Quality report 2021-2022

Communication via letter: Departments primarily communicate information to Patients via paper-based letters and telephone calls. These letters are generated by both clinical, administrative and operational staff via different solutions. ‘Report’ style letters are typically generated by the clinician or their secretary via CWP and DocMan. ‘Administrative’ letters (e.g. clinic appointments, treatment bookings) are typically generated by administrative or operational staff via The Christie PAS (CareFlow). A recurring theme highlighted by staff and Patients was the number of different letter templates used within The Christie. Circa 197,000 letters were issued in 2019/20 using 216 different letter templates. Patients are often provided with appointments less than a week after initial contact/referral and letters sent by post can take up to 7-10 days to be delivered. Communication via phone: Patients are currently only able to contact The Christie staff by phone via The Christie hotline, telephone numbers provided on letters or telephone numbers provided on an ad hoc basis by staff. Patients are often unsure who they should speak to about different issues (e.g. appointment information, transport booking, medications advice). Digital Communication: FireText has previously been used by the trust to offer one-way SMS communication. This solution has been under-utilised since purchase as it does not meet the needs of staff or Patients. Both staff and Patients expressed that utilisation of SMS and email communication could offer significant benefits. Technical staff have advised that gov.notify will provide the required functionality for generic communication via SMS and email. Boundaries around two-way direct clinician to patient communication through SMS and email should be reviewed as this is likely to meet the requirements for non-generic communications. Accessibility: Staff and Patients raised concerns around accessibility of Patient Communications. Limited consultation has taken place to assess the communication needs and preferences of patients. Patient communication accessibility issues have been raised on the internal risk register. Patient impact: It was noted that a fairly significant burden is also placed on Patients to manage their care and to flag issues such as missing appointments. Finally, a consistent theme raised by both staff and Patients was direct Patient access to medical information including appointment bookings, test results and medication information. Stakeholders expressed a preference for accessing this information through a ‘Patient Portal’ or app. High Level Benefits Improved user experience; Reduction in Patient related risks associated with the Patient Communications process; Increased clinical efficiency; Increased administrative efficiency; Utilisation and expansion of existing technical capabilities. • Electronic Medications There are over 60,000 patients treated in The Christie NHS Trust each year, with an estimated increase of over 13,000 in the next year. Almost every patient requires medicines during their stay. Medicine prescription and administration is largely based on paper charts. An electronic medication and prescribing system will enable the prescribing, supply and administration of medicines electronically bringing improved patient safety, productivity, financial and quality of care benefits. The Electronic Prescribing and Medicines administration system will provide: o Integrated (full) view of a patient’s medication history o Electronic communication of a prescription or medicine order o Clinical decision support including allergy and interaction checks o Audit trail by recording prescriptions and administration electronically The High-Level Benefits will be: o Improved patient safety due to reduction in medicine errors, adverse reactions and serious incidents caused by pen and paper-based processes. 6