IT ALL STARTS WITH YOU

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1 IT ALL STARTS WITH YOU Tell us about your experience Help us improve NHS services This guide takes you through the different ways you can tell the NHS about your experiences, so that services keep improving.

2 USING THIS GUIDE This guide takes you through the different ways you can tell your local NHS about your experiences, so that services keep improving. Click on words highlighted in blue for further information or contact details. You can telephone the services or your comments straight to them, using the local contact list. The guide also includes some top tips to help you make the most of your contact with the NHS, some other useful resources and links to further information on the web. We recommend asking for help at your local library, if you need some assistance in finding out more.

3 IT ALL STARTS WITH YOU. Click on a link and tell us about your experience of these local services.

4 GP, DENTIST, OPTICIAN OR PHARMACIST Tell us about your experience. 1. You should always start by contacting the practice or service direct. Click here to find the contact details for your local practice or pharmacy. 2. As a next step, you can contact NHS England (the national organisation) by or call

5 COMMUNITY SERVICES Tell us about your experience. 1. You should always start by contacting the service direct. Click here for the contact details of your local services. A list of our services can be found here. 2. As a next step, you can contact NHS England (the national organisation) by or call

6 HOSPITALS Tell us about your experience. 1. Contact the hospital direct and ask for the Patient Advice and Liaison Service (PALS) team. Click here to find the contact details for PALS at your local hospital. A list of our services can be found here. 2. Information about PALS and a directory of PALS round the country is available here.

7 MENTAL HEALTH SERVICES Tell us about your experience. 1. You should always start by contacting the hospital or service direct. Contact the Patient Advice and Liaison Service (PALS) team here. A list of our services can be found here. 2. As a next step, you can contact NHS England (the national organisation) by or call

8 Would you like to give your views on NHS plans for change? DO YOU WANT TO HELP MORE? There are also other ways for you to play a part in improving NHS services, depending on your interest and the amount of time you have. Are you interested in getting involved in a local group which advises the NHS and makes sure the patient s voice is heard? Would you like to know more about how decisions are made to change or improve NHS services?

9 HAVE YOUR SAY Have your say on what services are needed in the future and how they can be improved. Or comment on proposals for changes or improvements to services in a consultation. > You can contact South Devon and Torbay Clinical Commissioning Group (CCG) which is run by GPs in your area. The role of the CCG includes commissioning services from hospitals and other services in the community such as health visitors, and making sure these services are high quality. > Look out for leaflets and posters at your GP s surgery, local hospital, library or council offices. > If the NHS is consulting the public, they will usually invite you to answer some specific questions. The NHS consults in a number of different ways. For example, one-to-one interviews, small group discussions where a small number of people come together to provide views on a question, questionnaires, or drop-ins in a public location where people are invited to comment informally.

10 WATCH There are many places you can go to watch meetings and hear discussions, as they are open to the public. You may be able to ask questions, but not always. Sometimes you need to let people know you want to attend, so it is best to check this first. These meetings are often quite formal, but someone will be able to explain how they work and when you can ask your question. What are you interested in?

11 WATCH There are many places you can go to watch meetings and hear discussions, as they are open to the public. You may be able to ask questions, but not always. Sometimes you need to let people know you want to attend, so it is best to check this first. These meetings are often quite formal, but someone will be able to explain how they work and when you can ask your question. What are you interested in? WHAT YOUR LOCAL HOSPITAL IS DOING TO PLAN & IMPROVE ITS OWN SERVICES What your local hospital is doing to plan and improve its own services You can contact the office of the Chair of the hospital to find out whether they hold meetings in public and if you can attend.

12 WATCH There are many places you can go to watch meetings and hear discussions, as they are open to the public. You may be able to ask questions, but not always. Sometimes you need to let people know you want to attend, so it is best to check this first. These meetings are often quite formal, but someone will be able to explain how they work and when you can ask your question. What are you interested in? WHAT IS BEING DONE TO PLAN AND IMPROVE HOSPITAL AND COMMUNITY SERVICES IN YOUR AREA What is being done to plan and improve hospital and community services in your area > You can contact South Devon and Torbay Clinical Commissioning Group (CCG) to find out which meetings are held in public and whether you will be able to ask questions at the meeting. The CCG decides what services are needed. It is their job to make sure these services are delivered to a high standard. > You can attend a meeting of Devon County Council s Health Overview & Scrutiny Committee (OSC) or Torbay Council s Health Overview & Scrutiny Committee (OSC) which reviews and monitors proposals, plans and delivery of health. These are held in public and you may be able to ask questions. > You can attend a meeting of the Devon Health and Wellbeing Board (HWB) or the Torbay Health and Wellbeing Board. These are hosted by the council and hold some meetings in public. The HWB agrees priorities for health and social care in the local area.

13 WATCH There are many places you can go to watch meetings and hear discussions, as they are open to the public. You may be able to ask questions, but not always. Sometimes you need to let people know you want to attend, so it is best to check this first. These meetings are often quite formal, but someone will be able to explain how they work and when you can ask your question. What are you interested in? WHAT IS BEING DONE TO IMPROVE THE NHS AS A WHOLE, ACROSS ALL PARTS OF ENGLAND What is being done to improve the NHS as a whole, across all parts of England The overall purpose of NHS England is to ensure the best possible healthcare is provided for everyone. > You can attend a meeting of the NHS England board, usually in Leeds or London. These meetings are also broadcast live on the web, with agendas and Minutes (meeting notes) being publicly available. You can watch videos of past meetings as well. > Click here for information about the meetings and to watch the videos.

14 GET INVOLVED Getting involved in service improvement might require you to: attend regular meetings, help write leaflets and guides, explain about services to other people, speak on behalf of other people at events or meetings, or become part of a planning group or group which monitors service changes and standards. There are various lay positions (roles for non-professionals) on NHS boards and committees and these are advertised. What services do you want to get involved in?

15 GET INVOLVED Getting involved in service improvement might require you to: attend regular meetings, help write leaflets and guides, explain about services to other people, speak on behalf of other people at events or meetings, or become part of a planning group or group which monitors service changes and standards. There are various lay positions (roles for non-professionals) on NHS boards and committees and these are advertised. What services do you want to get involved in? MY OWN GP S PRACTICE My own GP s practice > Join your GP practice s Patient Participation Group (contact the practice manager). > You can also find out more from the National Association for Patient Participation (NAPP) here or call > In our area the Patient s Association has been working hard to develop PPGs and their newly produced resources are on our website here.

16 GET INVOLVED Getting involved in service improvement might require you to: attend regular meetings, help write leaflets and guides, explain about services to other people, speak on behalf of other people at events or meetings, or become part of a planning group or group which monitors service changes and standards. There are various lay positions (roles for non-professionals) on NHS boards and committees and these are advertised. What services do you want to get involved in? MY LOCAL HOSPITAL My local hospital For all hospitals (Foundation Trust and others): ask the Patient Advice and Liaison Service (PALS) about ways to get involved. This could be as a regular volunteer or to help with a specific activity such as gathering patient feedback on their experience. For Foundation Trusts (FTs) only: you can become a member or a governor. FTs are NHS hospitals with new financial freedoms and governance arrangements involving staff, patients and local people. You can read more about FTs here.

17 GET INVOLVED Getting involved in service improvement might require you to: attend regular meetings, help write leaflets and guides, explain about services to other people, speak on behalf of other people at events or meetings, or become part of a planning group or group which monitors service changes and standards. There are various lay positions (roles for non-professionals) on NHS boards and committees and these are advertised. What services do you want to get involved in? COMMISSIONING HOSPITAL & OTHER SERVICES Commissioning hospital and other local services > Contact South Devon and Torbay Clinical Commissioning Group (CCG) which is run by GPs in your area. The role of the CCG includes commissioning services from hospitals and other services in the community, and making sure these services are high quality. > Ask the CCG about opportunities to provide the patient or public viewpoint on advisory or other groups. This could include joining the governing body when a place becomes available.

18 GET INVOLVED Getting involved in service improvement might require you to: attend regular meetings, help write leaflets and guides, explain about services to other people, speak on behalf of other people at events or meetings, or become part of a planning group or group which monitors service changes and standards. There are various lay positions (roles for non-professionals) on NHS boards and committees and these are advertised. What services do you want to get involved in? ALL HEALTH SERVICES IN MY AREA All health services in my area Get involved with Healthwatch Devon or Healthwatch Torbay. Healthwatch is the independent consumer or public champion for health and social care. You can also share your experiences through the new NHS Citizen platform. NHS Citizen is a way for everyone to find out what other people are saying about the NHS and take part in discussions about how to improve services. These ideas and concerns will be directed to the part of the NHS which is most able to take action, which could be your local NHS or the board of NHS England.

19 GET INVOLVED Getting involved in service improvement might require you to: attend regular meetings, help write leaflets and guides, explain about services to other people, speak on behalf of other people at events or meetings, or become part of a planning group or group which monitors service changes and standards. There are various lay positions (roles for non-professionals) on NHS boards and committees and these are advertised. What services do you want to get involved in? SERVICES FOR A SPECIFIC GROUP OF PEOPLE, ILLNESS OR CONDITION Services for a specific group of people, illness or condition. For example, older people or diabetes. See Directory for local groups. Or get in touch with your local voluntary sector forum

20 GET INVOLVED Getting involved in service improvement might require you to: attend regular meetings, help write leaflets and guides, explain about services to other people, speak on behalf of other people at events or meetings, or become part of a planning group or group which monitors service changes and standards. There are various lay positions (roles for non-professionals) on NHS boards and committees and these are advertised. What services do you want to get involved in? THE NHS AS A WHOLE The NHS as a whole NHS Citizen is a work in progress and welcomes your input. The idea is that people will not just be users of the NHS, but active participants in its future. Through NHS Citizen, you will have the power to raise issues for discussion and connect with others who have the same interests in making the NHS as good as possible. Click here to get involved.

21 IT ALL STARTS WITH YOU! This guide was developed by Uscreates in association with Primary Care Commissioning, and funded by NHS England. We are grateful to the following organisations for their help designing and testing the guide, and to all the local groups, patients and public, who worked with us: NHS Mid-Essex Clinical Commissioning Group South Devon and Torbay Clinical Commissioning Group NHS Swindon Clinical Commissioning Group

22 WE HOPE YOU FOUND THIS GUIDE USEFUL This guide is about how to help the NHS improve its services. If you would like to find out more about the NHS and how the health and social care system is organised, see the interactive diagram on the Department of Health s website here. If you would like to find out more about how you can help the NHS improve its services, use the tabs at the top of the page, or click here to begin again.

23 TOOLS Select a tool from the dropdown menu below to find out more:

24 10 TOP TIPS 10 tips for patients and the public who want to help improve NHS services Select a tip from the menu to find out more: This guide takes you through the many different ways you can help improve NHS services. These different ways vary in the amount of time, cost and effort you will need to put in. Read our 10 top tips to help you get the most out of your engagement with the NHS, whichever route you take, by clicking the button below.

25 10 TOP TIPS What do you want to achieve? First of all, be clear what you want to achieve. For example: > Do you have praise or a complaint to make about your experience of NHS care at a particular time? Go to making a complaint. > Are you interested in commenting on proposals by the NHS to change services in your area? Go to Have your say. > Do you want to be involved in advising on how services can be improved on an ongoing basis? Go to Get involved. Select a tip from the menu to find out more: WHAT DO YOU WANT TO ACHIEVE?

26 10 TOP TIPS How much time do you have? Think carefully about the amount of time and effort you want to commit and choose what you do accordingly. If you do see an event or activity about a topic that interests you, go along they will be pleased to hear from you! Select a tip from the menu to find out more: HOW MUCH TIME DO YOU HAVE?

27 10 TOP TIPS Bring a friend For example: > Making a complaint? Ask someone you trust to go with you. They can take notes or help you remember what you wanted to say. > Going to an event where the NHS is asking for views? Take someone along with you who will be able to contribute. You will be able to provide better information as a pair and to bounce ideas off each other more easily than with other people you don t know. Select a tip from the menu to find out more: BRING A FRIEND

28 10 TOP TIPS Keep it simple Have one or two clear points you want to make, and know how you want to make them. You may have many more, but you will have a bigger impact if you stick to what you think is most important. Select a tip from the menu to find out more: KEEP IT SIMPLE

29 10 TOP TIPS Timing is all Choose your timing to ensure it will help you achieve what is right for you. For example: > If you want to comment or complain about your experience, it is best to do this as soon as possible while your memory is fresh. Make some notes to help you. > Public consultations about services have deadlines for providing your views and often include events on particular dates. Look out for details in public places, like your GP s surgery or the local library. > Is the service going through a period of change? There will be information about national and local changes in the news, including groups to join which may be representing patient groups. Select a tip from the menu to find out more: TIMING IS ALL

30 10 TOP TIPS Listen and ask questions Be open to conversation, as this is the key to making change happen. Listen to the responses you are given and if you are unsure about what you hear, do not be afraid to ask. This could be words or terminology or the reasons given for a decision being made. Select a tip from the menu to find out more: LISTEN AND ASK QUESTIONS

31 10 TOP TIPS Use your own words Talk about your experiences in your own words. This will have a better impact than trying to use NHS or technical jargon. Select a tip from the menu to find out more: USE YOUR OWN WORDS

32 10 TOP TIPS Be ambitious but realistic Strike a balance between being realistic (What can be improved now with the money and staff available?) and being ambitious (What do I think the best possible health services should look like in the future?). Select a tip from the menu to find out more: BE AMBITIOUS BUT REALISTIC

33 10 TOP TIPS Next steps Ask what are the next steps, so you are able to keep track of what happens and when. Select a tip from the menu to find out more: NEXT STEPS

34 10 TOP TIPS Get feedback Ask when and how you can find out what happens next. Select a tip from the menu to find out more: GET FEEDBACK

35 MAKING A COMPLAINT USEFUL GUIDES The NHS Complaints procedure explained can be found on the NHS Choices website here or call Citizens Advice and Healthwatch England have produced a number of guides and supporting materials to help you make effective complaints about health and social care which can be found here. Every service should have a complaints procedure. They should tell you what this is and it will not have a negative effect on how you are treated in future. > If you have an immediate comment or complaint, it is best to make this right away. However, constructive comments are always helpful and can be made at any time. > You should always start by contacting the practice or service direct. For all NHS services, you can contact the PALS (Patient Advice and Liaison Service) or the Complaints Team. The purpose of PALS is to ensure that the NHS listens to patients, their relatives, carers and friends, answers their questions and resolves their concerns as quickly as possible. PALS also helps the NHS to improve services by listening to what matters to patients and their loved ones and making changes when appropriate. PALS may also be able to direct you to opportunities to be more actively involved in improving services,for example as a volunteer. Contact details for PALS in your area can be found here.

36 THE FRIENDS & FAMILY TEST The Friends and Family Test (FFT) is used across the NHS. It asks people if they would recommend the services they have experienced and offers a range of responses. Ask about completing the FFT feedback form when you have had a hospital or doctor s appointment or used a local service. CLICK HERE TO READ MORE ABOUT THE FFT

37 NHS CONSTITUTION The NHS belongs to the people. It is there to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most. NHS Constitution, March The NHS Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities, which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. The Secretary of State for Health, all NHS bodies, private and voluntary sector providers supplying NHS services, and local authorities in the exercise of their public health functions are required by law to take account of this Constitution in their decisions and actions. You can read the Constitution in full here.

38 NHS CONSTITUTION NHS principles 1. The NHS provides a comprehensive service, available to all irrespective of gender, race, disability, age, sexual orientation, religion, belief, gender reassignment, pregnancy and maternity or marital or civil partnership status. 2. Access to NHS services is based on clinical need, not an individual s ability to pay. 3. The NHS aspires to the highest standards of excellence and professionalism. 4. The NHS aspires to put patients at the heart of everything it does. 5. The NHS works across organisational boundaries and in partnership with other organisations in the interest of patients, local communities and the wider population. 6. The NHS is committed to providing best value for taxpayers money and the most effective, fair and sustainable use of finite resources. 7. The NHS is accountable to the public, communities and patients that it serves. NHS values 1. Working together for patients. 2. Respect and dignity. 3. Commitment to quality of care. 4. Compassion. 5. Improving lives. 6. Everyone counts.

39 EXPLANATION OF TERMS Clinical commissioning group (CCG) are groups of GPs responsible from April 2013 for planning and commissioning health and care services for their local population, including elective hospital care, rehabilitation care, urgent and emergency care, most community health services and mental health and learning disability services. All GP practices will have to belong to a clinical commissioning group. Information about South Devon and Torbay CCG can be found here. Community services is the process of deciding what local people need from the NHS and buying those services with public money from the most appropriate providers. This can range from large contracts commissioning acute care from hospitals to smaller contracts with voluntary sector providers for a range of services to provide care and improve health. The CCG s commissioning plans can be found here. Council for Voluntary Service (CVS) are charities which brings together local charity and community organisations and may offer services and support for them such as training or advice on funding. The CVS may also act as the main contact between local charities and the council. See also Voluntary sector forum below. The Engagement Committee formed in July 2014, sets out and monitors key engagement activities in line with the CCG s strategic plan. It is chaired by the nonexecutive director for patient and public involvement and includes Healthwatch Torbay and Healthwatch Devon. It is a sub-committee of the CCG s governing body. Information can be found here.

40 EXPLANATION OF TERMS Foundation Trusts (FT) are part of the NHS but they are independent legal bodies with more financial freedoms than other NHS organisations. They are answerable to local people who can become members and governors of the FT, playing an active role in the strategic planning of the organisation and appointing board members. Friends and Family Test (FFT) The FFT is a feedback tool which asks people if they would recommend the services they have used. Different NHS services, including hospitals and GPs, may offer you the opportunity to respond to this question on a postcard or using an electronic device. Health and wellbeing boards will be established in each top tier and unitary authority. The boards will bring together key leaders from the health and care system who will work together to understand their local community s needs, agree priorities and encourage commissioners to work in a joined-up way. Health scrutiny means the arrangements established by local authorities with social services responsibilities through which they discharge the powers set out in the Local Authority (Public Health, Health and wellbeing boards and Health Scrutiny) Regulations This may be a health overview and scrutiny committee, a joint arrangement or other suitable arrangements.

41 EXPLANATION OF TERMS Healthwatch organisations are the local consumer champion for people to gather their views and experiences to improve health and social care services in their area. They represent the information from people who use services, carers and the public on health and wellbeing boards, and report concerns about the quality of health care to Healthwatch England, which can advise the CQC to take action. Local Healthwatch are able to refer issues of concern by local people to health scrutiny. In our CCG we work with Healthwatch Devon and Healthwatch Torbay. A lay member of a group or committee is a person who does not have specialised technical or professional knowledge. For example, lay members of clinical commissioning groups are not doctors, but they bring other important skills such as business planning, patient and public involvement or management. Local authorities are independently elected and autonomous bodies. They are largely independent of central government and are directly accountable to their electorates. Their powers are conferred on them by Acts of Parliament. Some powers are given to all local authorities, and some only to specific types such as district councils. Some powers are mandatory, which means that the authority must do what is required by law; others are permissive. Local authorities are the main mechanism for people to drive local priorities and shape the type and standards of services they receive. They enable local people to hold to account service providers.

42 EXPLANATION OF TERMS NHS bodies include NHS foundation trusts, clinical commissioning groups, the NHS Commissioning Board and all NHS trusts, including acute or hospital trusts, mental health and learning disability trusts, ambulance trusts and care trusts The NHS Constitution The NHS Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities, which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. The NHS Commissioning Board oversees the delivery of NHS services, including continual improvement of the quality of treatment and care, through local clinically-led commissioning. The Board is subject to a wide range of statutory duties, and is accountable to the Secretary of State and the public for how well it performs these NHS England NHS England is the national body which works with NHS staff, patients and the public, and other interested organisations in order to improve the health and care of people in England. NHS foundation trusts are public interest organisations accountable to local people and free from Whitehall control. NHS foundation trusts work for the NHS patients and the wider public benefit. Each NHS foundation trust has a Board of Governors, including governors elected by members of the local community and NHS staff, to provide accountability to local stakeholders.

43 EXPLANATION OF TERMS The Health Overview & Scrutiny Committee (OSC) is a committee of the local authority (council). It reviews and monitors proposals, plans and delivery of health in your area. Meetings are held in public. Patient Advice and Liaison Service (PALS) PALS offers confidential advice, support and information on health-related matters. They provide a point of contact for patients, families and carers. There is a PALS office at your local hospital. Patient Participation Groups (PPGs) are an effective way for patients and GP surgeries to work together to improve services and to promote health and improved quality of care. They do things like survey patients on their experience at the surgery and agree with the practice what they can do to change things for the better. There is a National Association for Patient Participation. Relevant health service providers are private, independent or third sector providers delivering services under contract to the NHS or to the local authority.

44 EXPLANATION OF TERMS Social care services help people who are in need of support due to illness, disability, old age or poverty. Social care services are available to everyone, regardless of background. However, social care is subject to rules about your needs and ability. Services can also support the families or carers of people who receive social care Services could include having a personal assistant to help you around the house, structural changes to help you move around your house, or even an alarm system so that you can call for help if you have a fall. Local authorities (councils) are responsible for providing social care services for those who need them and are eligible for them. After needs and financial assessments, the local authority may agree to pay for some or all of the care and support you need. Voluntary sector forum This is a general term often used to describe the network of local charities which comes together to share information and also to represent the views of charities and community groups to the council.

45 LIST OF CONTACTS

46 WE HOPE YOU FOUND THIS GUIDE USEFUL This guide is about how to help the NHS improve its services. If you would like to find out more about the NHS and how the health and social care system is organised, see the interactive diagram on the Department of Health s website here. If you would like to find out more about how you can help the NHS improve its services, use the navigation tabs in the top right of the page, or click here to begin again.

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