Healthwatch Derby presents the latest edition of its Local Intelligence newsletter ''. We aim to produce a quarterly summary of what we have been hearing from you. This newsletter is a means of recording what we are hearing, and also giving details of what we have done with your comments, concerns, and compliments. We aim to publish '' on a quarterly basis with the next volume due in April 2016. In this issue: Introduction to & Newsletter Index Page 1 Engagement Overview Page 2 Self Care Week Featured Engagement Page 3 Meet Dave! Page 4 Local Intelligence Summary Pages 4 Key Themes & Case Study Pages 5-8 You Said We Did Pages 9-10 What have you told us about Healthwatch Derby Page 11-12 1 P a g e
So how do we actually work? Healthwatch Derby is an independent consumer watchdog with a remit to scrutinise and have an overview of health and social care services in Derby city. We undertake numerous engagement activities within the city to speak to local communities about issues that matter to them. In the period October to end of December 2015, we attended 79 engagement events in the city. A brief glimpse at some of these engagements: From Left to Right - Healthwatch Derby Engagement stall at Joseph Wright College and at the Eagle Market Age UK) Pictured above left is the Healthwatch Reference Group this is our quarterly open forum to discuss health and social care issues in Derby City. If you would like to attend the next Healthwatch Reference Group please contact us on 01332 643988. 2 P a g e
Self Care Week Featured Engagement, November 2015 Mindful Monday (pictured left) an opportunity for people to find out about mindfulness and try it out for themselves Choose Well Tuesday (pictured right) interactive awareness raising events at A&E and the Urgent Care Centre looking at helping people to treat their illness or injury in the right place: home, pharmacy, GP surgery, Urgent Care Centre or A&E Well Hearty Wednesday (pictured left) information for people about how to take care of their heart No Fall Thursday (pictured left) learning the benefits of chair based exercise Fruitful Friday (pictured right) opportunity to learn about what people are putting into their bodies and to have free fruit and water 3 P a g e
Use of new media Meet Dave! Healthwatch Derby designed a Christmas cartoon 'Dave the Penguin' which was piloted using new software in December. Dave generated a lot of positive interest in other social media platforms, and we received positive feedback from our key stakeholders. The cartoon focused on the appropriate use of services during the winter months. We then developed a Christmas greeting card for the public using the same software which is even better and uses music and other visual effects. We are currently working on a new project for February around the Stay Well This Winter theme. Local Intelligence Summary 300 250 200 150 100 50 0 Feedback Breakdown October to end of December 2015 In the period October 2015 to the end of December 2015, Healthwatch Derby received 1141 items of feedback from service users, carers, patients, and the general public. The above illustration only shows a breakdown of 940 comments, as we received 201 comments which were generic about health services and health conditions. 4 P a g e
We have grouped this feedback to show the areas where we have received the most comments. To explain this graph better, we have produced a handy key: Cluster GPs DTHT EMAS DHFCT WICs Social Care Opticians Pharmacy Dentist Description Feedback about GPs Services at Derby Teaching Hospitals NHS Foundation East Midlands Ambulance Service Services at Derbyshire Healthcare NHS Foundation Trust Walk In Centres Feedback about social care services Feedback about opticians Feedback about pharmacies Feedback about dentists Derby Teaching Hospitals NHS Foundation Trust remains the single largest area of feedback, with 266 items of individual feedback received about the acute Trust's services in the period October to end of December 2015. This is partly due to our consultation 'Little Voices' which looks at pregnancy, maternity, and services for children aged 0 to 11 years. Our consultation has seen us shadowing specific Trust services yielding high feedback. Key Themes Emerging Themes may not be tied down to just the frequency of feedback, but are better understood to be reflective of patient experiences as a whole. 1. Poor access to GP services has been highlighted. 2. Communication issues at Derby Teaching Hospitals Trust. 3. Poor complaints processes have been highlighted at Derbyshire Healthcare NHS Foundation Trust. 4. Numerous enquiries about access to dental services have been highlighted: Access to NHS Dentists Capacity issues for emergency treatment Access to dental services for residents in care and nursing homes 5. Examples of good care and exceptional services are highlighted in positives 5 P a g e
A selection of comments received in the period October 2015 to the end of December 2015: "The Pharmacist is very knowledgeable" "My baby is 5 weeks old, the maternity service was good, I can't fault them" "It is really hard to get an appointment at my doctor, the average is a 3 week wait" "When I do call the GP, I feel like I have to fight the receptionist to get what I want" "A patient rang Healthwatch Derby to complain as their dentist had refused to see them with a bad tooth ache and had offered an appointment for two weeks time. The patient had called the Emergency Service at Coleman Street who said they were full and could not see him and also that he had to call between 8.40 am and 9.40 am to get a place" Case Study: A service user provided some deeply personal reflections about their journey into the inpatient services at Radbourne Unit. We have summarised their concerns rather than repeating the personal account to ensure no further distress is caused due to the personal experience shared. The service user was at a serious risk of suicide and was on a 24 hour watch. They were not allowed to have any objects near them that could be used to cause harm. They were not allowed to have plastic carrier bags as they are seen as a potential danger. Despite this, the service user noted that visitors were allowed to come in and hand over carrier bags with things brought for them such as food etc. The service user felt visitors should be monitored to ensure this does not happen, and there should be information about the hazards everyday objects may present to some patients. The service user mentioned that although a carrier bag may not look like much but it was a real threat to someone with their condition and vulnerable situation. Following our emergency information sharing protocol Healthwatch Derby alerted the 6 P a g e Trust firstly via a phonecall and thereafter formally through emails.
Response from the Trust: Thank you for bringing this to our attention, we will look into this. Its excellent that people are talking about their concerns to ensure safety is at the heart of things. We will ask the Senior nurses to look into this and ensure hypervigilance around patient safety The above is a summary of an emailed response received from Carolyn Green, Director of Nursing at Derbyshire Healthcare NHS Foundation Trust following our initial escalation email. This was followed by another email issued to all staff within the Trust: To: From: All inpatient areas (including day areas situated within inpatient units) Executive Director of Nursing & Patient Experience, Medical Director & Executive Director of Operations, Performance & IMT Date issued: 2015 Ref: Nature of concern: C96 Use of plastic bags for self-harm/suicide on inpatient mental health units Identified risks: Risk of death or serious injury. 7 P a g e
Response from the Trust: In 2012 following a serious incident involving the use of a plastic bag, the Trust reinforced information from the Signal safety alert produced and distributed by the National Patient Safety Agency (NPSA) on the use of plastic bags for self-harm in inpatient mental health units (25 March 2011). The Signal was produced following the suicides of three patients using black plastic bags. A search of the National Learning and Reporting System (NRLS) was undertaken which showed that between January 2008 and May 2010 there were 131 reports describing selfharm incidents using plastic bags. It was identified that patients use these in two different ways: Over the head in an attempt to suffocate Around the neck in an attempt to self-strangulate or to use as a ligature. In January 2012 the then Serious Untoward Incident (SUI) group commissioned a Trustwide project group to review the use of waste bins with plastic bag liners in inpatient areas. The project team produced a thorough options appraisal, and recommended the removal of plastic bags from all domestic waste management systems within direct patient areas in inpatient areas. An implementation date was set for 9 April 2012. The full documents produced by the SUI group can be viewed using the following links: Evaluation waste management Review of waste management. In addition, in 2015 we have had feedback from a service receiver and their family that we need to increase our vigilance in this area again. Actions to be taken All inpatient and day area staff to be aware and remain vigilant to the risk posed by individual service users using plastic bags for self-harm/suicide Ward managers and team leaders to review all waste bins to ensure compliance with the no plastic bags requirement 8 P a g e Contact your divisional nurse for advice and support if required. For further information please contact Carolyn Green, Executive Director of Nursing & Patient Experience.
You Said We did "Possible use of social media? Capacity is an issue for you and will always limit what's possible. Please use new means of getting connected to a wide variety of people" "We really enjoyed the Healthwatch Derby hosted public event and hope there are more such events in the future" "Speak to young health professionals and make then aware of the role of Healthwatch, because its an important service" We have enhanced our social media presence with new innovations such as the use of cartoons, as well as adopting new platforms such as Streetlife. We hosted 6 public events between October and December 2016, and have plans to ensure we regularly host public events. We did a comprehensive presentation for students from the Nursing School, University of Derby. We were approached by the Royal Voluntary Service who wanted to put forward their initiatives for safer discharge from hospital. We organised a Discharge Focus meeting for providers and commissioners, which was appreciated by all. The discussions at the Discharge Focus meeting were welcomed by Commissioners for service planning. "The translation service on offer is not suited to my needs" We raised the issue with the Commissioners who reviewed the needs and ensured appropriate provision was in place. 9 P a g e
You Said We did "The Healthwatch Derby membership should have more opportunities to feedback" We hosted the inaugural Healwatch Reference Group. This Group will meet on a quarterly basis and is an open forum. You highlighted certain services within Derbyshire Healthcare NHS Foundation Trust where there was a long waiting period for an appointment. We highlighted this to the Trust, and ensured that any significant risks or safeguarding issues were picked up without any delay. "The key worker given to me does not seem to have proper training, and I have to repeat everything many times" We have highlighted training as a significant area of focus for the Trust at the Safeguarding Committee meeting, and the Trust is committed to improve its staff training. In August parents of young children spoke to us about accessing services at a workshop we arranged in Chaddesden (Revive Centre). We forwarded our findings to Healthwatch England, who have included Derby's voices in their national report. Many service users in large numbers have raised concerns about the difficulties in getting a GP appointment. We continue to highlight GPs access as a major issue to Primary Care Commissioners and inspectors of Primary Care Services. 10 P a g e
Feedback about Healthwatch Derby In the period October to the end of December 2015, Healthwatch Derby received the following feedback about its services. "I understand from Paul Brooks that you had a really productive meeting last week with good examples of how the Discharge process is being enhanced through the increased involvement of volunteers in Leicester. Paul was very enthusiastic and could see how this would be the next phase of the volunteer scheme that DTHFT currently have in place. As a result of that conversation, there is a recognition of how this could fit with the current urgent care work and winter planning. This has allowed us to understand who the most appropriate person is in the CCG to take this work forward, and so I have e-mailed Mike Hammond who leads on this area of work and who can then work with Paul to explore it further. Thank you for your support in kick starting this piece of work, it is appreciated" Karen McGowan Deputy Chief Nurse and Deputy Director of Quality NHS Southern Derbyshire Clinical Commissioning Group "Thank you for your Local intelligence report for April 2013 to end of September 2015. I have spent time looking through it and I know Carolyn has shared it in the Organisation. It was really helpful to have a two year analysis and your helpful comments and case studies really highlighted things for us to focus on It was also very useful to see how we perform with other organisations and to see the issues with regard to GP s to help our strategic thinking about how we can assist others as a wider health community" Ifti Majid Acting Chief Executive Officer Derbyshire Healthcare NHS Foundation Trust 11 P a g e
"Thank you for coming to our team meeting. The team found it really useful to hear about Healthwatch Derby and issues within Derby" Andrew Peck Inspection Manager Adult Social Care Inspection Directorate Care Quality Commission - Central Region Regarding 'Dave' our new social media cartoon: "This is great, really simple but gets the key messages over - well done to Healthwatch Derby team" Cathy Winfield Director of Nursing Derby Teaching Hospitals NHS Foundation Trust "Thanks for sharing this Local Intelligence report, it is very informative and really showcases all the good work you do. Couple of points: have you / can you share with Primary Care colleagues? I am happy to forward; some great feedback in terms of case studies it would also be good to have a couple of case studies which are positive, especially from Derby Teaching Hospitals given good practice is a high scorer. Again, just my view and thoughts! I particularly liked the Mental Health Case study as these are often the most difficult to obtain" Alison Cargill Clinical Quality Manager NHS England, North Midlands "It s a great report (Local Intelligence Trend Analysis Overview) and very useful. Thank you. It s great and I have scheduled it for our Quality committee. Thanks for all of the hard work again" Carolyn Green Director of Nursing Derbyshire Healthcare NHS Foundation Trust 12 P a g e
Contact Us! If you would like to share your experience accessing health and social care services in Derby, we would like to hear from you, contact us via: Email: info@healthwatchderby.co.uk Telephone: 01332 643988 Write to us at: Healthwatch Derby 1 st Floor Council House Corporation Street Derby, DE1 2FS Visit our website: www.healthwatchderby.co.uk Visit our blog: https://www.facebook.com/healthwatchderby Facebook: https://www.facebook.com/healthwatchderby Twitter: https://twitter.com/healthwatchdby Instagram: Streetlife @hwderby Healthwatch Derby 13 P a g e