Update. January 2015
Contents
Making A Difference 2
Work Programme 9
Community Investment Projects 13
CRM Data and analysis of feedback on services 15
Community Engagement and Outreach Activity 27
Volunteers 29
Citizens Advice in Dorset (CAiD) 31
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Making A Difference
v “Every One Matters” report – Feedback on Dorset’s hospitals
Ø Dorset County Hospital has responded by identifying 8 areas for improvement and listing actions they are already taking or are going to take to address those areas
Ø We have asked Royal Bournemouth Hospital and Poole Hospital to do the same by the end of January. We will put all the responses together and publish them
Ø We have presented the report at meetings of the Dorset Health Overview and Scrutiny Committee (HOSC), Dorset CCG (Clinical Commissioning Group) Governing Body, Dorset County Hospital Board and Bournemouth & Poole Health and Wellbeing Board, thereby bringing the voices of patients and the public “into the boardroom” of decision-makers
Ø As a result of our presentations, the Dorset HOSC has put it on their agenda to discuss the situation with regard to complaints about local hospital services and the CCG, as their commissioners, has asked to see the hospitals’ action plans, which they will follow up with them
Ø N.B. The report has been downloaded from our web site over 500 times. BBC News online covered it and published a link to it on their web site.
v “Something to complain about?” Report on Mystery Shopping exercise on GP practices
Ø Many practices responded to the original report, thanking us for it and setting out ways in which they were going to improve, including updating and refreshing their information both in hard copy and online, and arranging training for staff on how to handle enquiries relating to concerns or complaints
Ø We have recently got back in touch with all the practices to:
§ Thank those who have made the changes they promised
§ Remind those who haven’t
§ Offer our support to help them make changes
§ Let them know that at the beginning of February we will publish an account of actions that practices have taken
Ø Through this piece of work we improved the way in which GP practices communicate about, and handle, concerns and complaints and made it easier and more accessible for people to raise concerns and complaints. It has also enabled us to help practices to see the benefit of taking a positive attitude to patient feedback, including concerns and complaints.
v “Local Healthwatch and health and Wellbeing Boards”
Our guide for local Healthwatch representatives on Health and Wellbeing Boards has been taken up by other local Healthwatch organisations and formed the basis of the Local Government Association’s new “On The Board” toolkit – a fact that they acknowledge at the beginning of their document: http://www.local.gov.uk/documents/10180/11309/L14-644+Healthwatch+on+the+board+toolkit/32853171-1a5e-4d2f-96a0-f918382434bd
v Dorset Clinical Services Review (CSR)
Ø We have influenced arrangements Dorset CCG has made in relation to engagement with the public, patients and service users about the CSR. Because of our interventions:
§ The membership of their Engagement Leads Forum now includes the voluntary sector and Healthwatch
§ Voluntary organisations were given the opportunity to submit feedback and intelligence they hold about people’s experiences and views on local services to form part of the process to draw up the “case for change”. Previously, this was going to be restricted to NHS bodies and Local Authorities.
§ We have emphasised the need to engage with “hard to reach” groups and given advice on how to do that (together with lists of contacts)
§ We have also emphasised the need to engage with the general public, not only with people who are already engaged. As a result, the CCG went out and engaged with people in the street to test out their “Need for Change” document
§ We have given advice on how to run focus groups, and the benefit of doing so
§ We have given advice on how the CCG’s communications could be improved, to make the CSR more accessible to the general public
Ø The CCG has acknowledged publicly on a number of occasions the help and advice we have given them and what actions they have taken as a result
Ø They have also publicly stated that one of their own tests of the success of their engagement strategy and activities will be Healthwatch’s approval
v Safeguarding/serious concern alerts
Ø We are receiving an increasing number of contacts from members of the public and from Healthwatch Champions reporting incidents (particular in residential care homes) which have led us to raise safeguarding alerts with the relevant Local Authority and to pass on information to the CQC
Ø Thereby, we not only help to ensure vulnerable people’s safety is protected but also help to build up the store of intelligence held both by local safeguarding teams and the CQC.
Ø Action we take in response to concerns over a person’s safety can extend into other areas too. A recent example:
§ Someone submitted a form through our web site detailing difficulties she has been having for some time in accessing mental health services. In the course of it she spoke about her desperation and mentioned ending her life if she wasn’t able to get the support she needs. Having first spoken to the Local Authority’s Safeguarding Team, we spoke to the person’s GP to make them aware of the situation and the GP agreed to carry out an urgent assessment. The person came back to us to thank us for the “kindness shown” saying, “It means a lot”.
§ We were contacted by a couple who have been working for a care home. The care home owner has not been paying them the National Minimum Wage, After the CQC (Care Quality Commission) inspector told her to she then took money out of their wages for accommodation, increasing the deductions to £125 per month each. The clients feel aggrieved by this and just want to leave the job. Their main worry is that she has told them she wants one month's notice. If they do not give her that, she has said she will deduct "training costs". They fear she will not pay them. In addition the clients commented thatthe care home had residents with dementia, and was not always adequately staffed. This case has been raised with the CQC who are investigating further.
v Media and online activity
Ø Over the last few months, there has been a significant expansion of our exposure in the media. This was partly due to interest in our report “Every One Matters” and partly because media came to us to comment on issues of local interest, particularly the Dorset Clinical Services Review, the news that the Royal Bournemouth Hospital was threatening to evict patients, and concerns about the pressures on A&E. As a result, we figured in a number of articles (and double-page spreads) in the Bournemouth Echo and Dorset Echo, in the Independent and on the BBC news web site. Also interviews on the following radio stations:
§ BBC Radio Solent
§ Wave FM
§ Hope FM
§ Bournemouth University Radio
§ BBC Radio 5 Live (national)
§ The Jeremy Vine Show (BBC Radio 2, national)
Ø We have also appeared on television on BBC South Today (twice) and on BBC Breakfast (national).
Ø Online, the number of users of our web site in the period October – December 2014 increased 55.72% over the previous period.
v Non-emergency patient transport
Ø We contributed a report to Dorset Health OSC with feedback on the non-emergency patient transport service operated by E-zec Medical Ltd. Subsequently, we worked with E-zec to improve the way in which they engage with their service users, including the format and language of their printed material, to understand how they can use feedback to improve their service, and to help them set up a specific user group for people who are renal dialysis patients.
v Living Well With Dementia
Ø As part of our Community Investment Projects, we worked with Bournemouth University to make a video “Living Well With Dementia”, challenging misconceptions and misunderstands about dementia. The video is now used in the training of health and social care staff.
v We regularly pass on to service providers any issues and concerns which local people have reported to us and which we consider “serious”, ask them to investigate and respond. An example:
v “N has liver cancer and has been receiving treatment at Bournemouth Hospital for the last 3 years. Her experience of Bournemouth Hospital has been poor. She talked about being moved from ward to ward and not being kept informed. A couple of weeks ago she was on a general ward with 2 other women who both had MRSA (Meticillin-Resistant Staphylococcus Aureusis). She was scared & asked to be moved as she has terminal cancer - but she didn't feel like anyone was taking her concerns seriously. She told me about another experience a few weeks before that when she was an inpatient at RBH waiting for an operation to fire chemo into her liver. The operation is very invasive and she was really nervous, she was told the operation would be in the morning but she was waiting around for hours - no-one she asked knew when the operation would be so she was getting more & more anxious. She left the ward to call her mum from the corridor (so she could have some privacy) and told a ward nurse where she would be so she could be called if they came to get her for the operation. When she got back a nurse told her that she'd missed the operation because she hadn't been in her bed when they came to get her. She was so upset that she was crying on the floor, begging them to do the operation and eventually they did the operation that day but she felt like she had to fight for it. She asked to see PALS several times and she didn't find them very easy to access. When someone from PALS came to talk to her she said she was told that it would probably affect her care if she complained - so she didn't progress a complaint.”
Ø With the person’s permission we shared the story with the hospital. (But the person didn’t want us to disclose her identity.) We had a number of exchanges with the hospital and here is their eventual response:
Ø “As you are aware, with the scarce information it is difficult to review our data as to the individual circumstances and who dealt with them. Even more so, as we do not even have a time frame and therefore cannot review our log with any precision. That said, we have reviewed the log and there is no patient with end of life details, who could potentially collate with this complaint. However, I have discussed this with the PALs coordinator, and she in turn has also discussed this with all members of her team. I am sorry to say that on the information given, none of them remember talking with an end of life patient, or hearing of any complaint or discussing with any patients with cancer about quality of care. I am sorry that we cannot offer any more information. I would like to mention that the staff were extremely distressed that anything they may have said would have been interpreted as making a patient fearful of complaining. They have emphatically stressed that they would not and have never told any patient under any circumstances that any kind of complaint would ever impact on the quality of their care. We agree that the perception of the patient may be influenced by many things at such a difficult time and all the staff in PALs are very concerned that their words have been misinterpreted, this has been discussed at length between them as a team and additionally with me present. They will be ever more vigilant to check and recheck patient understanding. I noted that you mentioned the patient found it difficult to access PALs from the ward, we will review how we ensure patients are aware of the PALs service and if you could let us know which directorate, without breaching confidentiality we will ensure all Ward Sisters in that directorate are aware of this situation and all staff are reminded to encourage Patients to access the service and offer information as to the methods available to them to do that. We thank you and welcome your feedback, and have taken this feedback very seriously and reviewed it in detail.”
Ø We have subsequently suggested a form of words the hospital can use in all its material relating how to raise concerns or make a complaint, to make it clear that nobody’s care will be compromised if they do so.
Ø This example shows how it’s possible for an organisation to learn from a patient’s experience (even if they don’t know who the actual person is and when the incident/s took place) and use that learning to gain a better understanding of the patient’s perspective and improve the way they act and communicate – and make it easier for people to raise concerns.
v Information and signposting
Every day our information and signposting service (through our telephone helpdesk and face-to-face in Citizens Advice Bureaux) is making a difference for people. Some examples: