Patient Inspections and Local Healthwatch: from PEAT to PLACE

There’s a lot of new Healthwatch info being published  – check out the new Healthwatch website at www.healthwatch.co.uk  – and one of the many new tasks for Local Healthwatch is involvement with new patient-led inspections. The info about this seems a bit fragmented, so to be nice and helpful I thought I’d try to summarise it here.

Patient-led inspections?! How did that sneak into my Healthwatch basket?!

David Cameron announced in January of this year that current PEAT (Patient Environment Action Teams) inspections would be replaced by new patient-led inspections, which will be known as Patient-Led Assessments of the Care Environment or PLACE.

What are (… were … ) PEAT inspections?

PEAT inspections, as they are known, have been going on since 2000. PEAT stands for ‘Patient Environment Action Teams’.  PEAT Teams are made up of NHS staff (such as nurses, matrons, doctors, catering managers, directors etc.) and also patients and patient representatives.

PEAT inspections are an annual event for all NHS sites that have more than 10 beds.  The PEAT teams look at non-clinical aspects of patient care – such as the environment, food, privacy and dignity – basically everything from how clean the floor is to how tasty the jelly is…

NHS sites and trusts are given scores from 1 (unacceptable) to 5 (excellent). The idea is that the inspections produce scores for each site to encourage them to improve their services – and to share best practice.

How are the new PLACE assessments going to work?

The final details haven’t been decided yet – but the new assessments are being piloted this October. A total of 68 hospitals are currently involved in pilot PLACE assessments. The Pilot assessments will run from 1 October to 12 October 2012. You can read the documentation that the hospitals have been sent here. They will be similar to the current PEAT inspections but with more lay members/patients on the teams (over 50% of the team members must be patients).

How will Local Healthwatch be involved?

Local Healthwatch will of course be the ‘new consumer champion for health and social care’ – and hopefully a source of eager patient representatives champing at the bit to do This Sort Of Thing. Local Healthwatches – like LINks – will decide what work they get involved with  so they might decide that they don’t want to get involved with the new PLACE assessments. But the initial message seems to be that Local Healthwatch should be invited to have a key role in the new PLACE assessments.

Which hospitals are taking part in the Pilot PLACE assessments?

Here’s a list of all the hospitals that are taking part (the list names the Trust and then the name of the hospital):

  • Sheffield Children’s, Sheffield Children’s
  • Salisbury NHSFT, Salisbury
  • Avon And Wiltshire, Callington Road
  • Worcester Acute, Redditch
  • Birmingham And Solihull, Ardenleigh
  • Royal Wolverhampton, New Cross
  • Sheffield Teaching, Northern General
  • Manchester Mh And Sc, Park House
  • Morecambe Bay NHS FT, Royal Lancaster
  • Leeds Teaching, St James
  • Devon Partnership, Langdon
  • Leicestershire Partnership, Evington Centre
  • Nuffield, Plymouth
  • Pennine Care, Fairfield General
  • S/W Yorkshire Partnership, Fieldhead
  • Bmi, Rochdale
  • East Cheshire NHS Trust, Congleton
  • Yeovil District NHSFT, Yeovil District
  • Bedford Hospitals NHS Trust, Bedford
  • Barking Havering And Redbridge, Queens Hospital
  • Chesterfield Royal NHS FT, Chesterfield Royal
  • Queen Victoria, Queen Victoria
  • West London Mh, St Bernards
  • Norfolk And Suffolk NHS FT, Hellesdon
  • Birmingham Women’s, Birmingham Women’s
  • Pennine Acute, North Manchester
  • South West London And St Georges, Springfield
  • Norfolk And Norwich, Norfolk And Norwich
  • Kent And Medway Partnership, Thanet
  • West Kent , Gravesham
  • Uclh, Heart Hospital
  • Southern Health, Parklands
  • York Teaching, York
  • Royal Brompton, Royal Brompton
  • Royal Liverpool And Broadgreen, Royal Liverpool
  • North Cumbria University, Cumberland Infirmary
  • Central And N/W London, Park Royal
  • Spire Healthcare, Harpenden
  • Western Sussex, St Richards & Worthing
  • Central Manchester, Central Manchester
  • Medway Maritime NHSFT, Medway Maritime
  • Dorset Healthcare, Blandford
  • Gloucestershire, Cheltenham General
  • South Tees, Friarage Hospital
  • University Hospitals Bristol, St Micheals
  • Southport And Ormskirk, Ormskirk
  • South Warwickshire NHS FT, Leamington Spa
  • Liverpool Heart And Chest, Liverpool Heart And Chest
  • Tees Esk And Wear Valley, West Park
  • Nottingham University, Nottingham City
  • Humber NHS FT, East Riding Community
  • Barts Health, Whipps Cross
  • Cambridge University Hospitals, Addenbrookes
  • North Staffs Combined, Harplands
  • Plymouth Hospitals NHS T, Derriford
  • 5 Boroughs Partnership, Hollins Park
  • Royal National Orthopaedic, Stanmore
  • Ramsay Healthcare, Colchester
  • Anglian Community CIC, Clacton And Harwich
  • Calderstones Partnership, Calderstones
  • Surrey Community, Woking Community
  • St Georges Healthcare, St Georges
  • County Durham And Darlington (Ex County Durham PCT), Richardson Hospital
  • Nottinghamshire Healthcare, Rampton High Secure
  • Leicester University, Leicester Royal
  • Papworth Hospital NHS FT, Papworth
  • South Staffordshire An Shropshire Healthcare, St George’s
  • Hinchingbrooke Healthcare, Hinchingbrooke
  • County Durham And Darlington NHS FT, Darlington

Some useful links:

What to do with this data:

  • Make sure your LINk understands that PEAT inspections are changing and – once established – Local Healthwatch should be offered the chance to be involved in the new PLACE assessments.
  • Check the list of Pilot areas to see whether your local hospital/s are involved. If so, get in touch with the hospital (ask for someone with ‘Director’ and ‘Nursing’ in their job title…) to ask whether you can be a part of the Pilot – or at least kept informed of developments.
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Mapping 4-hour A&E Targets

Tactix4 Performance Map

Tactix4 Map

I was recently rummaging around the internet when I came across a very cool map put together by healthcare software developers Tactix4. The map showed how hospitals were faring on their 4-hour Accident & Emergency targets by placing red, amber or green pins on an interactive map. (Acute Trusts release this information once a week.)

I dropped them an email saying that interactive maps are really my absolutely most favourite thing, and asking whether they could make this map a little more useful for LINks by showing a little bit of historical data on the map as well, so that we could compare the last week’s performance against previous weeks.  A lovely man called Dave Green replied and said he would give it a go! Dave is obviously the sort of chap who can’t quite resist fiddling with a good idea until he has cracked it, and two days later he’d produced the maps. And if there’s anything I love more than an interactive map, it’s an interactive healthcare software developer.

Cool Map 1: A&E 4 Hour Waiting Target Performance >>

Click on your local acute trust and see how it performed in the last week against the A&E 4 Hour Waiting Target. You will also see a link to the relevant page on Patient Opinion.

Cool Map 2: A&E 4 Hour Waiting Target Improvement >>

This map shows how your local acute trust’s performance compares to the previous four weeks. Green means it’s improved since last week, amber means it’s stayed the same, and red means that it’s got worse (it still might be within the targets, but it’s declined from the previous week). Hover over your local acute trust with your mouse and you will see the last 4 weeks’ performance, listed with dates.

What are these 4-hour waiting targets?
One of the key performance indicators set by the Department of Health for NHS hospitals over the last ten years has been ‘the 4-hour Target’.  This meant that a target percent of patients (originally 100% but rapidly revised to 98%) attending an A&E department must be seen, treated, admitted or discharged in under four hours.

Last year, the Department of Health announced that the 4 hour A&E target was to be scrapped, along with other targets – and immediately reduced the target from 98% to 95%.

From April 2011 the 4-hour target will be replaced with eight new “clinical quality indicators”. These new indicators will include ‘patient experience’, ‘effectiveness of care’ and ‘patient safety’ (and I am desperately wondering how many doughnuts I would need to send Tactix4 to persuade them to map those for us too…).

What is an Acute Trust exactly?
The figures on these maps are figures from ‘Acute Trusts’. Hospitals are managed by acute trusts. Acute trusts are responsible for hospitals’ services, finances, strategy, development, etc. and employ the staff that work in the hospital.

Most acute trusts will be responsible for just one hospital, and sometimes ‘acute trust’ and ‘hospital’ are used more of less interchangeably. Acute Trusts are also sometimes called ‘Hospital Trusts’. You will probably know what happens in your local area. Bear in mind, though, that some acute trusts are regional or national centres for more specialised care – and others are attached to universities, training healthcare professionals. They can also provide services in the community, for example through health centres, clinics or in people’s homes.

There is an excellent article summarising all the different sorts of trusts in the NHS on the NHS Choices website.

What to do with this data:
Have a look at your local area and compare the performance of your local trust against the 4-hour target. If you are receiving issues from members of the public about a particular hospital, this might be another indicator that things need looking into a bit more.

For the future, this sort of interactive mapping has huge potential for patient choice. For example, if Local Healthwatches have responsibility for giving information that facilitates patient choice, then a patient might want access to this sort of information in order to decide which A&E department to attend. ‘Do you want to be seen quickly?’ – then chose the hospital which meets waiting time targets. ‘Do you want a hospital with a good reputation?’ – then chose the hospital which has good reports on Patient Opinion. Of course, these specific targets won’t exist for much longer, but this gives you an idea of how the data might be useful for patients wanting to exercise choice.

So, while the 4-hour target might be on the way out, these figures are still useful for giving us an idea of current performance, and they’re definitely a great way of showcasing how useful interactive maps can be. Big thanks to Tactix4!