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Our quality plan

Moorfields Quality Plan: a commitment to quality and safety for all patients

The Quality Team have developed a new plan for better quality and safety for Moorfields’ patients, based on what patients tell us is important. The plan covers all our sites and all the care and treatment that patients may receive, and is structured around a patient visit (also known as the patient journey) to hospital. There are therefore three parts to the plan: preparing for a visit to hospital; having care or treatment at Moorfields; and what happens after a visit. The structure of the plan uses three simple and internationally accepted categories of quality of care: the patient experience, patient safety and clinical effectiveness.

We hope that this plan covers all the important areas of quality and safety at Moorfields andwill really help patients and staff alike to understand and focus on what matters most. It will be used to decide where we will concentrate our efforts to try to make things better and what sort of things we will measure and include in our performance reports.

We have consulted a wide range of stakeholders (including patients, governors, our staff and our commissioners) to get their views to ensure we have included the correct things, what isconsidered important, and what will really help us care for our patients better.

Part 1 - Preparing for a visit to Moorfields

Patient experience and patient safety

Objective 1: Patients should receive useful and clear information about their visit

All new patients will receive a ‘Welcome to Moorfields’ information booklet and from this and the new website will be able to access all the important information they require such as:

  • What to expect when you come to Moorfields.
  • How to find and access Moorfields.
  • How to make an enquiry about an appointment before attending.
  • How to become a Member of the Trust.

All patients will receive a letter regarding their attendance which will clearly provide the following information:

  • Name of consultant or team.
  • Site of attendance.
  • Time.
  • What to bring etc.  

 

Objective 2: Patients should be seen in the right setting by the right doctor at the right time

  • Patients are seen in the most appropriate clinic or by the most appropriate team (e.g. A&E if emergency, correct speciality clinic as requested in referral details or by internal follow-up decision, if surgery is admitted under correct team).
  • Patients are seen within the correct time (as indicated by referral or waiting list urgency or by internal follow-up decision and within national targets).
  • Patients are not cancelled unnecessarily on the day.
  • Patients’ appointments are not rescheduled more than once.
  • Patients and referrers will be offered a choice of which site to attend where possible.
  • Patients should receive the full care and investigations and not be required to return unnecessarily because of a lack of personnel or equipment.
  • Clinical Effectiveness.

 

Objective 3: Patients need to be referred appropriately and in a timely way to Moorfields

  • Patient referrals should be appropriate and timely.
  • Referrers are provided with enough information to be able to send the referral to the correct clinic.and should be able to have queries on patients who may require referral answered quickly.
  • There is clear communication with referrers to provide feedback and advice on the referral once patients have been seen.

 

Objective 4: Patients and referrers should be provided with enough information about ophthalmic conditions, waiting times and clinical outcomes (results) for treatments at Moorfields to inform patient choice

  • Patients and referrers should be able to find information about common ophthalmic diseases on the Trust’s website.
  • Patients and referrers should be able to find information about clinical outcomes for speciality care on the Trust’s website.
  • Patients and referrers should be able to find information about consultants and their specialist expertise on the Trust’s website.
  • Patients and referrers should be able to find information on current waiting times to be seen or admitted.

 

Part 2 – Having appointments, care and treatment at Moorfields

Patient experience

Objective 5: Patient transport arrives on time and staff are polite and courteous 

  • Patients who receive transport should find that their transport arrives and leaves on time.
  • Patients who receive transport should find that their transport is not cancelled.
  • Patients who receive transport should find that transport staff are polite and courteous.
  • Patients who receive transport should be provided with the appropriate transport type with the appropriate staffing.

 

Objective 6: Patients should be provided with an accessible and comfortable environment on hospital premises

  • Patients should be able to access the required areas of the hospital easily.
  • Patients should find the hospital comfortable with sufficient seating and appropriate lighting levels.
  • The hospital should be well signed, including signage suitable for those who are visually impaired.
  • Food and drink should be available for patients and carers.
  • Toilet facilities should be available for patients and carers and be clean and tidy.

 

Objective 7: Patients should be treated with respect 

  • A receptionist should be present in all clinics/wards.
  • Staff should be friendly, courteous and professional and provide appropriate greetings.
  • Communications should be clear and audible especially when patient are called for consultation.
  • Staff should always introduce themselves (name and role).
  • Staff should be dressed appropriately and wearing their names badges.

During consultations, explanations from staff should be clear and include, where appropriate, the patient’s diagnosis, prognosis (outlook), what is their treatment plan and when they should be seen again or if they are discharged.

Staff should spend enough time with their patients.

There should be enough privacy for discussions and there should be a private room for particularly sensitive or upsetting communications.

 

Objective 8: Patients should have access to suitable written information and support

  • Written patient information on conditions and treatment should be offered wherever possible.
  • Up to date leaflets should be available and on display in all relevant areas.
  • Where appropriate, patients should be provided with suitable discharge information (including how to use medications, what medication side effects to look out, what symptoms to look out for etc).
  • Patients undergoing procedures should be consented properly, by a suitably trained professional, with discussions beginning before day of surgery, risks and benefits explained and a consent form properly completed.
  • A written consent information leaflet and copy of consent form should be provided to all patients undergoing a procedure, usually before the day of the procedure.
  • Translation and interpretation for patients who require it should be available and suitable.
  • Patients who require it should have access to counsellors (ECLO), psychological and family support.

  

Objective 9: Patients should not have long waiting times to receive care or treatment

  • National and local waiting time standards for care and treatment should be achieved
  • Waiting times for patients in clinics should be reasonable and achieve the Trust’s standards
  • Information should be clearly provided on current waiting times and apologies and action taken where standards are not being met. 

 

Patient safety

Objective 10: Patients should not suffer harm from avoidable mistakes

  • Details of patient care must be transferred (“handed over”). appropriately between clinical professionals.
  • The correct patient should be treated.
  • The correct eye or part of the eye should be treated.
  • The correct intraocular lenses (IOL) for cataract surgery must be inserted.
  • Patient records (whether paper or electronic) must be updated accurately and in a timely way.
  • Instruments or foreign bodies must not be unaccounted for after an operation.
  • Staff must be trained in children’s and adult safeguarding, be able to identify at risk patients and act on any concerns.
  • The quality and safety of care must be consistent across all our sites.
  • When things go wrong, incidents must be recorded and reported and lessons learned to prevent further problems.
  • When things go wrong, patients must be told and receive an apology.

 

Objective 11: Patient confidentiality should be respected and their clinical information must be available during consultations 

  • Patients will have checks at every visit to see that their details. (NHS number, address, GP and telephone details) are up to date.
  • Patient prescriptions must be labelled correctly.
  • Record keeping needs to be complete, accurate, filed correctly, up to date and legible.
  • Medical records must be present and complete for consultations.
  • The results of completed tests need to be available in time for consultations.
  • All electronic systems for caring for patients need to work and be available.

  

Objective 12: All areas of the hospital should be safe, clean and free from infection for patients

  • All frontline staff will maintain hand hygiene.
  • All areas of the hospital and its equipment should be appropriately clean, hygienic and well maintained.
  • All areas of the hospital should be safe and well maintained, to avoid injuries.

 

Objective 13: All clinical areas should have the appropriate levels of staffing

  • Staffing levels in all clinic areas must be known and be safe.
  • All staff must be suitably trained, up to date with skills and, where relevant, registered with a professional body.
  • Clinics are booked with suitable number of patients for the number and type of staff available at that time.

 

Clinical effectiveness

Objective 14: Up to date clinical guidelines and policies are all available to staff seeing patients

  • Trust policies are up to date and accessible and staff must be aware they are there and know what they say.
  • Clinical guidelines are up to date and accessible and staff must be aware they are there and know what they say.
  • National guidelines (e.g. NICE) and requirements by national bodies (e.g. Monitor, the Care Quality Commission) are achieved.

 

Part 3 – After a visit to Moorfields

Patient experience

Objective 15: Patient and staff feedback should be used to learn and improve care

  • Patient feedback should be collected in appropriate ways (comment cards, patient surveys etc.) and used to improve care.

  • Information should be available at all sites about PALS about how to complain.

  • PALS queries and complaints should receive a timely response, supporting patients and answering their questions, and should be used to learn and improve care.

  • Staff feedback should be collected and used to improve care.

  • Patients and staff should be able to provide feedback safely, and anonymously if they wish (whistleblowing), and this should be used to learn and improve care.

 

Objective 16: Following a visit, patients and referrers should be able to communicate effectively with Moorfields

  • All patients should be provided with a telephone number for any concerns about their condition, treatment or medication, or advice about any further appointments.

  • Referrers should also be able to contact clinical teams with queries about their patients.

  • Telephone calls need to be answered without undue waiting. If messages are taken these need to be responded to quickly.

  • Responses to telephone calls need to be helpful for the caller and be clear and courteous.

 

Patient safety

Objective 17: Information is provided after appointments for patients and referrers

  • A letter or summary should be sent to the referrer and any other relevant clinical professional after each visit

  • Patients should receive copies of all such letters or summaries

  • Clinical letters need to include enough information on the diagnosis, treatment and plan for discharge or follow-up and need to be understandable

  • Clinic letters must be sent out quickly

Objective 18: No letters containing patient details or clinical information should be sent to the wrong address

  • No letters should be sent to the wrong GP or patient address where possible

  • Letters returned to the Trust are monitored and corrective actions taken

 

Objective 19: Patients should have continuity of care and not get “lost in the system”

  • The next follow up appointment should be provided before the patient leaves the ward or clinic

  • All patients who need a follow up appointment should receive it and it should be at the correct time and in the correct clinic

  • Decisions on whether to discharge or rebook patients who cancel or do not attend appointments should be taken safely, with regard to their condition, and they and their GP should be informed of the decision

 

Clinical effectiveness

Objective 20: Results of care (clinical outcomes) should be openly available and should be good

  • Results of care, (clinical outcomes), including complications and success of treatment, should be available for patients, referrers and staff for all major areas of work or operations in all sites and areas of the hospital

  • Outcomes should reach a recognised standards of performance

  • Patients should feel better following treatment and appropriate measures should be used to measure that