How you help us shape local healthcare. An annual report on patient participation and engagement in Great Yarmouth and Waveney during 2017/18

Transcription

1 How you help us shape local healthcare An annual report on patient participation and engagement in Great Yarmouth and Waveney during 2017/18

2

3 Welcome It has been another busy year for us at NHS Great Yarmouth and Waveney Clinical Commissioning Group (CCG), during which we have strengthened our relationship with our patients and the public as we continue to build towards our vision of delivering better health, better care and better value. We pride ourselves on the engagement work we carry out with our local communities. It provides us with a vital opportunity to listen to people s views and make sure their voices remain at the heart of all of our commissioning decisions. This annual report brings together the highlights of that work from the past 12 months, as well as explaining more about the ways we encourage patients, carers and the public to get involved so that we can make sure their local health service continues to meet their needs. Melanie Craig Chief Officer, NHS Great Yarmouth and Waveney CCG As the vice chair of the PPG Forum, I was invited to be a member of the Primary Care Commissioning Committee (PCCC). I have been welcomed by the other members of the committee and feel that I have been listened to when airing my views. It is so important for clinicians and staff to stop and think of things from a patient s perspective rather than what might be convenient for the NHS. I am able to keep the PPG Forum up-to-date with matters discussed and involve them, seeking their help when necessary. I always encourage others to come to the public PCCC meetings because it gives a greater insight into why decisions are made. Jean Goffin Vice chair of the PPG Forum and patient representative on the Primary Care Commissioning Committee (PCCC) I am genuinely delighted to join the CCG and feel privileged and honoured to be involved with public and patient engagement. My background is in managing community events. The PPG Forum has had another successful year influencing the provision of healthcare services and ensuring patients views are heard. We have made significant contributions towards how care in GP practices works and by pressing for more patient participation in the Norfolk and Waveney Sustainability and Transformation Partnership planning process. Forum members have also attended public events focusing on the development of the Shrublands health campus in Gorleston to make sure that all stakeholders were able to put forward suggestions. Importantly, our PPGs continue to share best practice, encourage patients to use online services and help the CCG deliver various initiatives for the benefit of local people. Graham Dunhill PPG Forum Chair I have created and developed several successful community engagement events as a volunteer and supported by East Norfolk Medical Practice where I have been a member of their Patient Participation Group for five years prior to joining the CCG. I have personally relied on the NHS for many years and feel if we work together, listen and share our ideas we can all play a part in the future of our NHS. Trevor Saunders Governing Body lay member with responsibility for patient and public involvement How you help us shape local healthcare 3

4 About us NHS Great Yarmouth and Waveney Clinical Commissioning Group (CCG) is made up of local GPs and clinicians and is led by Dr Liam Stevens, our Chair. The CCG commissions (buys) healthcare for a population of 239,500 people and covers a patch which is broadly aligned with the areas served by Great Yarmouth Borough Council and Waveney District Council. It is made up of all 20 GP practices in Great Yarmouth and Waveney. Seven GPs and one nurse are retained to work with us to make sure decisions made about healthcare will meet the needs of local people. We are responsible for planning safe, high quality health services and agreeing contracts with hospitals, community services, the mental health trust, GP practices and other organisations. During 2017/18, we managed a budget of around 361m, which we spent on services designed to improve the health and wellbeing of local people. Our aim is to deliver better health, better care and better value for everyone in Great Yarmouth and Waveney. 4 How you help us shape local healthcare

5 People s health in Great Yarmouth and Waveney The area we cover faces challenges caused by health inequalities. Data from Public Health England shows that between 2014 and 2016, Great Yarmouth was ranked within the most deprived local authority areas in the country and was among the worst for overall premature deaths and deaths caused by cancer, lung cancer and injuries. The Great Yarmouth area was also worse than average for deaths from breast cancer, heart disease and stroke and liver disease. Waveney, which is described as more deprived, was worse than average for overall premature deaths and deaths from cancer, breast cancer, heart disease and stroke and injuries. It was ranked as better than average for deaths from lung cancer and liver disease. We use this information, along with other data about hospital admissions and demand for primary care services, to help us plan and shape the healthcare we buy so that it meets the needs of local people. We also place an emphasis on preventing ill health and work closely with the public health teams in Norfolk and Suffolk to raise awareness of the importance of a healthy lifestyle and steps people can take to help themselves stay well. How you help us shape local healthcare 5

6 Our vision for engagement Good communications and engagement are at the heart of everything we do, they not only help build public confidence and trust in local health services but also support the work of our healthcare professionals. With the correct information to hand when they need it, patients are also empowered to make the right choice for themselves and better able to take control of their own health. The law requires NHS organisations to engage with the public before making decisions on changes to health services. Our role is to ensure that we involve people when we are planning, developing and considering any proposed changes, as well as taking their views into account when decisions are made. The services we buy should enable patients to look after themselves, make choices about the care and treatment they receive, self-manage their conditions and take personal responsibility for their health and wellbeing where possible. We make sure that this is happening in a variety of ways, including having a lay member with responsibility for patient and public involvement on our Governing Body (Trevor Saunders) whose role is to champion the patient voice in all decision making and discussions. You said, we did Over the past year, we have held several engagement projects to gather your feedback on proposals to improve healthcare in Great Yarmouth and Waveney. These include: Child and adolescent mental health services (CAMHS) Children and Young people s mental health services have never been more important. They are one of our top priorities and there is rightly a strong focus nationally on children s wellbeing. Norfolk and Waveney s five CCGs are working together to review CAMHS services to make sure they meet the needs of children and young people living in our area. As part of this work, we went to two special meetings held by Great Yarmouth Young Commissioners at the Youth Advisory Board (YAB) and Waveney Youth Council to ask people what they wanted from services and how they would prefer to access them. At both meetings, young people told us they value face-to-face services which they can trust, but also feel information and advice should be available online or in an app so that they have a choice about how to get support. The location of services was also raised as a concern, as many of the young people live in remote areas which do not have good public transport routes. The feedback from both meetings and others across Norfolk and Waveney is now being used to help shape the redesign of CAMHS services. 6 How you help us shape local healthcare

7 Shape of the system consultation Following feedback from the public we developed some principles for our new out of hospital services: NHS funded beds with care will be provided in local nursing and residential homes and these will be provided to NHS quality and safety standards and be closely monitored. Out of hospital teams will be based in new community hubs across the area. The CCG will work with local providers to make sure services are tailored to the needs of the local population. The CCG will work with local providers to make sure staff are appropriately supported throughout the changes. You told us that one size of community service would not fit all, therefore we agreed that services would be designed at a local level and that the mix of beds with care, out of hospital teams and community hubs would be different in each locality. We committed to working with local clinicians and other stakeholders to design a service that was right for each community and their care providers. We also heard the public say that they did not want any changes to take place until community services were in place. Out of hospital teams were introduced in Great Yarmouth and Southwold which enabled us to close Southwold Hospital and free it up to become a community asset. The closure of Patrick Stead Hospital was put on hold until earlier this year (2018) when the CCG was able to invest 1.3m in out of hospital services for south Waveney. The out of hospital team, beds with care and a community-based phlebotomy service are now running for the five south Waveney GP practices, while additional funding has also been made available for the minor injuries service which the practices provide. How you help us shape local healthcare 7

8 Rayner Green social day care centre In January this year we held an engagement exercise with the people of Halesworth to discuss the future of the Rayner Green social day care centre. Following the agreement to close Patrick Stead Hospital the CCG proposed that the phlebotomy service and other services such as diabetic retinopathy screening should be relocated to the Rayner Green building. The CCG asked for people s views on their plans to explore options for the services currently provided at the Rayner Green social day care centre and proposed that the services would no longer be funded by health. During the engagement exercise 274 questionnaires were returned and a range of views expressed. The vast majority of respondents were not in favour of the CCG proposals. They were particularly concerned about what would happen to the people who were still using the Rayner Green social day care service. The Governing Body decided to go ahead with the relocation of the services into the Rayner Green building but agreed that individual health and social care assessments for the people currently using the centre would take place so that bespoke packages of care could be planned Improved access to primary care Across the country CCGs are working with GPs to set up a service to offer improved access to primary care for patients, this means appointments available in the evening and on weekends. Before developing the service locally we engaged local people and asked them for their views on how these additional GP appointments would work for them. You told us that you wanted appointments after 6pm, morning appointments at weekends and that you were able to drive to appointments. You also said that you would be happy to see a clinician from another GP practice. From 1 October all registered patients in Great Yarmouth and Waveney will be able to access additional appointments after 6pm and in the morning at weekends. The service will be based in hubs which all practice will have access to book their patients into. 8 How you help us shape local healthcare

9 Involving people in their own care NHS Great Yarmouth and Waveney During 2017/18, we coordinated a campaign on behalf of all five CCGs across Norfolk and Waveney to raise awareness of self-care and wasted medicine. The campaign encouraged people to go to the right place for help and ask for advice from a pharmacist so that they can care for minor illnesses or injuries such as coughs, colds and sore throats at home. It also clearly explained the importance of cost-effective prescribing so that we can make sure the best use is made of valuable NHS resources. The campaign has been shared nationally and will continue during the coming year. We are committed to person-centred care and have a duty to empower people to feel in control of their own health and the choices they make about the treatment they receive. Through shared decision making, we encourage all of our health and care professionals, including GPs, consultants, nurses and therapy staff, to talk through the options and work together with patients to make informed decisions about their care in partnership. To achieve this, we regularly liaise with patients to make sure the right information, tools and support are available to help them make those choices. Shared decision making is now in place across the majority of services in Great Yarmouth and Waveney, and is givinglocal people have a greater say in what matters to them in the care they receive. One of our priorities is involving people in the care they receive and helping them understand how to look after their own health. Where appropriate, we also offer further choice through personal health budgets. For eligible individuals, personal health budgets support choice, flexibility and control over how their health and wellbeing needs are met by making it clear how much money they have been allocated so that they can better plan and budget for their care. They give the individual the opportunity to make decisions about the services, equipment or support which best meets their assessed needs. Currently only specific groups such as people with long term conditions or disabilities, who are in receipt of continuing healthcare and live in their own home are eligible to apply for a personal health budget. NHS England has directed that all individuals who are eligible for NHS continuing healthcare and cared for in their own homes should have a personal health budget in place by 2019, and over the coming year we will be working towards this goal. We are also exploring the options for extending PHBs to other groups such as people who use wheelchairs as we strive to make care as personalised as possible. How you help us shape local healthcare 9

10 Norfolk and Waveney Sustainability and Transformation Partnership (STP) We are fully involved in the Norfolk and Waveney Sustainability and Transformation Partnership (STP) and have also taken the lead for communications and engagement. As part of this role, we have organised several events to give the public, patients, service users, staff and stakeholders the chance to share their views about the health and care so that we can use their opinions to help shape the services we are developing. Reports and presentations from these sessions are available on the Healthwatch Norfolk website, at Primary care and acute services Working with Healthwatch Norfolk we organised public events in Taverham, King s Lynn and Great Yarmouth to discuss the STP, with a particular focus on primary care and some of the specialist services provided in acute hospitals. A further event took place in partnership with Healthwatch Suffolk in Beccles during March. Your views have helped us to develop proposals for cardiology, radiology, urology and ear, nose and throat (ENT) services. In particular, you told us that you didn t want to travel further for care, so we have taken into this account when developing our new model for these services. Prevention and integrating health and care services In April, we hosted an event in Lowestoft to explain more about the STP and discuss the future of health and care in Norfolk in Waveney. This meeting had a particular focus on how well health and care services work together, as well as what we can do to keep people healthy, well and more in control of their own long-term health. 10 How you help us shape local healthcare

11 We are using your views to help develop the priorities for our prevention work, and expect these to be agreed in autumn Your feedback about services working more closely is also being used to develop our integrated care system (ICS), which will bring together a range of health and social care organisations to help improve people s health. We will be engaging more with the public and other stakeholders as we move towards becoming an ICS over the next eight to 10 months. Mental health event Breaking the Mould The STP organised Breaking the Mould in May to kickstart the process of developing a long-term strategy for mental health. It was chaired by the Rt Hon Patricia Hewitt and the keynote speaker was Alastair Campbell, a national campaigner on mental health issues. We were privileged to hear from people who use mental health services and carers who came along to share their stories and make their voices heard. Other engagement We have also asked for people s views about a wide range of services and engaged stakeholders in individual projects carried out by the STP. For example, we ve run surveys about maternity services and access to primary care, as well as workshops about lung and prostate cancer with clinicians and patients and improving access to psychological therapies for people with long-term conditions. More information about the results of our engagement and how we re using people s views to improve health and care services is available on the Healthwatch Norfolk website. This engagement work will continue as the STP progresses. You can sign up to receive the STP newsletter and find out about future opportunities to have your say at The day included discussions which focused on the impact of mental health and wellbeing in key age and life stages, and the care available at different points within the current system. The next stage will see adult and older people s services reviewed, followed by the initial development of the strategy which is expected in late People who use mental health services, their families and carers will be fully involved as the project progresses, while doctors, nurses and other healthcare professionals will also be invited to give their input so that we can make sure the strategy will fully meet the needs of local people. How you help us shape local healthcare 11

12 Other ways we gather people s views Engaging and communicating with our communities is a priority for the CCG. Patients are rightly our focus, and we place excellent communication and engagement at the heart of everything we do. We achieve this in a variety of ways, including making sure information about services is readily available, easy to read and accurate and by regularly engaging with the public about changes to services and commissioning decisions. We also use a variety of methods to gather valuable face-to-face feedback, which include: 1. Patient Participation Group (PPG) Forum Our thriving PPG Forum attracts high attendance from our practice PPGs. The forum is an independent group which is made up of patient representatives from GP patient participation groups, as well as patient or carer representatives who are not linked to a PPG but have a strong interest in local health. The forum s aim is to influence the way health services are prioritised, planned, commissioned and monitored. Its chair is a non-voting member of our Governing Body, and ensures that patients voices are heard at the highest level within the CCG. The vice chair is a non-voting member of the newly formed Primary Care Commissioning Committee. During 2017/18 the PPG Forum has been involved in a number of areas, including: Exploring how the forum can work alongside the new Primary Care Commissioning Committee resulting in the vice chair sitting on the committee. Making sure patients voices are heard as we develop our primary care work. Development of the Shrublands health campus. Sharing good work across all GP practices in Great Yarmouth and Waveney. 2. Great Yarmouth and Waveney Patient Advisory Group (GWYPAG) Great Yarmouth and Waveney Patient Advisory Group is an independent patient group which meets regularly to discuss patient and staff issues within health. 12 How you help us shape local healthcare

13 3. Parent/Carer Forum The Parent/Carer Forum was set up in September 2017 to give parents and carers the chance to contribute to the planning and commissioning of community paediatric services within the Great Yarmouth and Waveney area. An independent group, it is made up of a cross section of parents and carers who meet to discuss services and any proposed changes, such as revisions to patient pathways. Anyone who would like to join the forum can find out more by ing kelly.penton@nhs.net 4. Healthwatch Healthwatch is a consumer champion created to make sure that the views of the public and people who use services are taken into account. Over the past year, we have strengthened our links with both Healthwatch Norfolk and Healthwatch Suffolk through engagement and communications work around the Norfolk and Waveney STP, which we lead on behalf of the five Norfolk and Waveney CCGs. 5. Health Overview and Scrutiny Committee We work closely with the Great Yarmouth and Waveney Joint Health Overview and Scrutiny Committee (HOSC), which meets every two months to scrutinise local health and social care services. The joint committee is made up of representatives from both Norfolk and Suffolk county councils. During 2017/18, it reviewed: Our new out of hospital team The ME and Chronic Fatigue Syndrome service Services for children with autistic spectrum disorder Our annual assurance rating and improvement plan Mental health services, including adult inpatient and dementia diagnosis Care Quality Commission inspections of local GP practices Emergency department performance at the James Paget University Hospitals NHS Foundation Trust Phlebotomy services How you help us shape local healthcare 13

14 Social media With more and more people using social media we have developed ways to engage with the public digitally so that we reach as many people as possible, We run our own Facebook, Twitter and YouTube accounts and have used these to support a variety of national public health campaigns during the year, including encouraging people to stop smoking, give blood and make use of their local pharmacist. We have also taken part in drives to raise awareness of the symptoms of cancer and the importance of safeguarding mental health, while also promoting NHS 111 and GP Online to make sure people know how to access the right healthcare at the right time. During the past year: We averaged 2,133 unique visits to our website every month, with visits peaking in March at 2,356 when we introduced a new blood testing service. Our Twitter followers continue to grow consistently and stood at 3,064 at the end of 2017/ people liked our Facebook page at the end of 2017/18. Our posts are being shared across several networks, which helped our reach exceed 20,000 people in November, December and January. During January, a post explaining how much it costs to prescribe everyday medicines, which came as part of our successful self-care campaign, went virally locally, resulting in a Facebook spike. We hosted 118 videos on our YouTube channel which were viewed 9,664 times. The majority of these have been filmed and edited in-house. 14 How you help us shape local healthcare

15 Health and Wellbeing Boards We work closely with our partners on the Norfolk and Suffolk Health and Wellbeing Boards to improve care for local people. We are a member of the Norfolk Health and Wellbeing Board, and have contributed to its strategy and its four priorities, which are: Promoting the social and emotional wellbeing of pre-school children Preventing obesity Making Norfolk a better place for people with dementia and their carers Reducing stigma around mental ill health, making mental health everyone s business, improving access to help at an earlier stage and self-help resources and commissioning better pathways into and through services The Suffolk Health and Wellbeing Board s strategy is for people to live healthier, happier lives so that differences in life expectancy between those living the least and most deprived communities can be reduced. It has four key themes: Stronger, resilient communities Embedding prevention Addressing inequalities Health and care integration Alongside partners, we have been working to deliver both county s visions by: Rolling out social prescribing, which actively supports the creation of strong links with the community and builds on existing strengths to find out what matters most to people. Developing a discharge hub at James Paget University Hospitals NHS Foundation Trust to improve discharge planning and effective discharge home. The hub includes input from a variety of partners, including social care, continuing healthcare, community care so that people can be discharged with the right support to meet their needs. How you help us shape local healthcare 15

16 What our stakeholders say Every year, NHS England commission independent experts Ipsos MORI to carry out a stakeholder survey to make sure each CCG has strong working relationships with its health and care partners. The survey allows groups, such as GPs and patients, to provide feedback so that partnerships can be further strengthened. This year s survey showed a number of significant improvements from the 2017 results, including: Our overall engagement score improved by 10% Our score for how effective our CCG is as a local system leader increased from 58% to 75% 79% of respondents said we had clear and visible leadership in place, compared with 44% in 2017 Our score for effectively monitoring the quality of services we commission improved from 42% to 64% 86% of people who responded said they knew about our plans and priorities a 22% increase on the 2017 score The survey also showed us that we could do better around safeguarding, engaging hard to reach groups and responding to concerns, complaints or issues raised by the public. We are now working to improve performance in these areas. Equality and diversity We use nationally-developed equality standards to help us improve the services we provide and make sure our working environments are free of discrimination. We also carry out equality impact assessments for all projects, service changes and care pathway redesigns. These are designed to make sure that any changes to services we make will not have an adverse impact on age, disability, sex, gender reassignment, marriage or civil partnership, pregnancy, race or ethnic origin, religion or belief or sexual orientation. A variety of policies and practices are in place to support our role as a responsible employer. These include our equal opportunities policy, which reaffirms the value of a diverse workforce and our commitment to equality of opportunity in all areas. We are registered with the Disability Confident Scheme, which means that we interview any disabled candidates for posts if they meet the minimum essential criteria. We fully engage with our Staff Involvement Group when developing workforce policies and treat all staff equally in terms of training and development and career opportunities. We also make sure our policy infrastructure complies with statute and best practice in relation to equality and diversity. 16 How you help us shape local healthcare

17 Comments, compliments and complaints Our Patient Advice and Liaison Service (PALS) provides patients, their carers and families with advice and information about all NHS services.. Their role is to help navigate patients through the system and find resolutions to any issues they may be facing. The team is a point of contact for enquiries when there are changes to the local health system. We also encourage anyone who has any concerns about the care they have receive to get in touch with PALS so that we can learn any lessons and use their feedback to further improve the services we commission. During the last year, PALS received: 434 enquiries about various healthcare providers 34 complaints We are always pleased to receive positive feedback about the care patients have received from the providers we work with, as well as compliments about our own staff. Some examples of the comments PALS have received recently include: Thanks for arranging fast-track care so that a patient was not alone when she passed away. Gratitude for the support we offer families and carers. Recognition for a member of our continuing healthcare staff for treating a patient with dignity and respect and helping to arrange a smooth discharge on her behalf. Appreciation for the advice given by our pharmacy team. We also receive written compliments. One recent letter about continuing healthcare said: I wanted to thank you. for all of your hard work, effort and patience in bringing this to a satisfactory conclusion. Your attention to detail and persistence have been very much a driving force in resolving this matter. Far too often, people are all to ready to complain but fail to recognise a job well done. How you help us shape local healthcare 17

18 How you can get involved We pride ourselves on listening to our patients and their carers so that we can make sure that their views are considered in depth and are taken into account when we make decisions about your health services There are several ways in which you can get involved and have your say: Join your GP surgery s patient participation group (PPG) PPGs allow patients to make their voices heard about healthcare in their area. Patients meet regularly and are able to feedback their views direct to health professionals.. The majority of the practices in the Great Yarmouth and Waveney area have a group to join, simply ask at the practice for the dates of their meetings. Our PPG Forum meets every two months and brings together representatives from all the PPGs to discuss local health issues. If your practice does not have a PPG please contact Lorraine Rollo, Head of Communications and Engagement, by ringing or ing lrollo@nhs.net Join your local Healthwatch Healthwatch is an independent organisation which is there to help you have your say about your health and social care services. You can become a member or contact them for more information about a particular issue. The service is free. People living in the Great Yarmouth area should contact Healthwatch Norfolk on freephone or by ing enquiries@ healthwatchnorfolk.co.uk. You can also visit their website at co.uk and leave a review about any health and social care service in Norfolk by clicking on Share your experience. If you live in Waveney contact Healthwatch Suffolk on , and you can also use their online engagement tool to let health and care bosses know what s good and what s bad about health and social care in the county. To visit the feedback centre, go to www. healthwatchsuffolk.co.uk/services Join the Great Yarmouth and Waveney Patient Advisory Group (GYWPAG) GYWPAG is a voluntary group which works closely with the CCG to give us the patient perspective on local health issues. Many of its members are also involved in other patient groups, including our Healthwatch organisations. For more information about GYWPAG, contact Jean Macheath on or jean.a.macheath@btinternet.com 18 How you help us shape local healthcare

19

20 1 Common Lane North, Beccles, Suffolk NR34 9BN Phone: gywccg.your views Published: September 2018 If you would like a copy of this publication in another format such as Braille, large print, audio or in another language, please contact NHS Great Yarmouth and Waveney CCG on