Beverly Davies, Strategic Partnership and Inclusion Manager, Hywel Dda University Health Board

Introduction

In the Hwyel Dda University Health Board (HDUHB) area, around 15,671 people have visual impairments, and around 85,864 have hearing impairments, meaning sensory loss is common among health service users.

A 2023 audit found only 7 patients identified with sensory loss in the Welsh Patient Administration System (WPAS). A staff survey, completed by 155 members, revealed difficulties in capturing sensory loss information due to lack of specific identifiers on WPAS. Operational pressures and staffing changes in Outpatients led to missed opportunities to ask patients about their communication preferences. Staff suggested that a standardised approach would be beneficial.

Methods

• A working group was established with wide stakeholder involvement.
• Reviewed staff and patient experience data and the number of patients with Sensory Loss key notes on WPAS.
• Used QI tools (Fishbone Diagram, SWOT Analysis, Stakeholder Analysis) to identify improvement areas.
• Implemented various change ideas:
  • Asked staff to complete the sensory loss e-learning package – 83% complied
  • Piloted Sensory Loss scenario training, including:
    • Creating large print and Easy Read information leaflets.
    • Visual Impairment Simulation.
    • EIDO Patient information in read-aloud format.
    • Using the Insight App for BSL interpreters.
    • Utilising equipment such as hearing loops and audio amplifiers.
• Shared improvements via “We asked, you said, we did” posters and adapted yellow boards with black text and developed a ‘Can we help?’ poster to encourage staff to ask about and accommodate preferred communication formats.

Outcomes

• Implemented change ideas improved patient and staff experiences.
• Staff show commitment to learning and collaborating for equitable service provision.
• Staff understand the need to improve experiences for patients with sensory loss.
• Awareness and use of patient record markers, both paper and online, is crucial for meeting patients’ communication needs.
• No significant increase in sensory loss records on WPAS yet, but plan to develop staff guidance and awareness of WPAS features is a key achievement.

What next?

• Cascade change ideas to all Outpatient Departments to ensure accessibility.
• Adopt and display the low-cost ‘Can we help?’ poster across HDUHB.
• Develop staff guidance and roll-out an awareness campaign of the Sensory Loss facility on WPAS.
• Increase identification of preferred communication methods for sensory loss patients by 50% by 31/12/2024.
• Achieve 95% completion of sensory loss e-learning for Outpatient nurses by 31/07/2024.
• Expand focus to include other communication needs, such as foreign language and easy read, aligning with the Equality Act (2010) to prevent discrimination or disadvantage for patients with protected characteristics.

Contacts

beverly.davies@wales.nhs.uk