How Can We Improve the Health and Independence of Older People Living in Croydon?

How can we improve the health and independence of older people living in Croydon?

Summary report from Thursday 3rd July feedback event

Introduction

Croydon Clinical Commissioning Group and Croydon Council have been undertaking a range of activities over the last few months to give local residents the opportunity to say what can be done to improve the health and independence of older people in Croydon.

Over400 people from around the borough have been involved so farand contributed to discussions in four key areas, which are of particular importance to older people:

1.keeping healthy and well

2.staying independent

3.long-term conditions

4.unplanned care.

We would like to thank everyone who participated. We value every opinion and took care to ensure that all views were recorded and carefully considered.

The event at Bernard Weatherill House on Thursday 3rd July was an opportunity to update local residents on the work we have been doing, and to let people know what has happened to all the information we have gathered.

What you told us

We discussed how the views of the public, patients and carers have been used by working groups to design a set of outcomes, or goals, which will be used to measure and improve the quality of care provided to older people. A copy of the slides from the event, and the outcomes that have been developed with the help of local residents, can be download here.

You can read a summary of the ideas, issues and suggestions raised at the meeting below. Additional feedback, comments or queries can be emailed to

All the contributions made at the event will help us plan services that meet the health and care needs of older people in Croydon.

Question and Answer session

Your question / Our response
How can we take account of the fact that people are different and want different outcomes.? / Paula Swann, Chief Officer, Croydon CCG said, “clearly what we are doing is hugely ambitious. We are trying to take a health service focused on delivering activity, that’s focused on managing ill health, in crisis often, and turn it on its head, so we can focus on keeping people as fit and healthy as possible using the combined resources of both health and social care for the people of Croydon.
“This is quite a fundamental shift.We are trying to use the outcomes that you have identified to shift the behaviour of services. And we can’t do this overnight, it will take time, we will need to follow a phased approach, but our objectives are to get services to think about how they can support people better, to keep them as fit and healthy as they can, to focus on prevention, to focus on supporting people with long-term conditions, but at the same time being available to support people in crisis and helping to support and manage that crisis.
“For an individual that is about putting in place individual care plans to help people with their individual needs. Focusing on outcomes will support that process to provide much more personalised care. “
How does the work of the Health and Wellbeing Board fit in with this process of designing outcomes for older people’s care? / Paula Swann said, “This is all about joining up thinking and working together more collaboratively so it is important that we are aligned across all the services in Croydon. That is why this is a joint project between the council and CCG and why we have involved people from many different sectors and organisations in this work.
“As part of the next steps in this project we will be engaging with the health and wellbeing board to talk through the plans in more detail. In fact, I know we have a couple of members here tonight.”
You say that you’ve engaged with 400 residents, out of a total of something like 395,000 people in the borough, to my knowledge you haven’t been to faith groups or to Patient Participation Groups (PPGs). How representative of Croydon are those 400 residents? / Andrew Hobson, Communications and Engagement Lead, said, “We have done a lot of work to try and make sure that the people we have spoken to are representative of people in Croydon. We have worked very closely, for example, with the BME forum, who did over 180 interviews with groups that they are connected with, so of those over 400 people, actually just under 50% of those are from Black and Minority Ethnic communities which are actually a big proportion of the community in the North of the Borough. I’ll actually circulate these figures because we have them so everyone who is here today – we’ll make sure you have these numbers, but around 60% of the people that we spoke to were aged over 65.
“And while we acknowledge that 400 out of 300,000-odd in Croydon isn’t anywhere near everybody, and it’s impossible for us to speak to everyone, we have made sure it is proportional and representative as possible, and we have spoken to as many people in as many different ways as possible. So, for example, we’ve done lots of one-on-one interviews, gone out to lunch clubs, and gone into residential homes.”
Hannah Miller, Executive Director of Adult Services, Health and Housing.
at Croydon Council, said, “it’s worth saying that there are absolutely no surprises in what’s come out of the exercise, because it reflects what has come out of the consultation that we have been doing for a number of years with older people.So,for example, we have run events, we have run conferences, and we’ve got the older person’s network. People don’t want to be in hospital, they don’t want to be in residential care, they want to be in their own homes, they want to stay fit and well, they want to have a good quality of life. I know I certainly do!”
Have you got a plan in terms of how do you monitor these outcomes and how do you review it as no-one has actually mentioned that. Would you look at that in 6 months, once a year, once a month, to be sure the outcomes are delivered. / Paula Swann said, “Absolutely, and what we would do is build the outcomes, build the indicators, build the key performance indicators into our contracts with the providers of our services so that we are reviewing these on a regular basis. Importantly we need to incorporate feedback from patients, the public, people being cared for, carers, to advise us to whether or not these outcomes are being met.
You seem to have ignored blind people. I came along to the first meeting, and have asked for materials to be provided in large print. This has not happened. I would also like to know how many blind people have been involved in this project? / Paula Swann said, “I’m really sorry that you have raised this and that we haven’t actually followed it through, and when we run these events in future we will make sure that it is.”
Andrew Hobson said, “I don’t have the number of blind people that we spoke to, but we did talk to Croydon Vision, who were involved so perhaps if you and I could have a conversation later, after the meeting, and actually we can work out how we can do some more of that as well.”
Why haven’t you involved Patient Participation Groups more? / Andrew Hobson said, “We have heard loudly and clearly not just today, but before, how important Patient Participation Groups are and we have put in place a package of measures that we want to deliver over the next year to improve the way that we work with those groups.”

Group discussion

How can we measure the impact of the outcomes? How will we know it is working?
Attendees split into groups to come up with ways we could measure the impact of the outcomes to make sure they are working. The following options were put forward and discussed
Listening to the views of local residents

• Take account of people’s personal experience
• Hosting focus groups
• Working with Patient Partition Groups
• Monitoring patient feedback
• Visiting people in residential homes to find out their views
• Training patient to engage at every level
• Training healthcare professionals to communicate and listen
• Feedback questionnaires from carers
• People are more aware of all the services available
• Surveys
• Patient must be involved from the very beginning of services at every level

Monitoring data

• Decreasing complaints
• Falling obesity statistics
• Less people dying unnecessarily
• People living more active and fulfilling lives
• Move visible and active over 65s in Croydon
• Change in trends around diabetes, obesity etc

Looking at the impact across the health and social care system

• Increased use of voluntary sector organisations
• Reduced need for mental health services
• Reduced pressure on urgent care services
• Improved consistency of services
• The existence of a central point to track and oversee progress
• More social workers, GPs, and support workers
• More prevention, less treatment
• Reduced admissions and readmissions to hospital
• Less use of health and social service overall
• Services will be more patient focussed