearing loss on their quality of life. Better patient / carer experience.

    4. Staff experience
    Implement a new model of clinical supervision in KCHFT community hospitals (This will be the second year of a two-year priority). In 2024, we will increase the proportion of nursing staff attending clinical supervision by 60-80%. Clinical supervision provides an environment in which staff can explore their own personal and emotional reactions to their work; reflect on and challenge their own practice in a safe and confidential environment as well as receive feedback on their skills and engage in professional development. Promotes clinical professional leadership and ensures our staff feel valued and heard.
    We will make sure the likelihood of applicants being appointed from shortlisting is improved for BAME (Black, Asian, minority ethnic) applicants, when compared to white applicants, from 2:0 to 1:7 over 12 months. Progression of BAME applicants from shortlisting to appointment. A diverse workforce ensures that our diverse service user population is treated by people who are as diverse as they themselves are. This also sets us as a leader in the system and nationally in championing equitable employment. A great place to work.