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Health and Wellbeing Together 13 January 2021
Time 12.00 pm Public Meeting? YES Type of meeting Partnership Boards Venue MS Teams
Membership
Councillor Jasbir Jaspal (Chair) Cabinet Member for Public Health and Wellbeing Craig Alford Third Sector Partnership Chief Superintendent Andy Beard West Midlands Police Emma Bennett Director of Children and Adult Services Katherine Birch Faculty of Education, Health and Wellbeing Katrina Boffey Assistant Director of Strategic Transformation, NHS England & NHS Improvement - Midlands Councillor Ian Brookfield Leader of the Council Tracy Cresswell Healthwatch Wolverhampton John Denley Director of Public Health Marsha Foster Director of Partnerships, Black Country Healthcare NHSFT Professor Steve Field CBE Royal Wolverhampton NHS Trust Lynsey Kelly Head of Community Safety Councillor Linda Leach Cabinet Member for Adults Professor David Loughton CBE Chief Executive - Royal Wolverhampton Hospital NHS Trust Juliet Malone Operations Commander, West Midland Fire Service Councillor John C Reynolds Cabinet Member for Children and Young People Sally Roberts Wolverhampton Safeguarding Board Councillor Wendy Thompson Shadow Cabinet Member for Public Health and Wellbeing Paul Tulley Managing Director, Wolverhampton CCG
Information
If you have any queries about this meeting, please contact the democratic support team: Contact Shelley Humphries Tel/Email Tel: 01902 554070 email:[email protected]
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Agenda
PART 1 – Items open to all attendees
Item No. Title
MEETING BUSINESS ITEMS - PART 1
1 Apologies for absence
2 Notification of substitute members
3 Declarations of interest
4 Minutes of the previous meeting (Pages 3 - 8) [To approve the minutes of the previous meeting as a correct record.]
5 Matters arising [To consider any matters arising from the minutes of the previous meeting.]
6 Health and Wellbeing Together Forward Plan 2020 - 2021 (Pages 9 - 14) [To receive the Health and Wellbeing Together Forward Plan 2020 - 2021.]
GROWING WELL
ITEMS FOR DISCUSSION OR DECISION - PART 2
7 Local Outbreak Engagement Board Update [To receive a verbal update on the findings of the Local Outbreak Engagement Board.]
8 Progress Update – Wolverhampton Health Inequalities Strategy (Pages 15 - 20) [To receive and endorse the proposed approach for the delivery and development of a Health Inequalities Strategy for the City of Wolverhampton.]
9 Maximising Digital Opportunities for Health and Wellbeing in Wolverhampton (Pages 21 - 26) [To note the progress against delivering the Wolverhampton Digital Infrastructure Strategy.]
10 Healthwatch Wolverhampton Annual Report 2019-20 (Pages 27 - 80) [To note and comment on the Healthwatch Wolverhampton Annual Report 2019- 20.]
11 Other Urgent Business [To consider any items of business by reason of special circumstances (to be specified) that in the opinion of the Chair are matters of urgency.]
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Agenda Item No: 4
Health and Wellbeing Together Minutes - 21 October 2020
Attendance
Members of Health and Wellbeing Together
Councillor Jasbir Jaspal (Chair) Cabinet Member for Public Health and Wellbeing Craig Alford Third Sector Partnership Katherine Birch Faculty of Education, Health and Wellbeing Councillor Ian Brookfield Leader of the Council Tracy Cresswell Healthwatch Wolverhampton John Denley Director of Public Health Professor Steve Field CBE Royal Wolverhampton NHS Trust Inspector Helen Jackson West Midlands Police Lynsey Kelly Head of Community Safety Councillor Linda Leach Cabinet Member for Adults Professor David Loughton CBE Chief Executive - Royal Wolverhampton Hospital NHS Trust Judy McDonald Black Country Healthcare NHS Foundation Trust Councillor John C Reynolds Cabinet Member for Children and Young People Councillor Wendy Thompson Shadow Cabinet Member for Public Health and Wellbeing Paul Tulley Managing Director, Wolverhampton CCG Becky Wilkinson Head of Adult Improvement Andrew Wolverson Head of Service Children's Strategy and Partnership
In attendance Madeleine Freewood Development Manager Shelley Humphries Democratic Services Officer Councillor Philip Page Chair of Health and Scrutiny Panel Hannah Pawley Community Safety Manager Martin Stevens Scrutiny Officer Anthony Walker Homelessness Strategy and External Relationships Manager Dr. Kate Warren Consultant in Public Health
Part 1 – items open to the press and public
Item No. Title
1 Apologies for absence Apologies were received from Chief Superintendent Andy Beard, Marsha Foster, David Watts, Emma Bennett and Katrina Boffey.
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2 Notification of substitute members Inspector Helen Jackson attended for Chief Superintendent Andy Beard, Judy McDonald attended for Marsha Foster, Becky Wilkinson attended for David Watts and Andrew Wolverson attended for Emma Bennett.
3 Declarations of interest Professor Steve Field CBE declared a non-pecuniary interest in item 9 in his capacity as Trustee of the homelessness charity, Pathway.
4 Minutes of the previous meeting Resolved: That the minutes of the meeting of 8 July 2020 be approved as a correct record.
5 Matters arising There were no matters arising from the minutes of the previous meeting.
6 Health and Wellbeing Together Forward Plan 2020 - 2021 Madeleine Freewood, Development Manager presented the Health and Wellbeing Together Forward Plan 2020 – 2021 and outlined future agenda items. It was noted that the Local Outbreak Engagement Board item consisted of an overview up to the minute data to avoid a repetition of discussions from the last Local Outbreak Engagement Board meeting.
It was noted that the next meeting of the full board was scheduled for 13 January 2021 and that any requests for additional agenda items be forwarded directly to Madeleine Freewood, Development Manager or through Democratic Services.
Resolved: That the Health and Wellbeing Together Forward Plan be noted.
7 Outcomes from Joint Health and Wellbeing Strategy Review Development Workshop Madeleine Freewood, Development Manager presented the outcomes from the Joint Health and Wellbeing (JHWB) Strategy Review Development Workshop.
It had been agreed at the last meeting of Health and Wellbeing Together Executive Group on 2 September 2020 that a review of the Joint Health and Wellbeing Strategy would be undertaken to evaluate existing health priorities and identify new ones that had emerged as a result of the impact of COVID-19.
To this end, a Development Workshop had taken place shortly before the public meeting. Intelligence had shown that pre-existing health inequalities in particular had been exacerbated by the pandemic and a discussion had taken place to explore how to plan a response.
It had been agreed that focus would be maintained on addressing the Growing Well, Living Well and Ageing Well priorities for the remainder of the JHWB Strategy’s life. In light of the impact of COVID-19 on health inequalities, it had been proposed that a Health Inequalities Strategy be developedPage 4 to address this. A number of workstreams
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had been identified which would be underpinned by engagement, participation and co-production with across the system and with Wolverhampton residents.
Health and Wellbeing Together agreed that a Health Inequalities Strategy be developed along with an action plan for the City. It was agreed that multi-agency task and finish groups would be established to plan activity for these workstreams and a programme of engagement opportunities with citizens. The January 2021 agenda for Health and Wellbeing Together would be informed by this activity.
Resolved: 1. That a Health Inequalities Strategy and Action Plan for the City of Wolverhampton be developed and co-produced with residents and health partners. 2. That multi-agency task and finish groups be established to scope and agree activity required to progress workstreams. 3. That a programme of citizen engagement exercises be carried out. 4. That progress updates be received at the January 2021 meeting of Health and Wellbeing Together.
8 Local Outbreak Engagement Board Update Dr. Kate Warren, Consultant in Public Health delivered the Local Outbreak Engagement Board Update. A slide provided the current findings of the Local Outbreak Engagement Board as at the time of the Health and Wellbeing Together meeting and an overview of the information was provided.
It was reported that there had been a daily increase in cases since September 2020 of around 60 – 80 cases per day on average. The table displayed on the accompanying slide showed the relative position of Wolverhampton at 142 per 100,000 case rate and it was clarified that this statistic informed the level of infection and in turn the tier the area was placed in. At the time of the meeting, Wolverhampton remained in Tier 2 and was seventh in the region as at 20 October 2020.
It was reported that NHS activity had increased at New Cross Hospital although numbers of COVID patients were still at relatively low levels.
The map on the slide showed there was no particular area of focus and the density of the areas changed daily. In terms of ward areas, there were no outliers that were significantly higher and cases were increasing across the City in general.
It was worth noting that a classed ‘outbreak’ in a setting could be as few as two people passing the virus on in one setting. Settings still required support, such as education, work and healthcare settings however it was noted that much of the transmission was passed on in community settings.
Resolved: That the Local Outbreak Engagement Board Update be noted.
9 City of Wolverhampton Council – Homeless Services Provision Anthony Walker, Homelessness Strategy and External Relationships Manager delivered the presentation on the City of Wolverhampton – Homeless Services Provision. The presentation provided background and an evaluation on the Everyone In programme. Page 5
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Following the Central Government announcement of a requirement for local authorities to house all rough sleepers and individuals, City of Wolverhampton Council established emergency accommodation in a City Centre location within the Redwings hotel. Co-ordinated support was provided by Council and Wolverhampton Homes staff, treatment services, statutory partners and third sector organisations throughout the pandemic.
It was highlighted that 16 of the City’s most entrenched rough sleepers had been accommodated and 160 people had received accommodation and support, 27 of whom had no access to public funds.
The programme highlighted that night shelters and other forms of shared accommodation are no longer safe under COVID guidelines therefore a demand for self-contained accommodation has risen. Following the work undertaken during the pandemic, it was acknowledged that there was an opportunity to refocus homeless services in Wolverhampton to provide the best possible support and ensure resources are best placed. It was identified that there was a need for a service to accommodate vulnerable single people in Wolverhampton that would take the form of an Assessment Centre staffed by partners.
It was noted that the suspension of landlord action due to COVID-19 had resulted in a significant backlog of court cases involving rent arrears. There were concerns around the emotional and health impact of the outcomes of these cases on tenants. Andrew Wolverson, Head of Service Children's Strategy and Partnership noted that the service was aware and were looking to engage with landlords to contact them prior to falling into arrears. There had been a Rent with Confidence scheme in progress to engage with tenants as early as possible before problems arose although delays had been experienced due to COVID.
The Leader commended the work carried out by Redwings and partners across the City and commented on the difference the work had made to the new model for tackling rough sleeping going forward. It was acknowledged that, although there were individuals who did so by choice, no-one should be forced to sleep rough. It was noted that further plans were in development towards tackling the issue. Councillor Linda Leach pledged her support as Cabinet Member for Adults and Professor Steve Field CBE also offered support from the Royal Wolverhampton NHS Trust. As a trustee for the national homeless charity Pathway, Professor Field CBE had observed that early intervention was most effective to prevent rough sleepers needing hospital treatment.
Resolved: That the City of Wolverhampton Council – Homeless Services Provision be received.
10 City of Wolverhampton Winter Plan Councillor Linda Leach, Cabinet Member for Adults provided a brief introduction to the City of Wolverhampton Winter Plan outlining that the NHS produced an annual Winter Plan and all local authorities had been called upon following the emergence of COVID-19 to provide its own.
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Becky Wilkinson, Head of Adult Improvement presented the City of Wolverhampton Winter Plan report and highlighted key points. It was noted that the 2020 -2021 had been published by the Government on 25 September 2020 with three key principles:
ensuring everyone who needs care or support can get high-quality, timely and safe care throughout the autumn and winter period; protecting people who need care, support or safeguards, the social care workforce, and carers from infections including COVID-19; and making sure that people who need care, support or safeguards remain connected to essential services and their loved ones whilst protecting individuals from infections including COVID-19
It also set out 15 key actions for Local Authorities and NHS organisation with a further 10 set out for providers. The draft City of Wolverhampton Winter Plan provided an outline on how the Wolverhampton system planned to address the requirements set out in the 2020 -2021 Winter Plan and how each action was proceeding.
It was requested that members of Health and Wellbeing Together contact Becky Wilkinson, Head of Adult Improvement with any queries, suggestions and feedback on the Draft City of Wolverhampton Winter Plan.
Resolved: 1. That the draft City of Wolverhampton Winter Plan 2020 – 2021 be received. 2. That members of Health and Wellbeing Together provide feedback on the draft City of Wolverhampton Winter Plan 2020 -2021 by contacting Becky Wilkinson, Head of Adult Improvement. 3. That Health and Wellbeing Together note the partnership approach Wolverhampton had taken to the Winter Plan response.
11 Safer Wolverhampton Community Safety and Harm Reduction Strategy (2020- 2023) Hannah Pawley, Community Safety Manager presented the Safer Wolverhampton Community Safety and Harm Reduction Strategy 2020 – 2023 and highlighted salient points. It was outlined that the Safer Wolverhampton Partnership (SWP) acted as the local Police and Crime Board for Wolverhampton whose purpose was to develop and deliver strategic plans for Wolverhampton.
It was noted that the Community Safety Strategy document was reviewed every three years to ensure it remained relevant and fit for purpose; the previous strategy ended March 2020 therefore had been refreshed as the Safer Wolverhampton Community Safety and Harm Reduction Strategy (2020-2023).
The Strategy had been approved at Full Council on 16 September 2020 and Health and Wellbeing Together partners were asked to endorse the Strategy and collaborate with the SWP wherever possible to strengthen the City response to crime and harm reduction.
Resolved: 1. That Health and Wellbeing Together endorse the Safer Wolverhampton Partnership (SWP) Community Safety and Harm Reduction Strategy (2020-2023). Page 7
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2. That Health and Wellbeing Together collaborate with SWP where possible to strengthen the City response to crime and harm reduction.
12 Other Urgent Business There was no other urgent business.
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Agenda Item No: 6
Health and Wellbeing Together 13 January 2021
Report title Health and Wellbeing Together Forward Plan 2020 - 2021
Cabinet member with Councillor Jasbir Jaspal lead responsibility Public Health and Wellbeing Wards affected All wards Accountable director John Denley, Director of Public Health Originating service Governance Accountable employee Shelley Democratic Services Officer Humphries Tel 01902 554070 Email [email protected]
Recommendation for noting:
Health and Wellbeing Together is recommended to note:
1. The items on the Health and Wellbeing Together Forward Plan 2020 – 2021.
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1.0 Purpose
1.1 To present the Forward Plan to Health and Wellbeing Together for comment and discussion in order to jointly plan and prioritise future agenda items for the Executive Group and Full Board.
1.2 The Forward Plan will be a dynamic document and continually presented in order to support a key aim of the Health and Wellbeing Together Full Board and Executive Group – to promote integration and partnership working between the National Health Service (NHS), social care, public health and other commissioning organisations.
2.0 Background
2.1 As agreed at the meeting of the Full Board in October 2016, the attached Forward Plan document seeks to enable a fluid, rolling programme of item for partners to manage.
3.0 Financial implications
3.1 There are no direct financial implications arising from this report.
4.0 Legal implications
4.1 There are no direct legal implications arising from this report.
5.0 Equalities implications
5.1 None arising directly from this report.
6.0 Climate Change and Environmental implications
6.1 None arising directly from this report.
7.0 Human resources implications
7.1 None arising directly from this report.
8.0 Corporate Landlord implications
8.1 None arising directly from this report.
9.0 Health and Wellbeing implications
9.1 The health and wellbeing implications of each matter will be detailed in each individual report submitted to the Group.
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10.0 COVID - 19 Implications
10.1 The COVID - 19 implications of each matter will be detailed in each individual report submitted to the Group.
11.0 Schedule of background papers
11.1 Minutes of previous meetings of the Health and Wellbeing Together Full Board and Executive Group regarding the forward planning of agenda items.
11.2 Agenda Item Request Forms.
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Health and Wellbeing Together: Forward Plan Last updated: 9 December 2020
Health and Wellbeing Together is comprised of a Full Board and an Executive.
Full Board meetings are structured to shift focus from service silos to system outcomes by adopting a thematic approach to addressing the priorities identified in the Joint Health and Wellbeing Strategy. The primary focus of the Executive group is to sign off statutory documents and provide a strategic forum for the Council and health partners to drive health and social care
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KEY Items in red are new or amended from the previous version. Items in bold are regular or standing items. Thematic areas: Growing Well, Living Well, Ageing Well, System Leadership Joint Health and Wellbeing Strategy (JHWBS) priority areas: 1. Early Years 2. Children and young people’s mental wellbeing and resilience 3. Workforce 4. City Centre 5. Embedding prevention across the system
6. Integrated Care; Frailty and End of Life Appendix1 7. Dementia Friendly City
[E] Executive
[FB] Full Board meeting
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Date Theme JHWBS Title Partner Format Notes/Comments Priority Org/Author FB 13 System Leadership Progress Update Dr Kate Warren Report January – Wolverhampton (CWC) 2021 Health Inequalities Strategy System Leadership Maximising Digital Heather Clark Briefing Note Deferred from 8 April 2020 Opportunities for (CWC) Health and Wellbeing in Wolverhampton System Leadership Healthwatch Tracy Cresswell Report Annual Report
Page 13 Page Wolverhampton (Healthwatch Annual Report Wolverhampton) E 10 West Midlands Madeleine Standing Item February Combined Freewood 2021 Authority (WMCA) (CWC) Wellbeing Board Update NHS Paul Tulley Standing Item Reconfiguration (Wolverhampton Update CCG) FB 28 April System Leadership Public Health John Denley Annual Report 2021 Annual Report (CWC) To be *Better Care Fund Becky Wilkinson *Given the ongoing scheduled… Quarter 4 Report (CWC) pressures of Covid-19 on systems, there is no quarter four reporting requirement.
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Agenda Item No: 8
Health and Wellbeing Together 13 January 2021
Report title Progress Update – Wolverhampton Health Inequalities Strategy
Cabinet member with Councillor Jasbir Jaspal lead responsibility Public Health and Wellbeing Wards affected All wards Accountable director John Denley, Director of Public Health Originating service Public Health Accountable Kate Warren Public Health Consultant employees Tel 01902 551497 Email [email protected] Madeleine Freewood Stakeholder Engagement Manager Tel 01902 553528 Email [email protected]
Report has been Health and Wellbeing Together 09 December 2020 considered by Strategic Executive Board
Children and Families Together 10 December 2020 Board
Recommendation for action:
The Health and Wellbeing Together Board is recommended to:
1. Comment on and endorse the proposed approach and year 1 priorities for the delivery and development of a Health Inequalities Strategy for the City of Wolverhampton.
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1.0 Purpose
1.1 Health and Wellbeing Together agreed at its board meeting on 21 October 2020 that the future focus of the board (2021 to 2023) be the development and delivery of a City of Wolverhampton Health Inequalities Strategy. This will provide the framework for addressing the board’s ‘growing well’, ‘living well’ and ‘ageing well’ priorities and support the City-wide recovery response to Covid-19, with the aim of enabling the City and wider system to “Build Back Fairer.1”
1.2 The purpose of this paper is to provide a summary of activity undertaken to date following the October board meeting to gain partner feedback and approve direction of travel.
2.0 Background
2.1 Health Inequalities are systematic, unfair and preventable differences in health outcomes by deprivation, protected characteristics as covered by the Equalities Act, and inclusion groups.
2.2 Covid-19 is exacerbating existing health inequalities with negative impacts falling disproportionately on more deprived, disadvantaged and excluded groups and individuals.
2.3 In the short term, people experiencing deprivation are more likely to be exposed to Covid-19, for example, they are more likely to live in overcrowded accommodation, or work in jobs in sectors where they will be more exposed to the virus and less likely to be able to work from home. In addition, deprived communities are more likely to experience poorer health and people with existing poor health are at greater risk from Covid-19 once they contract it. For example, the Office of National Statistics reported that in England, the mortality rate from March to November for deaths due to Covid-19 in the most deprived areas was nearly three times higher than the least deprived, with 252.0 deaths per 100,000 people in the most deprived areas compared to 89.7 deaths per 100,000 in the least deprived areas.2
2.4 In the longer term the financial impact of Covid-19 on the wider economy in terms of an increase in unemployment has the potential to increase and entrench poverty and lead to additional healthcare demand, further compounded by lost hours of education, again more likely to impact on digitally excluded children and families, vulnerable children, those with special educational needs and disabilities and young carers.
2.5 Health & Wellbeing Together is the forum where key leaders from the health and care system come together to improve the health and wellbeing of the local community, work towards reducing health inequalities and support the development of improved and
1https://www.health.org.uk/publications/build-back-fairer-the-covid-19-marmot-review 2https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/deathsduetoc ovid19bylocalareaanddeprivation
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joined up health and social care services. As such it is particularly well placed to be the catalyst for the development and delivery of a strategy to address health inequalities in the City.
3.0 Approach
3.1 The local health and social care landscape is composed of multiple overlaid geographical footprints. An initial mapping exercise demonstrates the level of complexity in the system and need for clearly understood lines of responsibility in the development and delivery of a health inequalities strategy for Wolverhampton. For example, at Black Country and West Birmingham STP level a ‘Health Inequalities and Prevention Board’ has recently been established with a series of sub-boards.
3.2 The West Midlands Combined Authority also has an established Wellbeing Board and at the October 2020 meeting discussed the opportunity to develop a collective response to reducing health inequalities at a regional footprint as a means lever additional resource from Government. It identified four draft recommendations for further consultation: 1. Improving outcomes for ethnic minorities 2. People-powered health 3. Widening access to health and care 4. Tackling the wider determinants of health
3.3 At City footprint anchor institutions including the Royal Wolverhampton Trust, Local Authority and Clinical Commission Group (CCG) are all committed to addressing health inequalities and have different projects and programmes already engaged in this activity.
3.4 Given the above it is not the intention to create additional sub-groups, forums or parallel structures to take forward the development and delivery of a health inequalities strategy for the City, rather it is proposed that the Health and Wellbeing Together board act as ‘enabler’ and ‘connector’, ensuring system join-up, with the strategy providing an overarching framework and set of principles that facilitate and embed an agreed approach to tackling health inequalities for the citizens of Wolverhampton in a way that is tangible and outcome focussed.
3.5 To drive this forward it is proposed that an approach is adopted building on the work of the Integrated Care Alliance, so that the Wolverhampton Integrated Care Partnership (ICP) act as delivery vehicle to drive forward activity across partners that addresses our agreed health inequalities priorities under the domain of equitable access to health and care services, supported by joint commissioning arrangements between the CCG and City of Wolverhampton Council, including through use of the Better Care Fund.
3.6 In addition, the Children and Families Together Board (C&FTB), a multi-agency sub- board of Health and Wellbeing Together, has committed to playing a lead role in contributing to the development and delivery of the strategy in terms of children and young people.
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3.7 It is also proposed that implementation plans take account of the contribution that other local authority functions and other organisations – for instance housing providers – can make to improving health and wellbeing and tackling health inequalities via action to improve the wider determinants of health.
4.0 Priorities – Year 1
4.1 Following discussion with partners and incorporating feedback from the Health and Wellbeing Executive and Children and Families Together Board, three priorities have been identified for 2021:
4.2 In addition, Health and Wellbeing Together received an update on the impact of Covid-19 on the Black, Asian, Minority and Ethnic population of Wolverhampton in July 2020, at which time it was resolved that the evidence be kept under review and partner agencies provide updates on specific action taken in response including the findings of any equity audits or participatory research. It is proposed that this activity is incorporated into the above, in particular activity relating to the intelligence and engagement and co-production workstreams.
4.3 It is acknowledged that partner organisations are already engaged in activity to tackle health inequalities and have committed resource and capacity to doing so. Some additional capacity and resource from existing budgets may also be required to support the activity aligned to each of the above themes, however this is still to be determined.
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4.4 It is also acknowledged that further conversations need to take place with Health and Wellbeing Together partners including the West Midlands Police, West Midlands Fire Service, University of Wolverhampton and Healthwatch, if the above is endorsed by the board, to determine how best for them to contribute.
4.5 Finally, it is understood that while this work is a key part of the activity to respond to Covid-19 recovery in the City, partners are simultaneously still dealing with the front-line emergency response to this pandemic including testing, enforcement and vaccination roll-out.
5.0 Financial implications
5.1 The work highlighted within the report will be met from existing approved Council budgets. If for future worsktreams this was not to be the case, further reports would be received by the Council’s Cabinet to detail the funding arrangements. [JB/04012020/K]
6.0 Legal implications
6.1 Health Inequalities are systematic, unfair and preventable differences in health outcomes including protected characteristics as covered by the Equalities Act 2010. [TS/04012021/Q]
7.0 Equalities implications
7.1 The proposal to develop a health inequalities strategy for the City will take account of inclusion groups, the protected characteristics as covered by the of the Equalities Act 2010, as well as the impact of Covid-19 on the Black, Asian, Minority and Ethnic population of Wolverhampton.
8.0 Climate change and environmental implications
8.1 There are no direct climate change and environmental implications.
9.0 Human resources implications
9.1 There are no Human Resource implications.
10.0 Corporate Landlord implications
10.1 There are no Corporate Landlord implications.
11.0 Health and wellbeing implications
11.1 Health and Wellbeing Together has a statutory duty to produce a Joint Health and Wellbeing Strategy, which addresses key priorities for the population. The proposal to develop a health inequalities strategy for the City will further strengthen this.
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12.0 Schedule of background papers
12.1 Build Back Fairer: The COVID-19 Marmot Review https://www.health.org.uk/publications/build-back-fairer-the-covid-19-marmot-review
12.2 STP Healthier Futures Academy ‘Working Together for a Healthier Post COVID Future’: https://www.healthierfutures.co.uk/key-documents/publications/54-working-together-for- a-healthier-post-covid-future-v1-1-06-10-20/file
Page 20 Agenda Item No: 9
Title: Maximising Digital Opportunities for Health Date: 13 January 2021 and Wellbeing in Wolverhampton
Prepared by: Heather Clark Job Title: Strategic Projects & Funding Manager/Digital Co-ordinator
Intended Internal ☐ Partner organisation ☒ Public ☐ Confidential ☐ Audience:
Purpose or recommendation
Health and Wellbeing Together is recommended to note progress against delivering the Wolverhampton Digital Infrastructure Strategy and activities underway to support the health and wellbeing agenda utilising technology.
Overview
This briefing note provides an update on progress in supporting the rollout of futureproofed digital infrastructure from full fibre broadband to 5G and the role it can play in the delivery of services and wider benefits it can bring to residents and businesses.
Background and context
The City of Wolverhampton recognises the value of futureproofed digital infrastructure, including full fibre broadband and 5G, not just in delivering services during lockdown but enabling service delivery for the future, better meeting the needs of residents and resulting in efficiency savings. Wolverhampton’s Digital Infrastructure Strategy outlined the key steps to supporting the rollout of full fibre and wireless connectivity. The Strategy is being refreshed to capture wider opportunities around innovation, digital inclusion and skills, the digital economy and data.
Our proactive approach to supporting the rollout of futureproofed digital infrastructure, including maximising use of our assets and removing barriers by simplifying processes and agreements, is proving successful.
The City secured funding for a local full fibre network connecting public sector premises across the city, including Council and Wolverhampton Homes offices and schools, although the health system were unable to participate in the procurement at the time. The wider commercial rollout of full fibre broadband has begun bringing gigabit connectivity to other public sector premises, residents and businesses across the city.
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All four Mobile Network Operators (MNOs) have announced the rollout of 5G in the city in 2020. Two MNOs already have live 5G connectivity across the city. Our proactive approach has accelerated the rollout by at least 6 months.
A Digital Wolverhampton Partnership Board has been set up, initially including the Council, Royal Wolverhampton NHS Trust, University of Wolverhampton and Voluntary Community Sector to provide strategic leadership for digital across the city and oversee revision of the Digital Wolverhampton Strategy.
Maximising digital opportunities for Health and Wellbeing in Wolverhampton
The current COVID-19 crisis has highlighted the importance of digital connectivity during lock down ranging from working from home, virtual GP appointments to reducing isolation through maintaining contact with friends and families. In extreme cases, digital connectivity offered people the only chance to say goodbye to loved ones.
Health and reducing isolation is a key driver of digital with digital technology having the potential to play a role in increasing an individual’s independence by enabling them to stay at home for longer and access health services. The ability to access health advice online has been crucial during lockdown with a 41% reduction in GP appointments with appointments moving from face-to-face to virtual.
However for some, the lack of digital connectivity has compounded exclusion resulting in isolation, increased stress and impacting negatively on mental health. In Wolverhampton, prior to lockdown an estimated 35,000 residents have not been online in the last three months (Digital Exclusion Dashboard), however this issue increased during lockdown due to lack of devices, connectivity, confidence or basic skills. Although age is the biggest barrier, 44% of those that have not been online are under 60 impacting particularly on disadvantaged and vulnerable people.
Work is underway to develop an approach to getting Wolverhampton a 100% digitally included city. This includes exploring further opportunities around the role that technology can play in reducing isolation and supporting resident’s health and wellbeing. The Council are currently running a pilot device and connectivity lending scheme Wolves Online through a number of trusted partners including Wolverhampton Voluntary Sector Council’s Social Prescribing service, vulnerable adults and carers team with ambitions to scale up the scheme to reach more residents and involve more trusted partners.
This builds on Support to Connect http://supporttoconnect.net/, part of social prescribing service, a 6-month pilot around getting online to support health and reducing isolation. Wolverhampton Voluntary Sector Council’s Social Prescribing Service supports people who are lonely and isolated, with low level mental health issues like anxiety and depression and/or long-term life restricting health conditions. Pre COVID-19 the focus was on supporting people to physically engage with their communities, through groups and activities, known as “social prescriptions”. However, the focus has shifted to keeping in touch with customers, linking them together, or with befrienders or other remote support, helping them maintain their wellbeing and offering some practical support. Its aim is to respond to current need by working with people referred, initially on a remote basis; in order to help them make the best use of the technology, including computers, tablets, iPad and telephones, to keep in touch with others.
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Discussions are underway with Adult Social Care to get vulnerable people online including utilising personal budgets to purchase devices and exploring links with telecare to enable connectivity. Vulnerable adults are included in the Wolves Online device and connectivity lending scheme. Digital technology offers huge potential to transform health and social care. The pace at which this field is advancing creates many opportunities, including greater choice on how to access services and the management of both acute and chronic conditions with a focus on personalised care. In 2021, a revised vision for assisted technology will be developed in the Housing Assistance Policy, which informs the allocation of the Disabled Facilities Grant including grants for Technology Enabled Care to facilitate disabled people to remain living at home where a bespoke package is needed over and above existing assistive technology provision.
The Sustainable Transformation Partnership (STP), bringing together Black Country Councils, CCGs, Hospital Trusts and Voluntary Community Sector, developed a Digital strategy focusing on increased use of technology in health and social care including the development of an Integrated Care System. Its remit has expanded to consider the wider digital divide and solutions. The STP Digital vision was focused on the following digital themes:
1. Empowerment: Through the use of technology patient and citizens can access and contribute to their health and care in both interactions and transactions such as online booking, virtual appointments, accessing records; 2. Infrastructure: A resilient infrastructure across the BCWB health and social care economy enabling access to required information to support decisions from anywhere supporting place-based working; 3. Integration: With the enabling economy wide infrastructure, system standards and principles are a fundamental requirement for the interlinking of systems. Standards adopted nationally with the appropriate information governance framework and agreements eliminate organisational and regional boundaries to wider digital interoperability; 4. Intelligence: Development of robust business intelligence across the BCWB to support decision making and identification of best practice models leading to improved patient care. Through COVID, a lot of the strategy has been delivered such as online and telephone triage, direct booking from 111, video conferencing for primary care and outpatients in secondary care. Therefore, it is proposed to refresh the strategy and stretch the ambition by establishing a digital innovation group reviewing what is available and testing to see whether they can implement new initiatives including the use of 5G to support these.
5G is mobile internet as fast as fibre with speeds up to 1GB, five-ten times faster than current home broadband connectivity currently. 5G benefits include huge capacity with the ability to connect thousands of users and devices at the same time at consistently ultrafast speeds and ultra-reliable, secure and low latency which will be transformational for industry. 5G offers huge potential to improve quality of life and the delivery of services as outlined in https://www.wm5g.org.uk/news/why-5g-will-prove-fundamental-to-improving-healthcare/.
Prior to lockdown, a 5G task and finish group of the HWT was established to explore potential use cases for 5G in the following areas:
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System flow – how do we stop people going into A&E. Real time tele tracking across whole system flow – primary, secondary, community Care and nursing homes – early warning systems – baseline diagnostics so if parameters outside the norm, monitored by central team who pick up early signs and alert care home. Smart beds currently measure heart, oxygen etc but no connection to clinicians therefore scope to work with company to enhance. Social isolation and older people impacting on health/ emergency admissions - inactivity monitoring. Keeping people active – live streaming exercises including 5G armchair aerobics, falls clinic, WV Active, older people in their own homes Screening is low in the city – how could we improve this
The work of the group was put on hold during the Pandemic, however a number of a number of initiatives have been bought forward both sub-regionally and via WM5G. The newly established Digital Wolverhampton Partnership aims to develop 5G plan for the City including potential use cases.
The West Midlands successfully bid for the Urban Connected Communities 5G programme to facilitate the rollout of 5G and exploring potential use cases to demonstrate the benefits of 5G in both industry and public service delivery. WM5G are exploring three use cases:
5G Care Home Project: connectivity GP’s and care homes to offer both video consultation, diagnostic tools and capturing vital sign information to allow for early identification of issues such as strokes. Demonstrate that 5G fundamentally enhances patient care in care homes while delivering significant financial benefits to the healthcare system and economic opportunities for technology providers. Ensure the mechanisms are in place for rapid regional scaling and national opportunity. This is currently being piloted between a GP and care home in Bilston. Capsule endoscopy to identify bowel cancer allowing patients to swallow a camera in a capsule in their own home as an alternative to endoscopy. The use case uses 5G- enabled patient self-administration to community-based managed service delivery of capsule endoscopy putting the West Midlands at the forefront of post-COVID endoscopy services. Royal Wolverhampton NHS Trust are a partner on this scheme. Connected Ambulance: Engage with the ‘Living Lab’ bid being submitted to 5G Create. Work with West Midlands Ambulance Service to reduce avoidable conveyance and improve quality of care. Contribute to the pathway innovation agendas in conjunction with regional Acute Trusts
Wolverhampton is hosting one of three Application Accelerators 5pring which aims to help organisations of all sizes harness the power of 5G to deliver growth and innovation throughout the West Midlands and beyond. The Accelerator will offer cutting-edge facilities and expertise can help public and private companies to understand 5G, its applications and support to unlock its potential. Engage: Build a core understanding of 5G and how it can benefit businesses and customers, looking at its possible use cases, its benefits vs other network technologies, and what applicable features are available (and when), as well as actionable next steps for organisations.
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Explore: Learn more about how 5G can address specific challenges by helping to understand the different roles 5G can play and providing support to build a business case and technical plan for organisations that want to adopt or supply 5G enabled products and services. Exploit: Develop innovative and ambitious 5G solutions in real (or close to real) environments providing expert technical and business support to deliver use cases, proof of concept and prototypes to help you develop new products and services that utilise 5G.
Citizen Wellbeing is one of the industrial vertical focus including supporting connected healthcare via remote real-time patient monitoring, using AI for diagnoses and innovative treatment including AR, VR and spatial computing. 5pring are inviting public sector organisations to indicate problems they would like to be solved.
This adds value to the University of Wolverhampton’s ambitious plans around a Centre of Excellence for Digital Innovation for Smart Cities (DISC). The University has submitted research and development proposal aimed at providing digital equality in society to accelerate digital economy. They are looking to pilot digital equality for our future digital society in social-care sectors (care providers and receivers, elderly and non-elderly).
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This report is PUBLIC [NOT PROTECTIVELY MARKED]
Agenda Item No: 10
Health and Wellbeing Together 13 January 2021
Report title: Healthwatch Wolverhampton Annual Report 2019-20
Report of: Tracy Cresswell Manager Healthwatch Wolverhampton
Portfolio: Public Health and Wellbeing
______
Recommendation for action:
Health and Wellbeing Together is recommended to note:
The attached Healthwatch Wolverhampton Annual Report 2019 - 20 for information (Appendix 1).
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This report is PUBLIC [NOT PROTECTIVELY MARKED]
1.0 Purpose
1.1 Health and Wellbeing Together is asked to review the Healthwatch Wolverhampton Annual report to review the progress made against the statutory functions, to comment on the impact of the delivery of Healthwatch services in Wolverhampton.
2.0 Background
2.1 Healthwatch Wolverhampton is the consumer champion for Health and Social Care, established as part of the Health and Social Care Act 2012. It is a requirement of local Healthwatch to produce an annual report of its work programme, detailing the projects undertaken, including findings, and recommendations, and the impact of such reports on the delivery of services. The Healthwatch Annual Report must be submitted to Healthwatch England by 30 June each year. Statutory functions of local Healthwatch also include the power to Enter and View NHS and Social Care services and to review the service levels provided, and to deliver Information and Signposting services. In Wolverhampton, Healthwatch also delivery the statutory advocacy service for NHS complaints and details of progress made in this service area is also included within the Annual Report
3.0 Decision/Supporting Information (including options)
3.1 The annual report references to a number of reports which Healthwatch completed during 2019/2020, namely, Isolation and Loneliness, Maternity Services, Cervical Screening, NHS Long Term Plan and completed 22 Enter and View visits. These reports can be found on our website www.healthwatchwolverhampton.co.uk .
4.0 Implications
4.1 There are no known implications in relation to this report.
5.0 Schedule of background papers
5.1 The background papers relating to this report can be inspected by contacting the report writer:
Tracy Cresswell Healthwatch Manager
Healthwatch Wolverhampton Freephone: 0800 470 1944
www.healthwatchwolverhampton.co.uk
Page 28 Appendix 1
Annual report 2019-20 Guided by you
Page 29 Guided by you | Healthwatch Wolverhampton 2
Healthwatch Wolverhampton W: www.healthwatchwolverhampton.co.uk Regent House T: 0800 470 1944 Bath Avenue Wolverhampton E: [email protected] WV1 4EG F: HWwolverhampton T: hwwolverhampton Page 30I: hwwolverhampton Guided by you | Healthwatch Wolverhampton 3 Contents
Guided by you 4 Message from our chair 5 About us 6 Meet the team 8 Our Priorities 9 Highlights from our year 10 How we’ve made a difference 13 Long Term Plan 30 Helping you find the answers 33 Complaints and Advocacy 37 Our volunteers 40 Our finances 46 Our plans for next year 48 Thank you 50 Glossary 51 Contact us 52
Page 31 Guided by you | Healthwatch Wolverhampton 4 Guided by you
Healthwatch Wolverhampton is the independent patient champion created to gather and represent views of the public. Healthwatch plays a role at both a national and local level to make sure the views of the public and people who use health and social care services are taken into account. We listen to views, concerns and suggestions about health and social care services and use the information to help shape and improve them. We engage at a strategic level with commissioners and providers to improve the quality of local services using patient experience. Healthwatch Wolverhampton is one part of a 152 part Healthwatch network across England. We were created in response to the Health and Social Care Act 2012 and are funded by the Department of Health through City of Wolverhampton Council. We are the independent consumer champion for health and social care services. We’re here to find out what matters most to the people and communities that use these services.
Page 32 Guided by you | Healthwatch Wolverhampton 5 Message from our Interim Chair
This annual report sets out the work that we have undertaken during 2019/20. It explores some of our key successes and how we have made a difference based on what people have told us about their experiences of health and social care services.
Our work has been recognised both nationally and locally, having received the Highly Commended award from Healthwatch England for our work with the Deaf community and the Employer of the Year award from Juniper Training for our work providing student placements and recognising the support we have given to their students.
We have undertaken 22 Enter and View visits, our statutory power to observe service delivery and engage with the people both receiving and delivering the services. Our reports have highlighted some of the great work taking place across Wolverhampton and we have made recommendations to Robin Morrison, Interim chair providers where needed. of Healthwatch Wolverhampton
I want to pay tribute to all our volunteers who have worked hard to support all our areas of work from Enter and View to supporting us on the Healthwatch Advisory Board (HAB), helping us to gather the views of the public and make a difference.
In February this year we said farewell to the Chair of our HAB, Sheila Gill. We would like to thank Sheila for her dedication to Healthwatch during her time with us and we wish her every success.
We have had to adapt to challenging times with the arrival of Coronavirus. We have stepped up to the challenge ensuring that our website and social media platforms have been updated on a daily basis with information from the Government, Public Health England and what is happening locally. We wanted to let the public know that Healthwatch is still working and how they could contact us.
Our condolences go out to everyone who has been affected by Coronavirus and we want to thank the NHS and social care staff including carers, residential homes staff and domiciliary care staff for the work they have been doing in tackling the virus and saving lives under very difficult circumstances.
I also want to thank the staff team for their hard work during the year, gathering service user feedback and supporting people in a rangePageof ways 33and for adapting to the challenges of Coronavirus. Guided by you | Healthwatch Wolverhampton 6 About us
Here to make care better The network’s collaborative effort around the NHS Long Term Plan shows the power of the Healthwatch network in giving people that find it hardest to be heard a chance to speak up. The #WhatWouldYouDo campaign saw national movement, engaging with people all over the country to see how the Long Term Plan should be implemented locally. Thanks to the thousands of views shared with Healthwatch we were also able to highlight the issue of patient transport not being included in the NHS Long Term Plan review – sparking a national review of patient transport from NHS England.
We simply could not do this without the dedicated work and efforts from our staff and volunteers and, of course, we couldn’t have done it without you. Whether it’s working with your local Healthwatch to raise awareness of local issues, or sharing your views and experiences, I’d like to thank you all. It’s important that services continue to listen, so please do keep talking to your local Healthwatch. Let’s strive to make the NHS and social care services the best that they can be.
I’ve now been Chair of Healthwatch England for over a year and I’m extremely proud to see it go from strength to strength, highlighting the importance of listening to people’s views to decision makers at a national and local level.
Sir Robert Francis, Healthwatch England Chair
Page 34 Guided by you | Healthwatch Wolverhampton 7
Our local vision is simple Health and care that works for you. People need health and social care support that works – helping them to stay well, manage any conditions they face and to get the best possible care from services.
Our local purpose To find out what matters to you and to help make sure your views shape the support you, your families and communities need. Our main job is to raise people’s concerns with health and social care decision makers so that they can improve support across the country. The evidence we gather also helps us recommend how policy and practice can change for the better.
Our local approach People’s views come first – especially those who find it hardest to be heard. We champion what matters to you and work with others to find solutions. We are independent and committed to making the biggest difference to you.
How we find out what matters to you We play an important role in bringing communities and services together across Wolverhampton Everything we do is shaped by what people tell us. Our staff and volunteers identify what matters most to people by: - Visiting services to see how they work - Running surveys and focus groups - Going out in the community and working with other organisations.
Wolverhampton Health Advocacy Complaints Service (WHACS) Healthwatch encourages partnership working and continues to enjoy being co-located with the Wolverhampton Health Advocacy Complaints Service (WHACS), with an advocate working from the Healthwatch offices. The advocacy service is a separate service which receives independent funding to that received by Healthwatch but we co-locate as we see the real synergies between the two contracts, with Healthwatch gaining valuable insight from the themes and trends coming through from the advocacy cases.
Find out more about us and the work we do Website: www.healthwatchwolverhampton.co.uk Twitter: @hwwolverhampton Facebook: @hwwolverhampton Instagram: @hwwolverhampton
Page 35 Guided by you | Healthwatch Wolverhampton 8 Meet the team
Tracy Cresswell Healthwatch Manager
Emily Lovell Ashley Lovell Rasham Gill Engagement and Engagement and Community Information Lead Information Lead Outreach Lead
Judith Stroud Andy Davies Complaints Advocate Information and Signposting Officer Started November 2019 Page 36 Guided by you | Healthwatch Wolverhampton 9 Our priorities
Last year people told us about the improvements they would like to see made to health and social care services in 2019-20. These were our four priorities for the year based on what you told us.
Isolation and Loneliness Maternity Following from phase one in Following from the Isolation and 2018/19, we wanted to understand Loneliness project in 2018/19 with the experiences of older people in new mothers, we wanted to relation to social isolation and consider the experiences of new loneliness, how this is managed and parents around their care after the what support could be offered to birth of their baby, including at the help old people overcome loneliness. hospital and within the community.
Cervical Cancer Mortality With low levels of cervical screening Due to Coronavirus and the attendance in the City, the focus of sensitive nature of this project, this the project was to understand why priority has been deferred over to women do not respond to screening 2020/2021. invitations and what can be done to improve attendance.
More information on these priorities can be found under the “How we’ve made a difference” section of this report. Page 37 Guided by you | Healthwatch Wolverhampton 10 Highlights from our year
Find out about our resources and the way we have engaged and supported more people in 2019-20.
Annual Public Meeting, July 2019, LowPage Hill Community 38 Centre Guided by you | Healthwatch Wolverhampton 11
Health and care that works for you 27 volunteers helping to carry out our work. In total, they gave up an estimated 450 hours of their time. 18 students Carried out work experience with Healthwatch Wolverhampton, giving up to 750 hours of their time.
Providing support 138 community events were attended by Healthwatch staff, volunteers and work experience students. 3,139 people were engaged with by Healthwatch Wolverhampton at community events. 646 patient experiences were shared with Healthwatch Wolverhampton to help improve health and social care services in Wolverhampton.
Reaching out 8,814 people Contacted us on our freephone number, leading to 140 information and signposting enquiries. 604,612 accounts were reached through our social media; Twitter, Facebook and Instagram.
Making a difference to care We published 24 reports about the improvements people would like to see with their health and social care, and from this, we made 192Page recommendations 39 for improvement. Guided by you | Healthwatch Wolverhampton 12 2019-20 Timeline
April 2019 October 2019 Highlights included our Highlights included Spotlight on care receiving Highly assessments event. 741 Commended in the people were engaged Championing Diversity with in the community and Inclusion and online. Healthwatch England awards. May 2019 November 2019 Highlights included Highlights included Mental Health week. holding a pop-up This month we engaged shop, where we with 432 people in the engaged with over community and online. 500 across the week. June 2019 December 2019 Highlights included Highlights included volunteers' week, PPG hosting a Samaritans week and receiving our fundraiser and a employer award from Volunteer afternoon Juniper Training. tea in the Mayor's Parlour. July 2019 January 2020 Highlights included our Highlights included Annual Public Meeting. attending This month we Wolverhampton engaged with 391 College’s Health Fayre. people in the community and online. February 2020 Highlights included August 2019 delivering a Highlights included presentation at the General Practice Deaf Studies Nurse (GPN) focus Conference on our groups and drop ins work with the Deaf at different health and community. social care settings. March 2020 September 2019 Highlights included Highlights included hosting a Time For a Carvers marathon, Cuppa Event for our college freshers and Volunteers and sexual health week. beginning our response to Covid-19. Page 40 Guided by you | Healthwatch Wolverhampton 13 How we’ve made a difference
Find out how we have made a difference to health and social care services in 2019/20.
General Practice Nurses Focus Group, Zebra Coffee Morning for D/deaf communities, Lighthouse Cinema, August 2019 Page 41 Guided by you | Healthwatch Wolverhampton 14 Community Outreach Community outreach plays an important role in collecting patient experiences for Healthwatch Wolverhampton. Our Community Outreach Lead carries out drop-ins across health and social care settings as well as attending events across the community to gather the views of people who use services in Wolverhampton. Listed below are just a few examples of where we have been over the last year:
- Newcross Care Home - Asian Ladies Group Prem Vadhaou - WV Active Aldersley and Central - Grove Medical Centre - P3 Café - St Joseph’s Church, Places of Welcome - New Cross Hospital, drop ins across various departments - Diabetes UK, Molineux Stadium - City of Wolverhampton College - Continence Team, Lower Green Health Centre - Tea and Chat, Central Library - Baitta Atta Mosque, Places of Welcome - Cannock Road Medical Practice - Aldergrove Manor Care Home
Helping homeless people unable to register with a GP. Healthwatch access health and social care contacted the Clinical Commissioning Group (CCG) who wrote out to GPs to remind services. them to take homeless patients and also provided a leaflet for us to share with the In January 2020, the Healthwatch team patient to help them register with a GP. undertook a training session of how to Unfortunately, the patient still experienced better engage with hidden groups and to difficulty finding a GP to register with so we support the relationships that we have with got back in touch with the CCG who the groups that support the seldom heard. signposted us to a GP that would take the We have been actively engaging with P3, a patient. charity aiming to improve lives and services for people who are homeless, we carried The patient was able to register with this GP out drop ins at their P3 Café, speaking to and rang to thank Healthwatch, they the community and assisting them to access explained that they were experiencing health and social care services. further problems with finding a hostel, so we signposted them to the Local Authority Following this, a service user with no fixed who would be able to provide further abode got in contact with us as they were support. Page 42 Guided by you | Healthwatch Wolverhampton 15
Pop up shop: Healthwatch week at the Wulfrun
In November 2019, we held a pop up shop in the Wulfrun Shopping Centre for a week where we engaged with over 500 people and were supported by 22 providers. Each day was themed to link in with a different health awareness days, posters were displayed to promote this.
The event started with a day of general health and social care topics. We were supported by various providers including; Breast Cancer Support Group, Flu Campaign team, Alzheimer's Society, Carer Support team, Antibiotics Awareness, Compton Care, Personalised Care, Special Educational Needs and Disabilities team and End of Life Care. There was also a CPR training session with St John’s Ambulance. The week also had another theme, National Alcohol Awareness Week. Therefore, we decided to focus Tuesday on alcohol and substance misuse and were supported by; Personalised Care, Recovery near you, Refugee Migrant Centre and Carer Support team.
Wednesday’s focus was cancer due to it being; mouth cancer, lung cancer and pancreatic cancer month. Healthwatch were supported by Macmillan, the Cancer Research and the Breast Cancer Support Group, the Patient Advisory Cancer Team (PACT), Carer Support, the Wolverhampton Clinical Commissioning Group and Personalised Care.
Thursday was world diabetes day so we focused on diabetes and healthy lifestyles. This day we were supported by; WV Active, P3, Carer Support and the TB Nurses Team.
On Friday we chose to focus on men’s health due to it being ‘Movember’, this is the much publicised month that sets out to raise awareness of prostate cancer, testicular cancer, mental health and suicide prevention. We were supported by Macmillan, Cancer Research and the Breast Cancer Support Group who all focussed their support and information to men, as well as the Carer Support team and Head4Health.
The event ended with the start of National HIV testing week, so we were supported by Embrace, the Sexual Health Service in Wolverhampton who were carrying out STD tests and supplying free contraceptives and advice. There was also a CPR training session with St John’s Ambulance.
This event was also supported heavily by our dedicated group of volunteers, who actively engaged with members of the public and other service providers.
Page 43 Guided by you | Healthwatch Wolverhampton 16 What People Have Told Us Over the past 12 months we have collected over 640 patient experiences; feedback from the people using health and social care services in Wolverhampton.
This feedback helps to make positive changes and improvements to the health and social care services in Wolverhampton. By Healthwatch actively engaging with commissioners and managers of services, playing a role in strategic meetings and carrying out Enter and View visits we are able to ensure that patient voice is heard and represented. Feedback is also used to shape our work plan and priorities, so we can ensure a larger change and impact for those communities. We are also able to signpost and refer service users to complaints and advocacy services, to ensure they are getting the answers they want from the people who deliver their care.
The graph below shows the themes of patient experiences we have received across 2019/20.
Other includes: Pharmacy, Other 11% Ambulance, NHS 111, Emergency Care and Opticians. GPs 46%
Hospitals 29%
Social care includes; Care Community Based Homes, Social Care Services 8% Social Care 6% and Domiciliary Care.
Collecting patient experiences health and social care services. Some of in our community. these experiences have been signposted to Wolverhampton Health and Advocacy Our community outreach lead regularly Services (WHACS). By working with WHACS attends Tea and Chat meetings at the and the Community Support Team we have Central Library. During these meetings we been able to help people get the answers have worked with the Community Support they needed as well as enabling them to Team to listen to people and their stories of get the right support and care. Page 44 Guided by you | Healthwatch Wolverhampton 17
We were shortlisted for the “Championing Continuing our work with the Inclusion and Diversity” award for the work D/deaf community we have carried out with this community, the awards were presented at the We have continued to work with Healthwatch England Annual Conference on Zebra Access, commissioners and 1 October 2019 and we received ‘Highly Commended’; a huge acknowledgement for providers to engage with the Healthwatch Wolverhampton. community around various health issues. As this piece of work started back in 2018 with Wolverhampton University looking at “The Deaf community especially feel that they the issues that the D/deaf community were are now truly included within experiencing, it was a pleasure to be invited the consultations that they have had at the to present at a deaf conference held by the coffee morning. The Deaf community University around the issues that we had historically do not get involved with found but also the health studies found community consultations, so it has been across the country, they were very amazing to see such development and similar. We presented on the work that we passion from both the community and had being doing with the community and Healthwatch.” how they felt more engaged. Sean Noone, Zebra Access “We were delighted that Healthwatch was a As part of the work carried out, a lot of part of this conference and it was a great emphasis has been on BSL users, however pleasure to work with you and have the we have presented the findings to BCHA opportunity to present the highly successful (Bone Conduction Hearing Aid) and to the journey and outcome of this research audiology staff at West Park. Both meetings initiative. Thank you for working so closely were well received, and they were all given a with us on this.” communication card to support them when speaking to professional staff. Whilst we were in the pop-up shop in the Wulfrun Centre a patient came to let us know that they had just used the card in a shop and the assistant was not looking at them so they showed them the card which asked them to look at them so they could lip read, which they did.
Tracy speaking at the Deaf studies conference at the University of Wolverhampton
Tracy, Healthwatch Manager and Liz, ECS Managing Director, collecting the award Page 45 Guided by you | Healthwatch Wolverhampton 18
Spotlight Meetings Spotlight meetings allow Healthwatch to focus on a topic of concern raised by patients. They give opportunity for members of the public to listen to and question changes providers and commissioners are making to services. Spotlight on… Care Assessments In April 2019, we held a spotlight on care assessments. 16 people were in attendance, from general public to professionals to hear about changes being made to social care assessments across the City. David Watts, Director of Adult Social Care and Louise Haughton, Principal Social Worker delivered a presentation, addressing the why, what and how. Below are examples of the questions raised at the Question and Answer session.
Why? Based on feedback of service users, carers, employees and consulting with other Local Authorities, it was identified that the current system was not working. It was time consuming, focused on deficits, lowered staff morale and was bureaucratic. Below are examples of questions that was raised by the public during the Question and Answer Session What? Moving away from tick box assessments encourages “good conversations”. Less paperwork allows for more face to face time with service users to find out what is important and develop solutions that are personal. Language would become more empowering and less negative. Having the first person you have a conversation with support and work with you, and bring the right people in to help if they need to.
How? This was piloted in the East of the City and with mental health over a 13 week period, this was evaluated to identify the impact of this change in working. Impact was positive, more time for workers to spend with service users, family, carers etc. Waiting lists were also cleared with nobody waiting longer than three weeks for assessment so people are no longer at the end of their tether. Feedback from service users was positive, they are seen quicker and do not have to be handed over numerous times, so they are not retelling their story. Question and Answer session Q: How do you challenge an assessment? A: Audit of case files are carried out on a regular basis, service users are contacted, we carry out quality assurance. The City Council carry out two surveys a year, one for the service user and one for the carer. Q: How are the general public aware of these changes taking place around care assessments? A: We are trying to encourage staff to be more proactive. Q: How are you working with care homes around these changes? David Watts speaking at the A: Some of the care homes are engaging with the Council Spotlight on Care Assessments especiallyPagearound 46 the SPACE project and other forums. Guided by you | Healthwatch Wolverhampton 19
Spotlight on Prescriptions We received a number of concerns around prescriptions, where patients' medication was either being removed or changed without patients being involved or informed. Healthwatch arranged to meet with the Medicine Optimisation team from the CCG to understand why this was the case. This meeting identified that the patient voice was not represented at the Area Prescribing Committee (APC) and it was agreed that Healthwatch would be invited to be part of the Committee as the patient voice.
We also chose to hold a Spotlight Event on prescriptions to give the public an opportunity to understand the changes to prescriptions and to ask the speakers questions. A presentation was delivered by the CCG.
We held the meeting in the South East of the City in February, there were 10 people in attendance including public, staff and professionals.
Discussions took place around the effect of Brexit and that medication was being held centrally and the CCG’s have been told to order as normal.
A discussion took place around stock shortages, the National Pharmacy Association have shared a leaflet with all Pharmacists regarding the stock shortages. The CCG explained that the CCG drugs budget is £45 million, and this covers all prescriptions, hospital medications and injections. Nationally they have been given lists of medication that should not be prescribed but can be bought over the counter such as paracetamol.
There was another discussion which took place around why medication has been changed, the CCG explained that this should take place with the patient and they hoped that the practice would do this.
Question and Answer session Q: If the hospital or your consultant puts you on medication, can a GP change it? A: When a GP writes and signs a prescription they are legally responsible for it. It depends on how well they know that area and if they feel comfortable with that.
Q: Who monitors the copy drugs? The manufacturers name is completely different but the active ingredient is the same but mix is not. A: The Medicine Health Regulatory Authority give a licence and ensure it is of a certain quality.
Q: A cream was taken off a prescription without letting patient know. A: The practice will have a process in place, you would hope they would inform the patient.
Page 47 Guided by you | Healthwatch Wolverhampton 20 Healthwatch Priorities
Isolation and Loneliness Phase Access to transport - This was a particular 1 and 2 issue for new mums especially accessing groups across the City.
We engaged with over 55’s who Family - A lack of family support was viewed were housebound and new mums to as a reason why people became isolated. gain an understanding how they Lack of confidence - This was identified as were affected by isolation and one of the reasons why people become loneliness. We engaged with new isolated and lonely as they are less likely to mums via focus groups and the over participate in activities etc. 55’s via surveys with support from Recommendations included: care agencies and District Nurses. - An increase of information, professionals Below are the themes that came from that people engage with should be properly both cohorts. equipped with information on statutory and voluntary provision. Importance of Groups - There has been a reduction in the groups that are available to - Groups were seen to be important and that new mums and the older people, which has numbers had reduced; it was resulted with this cohort being more isolated. recommended that mapping exercises take place to identify the need for greater Access to information - This has been provision. identified as a barrier to the groups that participated in our project. - It was recommended that a range of befriending services be provided that are Mobility - For the elderly and the people able to deliver face to face befriending and confined to their own home, mobility was a telephone befriending services. barrier to them, and they have become more isolated The full report can be accessed on our Cost - Due to the lack of disposable income website: for some of the cohorts, this had reduced to www.healthwatchwolverhampton.co.uk them not being able to socialise with friends.
The Coronavirus pandemic has emphasised the gap of support for isolation and loneliness for the people in Wolverhampton.
“This report highlights the damaging effects loneliness and isolation can have on our mental and physical wellbeing at any stage of life. As we emerge from the grips of the coronavirus pandemic, promoting inclusion and social connectivity will play a key role in recovery planning across our strategic partnerships to ensure people in the City of Wolverhampton experience longer, healthier lives.” Ankush Mittal, Public Health Page 48 Guided by you | Healthwatch Wolverhampton 21
Healthwatch Priority: Maternity Recommendations included: Services - Support for and communication for new fathers so they are able to provide support We carried out this project by focus to their families. groups and surveys, to understand how both mums and dads were - Consideration of how first-time-parents can be provided with more or better information engaged / supported after the birth and guidance on basic care to increase of their child. confidence on returning home.
Overall the response was positive - Consideration to be given on how feeding during the birth, however the advice can be personalised according to the preferences expressed by the mother. support after birth was mixed. - Consideration to be given on how to provide Below are areas identified: information in advance around what contact new parents might expect from their Support for and communications with partners community midwife and health visitor – new fathers were lacking the support and following the birth of their baby. advice that they need to support their partners and new babies.
Information on baby care – some commented The report was shared at Health Scrutiny they lacked information and advice especially in February and the Hospital took note of around feeding and bathing. the recommendations, they shared that a lot of work had already been carried out. Feeding support – this was mixed as the support they had received in the hospital was not as effective as the support they had received in the community. The full report can be found on our website: Home Visits – the overall comments made www.healthwatchwolverhampton.co.uk were positive around the midwives and health visitors, however some comments would have wanted more contact with the health visitors and midwives.
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Healthwatch Priority: Cervical Availability of appointments was used as a Screening barrier for some women going for the screening – As GP’s practices were identified as the choice where women would prefer to We carried out this project by focus go, it is suggested that the practices look at groups and surveys, to understand how extended hours appointments specifically why women were not going for for cervical screening would support breaking screening and to identify the down the barriers. barriers. We had 177 responses to HPV vaccine and cervical screening was the survey and 7 participants taking unclear as was the eligibility for the vaccine part in the focus group and the vaccination programme – more information to be provided on the vaccine, the vaccination programme and what it means for As the screening does not start until those who have been vaccinated. women turn 25, we felt it was important to include 18-24 to test The findings of the report will be shared their awareness on the reasons for with Public Health as the screening uptake is lower than the national level. screening. The full report can be found on our Below are themes identified and website: recommendations made: www.healthwatchwolverhampton.co.uk
Women do not understand the reason why they have the screening, with some thinking it was to check for sexually transmitted infections or for problems with the womb rather that the pre-cancerous cells in the cervix – More information to be included in the cervical screening invitation especially around the process and the purpose of the screening.
The reason for women delaying going for screening is mainly that they found the process embarrassing, they were self conscious of their body image, did not want to undress in front of strangers and the person carrying out the procedure especially around male practitioners – more work to be targeted with specific groups and the more information and advertising could help overcome some of the barriers.
Encouragement for attending cervical screening appointments – peer support and information could be developed and rolled out to specific community settings.
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General Practice Nurses As a Black Country, we were commissioned by Wolverhampton CCG, on behalf of the local STP, to undertake local engagement with patients, focussing on their knowledge and experiences of General Practice Nurses (GPN). We worked with Healthwatch Dudley, Sandwell and Walsall carrying out focus groups, drop in sessions and surveys. A total of 220 people gave their feedback.
Feedback from patients was collated into recurring themes, offering insight into their patient experiences. These included:
Understanding of roles and skills Provide more information on nurse The majority of patients lacked knowledge of services the role of GPNs meaning a possible Not all participants were aware of services underuse of appointments. Having more available or provided by their GPN. It is information would allow patients to make an recommended that this information is informed decision of choosing to book their provided by individual practices due to appointment with their GPN. Patients felt the discrepancies between services offered. responsibility of sharing this information lay primarily with the practices. Forms of information sharing Appointment preferences and Participants felt that information should be availability made available on practice waiting room Patients seeing the GP instead of their GPN noticeboards or by leaflets made available at was seen as a default decision rather than a reception. Consideration should also be preference. Although GPN availability was a made to reach a wide range of patients, positive for booking with them. including those who do not attend regularly.
Information sharing and signposting Signposting and active promotion of Patients found that they were unable to book nurse services by reception staff. with GPNs online, so development of this was It is recommended that reception staff are recommended. The approach of being utilised more regularly to help signpost signposted to a GPN by reception was widely patients to GPN appointments when supported by participants, although this is appropriate. This was largely supported by not done in all practices. patients.
What was the impact of this? The engagement events across staff and patients have highlighted some significant wider and more complex system issues that need consideration and discussions at a leadership level.
The recommendations were built into GPN Development and Retention "Case for Change”.
Page 51 Guided by you | Healthwatch Wolverhampton 24 Enter and View Enter and View is a programme of work that uses our statutory power, allowing us to observe the way NHS and social care services are delivered. Enter and View visits are not inspections, they allow us to gather service user feedback and use it to make recommendations for improvement. In 2019/20, 22 Enter and View visits were conducted in a variety of settings, a 57% increase on last year. Enter and View visits are used to respond to patient experiences shared with Healthwatch. Visits can be announced, unannounced or semi-announced depending on the nature of the visit. Revisits are also conducted to observe if service recommendations have been put in place by providers.
Relationships built with external providers such as CQC, CCG and Quality Teams have allowed us to share themes and intelligence in a more strategic way to ensure Enter and View is having a larger impact. Recommendations made to service providers are shared with various stakeholders. Of the 22 visits undertaken in 2019/20, over 190 recommendations were made.
Visits are based on the eight principles of Healthwatch, which underline the expectations from health and social care services. These include essential services, access, a safe, dignified and quality service, information and education, choice, being listened to, being involved and a healthy environment.
Visits in 2019/20 included: Bentley Court Care Home Wednesfield Dental Practice Bethrey House Care Home Eversleigh Care Centre Ashmore Park Medical Centre, Oaks Court House Care Home Bilston Health Centre, Dr Mudigonda The Cedar Grange Castlecroft Medical Practice The Croft Care Home Duncan Street Surgery Wulfrun Rose Nursing Home Highcroft Hall Residential Care Home Keats Grove Surgery Acute Medical Unit, New Cross Hospital Mayfield Medical Centre Rheumatology Centre Cannock Chase Hospital Thornley Street Surgery Rheumatology Centre New Cross Hospital Whitmore Reans Health Centre, Wards C16 & C18 New Cross Hospital
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Authorised Representatives Enter and View Visits are run by a group of trained volunteers and staff called Authorised Representatives. Authorised Representatives are not medically trained but are able to give a laypersons perspective to health and social care services.
Each Authorised Representative has their own set of skills and knowledge which has enabled us to shape and adapt our Enter and View visits over the last 12 months. We would like to say a special thank you to each Authorised Representative for their hard work and dedication to the 2019/20 Enter and View programme.
- Andy Davies - Josie Slater - Raj Sandhu - Anu Sandhu - Judith Stroud - Ranjit Khutan - Ashley Lovell - Kerry Southall - Rasham Gill - Beverley Davis - Kirpal Bilkhu - Roger Thompson - Dana Tooby - Maggie Makombe - Rose Urkovskis - Darren Richardson - Mary Brannac - Sam Saini - Emily Lovell - Matthias Katanga - Sheila Gill - Janet Chand - Pat Roberts - Tina Richardson
Wednesfield Dental Practice
Following group catch ups with Authorised Representatives, some asked for a bigger variety of Enter and View visits. This accompanied with an increase of patient experiences lead to an unannounced visit at Wednesfield Dental Practice.
The visit to Wednesfield Dental Practice was mixed, none of the patients engaged with raised concerns however, Authorised Representatives did observe and raise some Wednesfield Dental Practice safety concerns, which were reported to the The practice also acknowledged that using senior staff member and CQC. family and friends as an interpreter was not Recommendations were made around patient good practice and are now sourcing feedback and involvement, health and interpretation for the practice. safety, lack of interpreters and inclusivity and diversity. Authorised Representatives addressed concerns that there were no chairs with arms Since our visit, the practice has addressed to aid people to stand up, nor a space for and corrected all health and safety issues. wheelchair users in the waiting room. Since They have also compiled and started using a the visit, the practice has ordered chairs with survey to collect patient feedback and arms and has also made a designated space experience which will form the basis of a in the waiting room for wheelchair users. ‘You Said, We Did’ notice board.
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Enter and View Visit to Ashmore Park
Following patient experiences and a formal NHS complaint from WHACS, it was decided an unannounced visit to Ashmore Park would be carried out.
The visit was very positive, it was clear that Ashmore Park the practice was making excellent steps in offering more support to patients with Following our visit, staff have also recently additional health needs. Patients did raise enrolled in refresher care navigation training concerns around access to appointments and have been reminded to actively and patient involvement so this was encourage patient feedback through Friends reflected in our recommendations. and Family Test slips. The service acknowledged the positive impact Enter and View has and have The overall report is very much already made improvements and put in seen as a positive for our practice place changes based on our ten and we will continue to work recommendations. The practice have towards all the recommendations updated information to increase awareness listed above with some having of appointment access, as well as been put into place already. redesigning the Patient Participation Group (PPG) board to encourage more members.
Enter and View Visit to The Croft
At the time of our visit, The Croft was the only care home in the City of Wolverhampton to be rated as outstanding by Care Quality Commission (CQC). We chose to carry out a semi-announced visit to observe good practice that could be shared The Croft Residential Home amongst other care homes.
The home was beautiful and demonstrated Following the visit, the good practice shared an excellent level of care and good practice. has allowed us to identify further Residents were happy and enjoyed living improvements and recommendations in there, they were involved, listened to, and other homes. It has also been used as had choice in their care and daily life. Staff further examples in Enter and View training promoted resident’s dignity, privacy and sessions for Authorised Representatives to independence and treated residents with learn from. compassion. I would just like to say that it We only made one recommendation to this was a pleasure to meet Emily home which was; “to continue to share and Tina. Many thanks for the good practice” as this was done actively report. Your findings are with different homes. Page 54 appreciated. Guided by you | Healthwatch Wolverhampton 27
Enter and View has big impact at Acute Medical Unit (AMU), New Cross Hospital
Following a patient experience given to Healthwatch Wolverhampton from a patient who had a fall in AMU after staff were pressuring the patient to use the toilet, despite the family repeatedly telling staff that the patient needed more support. After discharge, the patient had incurred large bruises and was struggling to breath and was readmitted. During an appointment, the patient was found to have fractures, it was suspected these were sustained from the fall in AMU. In response, the Trust wrote an action plan for AMU to address the recommendations in This patient was referred to WHACS to the report. All actions referred back to the make a formal NHS complaint with the principles of Healthwatch and were due to support of an advocate. be completed by the end of April. Actions included: Following this and more patient experiences of AMU, it was decided to carry out a semi- • Ensure all staff are aware and competent announced Enter and View visit. at completing end of life paperwork – staff to be informed through the safety The visit to AMU was good staff were brief and walk around. enthusiastic, and this reflected in • Ensure adequate SWAN champions on positive patient feedback. Patients were AMU. extremely complimentary of the care they • Practice Education Facilitators to focus on were receiving, and we hope that this good the end of life paperwork/SWAN care in practice continues. order to ensure that all staff members are fully competent. Five recommendations were made to AMU • Content of Healthwatch report will be relating to paperwork, dietary requirements, shared with both medical and nursing patient and family member communication, staff as way of reminding them of the family and friends test results being importance of ensuring that all relatives displayed. are kept informed. The Acute Medical Unit (AMU) welcomes the Healthwatch report from their visit to AMU on 31st January 2020. In response to the report, we have developed an action plan to address recommendations made.
All Enter and View reports and more information can be found within the Enter and View section of our website.
Website: www.healthwatchwolverhampton.co.uk Page 55 Guided by you | Healthwatch Wolverhampton 28 Strategic Relationships Healthwatch Wolverhampton acts as a critical friend to local strategic partners and plays an active role in representing your views. We have attended many strategic and operational meetings as listed below:
• Area Prescribing Committee • Joint Engagement Assurance Group • Better Care Fund (JEAG) • Black Country Healthwatch Meeting • Maternity Voices Partnership • Black Country Sustainable and Black Country • Meeting with Deputy Chief Nurse Healthwatch Meeting Wolverhampton Clinical • Black Country Sustainable Board Meeting Commissioning Group (CCG) • Café Neuro Co-ordinators Meeting • Meeting with Deputy Chief Nurse (RWT) • Cancer Strategy Group Meeting • Meeting with Chief Executive and Chair of • Care Quality Commission (CQC) Information RWT Sharing • Meeting with Deansley Outpatient • Carers Support Development Workshop Department (RWT) • Carers Wellbeing Cafe • Mental Health Stakeholders Forums • Dementia Action Alliance • Mortality Reduction Meeting • Deterioration Patients Task Group • NHS Long Term Plan • Discharge to Assess (D2A) • Patient Advisory Cancer Team Meeting • Steering Group • Primary Care Committee • Communications and Engagement • Primary Care Operational Meeting Group • Quarterly meeting with Care Quality • Evaluation Meeting Commission • Operational Monthly meetings • Royal Wolverhampton NHS Trust Annual • Equality and Diversity Steering Group General Meeting meeting • Safeguarding Board • Flu planning meeting • Safeguarding meetings • Head of Patient Experience Team bi-monthly • Safer Provision and Caring Excellence meetings (SPACE) programme Care Home • Health and Scrutiny Panels Improvement • Health and Wellbeing Together • Special Education Needs and Disability • Healthwatch CQC/Cross Directorate Event (SEND) Health Steering Group • Healthwatch England Conference • System Development Board • Healthwatch Network Meetings • Vocare Meeting • Integrated Care Association Meetings • WCCG Annual General Meeting including: • WCCG Commissioners Meeting • Governance • WCCG Governing Body • Clinical • West Park Hospital Quality Visit • End of Life Sub-group • Wolverhampton Equalities Meeting • Frailty Sub-group • Wolverhampton Information Network • Children and Young People Sub-group Stakeholders • Mental Health Sub-group • Wolverhampton Lesbian, Gay, Bisexual • ED and UCTC and Trans Alliance • Investing in Volunteer Meetings
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Listed below are examples of how the relationship between Healthwatch and partners have made a difference to the members of public in Wolverhampton.
Issues with Radiography
We met with the Deputy Chief Nurse at the Trust around the issues that patients have had in Radiography. The Hospital updated us on the issues that they were having and the action plan they have in place to remedy some of the issues.
Healthwatch made several suggestions which they are going to take on, one was around that they often ask patients via a survey and change things as a result of the survey, however they do not let the patients know the changes have been made from their suggestions, so the manager suggested a “You Said, We Did”, this was going to be looked at throughout the Hospital by the patient experience team.
Another suggestion Healthwatch made was to update patients on the delays, this should be done not just by putting the information on the board, but the receptionists explaining to the patients the reasons behind the delays. Patient Experiences at West Park Hospital
Attended a Quality Visit at West Park alongside the Quality Team from the CCG, Healthwatch engaged with patients around their experience on the wards, and how they were engaged / involved in their discharge plans. A number of the patients were not aware of being involved, they got up at a certain time in the morning for their breakfast, then just sat in their chairs for the rest of the day. This was fed back into the report about ensuring that patients had activities during the day, other than receiving therapy. There was a vacant day room that could be utilised for patients to carry out different activities, communication with the patients was also included into the report about ensuring that patients and their relatives are being involved in the discussions about them and their care.
Patient Communication at RWT
At Health Scrutiny, Healthwatch asked Chief Executive of RWT how they were updating the public on outcomes of complaints that had been made. It was agreed that the Trust would produce a 6 monthly newsletter for the general public highlighting what had changed from patients raising complaints.
Isolation and Loneliness Report
We met with Public Health around the Isolation and Loneliness report that we had compiled, it was well received and the information in the report will be used to inform and support the work that Public Health is planning to carry out in the City with other stakeholders. Healthwatch will be part of the planning meetings
Working with Stakeholders
We attend the local Quality Assurance Meeting with RWT, CCG, CQC and Safeguarding, we share the issues we have around care / nursing homes. Some of the information gathered at these meetings feeds into our Enter and View visits. Page 57 Guided by you | Healthwatch Wolverhampton 30 Long Term Plan #WhatWouldYouDo
Page 58 Guided by you | Healthwatch Wolverhampton 31 Highlights
Healthwatch Our network held over Healthwatch Wolverhampton We held focus groups Wolverhampton received 299 survey with students at City attended various of Wolverhampton community groups responses. College and with the with the survey. D/deaf community. NHS Long Term Plan
Following a commitment from the In Wolverhampton we completed 299 Government to increase investment in the surveys, going out into the community, NHS, the NHS published the ‘Long Term Plan’ attending events, carrying out drop-ins in January 2019, setting out its key ambitions across various health and care settings. We over the next 10 years. NHS England asked also carried out 2 focus groups with students Healthwatch England, with the support of at City of Wolverhampton College and local Healthwatch to undertake public attended the coffee morning held by the engagement. The focus was to gain insight D/deaf community with over 25 people in into how people view local healthcare attendance. services and use the findings to shape local action to support delivery of the Long Term Plan.
As a Black Country Healthwatch (which consisted of West Birmingham, Dudley, Walsall and Sandwell) we agreed that the focus groups we carried out would be around “Self Care”, as this is part of the Sustainable Transformation Partnership (STP) work and agreed that we would use the questionnaires that Healthwatch England had designed.
The questionnaires were aimed at people with a health condition and a general survey.
Over 1500 people completed the surveys and over 200 people attended focus groups The full report can be found on our across the Black Country and West website: Birmingham. www.healthwatchwolverhampton.co.uk Page 59 Guided by you | Healthwatch Wolverhampton 32
Summary of findings Below is a summary of the common findings across both reports covering the whole of the Black Country and West Birmingham that was presented at the STP partnership meeting in July.
Information, signposting and health education People told us that they needed improved access to timely information and signposting to support them to self-care. This includes more accessible information which meets their needs i.e. easy read, no jargon.
Access to Services People want quick, timely access to professionals for diagnosis, treatment and support. This includes improved access to GP appointments and mental health services. Following diagnosis individuals want effective signposting to information and services that empower them to self-care.
Support in their communities People valued support and services in their areas through the voluntary and community services and want this to be supported and increased utilising community assets. Individuals identified key roles or ‘one stop shops’ as important to access information and services quickly.
Ongoing Engagement and Involvement People value being involved and welcome ongoing conversations about health and social care. Individuals want to see more engagement take place to share their experiences and ideas. Next Steps: 1. We asked the STP Board to discuss and specifically identify how the local plan will address the issues and themes raised in the report. 2. Following the publication of the local plan, clear communications to be carried out which highlights how the insight gained from this report was used and how it specifically influenced the plan. “The Black Country and West Birmingham Sustainability and Transformation Partnership (STP) received this report at our July Partnership Meeting.
We are committed to understanding and acting upon what matters to people. We recognise that part of the solution to the challenges we face rest in our ability to create the right environment for people to have more choice and control in their own health, this report will help us to do just that.
We would like to extend our thanks, not only to the Black Country Healthwatch teams who have worked collaboratively to produce this report but also to our neighbouring Healthwatch in Birmingham. Your collective effort to represent the views of local people will be key to informing our Long Term Plan. Our thanks also go out to local people who took time to express their views, whose experiencesPage 60have provided these useful insights”. Guided by you | Healthwatch Wolverhampton 33 Helping you find the answers
Find out how we gave people the information and signposting advice they needed to find the right support
Carvers Marathon, September 2019 Page 61 Guided by you | Healthwatch Wolverhampton 34
Finding the right service can be worrying and stressful.
Healthwatch plays an important role in helping people to get the information they need to take control of their health and care and find services that will provide them with the right support.
This year we helped 140 people get the advice and information they needed by: • Providing advice and information articles on our website. • Answering people’s queries about services over the phone, by email, or online. • Talking to people at community events. • Promoting services and information that can help people on our social media. Here are some of the areas that people asked about.
Health Sector 15%
Mental Health Complaints and 5% Advocacy 35%
Carers Support Team 4%
Support Services Social 23% Prescribing 4%
Local Healthwatch 8% Local Authority 6%
The Community Support Service can introduce you to community groups and services that could reduce isolation and improve the life you live, the way you want to live it. The majority of the people who attend are homeless or on a low incomes, this is a chance for them to have their voice heard, or just a general chat to meet others. Healthwatch have supported this ever changing group for some time, they have listened to concerns in relation to GP’s, hospital appointments and dentists. This has done wonders for the group as at times, engaging with NHS is difficult, especially, if they do not have a regular abode or if they are not registered with a GP, due to travelling aroundPage the62City. Community Support Service Guided by you | Healthwatch Wolverhampton 35
Support with Hearing Services During outreach in the Mander Shopping Centre, a patient spoke to our Community Outreach Lead advising that they had just been fitted with a new hearing aid but that they find it too heavy and uncomfortable. Our Community Outreach Lead signposted the patient to their GP so that they could refer the patient to West Park Hearing Services.
Orthotics referral A patient contacted Healthwatch Wolverhampton to see if the NHS provided a service to get specialist shoes due to them having one leg shorter than the other. Healthwatch checked to see if a service was offered under the Royal Wolverhampton NHS Trust and signposted the patient to their GP so that a referral could be made to the Orthotics Department at New Cross Hospital.
Supporting a foster carer A foster carer was referred to Healthwatch from their GP practice as they were having issues with school transport for a child with multiple medical conditions. Healthwatch contacted the appropriate person at the CCG who contacted the consultant and wrote a statement to support the family. Healthwatch also raised this at a local Special Educational Needs (SEND) meeting, the manager for the information and support service said they could offer more support. Healthwatch signposted the family to them.
Contact us to get the information you need If you have a query about a health or social care service or need help with where you can go to access further support, get in touch. Don’t struggle alone. Healthwatch Wolverhampton is here for you. Website: www.healthwatchwolverhampton.co.uk Telephone: 0800 470 1944 Email: [email protected] Page 63 Guided by you | Healthwatch Wolverhampton 36
Beginning our response to Covid-19
Since the start of the Coronavirus Pandemic in March 2020, we have adapted to new ways of working. Our community outreach, Enter and View Programme, student placements and volunteer work have all been postponed until it is safe to continue. The team also began to work from home and continue to ensure people get the information they need while supporting the key messages of Coronavirus from the Government.
At the beginning of the pandemic we created a page on our website dedicated to Coronavirus updates. This page contains links to Government guidance, Public Health information, local information, easy read and BSL (British Sign Language) interpreted videos, information for long term conditions and myth busting. 480 people have viewed this page since it was launched. Our social media has also been dedicated to supporting Government messages and in March 2020 alone we reached 20,066 people.
We had also come across a number of concerns raised by members of the public through social media, including patients becoming increasingly concerned over a text they had received from Ettingshall Medical Practice which said the practice was now located in a ‘Red Zone’ without any further explanation. This message caused a lot of speculation of whether this was a highly infectious zone.
Healthwatch Wolverhampton contacted the practice who explained the ‘Red Zone’ was part of a colour coding system being used by the City to enable them to manage services effectively and safely. It meant that this practice would be used for treating Covid symptomatic patients only and all other patients would be directed elsewhere. This message was shared publicly by Healthwatch to alleviate further concerns.
Page 64 Guided by you | Healthwatch Wolverhampton 37 Complaints and Advocacy
Find out how WHACS have supported Wolverhampton residents in 2019/20.
Mander Centre, October 2019 Page 65 Guided by you | Healthwatch Wolverhampton 38
Wolverhampton Health Advocacy Complaints Service (WHACS) is now in its fourth-year co-operating with Healthwatch Wolverhampton. Although it is a separate service and receives independent funding, the partnership has ensured a broader provision of support whether that is helping with a letter of complaint, a phone call or attending a local resolution meeting.
WHACS supported 74 Wolverhampton residents to make a formal NHS complaint and attended 14 local resolution meetings in 2019/2020.
Our referrals are received in a variety of ways, mostly via the Advocacy and Healthwatch Freephone numbers, and contacting us by email. Other referrals are made during events and outreach which reinforces how the partnership between WHACS and Healthwatch Wolverhampton ensures we are reaching as many residents as we can.
WHACS continues to promote self-advocacy and self-empowerment by providing everyone who contacts us with a Self-Help Information Pack containing information about the NHS complaints process. Approximately 17% complainants have used this resource. Where a complainant has a more complex complaint, they receive one to one support tailored to their needs.
Themes of NHS complaints this year included:
• Quality of care and treatment • Medication changes • Access to Services • Diagnosis • Delays / Cancellations
The majority of complaints have been resolved through direct communication with the service provider and the outcomes achieved include:
• An apology • An explanation • A change to process/procedures
When a complainant has not been able to resolve the complaint directly with the service provider, the advocate will support them to refer the complaint to the Parliamentary Health Service Ombudsman (PHSO).
We supported 7 complainants to refer their complaint to the PHSO in 2019/20.
Regular updates, explained what was happening at every stage and discussed options, provided appropriate help, support and information, achieved the outcome I was seeking from the NHS procedure.
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What our clients say
Complainants have the opportunity to provide us with feedback on the service they have received from their advocate as this helps us monitor and improve the service.
During 2019/2020, feedback included the following comments:
• “A very reliable advocate – credit to WHACS” • “Judith has been brilliant, and I wouldn’t have known how to go about doing the complaint without her intervention” • “My advocate kept me up to date with all correspondence and fought hard to achieve a possible outcome”
Case study: Improving patient patient's previous treatments and gave full experience by accessing “life explanations as to why they had not been successful. changing” treatment. The consultant offered a new method of A patient with multiple ligament injuries treatment during the consultation, providing contacted WHACS to help them get the success stories of other patients with similar answers they needed from their consultant. conditions. The patient chose to try the new With the help of an advocate, the patient treatment there and then, after 10 minutes asked the doctor a selection of questions as the patient was able to move and walk to why they were still in an excruciating around without pain, something they had not amount of pain after years of operations and been able to do in a very long time. The steroid injections in their leg. patient looks forward to starting exercising again with regular treatment. During a consultation with both the patient and advocate, the doctor went through the Patient contacted WHACS to say that after their first full treatment, it had been a life changer. The patient is much more mobile and already thinking about being able to restart their career.
Page 67 Guided by you | Healthwatch Wolverhampton 40 Our Volunteers
Find out about how our volunteers have supported Healthwatch Wolverhampton to ensure every voice is heard.
Johnathon carrying out work experience, January 2020 Page 68 Guided by you | Healthwatch Wolverhampton 41
At Healthwatch Wolverhampton we are supported by 27 volunteers to help us find out what people think is working, and what people would like to improve to services in their communities. Our volunteers are invaluable to our work.
This year our volunteers: • Raised awareness of the work we do at events, in the community and with health and care services. • Visited services to make sure they are providing people with the right support. • Helped support us in the day-to-day running of Healthwatch Wolverhampton. • Listened to people’s experiences to help us know which areas we need to focus on.
Christmas Volunteer Celebration
To say thank you for all the hard work our group of volunteers had given over the past year, we chose to celebrate their successes with an afternoon tea at the Mayor's Parlour. The event was co-ordinated between members of HAB and staff. The event was extremely well attended by our volunteers and their family and friends.
Volunteers enjoyed an afternoon with entertainment; Zoe Cresswell sang festive Volunteers enjoying afternoon tea at the songs, Amanda Kenny delivered a session of Christmas Celebration Event. laughing yoga and Emma Purshouse, the first City of Wolverhampton College (staff and ever Poet Laureate for Wolverhampton students) that was carried out earlier on in the performed a selection of health-related week, we raised a total of £365 and a cheque poems. was presented to the Mayor.
We raised money for Samaritans; some of Students from City of Wolverhampton College our HAB members wrote to organisations who had completed their work experience asking for donations that could be used for with us were also invited to be part of the raffle prizes, we had a good response and celebrations along with their tutor. They these were raffled off at the event. Along enjoyed the experience and had their photo with a cake sale supported by HAB members, taken with the mayor. staff and
Volunteer with us Are you feeling inspired? We are always on the lookout for new volunteers. If you are interested in volunteering, please get in touch at Healthwatch Wolverhampton. Website: www.healthwatchwolverhampton.co.uk Telephone: 0800 470 1944 Email: [email protected] 69 Guided by you | Healthwatch Wolverhampton 42 Our volunteers
We could not do what we do without the support of our amazing volunteers. Meet some of the team and hear what they get up to. Jane and Colin We like engaging with people either with surveys or promotion tables at events. This gives an insight to people’s thoughts and feelings and a voice to express what they would like to see happen within the NHS Health and Social Care. We endeavour to signpost people to the appropriate areas for answers to problems or just to say thank you for services they have received. As Volunteers we envisage that by talking with people we show how Healthwatch can be the contact they may be looking for which gives us a great feeling of satisfaction.
Tina I was in the care field for 28 years and felt that becoming part of Healthwatch would enable me to give back to the community after my long illness. I enjoy volunteering as I feel it’s an important service for the public to be able to access support with any issues within the local community regarding social care. I do the Enter and View visits and I really enjoy this. The staff are always helpful and make me feel part of the team which I think is very important as we support each other in our roles.
Kerry My experience as a volunteer for Healthwatch has been very enjoyable, interesting and I like to think that my volunteer role helps not only Healthwatch but our community, all the staff are helpful, supportive and friendly and were supportive with my ICT course, helping me gain experience for my course by letting me work in an office environment. I would encourage new volunteers to support Healthwatch. Page 70 Guided by you | Healthwatch Wolverhampton 43
Ranjit
Ranjit has a background in health and now teaches the future public health workforce, he said; I'm deeply interested in supporting services to be the best they can be, to help the public resolve issues when they have them and to help them navigate complex health systems. I am particularly interested in supporting those populations who have the greatest need, experience the greatest inequalities or are the most vulnerable - e.g. the elderly, those with mental health problems or minority ethnic groups.
Josie Josie worked as a Clinical Coding Summariser at a GP Practice in Penn before retiring. She said; most of my involvement with Healthwatch has been supporting the team in "Enter & View" visits. I felt I could make a reasonable and valid contribution. I also felt I had the understanding of difficulties that can be encountered. Healthwatch has an important role to play in these very demanding times and I hope that my contributions help a little towards their achievements.
Mary
Mary began volunteering after a suffering a stroke. She said; I have always enjoyed being involved in matters that are important to me. As a volunteer I take part in Enter and View with other members of Healthwatch. We go around nursing homes and hospitals and doctors surgeries where we observe and interview staff and patients or residents to get their opinion that we then report to Healthwatch.
There are some tasks that I have difficulty in performing but together with the members of Healthwatch we found out what works for me. I feel I am valuable and can contribute with my experience. Page 71 Guided by you | Healthwatch Wolverhampton 44 Work Experience Students
Throughout 2019/20 we have worked closely with Juniper Training Ltd and City of Wolverhampton College to provide students with work placements. In total, 18 students have had work placements through the year, contributing up to 750 hours of their time.
Throughout placements we work closely with students to tailor their experience so they can enhance their skills and work set. Students took part in a range of activities including administrative tasks, community outreach and Enter and View. Students were also able to take part in a range of training activities including; suicide awareness, Dementia Friend sessions, Enter and View etc.
By the end of placement, students gained valuable experience of working in a business environment as well as a clear understanding of why we gather patient experiences and how the work we do influences services.
We have found that often the learning and support becomes a two-way process, with students sharing their knowledge and skills with us. An example of this was that one student was able to provide advice on how best to use our social media channels based on their own experience.
Both staff and students have found this work incredibly valuable, it has been great to see students grow with confidence and recommend friends to join us for their placements. A student on his work placement from Juniper Training Ltd.
University Student Placement One of the students that had carried out their college work experience placement with Healthwatch had been sharing their experience with their family member.
Their family member, who was studying at University contacted Healthwatch to see if they could carry out their placement with us. We discussed what would be entailed and agreed that the student would start as soon as they had finished their final exams, however due to COVID-19 this has now been pushed back to September.
Page 72 Guided by you | Healthwatch Wolverhampton 45
What students say As this element of our work has grown, we have started to evaluate student’s experiences to ensure they are finding placement beneficial and to see what we could improve upon. Some feedback we have received includes:
• “Really friendly staff that communicated well. Challenged me by giving me the task to make calls. Took out the best of me and put my previous skills to practice.” • “I’m going to miss you guys, continue working well and hope you have a good rest of the year. You have taught me well”. • “I think you have managed to fit me effectively in to your work environment and managed to make me feel like I am part of the team. You also managed to make me gain knowledge in both Healthwatch and actual business working environment, giving me confidence I wanted and needed for future”. “Our business students have been completing 30 hours of work experience with Healthwatch, the time spent with Healthwatch has given the students chance to see what life in the ‘real world’ is. For each student the experience has been different as they have all gained different things, some have come back with more confidence, some with a lot more experience or using the phones… I cannot praise the team enough for the help and support they give to our students”. Julie Flavell, Wolverhampton City College In June 2019, Juniper also presented us with an Employer of the Year award, recognising our support and work provided to their students and the difference it had made to them.
Previous students were also invited to our volunteer Christmas celebration event, held at the Mayor’s Parlour in December 2019. Julie shared her experience of working with us and what the benefits had been to her and her students. It was also great for staff to catch up with students, since their time with us.
Supporting Youth Students also supported us hosting a Youth Healthwatch Have Your Say Event in February to encourage young people to share their During placement, students were experiences. One young person showed up encouraged to take part in Youth to this event and shared the issues they Healthwatch work or even join as a were experiencing around care across Local volunteer. One student, who showed a keen Authority borders and complex needs. interest has supported us to created social Students also supported us when delivering media pages for Youth Healthwatch and presentations about Youth Healthwatch and even posted videos and stories of what volunteering to 170 students at the Healthwatch is. University of Wolverhampton, This resulted in a number signing up to become Pagevolunteers 73 . Guided by you | Healthwatch Wolverhampton 46 Our Finances
Find out how Healthwatch Wolverhampton was funded in 2019/20.
Wolverhampton City Centre, June 2019Page 74 Guided by you | Healthwatch Wolverhampton 47
We are funded by our local authority under the Health and Social Care Act (2012). In 2019-20 we spent £216,609.38
£30,635.31 Additional income
£224,924.31 Total income
£194,289 Funding received from local authority
£12,091.76 Running costs
£36,194.80 £216,609.38 Operational Total expenditure
£168,322.82 Staffing
Page 75 Guided by you | Healthwatch Wolverhampton 48 Our plans for next year
Find out our plans for 2020/21.
Wolverhampton City Centre, June 2019Page 76 Guided by you | Healthwatch Wolverhampton 49
It has been a great year for us as we have continued to engage with the public to understand people’s experiences of health and social care to make a difference. We have offered work experience to more students and was recognised as Employer of the Year by Juniper training for the work that we done with their students. We launched our new website and feedback centre, where it gives more opportunities for people to have their say around their experiences. We presented the work that we had carried out with the D/deaf and hard of hearing community at a conference held at the University of Wolverhampton to interpreting students. This was the last chapter of the work with the University to understand the health and social care needs for the community and what Healthwatch had done to support this community ensuring their voices have been heard.
Looking ahead
Looking ahead at next year some of the Urgent and Emergency Care Services – challenges will be the effects that the feedback received is there is a lot of Coronavirus pandemic have had on the confusion and duplication with services for society as a whole, but especially around Urgent and Emergency Care, we will be health and social care. aiming to understand why people used services for certain ailments prior to We continue to work with our Black Country Coronavirus and what services they have and West Birmingham Healthwatch colleagues used during Coronavirus. ensuring the patient voice is heard especially at the Black Country STP
Our priorities for 2020/2021:
Mortality – due to Coronavirus and the sensitivity of this project this was deferred to this year.
Coronavirus pandemic - we will be engaging with the public around their experiences throughout the pandemic, that would be anything from sharing the different ways that they have had to have their appointments with professionals to sharing their loss of a loved one.
Identifying any gaps in the city that have arisen from the pandemic and how partners in Tracy Cresswell the city are going to work together to reduce Healthwatch Manager these gaps.
Page 77 Guided by you | Healthwatch Wolverhampton 50 Thank you
Thank you to everyone helping us put people at the heart of health and social care, including:
Members of the public that have shared their views and experiences either attending our events, drop ins, contacting us on the phone or using our feedback centre.
All of our amazing volunteers who have supported us throughout this year.
The amazing staff who have adapted to working differently especially around Coronavirus and some have volunteered their time to support the vulnerable members of the community collecting and delivering their medication.
All of the partners and stakeholders who we continue to work with.
Andy supporting the Orange Wolves event. Page 78 Guided by you | Healthwatch Wolverhampton 51 Glossary
AMU Acute Medical Centre APC Area Prescribing Committee BCHA Bone Condition Hearing Aid BSL British Sign Language CCG Clinical Commissioning Group CPR Cardiopulmonary Resuscitation CQC Care Quality Commission D2A Discharge to Assess ECS Engaging Communities Solutions ED Emergency Department GPN General Practice Nurse HAB Healthwatch Advisory Board HWE Healthwatch England JEAG Joint Engagement Assurance Group PACT Patient Advisory Cancer Team PHSO Parliamentary Health Service Ombudsman RWT Royal Wolverhampton Trust SEND Special Educational Needs and Disability SPACE Safer Provision and Caring Excellence STD Sexually Transmitted Disease STP Sustainability and Transformation Partnership TB Tuberculosis UCTC Urgent Care and Treatment Centre WHACS Wolverhampton Health Advocacy Complaints Service
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