Healthwatch Herefordshire Quarter 1 Report 2016-17 Contents 1. Introduction Page 2 2. Information & Advice Page 4 3. Volunteering Page 7 4. Engagement Page 8 5. Healthwatch Activity Page 12 6. Communications Page 15 1
1. Introduction Healthwatch Herefordshire is the independent body who champions the voice of the people of Herefordshire on Health & Social Care issues. The contract outcomes we strive to achieve are: Outcome 1 Local people are aware of Healthwatch Herefordshire, understand its purpose and how to access it for help and support Outcome 2 - Local people are empowered to give their views and influence decisions to improve health and social care services Outcome 3 Individuals are able to make informed choices about their health and care as a result of information and advice provided by HWH Outcome 4 The views and experiences of local people influence commissioning decisions to improve health and social care service Outcome 5 - Healthwatch Herefordshire is an independent organisation accountable to the people it serves Outcome 6 Healthwatch Herefordshire is good value for money 2
Healthwatch Quality Statements Healthwatch England have worked with the Local Healthwatch Network and Leeds Becket University to develop and pilot a list of Quality Statements. Healthwatch Herefordshire was one of the pilot Healthwatch s that used the statements to evaluate out work, effectiveness and impact booth through an internal self-assessment and also as a stakeholder perception exercise. The aim of these statements are to provide Healthwatch England, local Healthwatch and commissioners with a common understanding of who we are and what we do. Adopting a more consistent approach to our work will enable us to deliver the best possible service for the public, identify where we are making the biggest impact, and learn from one another. The quality statements are: Community voice and influence: Promoting and supporting the involvement of local people in the commissioning, the provision and scrutiny of local care services. Enabling local people to monitor the standard provision of local care services and whether and how local care services could and ought to be improved. Getting the views of local people regarding their needs for, and experience of local care services and importantly to make these views known. Making a difference locally: Making reports and recommendations about how local care services could or ought to be improved. These should be directed to commissioners and providers of care services and shared with Healthwatch England. Formulating views on the standard of provision and whether and how the local care services could and ought to be improved. Share these views with Healthwatch England. Informing people: Providing advice and information about access to local care services so choices can be made about local care services. Relationship with Healthwatch England: Making recommendations to Healthwatch England to advise the Care Quality Commission (CQC), to conduct special reviews or investigations direct to the CQC; and to make recommendations to Healthwatch England to publish reports about particular issues. Providing Healthwatch England with the intelligence and insight it needs to enable it to perform effectively. 3
2. Information & Advice Quality Statement - Informing people: Providing advice and information about access to local care services so choices can be made about local care services. Quality Statement - Making a difference locally: Making reports and recommendations about how local care services could or ought to be improved. These should be directed to commissioners and providers of care services and shared with Healthwatch England. Formulating views on the standard of provision and whether and how the local care services could and ought to be improved. Share these views with Healthwatch England. Relationship with Healthwatch England: Providing Healthwatch England with the intelligence and insight it needs to enable it to perform effectively. Number of enquiries April 1 st - June 30 th 2016: 35 Q1 Nature of Enquiry/Feedback Compliment 2% Request for Information 29% Point of view 19% Concern 33% Complaint 17% Concern Complaint Point of view Request for Information Compliment HEALTHWATCH 8 CONSUMER PRINCIPLES Information and Education Healthy 6% Environment 3% Safe, dignified and quality service 18% Being Involved 2% Access 33% Essential Services 18% 4 Choice 10% To be listened to 10%
9 8 7 6 5 4 3 2 1 0 Issues Rasised in Q1 Enquiries by Organisation Q1 2016-17 Q4 2015-16 Q3 2015-16 2Gether NHS Foundation Trust 1 0 3 Mental Health 0 3 2 Community Equipment 1 0 0 Dental Services 1 1 0 GP Services 12 12 11 Herefordshire Council - Adult Social Care & Assessments 3 4 9 Herefordshire Council - Children's Services 1 1 1 Pharmacy Services 1 0 0 Tertiary Care 1 1 0 Wales NHS - Cardiology 1 0 0 West Midlands Ambulance Service 1 0 1 Wye Valley NHS Trust - Acute Care 4 Wye Valley NHS Trust - Cardiology 1 Wye Valley NHS Trust - Community Nursing 1 Wye Valley NHS Trust - Endoscopy 1 10 8 Wye Valley NHS Trust - Hospital General 3 Wye Valley NHS Trust - Outpatients 1 Wye Valley NHS Trust - A&E 1 Clinical Commissioning Group 0 3 8 Healthwatch 0 0 5 Herefordshire Carers 0 0 1 Voluntary Sector Organisations 0 0 2 NHS Business Services Authority & NHS England 0 2 2 Total Enquiries 35 37 53 5
Organisations Healthwatch have made referrals to this quarter: Onside advocacy and ICAS service, Herefordshire Carers Support, Herefordshire Council Complaints, Herefordshire CCG complaints, Herefordshire Council Advice and Referrals Team, Welfare Rights, WVT complaints & PALS, NHS England complaints, CQC, Health & Parliamentary Ombudsman, CQC, General Dental Council, Disability Equipment Service. Working with Healthwatch England: Healthwatch have completed an annual intelligence return to Healthwatch England detailing our reports, priorities, recommendations and the public s views on health & social care. This information forms part of the national picture of patient and public voice for the Healthwatch Network and informs the national work undertaken by Healthwatch England. Outcomes met: Outcome 1 Local people are aware of Healthwatch Herefordshire, understand its purpose and how to access it for help and support Outcome 2 - Local people are empowered to give their views and influence decisions to improve health and social care services Outcome 3 Individuals are able to make informed choices about their health and care as a result of information and advice provided by HWH 6
3. Volunteering Quality Statement - Community voice and influence: Promoting and supporting the involvement of local people in the commissioning, the provision and scrutiny of local care services. Enabling local people to monitor the standard provision of local care services and whether and how local care services could and ought to be improved. Our volunteers Two patients trained as Enter & View Authorised Representatives. Five volunteers took part in a volunteer meet up and train event trialling and advising Healthwatch, regarding E&V conversation and young people s mental health survey and activity materials. Three new volunteers completed their initial induction process. 110 volunteer hours utilised 2Gether NHS Foundation Trust and Wye Valley Trust PLACE Visits Patient-Led Assessments of the Care Environment or PLACE, is the system for assessing the quality of the patient environment. The assessments are carried out by teams of local people who go into hospitals, hospices and day treatment centres that providing NHS funded care. They assess how the environment supports: patient s privacy and dignity, food, cleanliness and general building maintenance. It focuses entirely on the care environment and does not cover clinical care provision or how well staff are doing their job. Two 2Gether PLACE visits took place at The Stonebow unit and Oak house in this quarter with two volunteers and the Engagement and volunteer coordinator participating. Wye Valley Patient Experience Safety Visits Healthwatch board members joined WVT staff, executive an non-executives on 3 visits this quarter, providing feedback from a patients perspective. Stroke Early Supported Discharge Evaluation Two Volunteers have assisted with the Stroke Early Supported Discharge Healthwatch evaluation. Healthwatch Herefordshire and Herefordshire Carers Support have supported the evaluation of this service by interviewing individual patients and carers about their experience of the therapy, care and support they have received. 7
The purpose of the Survey was to make sure that the views of stroke patients, discharged from hospital early and supported at home, and the views of their carer s, were captured and represented alongside the clinical evaluation being carried out by the Wye Valley Trust. Recommendations were made relating to the findings and it is hoped that the service continues to deliver the high standard and quality of service. Healthwatch Herefordshire Recommendations Overall the recommendation from the patients perspective is that ESD was a resounding success, beneficial to their recovery and wellbeing. It is therefore recommended that ESD continues with all of the quality support offered. The following improvements were suggested by patients and their families: 1. That there be more explicit transparent involvement of both patient and family/carer around the timing of discharge ensuring that: a. The home situation is appropriate in terms of environment. b. The family/partner are willing and able to become carers. c. Both patient and family/partner/carer understand the level of support they will receive at home. d. The patient and family feel that they have enough information about the patient s condition and likely treatment and outcomes. e. Patient and family/carer are given the opportunity and time to ask questions prior to discharge and not at the last minute because discharge is sudden and feels rushed. f. Anxiety levels are reduced by discharge not coming as a sudden surprise so that carers and patients do not feel like they are going into the unknown. 2. That there be more explicit or clear instructions regarding what to do about any referrals so that patients or carers understand who is responsible for their follow up and expected timing. 3. That there is better co-ordination between different services preventing or limiting delays, in particular: a. Between hospital ward and hospital pharmacy regarding medication preparation for departure. b. ESD and Social Services/Council regarding physical adaptation like hand rails and ramps. Outcomes Met: Outcome 2 - Local people are empowered to give their views and influence decisions to improve health and social care services Outcome 4 The views and experiences of local people influence commissioning decisions to improve health and social care service 8
4. Engagement Quality Statement - Community voice and influence: Promoting and supporting the involvement of local people in the commissioning, the provision and scrutiny of local care services. Enabling local people to monitor the standard provision of local care services and whether and how local care services could and ought to be improved. Getting the views of local people regarding their needs for, and experience of local care services and importantly to make these views known. Quality Statement - Making a difference locally: Making reports and recommendations about how local care services could or ought to be improved. These should be directed to commissioners and providers of care services and shared with Healthwatch England. Formulating views on the standard of provision and whether and how the local care services could and ought to be improved. Share these views with Healthwatch England. Relationship with Healthwatch England: Providing Healthwatch England with the intelligence and insight it needs to enable it to perform effectively. Healthwatch have participated a range of engagement activities for Quarter 1: Engagement Gateway have met once, led by Healthwatch. Wye Valley Trust Patient Experience Safety Visits - 3 Preliminary work has been undertaken in Q1 with SHYPP Youth advisory board and HOPE Y-team, to test out materials we will use for engagement with Young People about their Mental Health to find out what tips they find useful to help achieve positive mental Health. This work will continue in autumn. 4 Enter & View visits to GP surgeries People s Passport In 2015 we heard from children attending special Needs Schools in the county about considerations they have accessing Health and Social Care services in communicating with professionals. We also heard from people with an Autistic Spectrum Diagnosis about what it is like accessing a GP surgery. A theme that emerged from this and other feedback is how difficult it can be in different health or care settings to communicate vital information about yourself and your needs to professionals, so that you are treated in the best possible way. It also highlighted the frustrations for people with a range of needs, communication difficulties and/or complex conditions, in having to tell their story over and over each time they visit a service, e.g. A&E, Dentist, GP, care settings etc. 9
Some services have a passport for some groups of people, but we felt that it would be useful to have a passport to use across all health & care services, for children & Adults, which was shaped and owned by people who find it useful to use it. This work has started this quarter with the Parent Carer Voice Forum and The Autism Partnership Board so far. Phase 1: March June 2016 Healthwatch asked parent carers and people on the autistic spectrum what style of passport would work for them. We worked with the parent carer voice forum and the Autism Partnership Board. As a result we have developed a draft passport to take to people and shape. Asking groups of patients, service users and carers, who might use a passport, to tell us what it should look like and shape it. We are also asking organisations who work with people who might use a passport to ask them on our behalf what a passport should look like. Phase 2: July October Healthwatch has a series of engagement events with groups of people who are likely to use a passport, asking them: What do you think of the passport? Would you use it? Does it include the important things about you, or is anything missing? Do they like the priority traffic light system and is the order right? What formats would be useful for you? Phase 3: October November Healthwatch will be asking professionals (District nurses, doctors, OT s, social workers) what they think of the people s passport. Phase 4: November February Healthwatch will work with commissioners aiming to embed the passport for use across health & social care. Autism Survey Autism as a Clinical Priority for GP s Healthwatch produced the results of the Autism Survey designed in partnership with the autism partnership board (APB) in November 2015 As a result Healthwatch and the APB have been meeting in Q1 to develop a training session on July 20 th to be delivered to GP s from all 24 Herefordshire practices, which will emphasise: Making Autism a clinical priority for GP s Raising awareness of autism and diagnosis in GP surgeries Championing reasonable adjustments in GP surgeries for people on the Autistic Spectrum The results of the report and presentation can be found on our website: www.healthwatchherefordshire.co.uk/autism Patient Participation Group Engagement Healthwatch have started a strand of work to build links with all of the Patient Participation Groups (PPG s) that represent the 24 GP practices in Herefordshire. This is to raise awareness of Healthwatch in local communities and also to gather patient views 10
and services from the Public. HWH board and staff members have been allocated to the 24 practices in Herefordshire to make contact with their PPG. Healthwatch and the CCG have met in Q1 to make plans to jointly host an event for PPG s in October, the theme will be Building Better Participation. This event will look at best practice in PPG s and how guides from the National Association of PPG s can be utilised. Enter & View In the first quarter of 2016-17 Healthwatch have started a programme of visits for the year in GP Surgeries seeking the views of patients and carers. We have undertaken 4 visits in this period, having 152 conversations with patients at the following practices: Kington Medical practice Belmont Surgery Quay House Surgery Golden Valley Practice Ewyas Harold Surgery The focus for talking to patients is to ask their experiences of the following topics: Patient Access Staff Communication and Joint Working Patient Engagement Raising Issues Information out of hours services. Fabric Our visits involve a meeting prior to the visit with the practice manager, to outline our purpose and provide materials advertising our visit to patients and staff. We then carry out the visit using fully trained enter & view authorised representatives, who are staff, board members and volunteers for Healthwatch. At the end of the visit initial feedback is given to the practice manager. The reports for these visits will summarise the findings outlining patient views and may include recommendations for the practice. The reports are sent to the surgery for factual accuracy prior to being published on the website and shared with the surgery and a range of stakeholders who include; NHS England, Healthwatch England, the Care Quality Commission, the Clinical Commissioning Group, and the Local Authority - health & wellbeing board and health and social care overview and scrutiny committee representatives. We have a further 4 GP surgery visits to undertake in Q2. Following this the themes and issues arising from all 8 visits will also be shared in a written report in the autumn. 11
Outcomes Met: Outcome 1 Local people are aware of Healthwatch Herefordshire, understand its purpose and how to access it for help and support Outcome 2 - Local people are empowered to give their views and influence decisions to improve health and social care services Outcome 4 The views and experiences of local people influence commissioning decisions to improve health and social care service Outcome 5 - Healthwatch Herefordshire is an independent organisation accountable to the people it serves Outcome 6 Good value for money 12
5. Healthwatch Activity Quality Statement - Community voice and influence: Promoting and supporting the involvement of local people in the commissioning, the provision and scrutiny of local care services. Getting the views of local people regarding their needs for, and experience of local care services and importantly to make these views known. Quality Statement - Making a difference locally: Making reports and recommendations about how local care services could or ought to be improved. These should be directed to commissioners and providers of care services and shared with Healthwatch England. Formulating views on the standard of provision and whether and how the local care services could and ought to be improved. Share these views with Healthwatch England. Relationship with Healthwatch England: Providing Healthwatch England with the intelligence and insight it needs to enable it to perform effectively. The Chair of Healthwatch and seven board members represent Healthwatch and the public voice of people in Herefordshire at the following key forums. The staff team also represent Healthwatch at an operational level to feed in the issues from the members of the public to commissioners and providers in order to improve the quality of patient experience and ensure that the people s voice is heard. One of the key roles that Healthwatch perform, is to hold to account our stakeholders who commission and provide health & care services. We approach this as a critical friend through our presence, membership and strong links with; boards, committees, performance & quality groups and forums. Whenever possible, we offer the views and experiences of the public. Herefordshire Council Health & Wellbeing Board Health Overview & Scrutiny Committee Making it Real Board Children s and Young People s Partnership Adult Safeguarding Board Safeguarding Improvement Process Home and Community Support Provider Forum Learning Disability Partnership Board Adult Social Care Multi Agency Information Sharing Meeting Values Board (Diversity) Voice of the Child Herefordshire Autism Partnership Board Help to live at Home board Safeguarding Board Performance Audit and Quality Sub Group 13 Safeguarding Communications Sub Group Wye Valley Trust WVT Board in Public WVT stakeholder reference group Cancer Board Quarterly forum HWH with WVT Quality Lead & Director of Nursing Midwife-led Unit Project Board WVT Medicines Safety Committee WVT Quality Improvement & Review Meetings (Special measures) 2Gether NHS Foundation trust 2Gether Service User Experience Group 2Gether Board Meetings
Cross Border Quarterly forum with Wales Community Health Councils cross border working group, feeding into joint Healthwatch NHS England cross border network meeting Voluntary & Community Sector, Patient & Public groups Hereford Disability United Carers Hub of third sector organisations hvoss Health & Social Care Forum hvoss Children s interest Group Parent Carer Voice Forum Onside Advocacy quarterly meetings Patient Participation Group links System Wide Groups Sustainability & Transformation Programme Board, and communications sub group NHS England Quality Surveillance Group System Communications Group Engagement Gateway West Midlands Ambulance Service West Midlands Ambulance Board National Healthwatch & CQC Frequent regional and national meetings with Healthwatch England & Network Quarterly operational Meeting with Care Quality Commission Examples of Influence & Challenge CQC Information gathering exercise for inspection of Wye Valley NHS Trust (WVT): Healthwatch used the views of patients and carers experiences of services received by the WVT to inform the CQC inspection team of the views of the public and also to outline the range of links HWH has with the WVT both operationally and strategically. Help to Live at Home: Healthwatch queried the meeting outcomes description to be re-stated as wellbeing outcomes which has a person centred approach, council outcomes should be added explicitly. Also the model of future care types was presented in its most recent form, Healthwatch stated that much more explicit reference to carers and family in achieving the person-centred goals should be made. Healthwatch stated that the frailty pathway work in health and care has revived and this project must link into the frailty pathway directly. Health & Social Care Overview & Scrutiny Committee.(HOSC) Healthwatch present a report of activity and summary of patients issues at each HOSC meeting. In addition Healthwatch were asked to consider and put forward suggestions for potential future scrutiny topics, which were: NHS England - Sustainability and Transformation Plan for Herefordshire and Worcestershire - Presentation for Scrutiny. Herefordshire Council - Adult Social Care. - Health and Social Care Integration ensuring a fair and equitable service being provided across the county of Herefordshire - Task and Finish Group. - Issues in relation to supporting vulnerable people and rural isolation - Task and Finish Group. Herefordshire Council - Children and Young People. - School Nursing in Schools and Colleges - Task and Finish Group. - Children and Young People with Mental Health Issues - Task and Finish Group. - Children and Young People with disabilities - to also include short term breaks and support - Task and Finish Group. Herefordshire Council - Public Health. - Prevention work within schools and colleges - Task and Finish Group. 14
Herefordshire Clinical Commissioning Group. - The Urgent Care Review and Final Report - Presentation for Scrutiny. - 7 Day Access for Patients to GP s - Update Presentation. Wye Valley NHS Trust. - Care Quality Commission Follow-Up Inspection in Early July 2016 - Presentation on Outcome, Results and Grading - Presentation for Scrutiny. 2Gether Mental Health NHS Trust. - Care Quality Commission Report and Findings and Action Plan in relation to Activity in Herefordshire - Presentation for Scrutiny. Kingstone Surgery Patient Participation group (PPG): raised awareness of the role of Healthwatch to the community and local councillors, answering questions about health & social care. Joint Primary Care Commissioning Programme Board: Healthwatch is an integral part of this meeting which discussed confidential plans for transforming primary care services in Herefordshire. Healthwatch has suggested ways in which technology should be used and also how services could be delivered to have a direct positive impact on patients. Autism Partnership Board (APB) and GP training: concluding work over the last 12 months on Making Autism a clinical priority for GP s, gathering views from the public about Autism awareness and diagnosis in GP surgeries, APB & HWH will be attending a GP training event in July to deliver autism awareness training to all GP's in the county. This work has a huge impact on patients and has been a fantastic example of partnership working with GP s The CCG, The local Authority and the Herefordshire National Autistic Society branch to amplify and utilise the authentic patient voice and shape the way that GP services are delivered for people. Hereford Disability United Mental Health event: Highlighted to the lead commissioner for mental health that Autism has been left out of the latest MH strategy and linked this to the Healthwatch board member for mental health. Highlighted the benefits of sharing patient experience stories from people to the chair of the local National Autistic Society branch to encourage people to speak out. Home Care Brokerage Discussions: Healthwatch have asked for assurances and confirmation of what is being implemented to avoid this level of homecare packages being handed back (284 hand backs since September 2015). Contracts have now been changed so the hand back period has gone from 7 days to 28 days. Healthwatch will continue to pursue this via the home care provider forum to find solutions to prevent this happening again. Healthwatch have asked for clarification about the number of service users who have gone into residential care as a result of the brokerage issues, roughly 12 people are affected but Healthwatch have asked for confirmation of this number and how many of those service users remain in residential care. Healthwatch will continue to ask for clarification, challenging were necessary, for the benefit of service users. Healthwatch have recognised and provided feedback that the brokerage team have dealt with this situation very well. The Wye Valley Trust Board Meetings in Public: Healthwatch continue to attend these meetings tabling questions to the board which relate to patient experience and the performance of the trust. We have raised issues relating to the following in this quarter: 15
- The total number of bed days lost due to delayed discharge remains high, with a daily average of 17. What steps are the Trust taking to reduce this number which clearly impacts on the patient flow in the Hospital? - Training and Appraisal Rates continue to be of a concern. Appraisal rates within the Director of Operations Service Unit are particularly worrying at 28.13%. Appraisal is a vital tool which can motivate staff, improve performance and enhance the patient experience. What steps are the Trust taking to improve these figures? - Responsiveness Domain: The Ambulance Handover figures show a considerable deterioration since January and are worrying. More than 30 minutes: 370 incidents compared with 195 for January, more than 60 minutes: 90 incidents compared with 36 for January. Has the Board investigated the reason for this deterioration and has it a plan to improve these figures? - Effectiveness Domain: The numbers of Elective Caesarean Sections is very high, standing at 19.4% (an increase from 16.8%) against a target of 9%. Midwife Led Units (MLU's) are successful in providing pregnant women with less interventionist care, which is both safer for pregnant women and less expensive. When can we expect real progress in the development of the MLU so that the women of Herefordshire have both choice and improved safety for themselves and their babies? West Midlands Ambulance Service Meeting: Healthwatch continue to meet with service delivery managers for Herefordshire and other member of the region and Focus on the patient experience & the importance of patient outcomes in relation to the proposed changes to the structure of the service. 2gether NHSFT Board Meetings: Healthwatch attend regularly and continue to challenge the parity of services for Herefordshire compared to Gloucestershire, and performance related issues which impact on patient experience. - Performance report: Hereford 23 compliant measures, 6 non-compliant. 4 children under 18 admitted to adult wards, IAPT performance still low (35% v 50% access target). Data quality issues re conformance re IAPT 'significant issues', Healthwatch have asked for external review, looking at service model, discrepancies between local and national reporting. - Service Experience Report: raised some issues about 2g records not reflecting patients' own. Main red issue is poor link between mental and physical health services. Annual Quality Report: HWH have comments as part of it, main issues for us are care plans, access to IAPT, access for YP, signed off formally. Complaints Annual Report: Fewer complaints than last year. 131 individual complaint c500 concerns. Lessons and practice development issues reported. Three main issues are admission and discharge arrangements, privacy and dignity and personal records. - Workforce and Training Strategy: part of overall HR strategy. Workforce plan, professional training protected time, approved by audit and delivery committees. Future workforce plan across STP area being considered. Sean Clee chairs 16
workforce and OD groups for both Gloucestershire and Hereford and Worcester STPs. Too few medical training posts for future need, pushing royal college to allocate more to the SW region. Need to look for different ways of delivering services to compensate. Need for service redesign skills. Urgent & Emergency Care Network West Midlands with Healthwatch: - Healthwatch were able to feed in the achievement in Herefordshire of adopted patient experience outcomes for Urgent Care and our ongoing involvement. Urged this to be considered as part of co-design they were talking about info sent on to lead person. - Pointed out the importance of shared records which we at least have across GP practices in Herefordshire - Welcomed the emphasis on MH being integrated into Urgent Care but that our provider is not part of the work anywhere else in the network area which has been noted. CCG Mental Health Joint Programme Board: Healthwatch are part of the discussion on this strategy. Observations and comments made: - Outcomes Framework updates and indicators: some areas difficult to quantify e.g. challenging behaviour, separating out Patient satisfaction. There is a need for challenging targets e.g. upper quartile not above average. 2g performance data analysis to be completed. - Adults outcomes framework needs further development, go back to HWB and explain approach and status, link this to Carers' strategy - Need for fresh look at elderly community poor CQC area, review tor for this group. Look for more collaborative arrangements e.g. Learning Disability and dementia partnership. Children & young people s Mental Health Pathway Group: Healthwatch contributed to discussions about workforce planning and development and general pathway development, also raised the issue of carers and young carers being included in parenting programme planning Estates and Technology Transformation Fund Prioritisation panel (previously Primary Care Transformation Fund Panel: Healthwatch contributes to the discussions around the bids which are being shaped for submission for this money, to ensure that the services which could result from these projects are of the most benefit for patients. Quality Improvement Review Group for Wye Valley Trust: Healthwatch asked about the following key issues: - Preparation of staff for the Inspection and was given details of the work both already carried out and planned. Confidence was seen as essential to enable the staff to give the story of the journey the Trust is taking to move out of Special Measures. - Queried a possible extension of the pilot with 4GP's surgeries, regarding the 18 week plus waiters. There is a plan to extend it and include the Powys GP's too. It was agreed that this was a good initiative & should be shared with other Trusts. It is about patient safety & keeping them from harm. 17
- Healthwatch asked if any patterns had emerged when investigating Serious Incidents, i.e. had any particular department had more than one/several SI's. Radiography has more than one & there was some concern about the Head of the Department. - Healthwatch stated we are encouraged to hear there is a cultural shift happening within the clinical staff, as we believed this had been needed for a long time & had contributed to many of the Trust's difficulties in the past. - Healthwatch asked how the front line staff were being prepared for the Inspection as HW had been in the Hospital over the past year for a range of reasons & found that staff were NOT good at talking to visitors about their work, giving information, their successes & were often reluctant to engage & give out positive messages Home Care & Community Provider Forum: - Zoning Providers - LA considering setting up a zoning model for providers to solve some of the brokerage problems. Healthwatch raised the voice of service users by stating that if a zoning model was adopted in Herefordshire SU's would have less choice and control over who supplies their care - as well as going against the principles of the care act. Response from LA 'SU's in hard to reach may not have any choice anyway. '?? I'm bringing to feel like a broken record. One provider stated that the zoning model hasn't worked in the past and it isn't working in Wales. - Brokerage - I asked questions about what happens to service when they are being processed by the brokerage team. - Integration of Adult Social Care & health - To note that there is no Health representation at any of these discussions. Stroke Programme Board: Expressed the positive views of patients on Early Supported Discharge programme which had been highlighted through Healthwatch Independent Evaluation of the service for patients, and endorsed the effectiveness of the programme in encouraging independence for the patient. Radnorshire & Brecknock Local Committee of Powys Community Health Council: Healthwatch was the only representation from Herefordshire at this forum and contributed to a vibrant discussion about cross border issues and answered many questions. Healthwatch summary of work on the transfer of the Independent Living Fund to the Local Authority: (SM & CJ are lead board members undertaking this work. - In December 2012 it was announced that the ILF would close in April 2015. This would have dramatic consequences to the 71 SU's in receipt of the ILF in Herefordshire. SM & CJ have made a difference over two years by consistently challenging ASC staff and the lead Councillor in ASC (G Powell). The Council responded to this issue well and put a plan in place to assess and then transfer SU's onto other sources of funding. They also ensured funding was ring fenced until June 2016, which enabled the plan to be implemented in a reasonable amount of time. - Monitoring the transfer process: SM & CJ have monitored and liaised with Council staff to make sure the plan was being implemented over this period. In March 2016 we were informed by the ASC staff that all SU's in receipt of the ILF have been 18
assessed and transferred onto other funding streams. A breakdown to clarify what happened to the 70 people who were in receipt of the ILF in terms of numbers (I.e. How many moved to a direct payment, how many had reduce hours etc.) is below. - End of a long process: SM & CJ demonstrated value for money by acting as an independent body who have been the 'voice of people with disabilities in Herefordshire' and by raising an issue that would dramatically affect those people. Half way through this period the leaders in the Council changed (councillor, Director of ASC). SM & CJ played a crucial role by being the memory in the system and continued to monitor this situation. Outcome 1 Local people are aware of Healthwatch Herefordshire, understand its purpose and how to access it for help and support Outcome 2 - Local people are empowered to give their views and influence decisions to improve health and social care services Outcome 3 Individuals are able to make informed choices about their health and care as a result of information and advice provided by HWH Outcome 4 The views and experiences of local people influence commissioning decisions to improve health and social care service Outcome 5 - Healthwatch Herefordshire is an independent organisation accountable to the people it serves Outcome 6 Healthwatch Herefordshire is good value for money 19
6. Communications Quality Statement - Community voice and influence: Promoting and supporting the involvement of local people in the commissioning, the provision and scrutiny of local care services. Quality Statement - Making a difference locally: Making reports and recommendations about how local care services could or ought to be improved. These should be directed to commissioners and providers of care services and shared with Healthwatch England. Relationship with Healthwatch England: Providing Healthwatch England with the intelligence and insight it needs to enable it to perform effectively. Annual Report Healthwatch have published their annual report for 2015-16 in Quarter 1. This report is primarily shared with Healthwatch England and is available on the website here. http://www.healthwatchherefordshire.co.uk/our-annual-reports Awareness Raising Events April - British Red Cross Annual Gardening Event June - Carers week Healthwatch and Herefordshire carers Information stand at The County Hospital At the following events in June, Healthwatch held an information stand and asked for people s feedback on the Healthwatch Passport: Hereford Disability United - Disability Roadshow Exhibition Barr s Court Road School & Hub - Transitions Event for Children with disabilities Healthwatch involvement in joint messaging campaigns for health & social care One You Campaign One You is a national Public Health campaign aimed at helping adults to live healthier lifestyles by offering useful tips and advice. The key message is Our lifestyles can be unhealthier than we think. Start the fight back to a healthier you. Take the One You quiz and see how you score. Healthwatch, as a member of the System Communications Group, contributes to raising the profile locally of health messaging which is of benefit to patients, service users and the public. Carers week Young people s mental health week 20
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Publications CCG newsletter Healthwatch Newsletter Healthwatch published the spring edition in June 2016, circulated to a readership of 650 people https://issuu.com/healthwatchherefordshire/docs/spring_newsletter_june If you would like to be on our newsletter and communications mailing list please subscribe Here or email: info@healthwatchherefordshire.co.uk Outcomes Met Outcome 1 Local people are aware of Healthwatch Herefordshire, understand its purpose and how to access it for help and support Outcome 3 Individuals are able to make informed choices about their health and care as a result of information and advice provided by HWH Outcome 5 - Healthwatch Herefordshire is an independent organisation accountable to the people it serves Outcome 6 Good value for money 22