We Asked, You Said, We Did

For expressions of interest to participate in an online workshop for national principles for forensic mental health.

There was a large number of individuals and organisations that let us know that they were interested in participating in the project.  Thank you to those of you who have already nominated!

We are working through the responses now and making arrangments for the workshops.  We will be in touch with you very soon to let you know the best way to contribute your views. 
For people with Lived Experience of the forensic mental health system either personally, as a family member, supporter, carer or close friend - it's not too late to participate.  For more information email Mental Health Matters 2 - Mentalhealthmatters2@gmail.com

Our online survey is still open for you to share your views.

Collaborating in Health Strategy 2022-24 sets a new strategic direction for lived experience experts to influence the way Metro North Health delivers healthcare. There were 5 proposed priorities in the Strategy focusing on the known gaps, such as expanding the diversity of community representation in our improvement activities and empowering consumers as partners in their healthcare journey. The priorities also align with the National Safetyand Quality Health Service (NSQHS) Standards for consumer partnerships.

We asked for feedback on our proposed approach and priorities to strengthen consumer and community engagement across our health services.
 

You supported the general approach and recommended a couple of additions.
You commended us for our proposed commitment to inclusive engagement to ensure a diversity of views and perspectives are heard. 
You asked for a greater focus on collective action that brings together different consumer perspectives to influence system change.
You requested evidenced based health literacy methods be included in the strategic approach to involve consumers as partners, for example, “teach back” and “show me”.
You requested that some of the language in the strategy be simplified.
 

We incorporated your suggestions in the strategic priorities. 
We simplified the language and created graphics for the principles that underpin our approach.
The Board endorsed Metro North Health’s Collaborating in Health Strategy 2022-24.

For feedback and input into the Draft Metro North Hospital and Health Service, MN32.

Through the survey we, we asked you if there are any significant additional aspirational initiatives that should be considered under –

• Clinical models
• Research, knowledge and innovation
• Workforce

Infrastructure

You provided feedback and aspirational initiatives for the MN32. You provided feedback around climate change, workforce support, precision medicine, robotics and need for integrated technology.

We systematically reviewed the feedback and integrated the feedback into the draft MN32 where it was relevant. The feedback that was not directly included in MN32, was sent to the related Clinical Directorates for further action.

A final copy of the Metro North Hospital and Health Service, MN32 (hyperlink document) is now available.

For feedback and input into the Draft Metro North Hospital and Health Service, MN32.

Through the survey we, we asked you if there are any significant additional aspirational initiatives that should be considered under –

• Clinical models
• Research, knowledge and innovation
• Workforce
• Infrastructure

You provided feedback and aspirational initiatives for the MN32. You provided feedback around climate change, workforce support, precision medicine, robotics and need for integrated technology.

We systematically reviewed the feedback and integrated the feedback into the draft MN32 where it was relevant. The feedback that was not directly included in MN32, was sent to the related Clinical Directorates for further action.

A final copy of the Metro North Hospital and Health Service, MN32 (hyperlink document) is now available.

We asked how could we improve consumer and carer engagement and partnership.  We wanted to look at different models and approaches to engagement within a mental health service context.   

We also asked for your reflections on and confidence in the process itself. 

You said that consumer and carer engagement needed to be:

• honest
• realistic
• collaborative
• flexible
• inclusive
• fit-for-purpose and purposeful

There needed to be accountability for engagement, a proactive approach and based on our organisation's values.   Consumer and carer engagement needed to support an independent consumer voice, as distinct from a peer / lived experience workforce. 

• Two clear paths for engagement were determined: a collective community of consumer and carer partners and an extended peer workforce.   
• Four ideas were prioirtised along these paths:a register of lived experience for on and offline purposeful consumer and carer engagement; consumer educator role; and strengthened carer partnership and an expanded peer workforce. 
• Three other areas that cut across are:community partnerships; platform for lived experience stories; and building capacity of carers and consumers to participate.   
• All of these elements rely on, build and reinforce organisational culture and capability. 

Feedback was collected in survey and in a feedback form at all workshop with many expressing appreciation of the mix of voices and perspectives, the importance of  interactions and participation of Executives (although this did not happen at all workshops, the support of Executives at the final workshop was noted), participants felt that their ideas were listened to

• From the first four workshops which were focused on idea generation, 75% of participants said they were either confident or very confident that their involvement will inform MNMH’s approach.  The rest were either uncertain or not confident. 
• From the final workshop, where voting for ideas took place, the confidence level was the same.  

Positive comments included: ​

“I found today's meeting valuable, insightful and meaningful”.  ​

“Great collaborative approach”,

“innovative approach””,

“very productive”, ​

“Thank you for listening and being interested” ​

“Relevant, open conversation with a broad range of voices” ​

Negative: ​ “Based on previous experience (not MNMH) where the system decides what to do based on budget.”

We also heard through other feedback and channels that there were concerns about the findings being translated into practice and being acted on.  
 

We asked what was most valuable to the co-design process. Below are some of the comments:

"The depth of input each participant can provide. That everyone is heard and can make themselves heard. That people can seize opportunities to participate. Getting away from the "they didn't do this or that..." ie all participants are now "they"

"The opportunity for my voice as a consumer to be heard. To be able to provide feedback and ideas on how to move forward."

"People coming together and having a say and some control over how services will be delivered in the future."

Based on the reports and findings of each of five workshops, and Consultation Hub Surveys completed, we have developed a new framework for consumer and carer engagement that addresses the findings and captures all the principles and priorities identified.  To ensure that this framework is turned into practice, an implementation plan has been developed that outlines areas and pathways for rapid progress, as well as longer-term planning.    Work to date undertake includes:

• a register (my "ROLE") with an EOI developed and promoted
• discussions and planning with e-health and IT department to develop a system that better supports staff with bringing consumers and carers on board for discrete projects
• initiate a mental health literacy project focusing on shared decision making and involving family and carers
• working with ED Access and Coordination on feasibility of integrating a Carer's app to improve support for carers
•  determining collaboration with PHN and Carer's Qld and shared agenda on supporting carers and developing tools and mechanisms for lived experience speakers
• consultation and submission of a SEED innnovation grant to fund, trial and evaluate a Lived Experience Educator role in Metro North Mental Health 
• a number of presentations of the co-design project upcoming (QUT Design for Healthcare, Metro North Safety & Quality, PPIMS network, Metro North Consumer Engagement annual showcase) with reflections of lessons from the co-design process to share with others, and build co-design practice. 

For feedback on the consultation draft for Metro North Health Literacy Approach.

The aim of Metro North Health Literacy Approach is to create a platform for a shared understanding of health literacy that will support proactive and coordinated actions for improvement across Metro North.

The Health Literacy Steering Committee which includes consumers, staff and community partners has overseen the development of this approach. 

Two consumer workshops were held earlier in the year to inform the foundations for Metro North's approach to health literacy. A working group of consumers and staff developed Metro North Health Literacy Approach as a consultation draft.

50 people provided feedback on the consultation draft (7 consumers and 43 staff). RBWH clinical council was consulted and another workshop was held with consumers and staff to consider all of the feedback and finalise the approach. In summary you told us:

• to focus on health and wellness and not just managing illness
• health literacy is a shared responsibility requiring collaboration amongst staff, consumers, carers and community partners
• we needed to clarify what we are aim to improve by tackling health literacy
• to ensure our entire healthcare workforce is supported to contribute to health literacy
• commit to continuous improvement, evaluation and research.

We revised the Metro North Health Literacy Approach.

It was approved by Metro North Operational Leadership Team in December. A health literacy webpage will be launched in the new year and we will take action to address the priorities in the approach.

For feedback from staff, consumers and community on the draft Metro North Safety and Strategy 2019-2024. The draft strategy was developed following extensive consultation with staff, consumers and partners.

In Metro North, we’re committed to making sure that the people who use our services are safe and feel safe.  We’re also striving to continuously improve the quality of the services we provide.  Achieving this means having a culture that is focused on patient safety and quality improvement.

We recognise that for patients and consumers to have the best outcomes from their healthcare, they need to be at the centre of all that we do - from the way we communicate, plan and provide care, to the ways we design systems of care that keep patients and staff safe.

Patients are also our focus as we assess the safety and quality of the care we provide and research new and better ways of caring.

We updated the draft strategybased on the feedback received. Please see the final Metro North Safety and Strategy 2019-2024 below.

For feedback draft Metro North Mental Health Clinical Services Plan 2018-2023.

The plan was informed by a comprehensive assessment of health need, current and future service activity, literature and targeted consultation. The Draft Plan will guide public mental health services and public alcohol and other drug services (provided by Metro North HHS) over the next five years with a ten year outlook.

You provided feedback and ideas for how to improve the plan.

We integrated the feedback we received into the draft. A final copy of the Metro North Mental Health Clinical Services Plan 2018-2023 is now available.

Keeping older people healthy and independent is our priority. What should be done to support this priority?

If three (3) things could be improved in health care for older people with complex care needs what would they be?

Carers play an important role in supporting many people who are ageing. What is working well to support carers? What could be improved for carers?

There were 70 respondents in total, noting one of these was invalid as no answers to the questions were provided. Of the respondents 70 per cent identified as an older person. More than 24 per cent of respondents stated that they look after an older family member or friend in an unpaid or informal capacity, and less than three per cent were paid carers working for an organisation.

More than 40 respondents identified a willingness to be involved in future consultation by providing their contact details.

Older Persons’ Health Services Plan: Summary of online survey consultation

Metro North Hospital and Health Service and Brisbane North PHN have developed a new five year healthcare plan for older people which will guide the way we deliver healthcare services to this group of people in our community. It is not the last word, but a document that will allow the vision to expand and grow.

Thank you for your support

Through the CaRE Patient Experience survey trial undertaken at Caboolture Hospital in November - December 2016, we asked patients and carers about thier experiences through the CaRe "Connection and Respectful" Experience  (CaRE) survey.

Through the CaRE survey, we asked you how we are going in following key areas and scored us out :

• connection to reflect the importance of taking time to establish  trust and relationships
• respect  to ensure that you experience respect in the way you are treated and in all communication
• empathy  to ensure that compassionate care was provided to you
• information to see if you received all the information you needed, in a way that you understood, and was helpful and timely
• continuity and consistency to ensure that all healthcare professionals involved in your care were consistent and worked as a team to support you
• involvement as a way of understanding if you felt you were involved in the decisions about your care as much as you wanted to be. We also asked if you wanted your family to be involved and how well we did that.

176 people participated in the survey across a variety of locations (Emergency Department, Wards, Maternity).  Overall, you  said that your experience was positive; however there was also some consistent themes where you said we could improve.  The areas in which we scored lowest are:

• the score that you gave us for your overall experience highlghted room for improvement
• involving you and your family as much as you would have liked is another where you said we could improve
• taking time to connect with you and understand  your individual needs is something you also said we could improve.

From the additional comments that you provided, we identified the following areas  areas of importance to our consumers:

A few specific issues were raised :

• maternity visiting hours were restrictive and partners wanted to be able to  stay with mothers and newborns for extended hours
• parking was a signficant issue, particularly for people who are older or those with a disability
• the abilty to charge phones
• care of elderly, particularly frail, and their carers

A Metro North group of consumers has reviewed  the themes that emerged to develop a Metro North patient experience strategy that will aim to improve the experience of patients in these areas.

We are now commencing our 2017 CaRE survey with the aim of ensuring we are on track to achieving 10/10 in all areas of importance to the patient.

For your input into the revision of the Health Service Strategy 2015-2020

Health Service Strategy review and refresh – phase one consultation themes emerging

Over the past 18 months Metro North Hospital and Health Service (Metro North) has actively worked towards implementing the Health Service Strategy 2015-20. Through the commitment of all staff many priority areas identified in the Strategy have been achieved. To ensure the Strategy aligns with the Metro North Strategic Plan and continues to guide the development and delivery of health care services a review and refresh of the Health Service Strategy is underway.  

The first phase of the review included extensive key stakeholder consultation with staff, community partners and consumers.  This phase is now complete and a summary of the key themes are described below. The full consultation report is available. Please email metronorthengage@health.qld.gov.au to request a copy.  Thank you to all who participated.

Summary consultation key themes

Please note the themes described below are a summary of information heard though consultation with a broad range of stakeholders.  The information will be used to guide and inform the development of a refreshed Health Service Strategy.  The themes do not reflect MNHHS policy or position at this time.

Potential new and/or expanded priority areas:

1. Expanding partnerships to include care of the individual ie person-centred care including role of families/carers - caring for people’s social, emotional and physical needs. Person-centred models of care rather than speciality (subspecialty) approaches to care. Patient health literacy to enable informed decision making, timely care in the right setting. Working with families and carers ensuring their health, including mental health, during the care of their loved ones, especially long term
2. Keeping people healthy and well - public health, prevention, screening and health promotion could be strengthened in the refreshed Strategy.
3. Preventing functional decline and long term problems for people with chronic disease or injury.
4. Older persons care- considering three age groups individually over 65, over 75 and 85. This would include keeping people healthy and helping people to participate in healthy lifestyles eg increasing physical activity and eating better. Better managing chronic disease in community settings.  Consider care across organisations, services and settings.  Rehabilitation, end of life and palliative care included in this theme. Improve transition care, links to residential and interim care and raise awareness of services available across Metro North.
5. Children and young people- this was a broad theme consistently discussed in consultations including:

• Mothers health, including mental health, while pregnant (perinatal)  to enable healthy well babies
• 0-5 health recognising improving wellness in this age group will have lifelong outcomes
• Young people (no age definition agreed)- staying healthy and active, mental health and access to age-appropriate acute care and environment

6. Aboriginal and Torres Strait Islander and Culturally and Linguistically Diverse populations –missing from current Strategy

Other themes that have been raised but not consistently in consultation are:

1. Urgent care in the community and home - alternatives to the Emergency Department.
2. Drug and alcohol complex detox services.
3. Information and data – consultation identified opportunity to review data collected and streamline/reduce, share information, standardise and make available to improve care (eg by clinicians on the floor-real time- (similar to the Patient Access Coordination Hub), share information across providers.
4. NDIS pathway – consideration of consequences if system failure. If successful more people will be seeking care in own home.
5. Social model of health - connectivity with broader community.

The next step in the engagement process involves an executive stakeholder workshop that will be held in February to consider all the feedback and to discuss the refreshed Health Service Strategy. Consumers and community stakeholders will be represented at this workshop and will contribute to the discussion. It is anticipated that a refreshed draft Strategy will be available and disseminated for comment in April 2017.

We asked for:

- feedback about your experiences using any genetic service

- opportunities to enhance the current and future supply of services

- addionional comments

You said:

- the service was comprehensive and caring

- poor support for patients and carers of rare diseases

- reduce wait time, expand services in regional areas

- better linkages and communication with genetic specialists

- integrate IT systems

- develop fact sheets and promote services

- enhance opportunities for research, education and training

We did

- all responses were tabled at the Genetic Steering Committee held in May 2016

- all responses will be systematically analysed and considered in developing future service directions for the statewide health service plan for Genetic Health Queensland