Case Study - South Staffordshire and Shropshire Healthcare Foundation Trust (SSSFT)
Case Study - South Staffordshire and Shropshire Healthcare Foundation Trust (SSSFT)
Dignity and Respect: “In Practice”- EDS2 Research
An investigation into those using the services of SSSFT, the experiences of those with protected characteristics, and cross referencing with EDS2 Goals and Outcomes
Who: South Staffordshire & Shropshire Healthcare NHS FT
What: Qualitative and Quantitative Research
Why: Are SSSFT achieving EDS2?
Where: Staffordshire
About the Client
South Staffordshire and Shropshire NHS Foundation Trust
SSSFT provides mental health, learning disability, and specialist children’s services across South Staffordshire as well as mental health and learning disability services in Shropshire and Telford & Wrekin. They also provide some services on a wider regional or national basis.
Serving a population of 1.1 million, over a geographical area of 2,200 square miles, with around 3,500 staff.
They are one of the first three mental health style NHS foundation trusts and are committed to using the opportunities this gives them to improve and develop services for their patients.
Background
South Staffordshire and Shropshire NHS Foundation Trust provide a wide range of services, including both inpatient services and services in the wider community, across a broad geographical area. They provide mental health, learning disability, and specialist children’s services across Southern Staffordshire, and mental health and learning disability services in Shropshire, Telford & Wrekin, and Powys. They also provide some services on a wider regional or national basis.
Due to the broad range of services offered by the Trust, it is particularly important that the Trust provides services that meet the diverse and varied needs of their many service users. It is also important to SSSFT Trust that they provide services that are equitable and fair to all. SSSFT is committed to putting equality and diversity at the heart of services and their main objectives in relation to equality are:
• To continue to improve the safety and quality of life of people in the Trust’s care, across all protected characteristics, by ensuring that the trust has the systems in place to provide staff with the necessary skills, tools, and outcome measures.
• To ensure that service users and carers across all protected characteristics are informed and supported to be as involved as they wish to be in their diagnosis/formulation and decisions about their care, and to exercise choice about their treatments.
• To improve the capture, analysis, and application of equalities data.
• To ensure that equality and diversity become positioned as a core strategic leadership issue in the Trust Board.
The Trust follows the Equality Delivery System (EDS2) for the NHS and in order to dive deeper into the experiences of service users commissioned Engaging Communities to investigate across protected characteristics and the geography they operate in.
The trust is committed to achieving the outcomes and to guarantee honest and objective results they wanted external expertise in social research to provide that independence.
Goals
To understand if SSSFT are achieving the outcomes set out in EDS2
To design research that engages the service users from across the protected characteristics and geographies that SSSFT operates in. To create a solution that is sufficiently suited to the timescales of EDS2, the primary delivery system for Equality and Diversity in NHS organisations and can be used to show the direction of travel over that timeframe. Ensure that the delivery gives all individuals the opportunity to participate.
Challenges
To research service users representing all characteristics and geographies
Reaching out to service users across a variety of ages, genders, disabilities, and conditions. To work in areas where we had not previously developed links.
To work with different languages and ethnic groups in culturally sensitive ways. Create questioning that can understand experiences against the outcomes within EDS2. Work with the trust to create practical and actionable recommendations.
Solution
Qualitative—Quantitative—Qualitative
The research proposed consisted of a three phase approach including both qualitative and quantitative methodologies.
Phase A — Qualitative
Hosting focus groups across Staffordshire and Shropshire to explore the experiences of service users. Working with local Healthwatch networks to access specific groups and individuals covering protected characteristics. Avoiding duplicating engagement activities and making the best use of local knowledge and existing community links.
Developing focus groups built on questioning communication, information, listening, coordination and attitudes, what does a good service consist of and how can it be achieved.
Phase B — Quantitative
The Findings from Phase A were used to devise highly targeted and relevant surveys, further investigating the themes emerging from the group discussions. Using statistical analysis to identify significant results between demographic profiles and therefore conclude whether services are delivered equitably for all service users.
Phase C — Qualitative
The final methodology returns to a qualitative format and engages those groups that participated in Phase A. Investigating how recommendations made to SSSFT have translated into improved experiences across the range of services users. Asking if experiences are common across geographies or characteristics? Are the same issues and concerns from previous phases still prevalent?
Communication is the Key
Phase A was comprised of 12 focus groups engaging 123 service users and involved working with Healthwatch Staffordshire, Healthwatch Shropshire and Healthwatch Telford & Wrekin local networks.
Key themes surrounded:
• Access
• Provision of Information and Advice
• Continuity of Care
• Discharge and Transfer between Services
• Social Isolation and Stigmatisation
• Medication
• Dignity & Respect and
• Community Transport
There were many common themes across different group sessions but with considerable unique experiences and opinions, contributions were well distributed. Groups featured honest personal stories recounted and discussed with empathy and understanding.
Communication was the common feature between all themes. Often the reasons for either positive or negative experiences were influenced by the style and appropriateness of that communication.
Recommendations
ECS covered five broad themes with their recommendations
Increasing accessibility through greater primary care integration for mental health services providing greater options for access points.
The creation of a central contact point outside primary care.
Improve transfer and continuity of care through a “patient passport” including the history and story of the patient that can accompany between and within services.
Reducing social isolation and stigmatisation around mental health through raising awareness and targeted campaigns in local areas.
Greater integration of SSSFT with peer support and community groups and developing joint solutions and opportunities for increasing their size, scope, and accessibility in local communities
Impact
SSSFT took on board the initial findings and recommendations, they sought to understand how the suggestions could be integrated with existing plans for continuous improvement. To ensure that they were being thorough in their response they created an action plan to address each point raised.
Two of the greatest impacts to come from this work include a programme for improving relationships and knowledge of services within Primary Care.
Primary Care is the access point to mental health services and inconsistencies exist based on location and characteristics. A key recommendation is for the trust to work more closely with Primary Care to guarantee equality.
Transfer between services internally and externally of SSSFT was a point of concern for service users. The effort of having to explain your story repeatedly for different professionals was highlighted as being stressful. To counter this we recommended the use of a “patient passport” by service users and staff.
SSSFT has begun the process of implementing a new IT system. This new system will focus on improving paperless records and will also feature the ability to easily transfer information between front-line workers and central organisations. By reducing the negative aspects of both gathering and providing information in a health and social care setting, the Trust hopes to improve outcomes and experiences for the public.
Additionally, the Race Equality Foundation is using ECS work done on this project as a reference point for a key NHS Toolkit that is being developed. The Toolkit will advise on the best practice for interacting and engaging with the local community and peer support groups.
Testimonial by Jaskiern Kaur, Equality Lead South Staffordshire and Shropshire Healthcare NHS Foundation Trust
“Engaging Communities have been central to our organisation being able to get a wide range of feedback from the communities we serve in an honest and transparent fashion.
ECS has used a combination of research methods to really help evaluate SSSFT services and suggest follow up recommendations, giving the opportunity for SSSFT to also feedback to communities. We have found the approach that ECS takes with communities leaves them feeling empowered and really positive about their contributions that they make towards services development. ECS has helped us hold up a very honest mirror-making service specific to service users needs.“
About Engaging Communities Solutions CIC (ECS)
ECS is an independent, not-for-profit, community interest company that works to give the public a voice in the way services are delivered. To do this we bring together public engagement, consultation, and consumer advice services within a central organisation. We work to support the voice of the community and to offer an effective way for people to be involved in the services that provide for their health and social care needs.
We enable better decisions to be made by health and social care organisations based on the experiences and views of the public and the collection and analysis of data.
We involve people in ways that are both efficient and effective.
We use our expertise and industry knowledge to maximise our impact on engagement.