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Northamptonshire Integrated Sexual Health (NISH) has approximately 40,000 contacts a year and operates clinics from two hubs in Kettering and Northampton, as well as their spokes in Daventry, Corby, Wellingborough, Rushden, Weston Favell and Northampton town centre. A diverse service with reach across a large and varied population, patients at NISH can attend for a range of services including contraception, screening and treatment for sexually transmitted infections (STIs), the management of genital skin conditions and genital pain, as well as HIV management and care.
When it came to the subject of implementing iWGC, Claire Bailey – NISH Service Manager – described NISH as one of the more reluctant departments within Northamptonshire Healthcare NHS Foundation Trust. The current in-house solution – a comments book and suggestions box at reception – had served the clinic well enough over the years; the NISH even ran an annual survey assessing patient satisfaction – why was there a need to change all this now? The information gathered from these sources found its way into departmental meetings and reports and whilst it was used to generate discussions about change and to make improvements there was scope for more extensive usage. Compared to the data the service now receives, the information was largely generic, used only intermittently and didn’t explore with any depth how patients really felt about the service that was being provided at any point in time. Furthermore, feedback was not shared as regularly with staff and patients as it could have been.
Delighted by the initial volume of feedback given, with 2,000 reviews collected in the first 12 months, the NISH team has put the insights gleaned from the feedback to good use, supporting a number of major changes across their service. In particular, this applied to the organisation of appointments and drop-ins. Conscious of the NHS target for 48-hour access to sexual health services and believing that the arrangement best met patients’ needs, NISH had typically operated a combination of drop-in clinics and appointments. The downside was the difficulty of predicting how many patients would arrive on a day-to-day basis for the drop-in clinics. This would lead to long waiting times and staffing levels which had to be structured around estimated numbers only. From the real-time feedback, it was evident that patients found the delays excessive and frustrating, although they were very satisfied with the care they received. Testing a new approach, on arrival at the drop-in clinic, patients were given a guide time and chose to wait or to come back closer to their allocated time, allowing them to use their time more effectively. This immediately resulted in positive comments from people who had taken this option.
NISH has also used the feedback, especially the qualitative comments, to support a business case for the much needed refurbishment of their clinic in Northampton. Adding the voice of the patient to other harder metrics in the business case proved to be very powerful and helped secure a significant additional investment to improve the environment in which their services were delivered. During the refurbishment, which temporarily reduced capacity, NISH had to alter their system to allow patients to book an appointment the day before. In fact, this combined the immediacy of drop-ins with the certainty of a fixed time appointment and once again, feedback showed quickly that this was very popular with patients, giving NISH the cue to investigate rolling this approach out across their other clinics. In addition, they have purchased an online booking system, which they are due to implement shortly.
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