National Adult and Children S Services Conference 3

October - December 2015

Table of Contents

Highlights

National Adult and Children’s Services Conference

We were invited to give a presentation in October at the National Adult and Children’s Services’ Conference, held in Bournemouth. We asked representatives from The Chatterboxes group to come with us and when talking about our work with young people we focused on the piece of work we had done with them which produced the Quilt (which we took with us). NHS England chose our session to also launch the new “Children and young people’s mental health services passport”. The session received a lot of attention and positive feedback, both in the hall and online. We drew online discussions together on Storify, which can be read here.

1 Two of those who attended the session on the day and who subsequently wrote about it online were Dr. Jacqueline Cornish, NHS England’s National Clinical Director for Children, Young People and Transition to Adulthood, and Jon Rouse, Director General for Social Care, Local Government and Care Partnerships at the Department of Health.

Be yourself: everybody else is taken

We have been preparing to launch (January 2016) a new digital project for young people aged between 11 and 25, called “be yourself: everybody else is taken”. This project will give young people across Bournemouth, Poole & Dorset the opportunity to share their thoughts about health and wellbeing in a creative way that suits them. As part of the planning and preparations for the project we have engaged with and met other community groups, schools, local authorities and youth groups,CCG and The NHS. The project will have an official launch in January 2016 when we will attend a series of school assemblies and college sessions across Dorset. Every entry and submission will be collated and we will be able to present patterns and opportunities for social services and the NHS to make positive changes in the way they deliver services to young people, at an event we will be hosting in April. Your Say Your Way

We have begun working with Creative Events Management students at Bournemouth University to plan a Healthwatch Dorset Promotion Event which they are calling “Your Say Your Way”. The event is specifically aimed at young children between the ages of 5 and 10. The students have arranged to host the event at the Creative Kids Centre in Boscombe during the February half term week. There will be creative stations where the children can design puppets, take part in a creative writing competition and participate in fun games. The aim of the event is to raise awareness of Healthwatch but to also gather feedback on the experiences children have had with Health and Social Care. We will be gathering feedback from both the children and the parents.

Taking local people's views to the heart of Westminster

We joined with other Healthwatch organisations from around the country to voice concerns on health and social care to parliament. Our Chair, Joyce Guest, and one of our volunteer Champions, Eileen Mitchell, travelled to London with 70 other Healthwatch organisations from around the country to discuss the real life concerns of people using health and social care services. More than 30 MPs as well as key decision makes from across health and social care attended the event at the Houses of Parliament.

We had the chance to speak to Mid Dorset and North Poole MP Michael Tomlinson about the work we do in Dorset to shape local services on behalf of residents. The work we discussed included our project on home care which has gathered

2 feedback from more than 700 people across Dorset, and how we have created changes to local hospitals following our Every One Matters report. We also highlighted problems with mental health crisis care.

Dental Services

Following on from our work around dental services earlier in the year, the new “Toothbus” service has now started, based at Routes2Roots in Poole and targeted at people who are homeless. In addition we have arranged for flu clinics to take place at the same time.

Communications and Media

Some of the ways in which we reached out and promoted Healthwatch Dorset in this period:  Social media promotion for our presentation at the NCAS conference.  Interview with Emilia, our new Children and Young People’s Officer, featured by Healthwatch England as their “story of the week” in their Network News.  Advert in Your Dorset (sent to every household in Dorset).  Article published about our visit to Westminster.  Our Chair, Joyce Guest, gave an interview on Wessex FM.  Our press release to promote the Community Investment Fund was published in the Bournemouth Echo, Dorset Echo, Western Gazette, Blackmore Vale Magazine and featured on BBC Radio Solent and BBC TV Spotlight. The press coverage led to 2 applications from Radio/TV coverage, 5 applications from newspaper articles and 1 application from twitter promotion.  Social media promotion of Twitter questions for Health & Wellbeing Boards.  Articles published about our work with Routes2Roots and dentistry for homeless people.  A general article about Healthwatch Dorset was featured in the Gillingham & Shaftesbury Guide.  We were quoted in an Echo article about hospital car parking.  We featured in Healthwatch England’s end-of-year roundup: 12 ways in whuch local Healthwatc have made a difference.  We were approached by ITV Meridian news about filming a piece at Routes2Roots about the Toothbus.

3  We were also contacted by ITN, who are researching a documentary about homecare and would like to use our report “Where the Heart Is”. We put them in touch with 2 Healthwatch Dorset Champions to discuss some of the issues raised in our report. Equality and Diversity

In September 2015 we welcomed Alan Mercel-Sanca as our new Equality and Diverse Communities Officer, leading to development of new work and approaches to support for the voice of Dorset’s diverse communities in regard to access and experience of health and social care. Some of the work for outreach to diverse communities completed in the final quarter of 2015 included: * Creation of a diverse communities’ engagement strategy * Supportive input to the Healthwatch Dorset Young Persons Health & Wellbeing Engagement project to enhance outreach to diverse and especially BME communities * Work began in December on developing online and hardcopy translated information to promote awareness of Healthwatch Dorset and its role as health and social care services consumer champion, to a range of Pan-Dorset BME communities * Research and diverse communities’ engagement meetings (15+) work to prepare for a major campaign in the first quarter of 2016 to promote greater engagement with and outreach to diverse and Protected Characteristics communities * Preparatory input to a review of Dorset CCG intranet material to assist the CCG have enhanced understanding of the healthcare needs and healthcare access experience of diverse communities

Community Investment Projects

We launched an appeal for applications to a new round of Community Investment Projects, which received coverage in our local media. As a result, we received 43 expressions of interest, out of which we chose 13 to support (with a further 3 for we which we are seeking more information before making a final decision). In making our assessment we took into consideration factors such as where the gaps (demographically and geographically) had been in the previous round of Projects.

A full list of the projects, with a brief description of each, is below.

4 Project Protected Area Description Characteristic / Community

Age Poole Dementia Friendly films for people with Poole Lighthouse project to run dementia friendly (dementia & dementia & their carers film screenings monthly. Pilot in December of carers) "Some Like It Hot". HWD to part fund promotion of the project, leading to the screenings becoming self funding. HWD will be promoted at the screenings, logo added to flyers/posters/press & feedback gathered at the screenings.

Age Dorset To set up Parkinson’s Dance sessions across Parkinson’s Dance Dorset starting in Poole and Purbeck - looking for (long term part funding for a much bigger project which will condition specific & research the impact of dance sessions over the carers) next 2 years. Launch of project in April 2016.

HWD will be promoted at the launch event, logo added to flyers/posters/press/online promo & feedback will be gathered at dance sessions.

Age /Race Pan-Dorset Restore will gather feedback about health & care Restore services from older ex-offenders across Dorset (ex-offenders) through at least 12 individual case studies,

5 including some photos and video footage. The case studies will be collected through 121 support sessions over the next 6 months and used by Healthwatch Dorset to raise issues of concern with local NHS & social care, to promote the project and in press releases. Restore will promote Healthwatch Dorset to ex- offenders on probation and through the BME dialogue groups run in local prisons. Healthwatch Dorset will provide Restore with funding and ongoing promotion through our website, e-Newsletters, press releases, social media accounts and our Annual Report.

Race /Sex Bournemouth Damaris Mwangi supports the Bmth BME BME Women’s Group community engagement group and is looking to create a walking/social group for BME women. The objective is to improve the health and wellbeing of the members and to enhance integration and connectedness. Planning to start with a focus on walking and a stopover for a coffee and chat over women’s issues or any concerns in the community. HWD will be supporting the pilot project, paying for refreshments and promotion etc. - leading on to gathering women’s stories as vlogs (video blogs).

Food Bank Pan-Dorset The Club ran a pilot project with the food bank in The Friendly Food Club clients Blandford to produce a variety of meals from a typical food bank item offering them as tasters to the clients with accompanying recipe cards.

6 With our support they will be able to develop this idea into offering a buffet meal for the food bank users at the local venues, showing what can be done with their box of goodies, a few recipe cards and a bit of imagination. A pilot will be run across Dorset (to include Weymouth, Dorchester and North Dorset). 5 sessions with recipe cards produced to go into food bank parcels.

HWD logo will be displayed on recipe card. HWD leaflets will be placed in food bank boxes & feedback gathered at sessions.

Age Dorset Musica is a southwest based company with a Musica Dorset (dementia / passion for helping older adults, particularly those care homes) with dementia to enjoy music. Bringing live music to people who may otherwise not be able to experience live performance, improve social interaction between residents and staff, enhancing the community within each home.

Our support will enable them to expand their work in North and West Dorset, particularly carrying out work in more rural residential homes in and around Shaftesbury, Sherborne and Dorchester. They have all the equipment and resources in place to carry out these workshops, and Musica has all the safe-guarding policies in place that are appropriate to the project including full DBS checks and public liability insurance. They will also help to promote HealthWatch

7 Dorset by displaying posters in care homes and through Musica's network of contacts and use of social media. Each session could involve 15-20 residents, so potentially reaching 250 residents.

Age North Dorset Providing funding for a radio club project run at Yewstock School Radio (children / Yewstock Special school in Sturminster Newton, special needs) to cater for special needs children from primary through secondary to Post 16.

HWD will receive feedback on people’s experiences and views through audio and video.

Public North Dorset Funding a Health Education Event for patients and Ideal Health Exhibition public in North Dorset. This follows a patient survey undertaken by the Patient Participation Group conducted in early 2015. A vast number of health topics were identified by the survey respondents including Asthma, Dementia, Osteoarthritis and Stroke. The event is called the "Ideal Health Exhibition – Live Life to the Full" and it is due to be held on Thursday, 14th April 2016 at The Exchange, Sturminster Newton, Dorset. Our funding will support the costs for funding the Venue & Publicity i.e. advertising, also production of a brochure to hand out to visitors, which will have within it the details of exhibitors and pertinent information, which people can keep as a directory of support services.

8 HWD logo will go on leaflets/posters/promotion/press & feedback gathered at the event. Disability Bridport Support to set up a new Dorset Blind Association (DBA) group in Bridport for people of working age. DBA has had great success with other Socialeyes groups in Poole/Bmth & over last 18months in Weymouth (built up a group there from 3-4 people to 35 attending the last event) Funding will pay for a member of staff 1 day a month for a year, recruiting & training volunteers in Bridport to make the group sustainable after 1 year and support for people to attend the group to start with. http://www.dorsetblind.org.u k/social-eyes-clubs.html

HWD logo will go on all promo & feedback gathered at sessions. (Homeless people, people Weymouth / Portland Start up costs for a new Soulfood & Refresh (Church of vulnerably housed, mental project starting in March. Weymouth and Portland in health, isolated, They already run CAP Debt Action religion/belief) counselling, and CAP money

9 management courses, with proven success rates. Many of their clients have mental health issues and are socially isolated. All clients are supported by a volunteer, and from March 2016 they are launching a CAP job club in Weymouth and Portland, starting principally with existing clients together with those who come to Soulfood (Soulfood works with those in hostel accommodation, many of whom also have mental health issues). As part of the job club they will also be offering literacy and numeracy skills, and the CAP JOB CLUB project will be run entirely by volunteers, who will receive their training and support from the national charity CAP. Our funding will send 3 volunteers to Bradford for training, and provide a laptop and printer and start up stationery etc.

Age Christchurch The organisation works with Christchurch Activities for Young

10 (young people, family vulnerable young people People support, emotional aged 8-19 across the wellbeing) Christchurch area by providing a range of out-of- school activities and projects which engage them and which improve their skills for life. They are currently working with a group of young people in an informal setting where they just meet up once a week and where they talk about anything and everything. From this they have helped young people with issues of self harming, signposting to other services and enabling them to take better control of their lives. Some of the young people come from low income families and so when they meet they cover the cost of refreshments and many of their staff are trained volunteers. They would like to continue this scheme and get the group to plan activity trips where they have the opportunity to develop more skills. They will target

11 approximately 50 young people with this project. The young people are interested in making a video diary and they have recently established links with Bournemouth University who are prepared to help them with their evaluations.

Homeless people, Boscombe The BH1 project provides a Salvation Army religion/belief safe environment for vulnerable adults to meet, greet and eat. They entertain a large number of rough sleepers each week and provide washing facilities, clean clothing, coffee/tea/squash and biscuits, plus food Mon-Fri. Many of their rough-sleeping clients (approximately 80 people access the service) arrive carrying large bags and this causes a security problem on many fronts. The bags are vulnerable to theft, & potentially a means to circumvent their strict drug and alcohol policy. They would like to provide a large secure storage area for

12 baggage, which will mean access to secreted drugs and alcohol will be restricted whilst clients are using the project.

The BH1 project has no indoor storage available and would like to provide a garden shed to store luggage, plus an outdoor quality lock. This would be coupled with an outdoor gazebo to allow open air socialising during the winter months.

The shed will be HWD- branded, be featured in photo shoots and used as a location for recording conversations with people about their experiences, plus promoting HWD at the project.

Drug & alcohol misuse Bridport EDP Bridport Pop Up EDP pop up Wellbeing Cafe Wellbeing Café. The aim is to provide a space for vulnerable and isolated members of the

13 local community (including those within their existing client group who face multiple health needs, such as drugs and/or alcohol dependency, depression and anxiety and poor diet, to improve their wellbeing) to have a voice, learn and share health and wellbeing skills and resources. The pop up cafe will be developed by an EDP wellbeing practitioner supported by trained Health Champions, volunteers from the community who are passionate about encouraging others to improve their health and wellbeing. Each pop up café session will have a facilitated discussion/activity based on wellbeing topics, such as ‘Five Ways to Wellbeing’ (Connect, Give, Keep Learning, Be Active and Take Notice), how to have a say about health services, healthy eating and taking up exercise. The Wellbeing Practitioner

14 will run a session a week (one day including two planning days and 10 café days over the 12 weeks). The practitioner will:  Coordinate the pop up cafés  Manage a group of Health Champions to devise a programme of cafe sessions.  Provide feedback to Healthwatch Dorset including a summary of the discussions had in the café and participants’ thoughts on health and care services. Mental Health Sherborne/ Safe Haven in Sherborne Developing a late night ‘safe North Dorset (TBA) haven’ for people with mental health issues in partnership with the 4-Leaf Clover Club in Sherborne and the Community Mental Health Team (CMHT) at the Yeatman hospital. The support would come from the CMHT based at the

15 Yeatman community hospital, who would be invited to provide training to volunteers from the 4-Leaf Clover Club. Amount of funding to be discussed with the manager of the Zest Cafe which hosts the Club and would provide the location for the safe haven. Maternity project TBA Transgender Project TBA

16 Facts and Figures

Number of pieces of feedback by month

(The dotted line is a trend line, showing the change in volume of feedback over time.)

Source of feedback

Graphs showing a breakdown of sources of feedback together with detailed analysis of feedback on specific service areas can be found in a datasheet, which can be viewed by clicking here.

What we’ve been hearing

In the period October to December the three topics about health and care services that people have raised most often with us were:

1. Quality of treatment (both positive and negative) 2. Staff attitudes (both positive and negative) 3. Long waiting times

The positive Among the service areas for which we received positive feedback in this period are:

 A&E  Acute care  Ambulance services  Cardiology  Community Hospitals  End of Life care  Gastroenterology  Ophthalmology

17  Paediatrics  Pharmacy services  Radiology  Urology

The negative

These are some of the service areas where people have told us they have had a negative experience. Many of these issues are ones we are following up with service commissioners and providers, feeding back to them people’s experiences and discussing how services can be improved.  Cancer Services  Care Assessments  Care at Home  Care of the Elderly  Dementia services  Dentistry  Inpatients  Maternity services  Mental Health and CMHT and CAMHS  Nursing and Residential Care Homes  Orthopaedics  Outpatients  Out of Hours  Primary Care/GP/Dentists

We include a summary of what people have been talking to us about each month in our regular newsletter, which can be found here. Information and Signposting

The number of calls taken by the telephone helpdesk between October and December 2015 was 249.

The time spent on a call (including research) varied from 5 to 90 minutes, with the average being 32 minutes.

18 Examples of calls to the helpdesk A The caller’s wife is a tetraplegic and is receiving ongoing treatment at three local hospitals. She had suffered from a collapsed lung twice, was being PEG fed, had had a tracheostomy and was using a respirator. Earlier in the year she had been declared medically fit for discharge and CHC (Continuing Healthcare) funding had been put in place. She remained in hospital despite training available to maintain equipment and keep lines clean. There had been no date given for her discharge and the hospital feel it is unsafe. OT (Occupational Therapy) department has taken six months to do a home visit. The caller feels let down by the hospital PALS (Patient Advice and Liaison Service). The helpdesk discussed his options with the caller, including independent advocacy. With his agreement, the helpdesk made a referral to Dorset Advocacy. B The caller had been diagnosed with cancer but the Consultant had not given her the formal diagnosis. The nurses had. She needed to attend a range of appointments for tests which had overlapped. The Consultant had told her to “think very carefully about what she was saying” when she asked why he had not given her a diagnosis himself. Her GP had agreed to write to seek clarity from the consultant who had written back and put her treatment on hold until she has a psychological assessment before providing further treatment, even though her condition remains. The helpdesk discussed her need for ongoing treatment and how she might continue dialogue with her GP who might refer her to another consultant. In the meantime, the caller was given information on complaints advocacy and the complaints process, as well as on how to report details to the GMC (General Medical Council) and the CQC (Care Quality Commission). C The Caller had been signposted to Healthwatch by an SEN (Special Educational Needs) inclusion officer at her Local Authority, as she had been trying to access CAMHS (Child and Adolescent Mental Health Services) support for her 10-year-old son. The GP had referred 13 months previously but her son was yet to receive therapy. Initially CAMHS offered play therapy, but when she chased for an appointment she found that they hadn’t been put on the list. She had not made a formal complaint but she felt let down as she repeatedly did not get promised call backs. She was advised that her son would actually require longer-term therapy, which was further delayed by not being on the initial waiting list. The caller was very concerned as her son was demonstrating challenging behaviour, was depressed and had attempted to self-harm. He was not attending school as he had been physically bullied at a previous school. She reported incidents of emotional abuse from the absent father and another incident involving a 9-year-old child. She was very concerned that her son would not get any support before he reaches adolescence as each appointment has a 4-6 week wait. The helpdesk researched and called her back to give details for the Young Minds Parents Helpline and of advocacy support available should she want to make a complaint. The helpdesk also suggested she report the delays to her GP and the

19 impact it was having on their family life. The caller advised that she was happy to speak to their GP and would contact Healthwatch again if she needed further advice.

Community Engagement & Outreach

Two or three times every week Healthwatch Dorset sets up a stall in public locations around the county (details can be found on the Events page of our website). In addition, every week we are meeting with local community and voluntary groups. These were some of our engagement and outreach activities between October and December 2015:

o Health and Wellbeing Fair o Dorset Fire and Rescue Information events o Dorset Community Action event o Royal Bournemouth Hospital carers’ event o Dorset POPP event o Promotional day at Beaminster library o Sherborne Market o Promotional day at Dorchester library o Information stand at Weymouth College o Bournemouth Marathon (runners sponsored by Healthwatch Dorset) o Mental Health week o Black History Month o Teen 2 Adult conference o National Adult and Children’s Services’ Conference o Chancery House Day Centre, Bridport o Parkinson’s Groups o Learning Disability Event o Toothbus event o Equality and Diversity Day o Carers Rights Day o Dorset Patient Participation Groups networking day o Flu clinics o Spectrum Housing communities group

20 o Discussions and meetings with community groups interested in our Community Investment Fund Healthwatch Champions

The number of our volunteer Healthwatch Dorset Champions continues to grow. There are now 290. We have met with the lead officer for Dorset County Council’s (DCC) Library Service who has agreed to recruit Healthwatch Dorset Champions for all of the DCC libraries, including the voluntary-led libraries and the home library service. We are now going to do the same for Poole. All of Bournemouth’s libraries already have a Healthwatch Dorset champion. (14) Our Volunteers Officer and our Equalities and Diverse Communities Officer are currently working together to recruit more Champions and make the whole group of Champions more representative of protected characteristics. The volunteers who make up our Reference (Reading) Group have inspected and given feedback on 13 documents in this period for NHS England and the Weldmar Hospice Trust. Volunteers continue to assist at our community stands, promoting Healthwatch Dorset and collating people’s feedback. Champions supported the Care Quality Commission on their “listening stands” when they were gathering feedback on Bournemouth Hospital prior to their inspection. One of our Champions, Eileen Mitchell, attended the Healthwatch England Parliamentary reception with our Chair in October. A special Champions Newsletter goes out to our volunteers. Copies can be found here

21 Our Work Programme Priority Areas Actions Outcomes Timescale Children Highlighting issues National interest generated. Profile of Concluded and young local people are the issues and of Healthwatch Dorset people’s experiencing in this raised. Attention and responses from mental area at the National Department of Health and health and Children and Adult Healthwatch England. wellbeing Services “Above all, we must continue to listen Conference, through to young people to make sure we are a presentation with approaching our system changes in the Chatterboxes of the right way.” (Jon Rouse, Director one of our General, Social Care, Local Community Government and Care Partnerships Investment Projects. at Department of Health.)

“Be yourself: Increased feedback from young everybody else is people and the opportunity to share January – taken”. New young their feedback with commissioners April 2016 people's project for and influence services. anyone aged 11-25.

“Your Say Your Way” Event. Engagement with and feedback from Working with children aged between 5 and 10. Creative February Events Management 2016 Students at the University of Bournemouth to plan a Healthwatch Dorset Promotion Event, aimed at young children between the ages of 5 - 10.

Access to Following up the NHS England responded to our report Concluded Primary recommendations by drawing up an 8-point Action Plan, Care contained in our which is now in force. Services report on Primary NHS England has adapted the way it (focusing Care Dental commissions dental services to better Services in Dorset. meet the needs of homeless people

22 on dental in Dorset. services) NHS111 has adapted its pathways and staff training to better signpost people presenting with severe dental pain. Carers Focusing on difficulties relating to CHC (Continuing Healthcare) – especially in two specific areas:

Pathway for young people with March 2016 1. young people multiple disabilities and complex with multiple medical transitioning to adult services and profound now being re-designed to better meet disabilities people’s needs. Review being and complex undertaken by CHC team of how they medical needs communicate, to make the service more accessible and person centred.

Difficulties around end of life care raised with CCG and CHC. On-going March 2016 discussions. 2. people receiving end of life care. Mental Raising the issue of March 2016 Health difficulties in this Crisis Care area with the Health and Wellbeing Board and engaging with Dorset Healthcare University Foundation Trust and Dorset Clinical Commissioning Group to discuss action. Information Exploring where (Exploring with other local information March 2016 and Healthwatch Dorset providers where the gaps in provision Signpostin can add value to the are.) g current provision of information and Producing Easy Read versions of the April 2016 signposting Complaints Guides developed by services. Healthwatch England and Citizens Advice.

23 Residential Scoping out a (Draft project plan first to be March 2016 Care project to be carried discussed by Healthwatch Dorset Homes out in residential Board) care homes. Additional

NHS Surveying everyone Increased understanding of people’s Beginning Complaints who made a experiences of the complaints April 2016 complaint about systems and the opportunity to services at the three influence and improve them. Acute Hospitals and Dorset Healthcare Trust in 2015. Brought forward Home Published our report Have discussed findings with the March 2016 Care “Where The Heart Cabinet leads in the three local Services Is” – an investigation authorities. into home care services in Dorset. Meeting with lead commissioners January from the three local authorities. 2016 Ongoing

Dorset Monitoring CCG has adopted suggestions made Clinical engagement and by Healthwatch in relation to how they Services consultation engage and the material they use. Review undertaken by Dorset Clinical Commissioning Group (CCG) and advising and influencing to make consultation as wide as possible. Community Applications being New tranche of Community December Investment invited for new Investment Projects agreed. 2015-March Projects round of Projects 2017 Wessex Extending the NHS England has agreed a Community collaboration framework to sustain the collaboration Voices between the 5 going forward. Wessex local Healthwatch Project Manager being recruited. January organisations and 2016 NHS England Care Contributing Local people’s feedback through local Quality feedback to CQC in Healthwatch forms part of the Commissio advance of their evidence in CQC inspections. n (CQC) inspections of local inspections providers

24 Dorset On-going A more seamless and supportive Advocacy collaboration to service for people who are, or might, Help with ensure appropriate pursue a complaint about an NHS NHS information sharing service. Complaints and smooth referrals Membership Health and Wellbeing Boards (2)

Attendance Health and Care Overview and Scrutiny Committees (3)

Joint Primary Care Commissioning Committee

Quality Surveillance Group Activity Road shows and community engagement/outreach

Recording and analysing feedback from patients, service users and the public

Healthwatch Champions (volunteers)

Measures and Indicators

No . Outcome Measure

Well Managed & Evidence of health and social care issues is Number of recorded issues Organised brought together from the diversity of local brought to Local A1 networks. It has a focus on partnership, outreach, Healthwatch by named local networking and relationship building. networks.

See above and datasheet.

A2 People are aware of the signposting service and Number of contacts with are able to access appropriate information, people each month broken advice and advocacy and are helped to find out down by method/media, i.e. about the choices available. face to face, telephone, etc.

See above and datasheet.

25 Health and social care services are influenced by Case studies as examples of the views and aspirations of local people, co- local Healthwatch initiatives A3 ordinated by Local Healthwatch. that have had a direct impact on local health and care service development.

See above and on our website.

Reports and information to accountable bodies Evidence of members views are delivered to professional standards. collected through Survey of Health & Wellbeing board Health & Wellbeing board members view reports members to confirm as credible and influential. standards of input from local A4 Healthwatch.

Independent Review recently collected and reported on stakeholders’ views

No. Outcome Measure

Well Known Local Healthwatch should be visible and ensure Citizens Panel, Annual Adult people know what it does and know how to make Social Care Survey including their views known. Health surveys and other B1 relevant surveys.

B2 Local Healthwatch is a well-known brand Citizens Panel, Annual Adult championing health and social care issues. Social Care Survey including Health surveys and other relevant surveys.

Independent Review recently collected and reported on

26 stakeholders’’ views

Also see local press coverage and social media activity.

No. Outcome Measure

Local Healthwatch Number of contacts should be easy to with people each month C1 access across broken down by Bournemouth, Dorset & method/media, i.e. face Poole and be truly to face, telephone, etc. reflective of collective issues. See above.

Proactive and effective Equalities monitoring of C2 outreach is in place to users of Local ensure participation of Healthwatch. minority groups, those Accessible “for seldom heard and See datasheet. And everyone geographically Community Investment dispersed communities. Projects.

Local Healthwatch is Customer/stakeholder accessible in satisfaction for those C3 imaginative ways that using advice/sign effectively reaches posting services. people across Bournemouth, Poole Independent Review and Dorset. recently collected and reported on stakeholders’ views

Outcome Measure No. Influentia l, Local people’s views are integral to local Evidence that local people’s Independ D1 decision-making about health and social care views were integral to the ent & services. decision making process. Trusted See Decision-Making Process.

D2 Bournemouth, Dorset and Poole consumer Survey of Health & Wellbeing voice for health and social care is effectively board members to confirm championed at Health & Wellbeing Board standards of input from local meetings. Healthwatch

27 Independent Review recently collected and reported on stakeholders’ views

Local Healthwatch is recognised as being an Citizen’s panel, Health, social independent organisation, representative of care and other surveys to D3 local people. evidence level of public trust and preserved independence.

Expertise and resources of the local Stakeholder focus group / D4 community, voluntary and public sectors is other engagement to gauge harnessed to influence local health and social their ties to Local Healthwatch. care services. Independent Review recently collected and reported on stakeholders’ views

28 Appendix. Citizens Advice in Dorset: Healthwatch Dorset report October to December, 2015

1: Introduction Citizens Advice in Dorset is contracted by Healthwatch Dorset to provide information, advice and signposting on a face to face and walk-in basis, for the following: 1. a query relating to Health or Social Care that could be of any nature; 2. a request to record an experience with the intention that it will inform the influencing remit of Healthwatch.

The delivery of this service is provided by the nine Citizens Advice Bureaux that serve Dorset Bournemouth and Poole, and come together as Citizens Advice in Dorset: Dorset County Council: Bridport CAB Christchurch CAB Dorchester and Sherborne CAB East Dorset CAB North Dorset CAB Purbeck CAB Weymouth and Portland CAB Bournemouth Borough Council: Bournemouth CAB Borough of Poole: Poole CAB

2: Activity summary, Year 3 - Quarter 3

Client numbers and issues increased in Quarter 3. Bureau ‘Leads’ met in December 2015, again joined by Annie Dimmick (Help and Care) to review cases on the CRM, and to get an update on proposed changes to the CRM from April 2016. There was also a presentation from Beth Bell, Independent Complaints Officer, Dorset Advocacy.

CAiD continued to be represented by Caroline Buxton and Roger Tilley at contract review meetings, CIC Board meetings and a meeting to develop a work plan in response to the independent review carried out in the Autumn.

3.1: Statistics – Quarter 3: October, November, December 2015

Data from the Citizens Advice ‘Petra’ system for this period shows that we have recorded 308 unique clients with a health or care issue, raising 444 separate issues. Comparison over the 11 quarters is as shown below:

Unique Clients Issues 2013/2014 Qtr 1 Pre ‘Petra’ 158 Qtr 2 254 331 Qtr 3 283 453 Qtr 4 360 526 2014/2015 Qtr 1 308 454 Qtr 2 294 456 Qtr 3 251 371 Qtr 4 302 492

29 2015/2016 Qtr 1 321 466 Qtr 2 263 373 Qtr 3 308 444 Of the 308 clients, 274 are recorded as from our three areas, Bournemouth (66), Poole (34) and Dorset (174).

3.1.i Client data

The following analysis of the 274 clients by authority uses the contract categories, and gives a good indication of the profile of CAB clients with a Healthwatch issue:

Age B/mouth Poole Dorset 18-24 2 3 7 25-34 6 3 14 35-446 9 4 20 45-54 21 2 26 55-64 12 6 32 65+ 9 15 60 Not stated 7 1 15

Gender Male 33 17 71 Female 32 17 71 Not stated 1 Transgender

Ethnicity Other Black 1 1 Other White 2 4 W & Black African 1 1 W & Carribean W & Asian 2 White British 50 34 156 White Irish 1 4 Carribean Not stated 9 8 Not completed

Disability Disabled 13 9 33 Long-term health prob 33 19 69 Not disabled 8 6 57 Not stated 12

 Overall percentage of those with a disability/long-term health issue: 64% (Qtr 2: 52%)  Percentage under age 35: 13%

30  Percentage aged 65+: 31%

3.1.ii Issue data

Advisers record issues using specific codes; currently we have our existing health and social care codes, plus new Healthwatch specific codes, which mirror the Healthwatch England Hub categories. The breakdown below is a very useful overview of the main types of issues. Due to a change in the way codes are recorded it is now harder to pull out specific data on those issues that were only dealt with at a Gateway Assessment (‘level 1’: information / signposting) as compared with a full advice interview (‘level 2’). Data from the issue codes suggests 1 in 5 cases was dealt with at Gateway only.

Advice Issues: Quarter 1, 2 and 3 comparison 2015/16

Issues raised over 8 times are listed below, and compared with quarters 1 and 2:

Qtr 3 Qtr 2 Qtr 1 15/16 15/16 15/16 NHS: prescriptions 21 11 7 NHS: low income scheme 20 14 10 HW Hospital service: mental health 17 1 1 Community care (non mh): eligibility 17 13 15 Residential care: charges 11 9 19 NHS: travel to hospital scheme 10 16 16 Residential care: finding care 8 4 7 NHS: optical vouchers and sight tests 8 4 5 Residential care: self-funding 4 10 4 3.2: CAB Case Studies

The following cases provide a snapshot of issues brought to CABx in the perdo October to December 2015. [* indicates a provider was named]

Key issue: change of dentist without notification or explanation. The client had been registered with the ….* dental practice for about 24 years. At her appointment in September, she was called into a different surgery and was told that she was no longer a patient of her usual dentist and had been moved to another dentist. She therefore refused to be treated and demanded an explanation as to why this had happened. She waited an hour whilst there were discussions between the dental nurse and reception staff, but she still didn’t receive an explanation. The client had never received any notification that her dentist was changing nor any reasons why and was very upset by the way she had been treated by all staff at the practice. She asked for their complaints procedure and was given a slip of paper with no named person on it, just an address to write to. She is pursuing this route.

Key issues: interruption of dental service. The client had braces fitted in 2010. She paid in full for the treatment (£2650) but part way through the orthodontist died. 31 A locum dentist then advised her to have the braces removed as she was at risk of gum damage. She thought that they would be re-fitted after a period but when she returned the practice had been taken over; the new dentis told her he would not take her on and stated that she had asked for the braces to be removed as she was moving out of the area. On subsequent occasions this dentist refused to speak to her on the phone. She was very concerned as to who was responsible for her care, and how to resolve the issue. Key issue: complexity of rules for getting optical vouchers. The client wanted hep with his ‘help with health costs’ form (HC3) for the current year. The client was concerned as the figures shown for his payments were significantly more than in the past. He wondered why, especially as his wife needed new glasses (possible cost between £200 - £300). The adviser telephoned the Healthcare costs helpline to get more information about the voucher scheme and was informed that the value of the voucher depended on the prescription and could vary from say £38 to £200. On further exploration it also appeared that the amount the client was entitled to had reduced because his pension had increased so his Pension Credit had stopped. However he still had a relatively low income overall. Later on this client returned to the bureau because he had forgotten what he had been told . The supervisor therefore accompanied him to the optician to have the matter clarified. The optician was very helpful and explained that the NHS voucher was only worth £68.80 for the glasses. As the clients HC3 explained that her had to pay the first £140 on this occasion it was of little help to the client. Key issue: inadequate nursing care following operation. This client has spina bifida and has a permanent catheter, which usually he self-administers. He was admitted to Poole hospital for surgery on his left hand, which would mean he could not self-catherterise until recovered; therefore he would need to go to a Nursing Home for care until he was able to self-catheterise and return home. After the operation he spent two additional weeks in hospital as a Nursing Home could not be found. He moved to a home near Broadstone with in-house nursing which he described as excellent, and his catheterising issues were managed effectively. After 6 weeks he returned to hospital for a check-up on wrist and was told by the consultant that he would have to stay longer in the home as his hand/wrist was not properly mended. He then received a letter from NHS saying it would no longer pay for his care and he would be passed to Social Services. He was visited by a Social Worker and he indicated that he was prepared to move anywhere providing there was in-house nursing due to catheterising needs. He felt that the Social Worker did not fully understand his situation. He was told that a place was found in Boscombe and although it did not have in-house nursing it had a near-by on-call surgery. The client was forced to accept this move as a taxi was sent to take him. This Care Home was not suitable as he could not move out of his room as there were only stairs, and he could not get his wheelchair into the toilet. The care workers were however excellent. He had a problem when his catheter backed up; it took 4 hours for the nursing support to arrive by which time he was in shock. Paramedics were called and he was taken to Bournemouth Hospital where he was put in an Acute Medical Unit for a week as he had Sepsis. He was them moved to Alderney Hospital Rehabilitation ward until he was well enough to go to his own home Key issue: inadequate diagnosis delayed treatment. The client has had urinary pains since 2004 and over an extended period was treated for urinary infections without examination until June 2008 when he was finally examined and referred to a

32 specialist who eventually discovered a growth within the bowel and operated to remove it. The client has since received further treatment for an underlying disease which may have caused the problem. The client started a medical negligence claim because he felt the delay had exacerbated the problem and contributed to his current condition where he cannot work and has to live on benefits. The client recently went to the doctor on another unrelated issue and was shocked to discover that in his medical records the growth treated in 2008 was a malignant cancerous tumour; he had not been told this. He now wishes to complain further concerning the NHS's handling of his case, so that it is not ‘swept under the carpet’. However, he felt doubtful about pursuing matters through the NHS complaints service as he feels that they are not impartial enough. Key issue: options when a care home closes. The client's nephew, a 57 year old with Downs Syndrome, had been living in a small private care home in Durham for 10 years. Following an audit by CQC last year the owners decided to close the home. The client does not have power of attorney but is accepted as next of kin. It seems Durham CC has authority for the nephew and he has social workers assigned to him. Until recently they were managing the nephew’s benefit income, but the client is applying to take this on. The lady who runs the care home was a very close friend of the nephew’s mother, and before the mother died she left written wishes that if the home were to close the nephew would go to live with this lady and her family. This was agreed with all parties directly involved, though the letter had not been witnessed by anyone. The client wanted to know who will have final say in the nephew’s future.

Key issue: poor communication from Social Care re 17 year old’s mental health. The client’s 17 year old son had a history of autistic tendencies and depression; in August 2015 he told his parents that he was non-binary transgender, and identified as female. Relationships within the family home broke down and the 17 year old was taken into care. Since then the parents have been concerned that Social Services have not kept them up-to-date; there was initially a consent to share medical and care information with the parents; however at 17 years old a young person can withdraw this and so far the parents have not been made aware of whether the mental health aspects of their child’s care are being dealt with They are concerned that Social Services are placing too much emphasis on the transgender issues and are not paying sufficient attention to dealing with getting a formal assessment / diagnosis of autism and helping with mental health issues. The client was given information on what to expect from Social Care services, and other support organisations for transgender issues. The client does not at this stage want to make a complaint to Social Services as she wants to build up a working relationship with the social worker rather than create barriers, but is concerned that things are sorted as soon as possible given that their child’s 18th birthday is in the summer.