Influencing service improvement
Healthwatch Lancashire has been focused on influencing improvements in the experiences people in Lancashire have when they are using health and social care services.
In 2015/16 Healthwatch Lancashire published a total of 50 reports presenting the experiences and views of people in Lancashire when it comes to hospitals, care homes, community services, GPs, dentists, hospices and more.
All Healthwatch Lancashire reports have been shared with Lancashire County Council, clinical commissioning groups, NHS England, Care Quality Commission, Healthwatch England along with other relevant stakeholders.
Healthwatch Lancashire has submitted reports to contribute to Care Quality Commission inspections and has shared intelligence at inspection summits.
Making a difference through Patient Engagement Day events
The Patient Engagement Days project was established in May 2015 by Healthwatch Lancashire to take a team approach to gathering feedback from local people about hospital services in order to understand people’s experiences on a particular day and to influence service improvement.
Healthwatch Lancashire has published 16 Patient Engagement Day reports since May 2015 with responses and actions being undertaken shared as a result by East Lancashire Hospitals NHS Trust, Lancashire Teaching Hospitals NHS Foundation Trust, University Hospitals of Morecambe Bay NHS Foundation Trust, Southport and Ormskirk Hospital NHS Trust, Blackpool Teaching Hospitals NHS Foundation Trust, Spiral Health CIC and Ramsay Health Care UK.
As a result of the pilot Patient Engagement Day at Royal Lancaster Infirmary in May 2015, Sue Smith, Executive Chief Nurse for University Hospitals of Morecambe Bay NHS Foundation Trust, provided a list of actions, which were as a direct result of the report. These included the reviews of clinics by teams, which include managers, doctors, nurses and patients, to understand both good practice and issues. She stated has provided an opportunity to identify, make and evaluate improvements.
One of the most significant pieces of evidence to support influencing service change is that East Lancashire Hospitals NHS Trust have published a report which demonstrates that Healthwatch Lancashire’s Patient Engagement Day intelligence has contributed to their site development plans at Burnley General Hospital.
East Lancashire Hospitals NHS Trust provided responses to five Patient Engagement Day reports and acknowledged in their response that our reports highlighted areas where the trust can improve. A representative provided the following response: “We take all feedback very seriously and constantly strive to ensure all our patients and relatives have a good experience when using the Trust’s services. We will be taking on board all the comments received and ensuring any issues raised are looked at in further detail and any changes or improvements communicated to the public in due course.”
Lancashire Teaching Hospitals NHS Foundation Trust’s, Associate Director of Quality, Steve O’Brien, said, “We welcome Healthwatch Lancashire’s report and thank the team for not only undertaking this work but also for thesupport they provide to us as we continually strive to improve the experiences of our patients and their families.”
“As stated in the report, we have already started work to make a number of improvements, including installing extra seating on the corridors to make it easier for patients with mobility problems to get around, increasing the availability of wheelchairs for patients who may need one when they arrive, and ensuring water is available for patients attending fracture clinic.”
Improvements in care homes
Between September 2015 and March 2016, Healthwatch Lancashire carried out a total of 29 Enter and View visits and published 20 reports with the remaining being published after 1st April 2016. These reports have supported service improvement, the sharing of intelligence and has developed a strong relationship with local Care Quality Commission inspection managers. Following an Enter and View visit, Christina Durnan, Registered Manager at Fleetwood Hall Care Home, commented: “The visit itself was very helpful to us as it has provided us with additional insight into what our residents like and don’t like about the service that we provide, and more importantly, gives them a voice. It was great that the residents were the main focus of the visit, which I felt empowered them, both during and after the visit, knowing that their voices had been heard and that their opinions matter.”
Shehmaz Saiyed from Abiden Care said: “It is pleasing to note that this is different aspect of seeing the daily life of the residents in a care setting instead of ticking boxes. This can only be a positive way forward and more beneficial to the welfare of the care sector.”
In addition, Healthwatch Lancashire has been invited to be involved in East Lancashire Clinical Commissioning Group’s Quality Improvement Plan multi-agency working group to help service providers understand the importance of quality services and engaging their service users.
Healthwatch Lancashire distributed news releases highlighting where services have made a 23 Healthwatch Lancashire significant number of changes as a result of the visit. The press coverage that these achieved totalled £2,733.84 in equivalent advertising cost during February 2016.
Contributing to protecting adults
Sheralee Turner-Birchall, represented Healthwatch Lancashire at the Lancashire Adult Safeguarding Board and sub-groups across the county. Healthwatch Lancashire is able to contribute by presenting information which has been shared with us to prevent Safeguarding incidents occurring.
In addition, Healthwatch Lancashire has:
- Contributed to Lancashire County Council’s quality improvement plan programme with care homes.
- Contributed to the implementation of quality improvement plans by Lancashire County Council and clinical commissioning groups.
- Shared intelligence and reports with RADAR multi agency safeguarding working group which includes representation from Care Quality Commission and Lancashire County Council.
Reporting on projects and campaigns
14 reports were published that were a result of Healthwatch Lancashire campaigns and projects such as a ‘Real People of Lancashire”. “Your Care and Getting There”, “Your Dentist, Your Say”, “Lifting the Lid” and reports on a collaboration with Macmillan Cancer Support and local Healthwatch.
Our “Your Dentist, Your Say” report aimed to help understand how people in Lancashire would like to register for NHS dental treatment and when and where they would like this to take place. NHS England confirmed in December 2015 that the findings had already been used to change the opening times of a new practice being procured in Lancaster.
NHS England have also stated that new funding is being invested in the county on dental access meaning that existing practices can open earlier, for longer hours or at the weekend.
Innovation award finalist
Healthwatch Lancashire received a finalist award for the Research Innovation category of the North West Coast Research and Innovation Awards. The award was in recognition of the project ‘Patient Journeys at Royal Lancaster Infirmary’, which resulted in a significant number of changes being made throughout the hospital after Healthwatch Lancashire were invited, by University Hospitals of Morecambe Bay NHS Foundation Trust, to follow a group of patients and listen to their experiences during a full week on Ward 39.
Pictured above (left to right): Neil Greaves, Sheralee Turner-Birchall , Dorothy Jopson (Clinical Leader, from University Hospitals of Morecambe Bay NHS Foundation Trust) and Gill Brown.
Supporting innovation in the approach to friends and family tests at Calderstones
In January 2016, Calderstones Partnership NHS Foundation Trust undertook a project to restyle their “Friends and Family” test, with help from services users and Healthwatch Lancashire.
A working group looked at the way the current Friends and Family test questions are written, and how they could be changed and improved for service users at Calderstones. Service users were encouraged to develop their own questions to be used as part of the Friends and Family Test for Calderstones.
Funded by NHS England, service users revised all the questions and added video to ensure the questions were appropriate to people who are detained, and to make it feel less like a test.
Amanda Higgins, Project Officer at Healthwatch Lancashire, supported the Calderstones Involvement Group by providing intelligence, which has been captured by listening to service users at Calderstones. The valuable input from service users has been used to develop the questionnaire to best suit service users.
Service users were also given the opportunity to ask Calderstones Partnership NHS Foundation Trust staff why it is important to listen to service users, what happens to the feedback, and what difference does it make.
This new Friends and Family Test Questionnaire was held up as an innovative project at the “NHS England Improving Patients Experience of Care” event in March 2016.
Listening to people who use health and care services
In 2015/16, Healthwatch Lancashire listened to more than 6,000 people about their views and opinions on health and social care.
We have developed a number of programmes which have been focused on listening to people in Lancashire about their experiences in hospitals, GP practices, dentists, care homes, pharmacies and other health and social care services. Since July 2015, more than 96% of people we shared an experience about health and social care services said that the information they shared with Healthwatch Lancashire had not been shared with any other organisation or service. This is more than 2,400 people.
Healthwatch Lancashire has undertaken a number of creative projects and campaigns to demonstrate that the organisation is giving people in Lancashire the opportunity to say “I’ve had my say”.
In November 2015, we launched the “I’ve Had My Say” campaign which included a programme of Care Circle events taking place with community groups across Lancashire. These Care Circle activities allowed the Healthwatch Lancashire team to listen to views from more than 30 seldom-heard groups which included older people, carers, those with learning disabilities, those with visual or hearing impairments and young parents. Reports from Healthwatch Lancashire’s community engagement activities are now published each month and shared with health and social care providers and commissioners. The groups we visit are shared on the Healthwatch Lancashire website.
Healthwatch and Macmillan On Tour
Healthwatch Lancashire teamed up with Macmillan Cancer Support, Healthwatch Blackburn with Darwen and Healthwatch Blackpool to deliver a series of interactive events between December 2015 and March 2016, which gave seldom-heard groups the opportunity to discuss their views on cancer services.
Healthwatch Lancashire delivered three events with students at Preston College, a Seniors Together In Rossendale group and a Fylde Community Lesbian, Gay, Bisexual and Trans Friends group.
The events were delivered with the support of drama-based training company, AFTA Thought, who encouraged the group to share their views using scenarios and real life case studies provided by Macmillan Cancer Support.
Lifting the Lid
On 26th November 2015, Healthwatch Lancashire supported Lancashire BME Network and East Lancashire Clinical Commissioning Group to deliver “Lifting the Lid”, a public event which focused on the health and wellbeing issues faced by Black, Asian and Minority Ethnic communities in Lancashire.
47 people attended the event which discussed challenging topics including mental health, culture and diversity, genetics and reproductive health within Black, Asian and Minority Ethnic communities in Lancashire and lifted the lid for further discussions.
Healthwarch Lancashire published a report summarising the opinions from the attendees regarding where they feel more research is needed and what they think are the key issues affecting BME communities in Lancashire. The report was shared with East Lancashire Clinical Commissioning Group.
Your Dentist, Your Say
In July and August 2015 Healthwatch Lancashire undertook a research study with 1059 residents of Lancashire participating to identify issues relating to access to NHS dental services.
The remit of the research was to engage with local residents across Lancashire with a short survey to find out whether or not people are registered with a NHS dentist and to identify how people would like to be able to access dental services in the future.
The report shows that across Lancashire 63% of people said that they are registered with a NHS dentist, 19% said that they are registered with a private dentist whilst 18% of people said that they were not registered with a dentist.
NHS England confirmed in January that the findings from our report had already been used to change the opening times of a new practice being procured in Lancaster.
NHS England also stated that new funding is being invested in the county on dental access meaning that existing practices can open earlier, for longer hours or at the weekend.
In 2015/16 Healthwatch Lancashire will continue to deliver engagement activities with those who are using or are not currently accessing special care dentistry services and will feed this information into NHS England Lancashire Area Team.
Visiting Age UK Lancashire daytime support centres
Between May and July 2015, Healthwatch Lancashire captured the experiences of service users and their relatives in a number of daytime support centres at locations across Lancashire including Walton Lane Community Centre, Ormskirk Health & Wellbeing Centre, Knight Hill House and Tarleton Sheltered Housing Scheme.
Age UK Lancashire requested an independent assessment of four of their daytime support centre services by Healthwatch Lancashire to gather views of service users and their next of kin to inform their quality improvement programme. Healthwatch Lancashire volunteers, supported by staff, took part in the four events.
“Age UK Lancashire is committed to a culture of continuous improvement. We took the unusual step of requesting a visit from Healthwatch Lancashire because we believed this would provide the most independent and objective view of our service to inform our quality improvement plans. I was delighted to see our managers, staff and volunteers embrace the report, leading to some quick and effective improvement straight away.” – Stephanie Tufft, CEO at Age UK Lancashire
Access to GPs
In January and February 2016, Healthwatch Lancashire engaged with residents in Lancashire to gather their views and experiences about access to GP services.
The remit of the survey was to engage with local residents across Lancashire with a short survey to find out whether people feel that their GP practice is convenient and to understand how people would like to access their GP appointments.
1,044 people took part in the survey and a report, currently awaiting a response from NHS England, will be published soon.
Understanding the views from the lesbian, gay, bisexual and trans community
In May 2015, Healthwatch Lancashire and Lancashire LGBT published a report about the barriers lesbian, gay, bisexual & trans people face when accessing routine healthcare.
Lancashire LGBT have confirmed that the report, which highlighted that one in four lesbian, gay, bisexual and trans men and women in Lancashire think that their sexual orientation affects the way they are treated by healthcare professionals, has been used to influence a number of projects which aim to improve people’s experiences of using health and social care services.
Healthwatch Lancashire presented the report to lead clinicians within the clinical commissioning groups in Lancashire and will continue to share the results of the study with health and social care professionals.
Healthwatch Lancashire has continued to engage with members of the lesbian, gay, bisexual and trans community through Healthwatch and Macmillan on Tour events and care circle community engagement activities.
Contributing to patients’ stories
In February 2016, Healthwatch Lancashire has produced a number of “Real People” videos, which bring to life what matters in relation to health and social care to people living in Lancashire.
The videos have been produced as part of an NHS England Person-centred Outcomes project, which aims to influence the way health and social care services are provided.
Healthwatch Lancashire’s Real People videos gave four people the opportunity to have their voice heard and share what it is like for them to live with conditions or to use services. The videos enabled the individuals to influence service planning and development without having to sit on a committee or make a complaint.
Healthwatch Lancashire heard from Len, Elaine, Pam and Debs, who each shared their stories of living with health conditions, living without hearing or experiencing end of life hospice care. The videos are available to watch on the Healthwatch Lancashire website and more of these videos are planned for 2016/17. Click here to watch the videos