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The 15 Steps Challenge

We see and hear in the media many adverse reports about our NHS services, but not many of the good events that take place every day. To ensure the quality of the numerous services provided, hospital trusts have many tools at their disposal to check that patients are receiving the best possible results and to enhance their experience.

One of these tools is "The 15 Steps Challenge", so named because a mother, one day attending a hospital with her daughter, said: "I can tell what kind of care my daughter is going to get, within 15 steps of walking on to a ward." This made a senior member of the Trust realize how important it was to see how a patient perceives good quality treatment, and eventually, it was introduced as an assessment tool by many hospital Trusts.

I was recently invited to participate in a "15 Steps" visit to the Children's Orthoptics Clinic at Vale Drive Primary Care Centre, Barnet. This paediatric eye service includes screening, diagnosis and treatment for children within the Borough. Now, this is a very small unit, when compared to some of the large hospitals, and it is to their credit, that the Central London Community Healthcare NHS Trust (CLCH) are just as serious with the quality of service at a small clinic, as well as, say Barnet Hospital. The clinic is on two levels, having (mainly) GP's on the ground floor, with dentistry and orthoptics upstairs. There are toys for younger children, and colourful images on the walls in clinical rooms.

The small visiting team, always includes some "top brass", and our group of five consisted of the Trust Chair, deputy chief nurse, 2 patient experience facilitators, and myself. We were to look at four key areas:

• Is it welcoming?
• Is it safe?
• Is it caring?
• Is it well organised and calm?

On arrival, we were met by an, Orthoptist, who showed us around and introduced us to other members of the staff. Our visit included observation, and then, having split-up, chatting to patients or parents (with their consent) and staff, so that a true picture could be built-up, concerning their opinion of treatment, staff and premises.

We checked out for cleanliness, including toilets; staff, including name tabs and attitude; we listened and looked. What was the atmosphere like? Were there any unpleasant smells? Was there good information on the notice boards? Was the signage clear and visible? Were hand gels available? Are the chairs in good condition? Is there a calmness around the clinic? I could go on, but suffice to say . . . we were very thorough!

There were only 3 or 4 patients, and I was allowed to watch the orthoptist carry out one of her consultations. Most of the patients are usually between 7-9 years old, but in this case, it was a 14 year old with her mother. I was very impressed with her treatment and diagnosis of the patient, following which I was able to discuss the experience with the patient.

At the end of the afternoon, we met-up to discuss our research, and thank the staff for their assistance.

Altogether, it was a very fascinating and rewarding experience.

Melvin Gamp 19th November 2016