“We are aware that Healthwatch work is respected, recognised and used at very senior level - for instance the Health and Wellbeing Board - and is contributing to both strategic and operational planning of health and social care services across the district.”
“The content of discussions at key meetings such as Mental Health Strategy Group and Connecting Care are richer because of contributions by Healthwatch.”
“Healthwatch enables asylum seekers and new refugees to understand how things work.”
“Strong participation and constructive challenge from Healthwatch in key strategic discussions.”
“We have the upmost confidence in sign posting individuals and promoting Healthwatch knowing that their response will be thorough and led by the individuals involved.”
“Contract management meetings evidence that seldom heard groups are regularly in touch with Healthwatch and demonstrates that local people participate in commissioning, delivery and scrutiny through the regular volunteering opportunities.”
“Broad reach - strong evidence of genuine engagement.”
“Deliver a good service and approachable.”
“Strong engagement of young people and older people in the design and delivery of local evaluation.”
“Evaluation work especially valuable”
“Healthwatch have helped support complainants resolve their concerns by acting with them and guiding them through a more constructive process. The lessons from this has been for the Trust to understand more about how it can be more inclusive in its care planning and understand more about the difficulties faced by patients.”
360° Quality Statements Review
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Healthwatch Wakefield’s transition to an Besides me, other trustees especially Andrew and independent charity limited by guarantee has Lee have had a most significant influence been a great success thanks to the hard work of regarding this. both staff and trustees. There was an active It is worth reminding readers of this report what transition team of Nichola Esmond, Chief governance is. Executive Officer, Andrew Kent, Treasurer, and “Governance is the systems and processes Lee Wood, Vice Chair, which worked very hard on this massive change for which I am very grateful as concerned with ensuring the overall is our organisation. This team has now been direction, effectiveness, supervision and disbanded and we now have Human Resources accountability of an organisation. and Finance sub-committees in place. Good governance ensures: In the last year I have tried to meet more compliance with law and regulation volunteers, for example at the Safeguarding Adults that an organisation is well run and training. I have slowly realised two things. Firstly, efficient that problems are identified early and that the volunteers I have met have some amazing dealt with appropriately skills that truly enrich our organisation. Secondly, the preservation of the reputation and my fellow trustees are all volunteers and they too integrity of the sector are an enriching influence. It is an honour for me that charities make a difference and the to be Chair of Healthwatch Wakefield which has objects of the charity are advanced.” such fantastic volunteers. Becoming a charity has meant that our Chief The National Council of Voluntary Organisations Executive Officer, Nichola Esmond, has led the I hope 2017-18 will be as successful for us as Board of Trustees such that our organisation has a last year. governance approach of the highest order. I have also attended a number of development sessions in the last year on governance and I hope this has contributed to the way we run our organisation. Richard Sloan, Chair
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Our first year of independence has been a engagement work across our patch, again successful and extraordinarily busy one. While underpinning major service change proposals. we have been writing this report and looking In addition to the bigger picture work, we have back over the year, I have been enormously maintained a focus on other aspects of the proud of what we have achieved. Although health and care system in Wakefield, taking a we’ve had our challenges and have taken on particular interest this year in the mental health significant additional pieces of work, our staff of children and young people, the impact of the and volunteers have stepped up and produced Care Act on social care assessments, and what is nothing less than our best at all times. happening in our local care homes. One of the challenges of a local Healthwatch is The American surgeon and writer Atul Gawande to make a difference and have an impact. We stated in the annual Reith lectures in 2014 that measure this in a number of ways, but I feel that we are living in the ‘century of the system’; over the last year our good relationships with problems in health and care are too complex providers and commissioners have led to work now to be solved with simple solutions. Chris that has really put people’s voices at the heart of Ham, Chief Executive of The King’s Fund has also decision making. Two Vanguards in Wakefield argued ‘there is much more potential to involve District and a Pioneer integrated care patients – and their carers where appropriate – programme have had patient and service user as partners in care.’ Local Healthwatch are key experience embedded throughout. We have enablers to supporting patient and carer polled, surveyed, run focus groups, interviewed involvement in health and care and we will and researched people’s views alongside new continue to offer constructive challenge and services being shaped. insight where we can. Our working relationships with other local Healthwatch in our West Yorkshire and Harrogate STP footprint have also been strong. We have delivered some good integrated
Nichola Esmond, Chief Executive Officer
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We know that you want services that Independent work for you, your family and friends. We act on behalf of local people independent of That’s why we want you to share your political parties, commissioners and providers. experiences of using health and care We have no vested interests in the outcome of our work apart from improving local health and services with us – both good and bad. social care services for the people of Wakefield. We use your voice to encourage those who buy and run services to act on what matters to you. Engage Listen to and engage effectively with people who use local health and social care services. We will put the public voice at the heart of decision making around health and social care. Inform and advise We will do this by growing and strengthening Offer a variety of ways for people to access the organisation so that we can challenge and information, advice and support. improve provision of health and social care services on behalf of local people, particularly Involve those whose voices are often under represented. Involve local people in our work.
We will be a credible and influential organisation Influence that has good relationships with local people, Influence positive change in service provision commissioners and providers of health and and commissioning. social care.
Governance and Finance Govern ourselves effectively and in line with our values and statutory functions. Inclusive and collaborative We put people first, particularly those who are Sustain our core funding and develop other less able to represent themselves. We aim to income streams to support our sustainability. involve all communities in Wakefield District. We work in partnership with all key stakeholders. Proactively attract, support and develop a high quality team of staff, board and volunteers. Credible and effective We aim to be respected for our rigour and high standards of information, intelligence and reporting. We want to make a difference.
Open and accountable We hold meetings in public and carry out decisions and publish our findings according to our governance processes, which are available on our website.
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Group (CCG) to deliver evaluation from a resident perspective. Primary care: impact on patients of the change Some of our work streams from the previous year in GP contracts locally, including access to continued into 2016/17 because they were prescriptions, changes in triage and ‘out of designed as ongoing projects or were still areas we hours’ provision. felt needed follow up to make sure the impact of the work had been as significant as it could be. Hospital transformation: impact on patients of changes to Mid Yorkshire Hospitals Trust The work streams described are the major provision of services across three hospitals projects that Healthwatch Wakefield took forward this year. but don’t reflect the ongoing day to day pieces of work supporting individuals or smaller issues that Focus on information, advice and advocacy: we dealt with. for people trying to navigate the health and care system. Continued from 2015-16 Future in Mind: work streams ‘Voice of children and young people’; ‘Effectively target and engage Young people’s mental health: Young vulnerable groups’; and case studies. Healthwatch investigation into young people’s mental health issues, including access to MCP Vanguard Evaluation: providing the immediate help and support, and an independent, patient and carer perspective on seven primary young person led evaluation of CAMHS. care and integrated care initiatives. Access to social care: a ‘reality check’ on the implications of the Care Act on people being able to access care support, measuring impact on those people who are unable to access support, what other services do they then use, how is their health and wellbeing affected.
Connecting Care: an evaluation of integrated care services across the District.
Home care: survey in partnership with Wakefield and District Housing and Carers Wakefield. Public Voice report to the Health and Wellbeing Board: report drawn from public experience and intelligence from a wide range of health, care, council and voluntary sector partners.
New to 2016-17
West Yorkshire Urgent Care Vanguard: working with other West Yorkshire Healthwatch on engagement around proposals to reshape urgent care in West Yorkshire, including paramedic services, emergency departments and stroke services.
Care homes Vanguard evaluation: working with Public Health and our Clinical Commissioning
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Over the next few pages you will be able to see: How local people’s experiences of health and care services have been collected and their needs identified. Examples of how and why we engaged with diverse groups and communities in our local area, including: Young people (under 21) and older people (over 65). People we believe to be disadvantaged, or vulnerable. People who live outside our area, but use services within here. In this year we visited 14 general practices to find out what patients “Healthwatch enables asylum thought about new ways of working seekers and new refugees to understand how things work.”
360° Quality Statements Review
“Strong engagement of young people and older people in the design and delivery of local evaluation.”
360° Quality Statements Review
What we’ve learnt from visiting services In this section, you will also find out: The reasons we decided to carry out Enter and View activity and other visits; and action we took following this, such as making recommendations and identifying good practice.
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Child & Adolescent Mental Health Service (CAMHS) To find out about the quality of provision of mental health support for young people, the criteria for getting the service, appointment availability and waiting times, quality of information around planning treatment, information and signposting provided on discharge or during transition, waiting room facilities and access.
Pinderfields Emergency Department To find out why people attend A&E.
Wensleydale Unit BUPA Residential Care To talk to residents, observe the quality of care, dignity of patients, and staffing levels.
General Practices To evaluate Vanguard primary care interventions, including care navigation (the practice of reception or administrative staff offering patients an appointment with an appropriate health professional other than a GP, based on an assessment of their presenting issue), Physio First and Pharmacists in General Practice, (appointments offered in practices as an alternative to a GP), Extended Operating Hours (shared provision of after-hours appointments for patients) and HealthPod (pop-up primary care ‘pod’ to help access people who wouldn’t usually go to their GP). Middlestown Medical Centre; Orchard Croft Medical Centre; Warrengate Medical Centre; Lupset Health Centre; Maybush Medical Centre; Outwood Park Medical Centre; Almshouse Surgery; Chapelthorpe Medical Centre; Homestead Medical Centre; Grove Surgery; Church Street Surgery; Prospect Road Surgery; Alverthorpe Surgery; Eastmoor Health Centre.
Patient Safety Walkabouts Organised by the CCG throughout the year to look at safety and care with the adult safeguarding nurse, infection prevention and control practitioner, a pharmacist etc, and Healthwatch Wakefield. Pinderfields: A&E; Eye Centre; Gate A2 Stroke and Neurology; Gate 18 Maternity; Gate 31a Cardiology; Gate 32 Surgical Assessment Unit; Gate 33 General Surgery; Gate 41 Elderly; Gate 43 Elderly; Gate 45 Respiratory; and Gate 46 Children’s ward. Pontefract: A&E; Elective Orthopaedic; Intermediate Care; and the Midwife Led Unit.
Care Homes To provide a valid and reliable means by which to engage residents in the Care Homes Vanguard evaluation, to industrialise the resident engagement process to provide it at sufficient scale to be valid, to use local volunteers to conduct the interviews via Healthwatch, to provide the process in a way that overcomes barriers of literacy, language and access, to add value to the Wakefield programme by working in alignment with both the proposed national evaluation and the other five Care Home Vanguards.
Carleton Court; Earls Lodge; Croft House; Vicarage Court; Walton Manor.
Wakefield Intermediate Care Unit (WICU) Start of a visit programme to Wakefield Intermediate Care Unit, also known as Queen Elizabeth House, to talk to patients and visitors to find out what they thought of the services they receive there.
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Children and Young People’s Mental Health Survey
Residential Care Survey
General Practitioners
General Practice Managers
Healthpod
Extended Hours Clinic
Care Navigation
Physio First
Young People, Families and Carers Mental Health
Urgent and Emergency Care
Hear, See, Treat
Care Act Assessment and Support
Integrated Care
Children’s Oral Health Insight
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“I am very pleased your service is here to help the public and thank you.”
In addition we provide people with advice and Our advice service based within Citizens Advice information through our usual communication helped 170 people who came to them with a channels and our quarterly newsletter. range of issues. “Excellent regular e-bulletin that They were signposted to services, given support covers all sorts of health/social care with complaints, and advised on options info in one place that we don't available to them. receive from anywhere else.” Of those who responded to a customer satisfaction survey 84% said they would We are particularly proud of the reach of our recommend it to others and 89% felt the adviser Engagement Officer, who ensures we go out to had understood them and their problem and the our communities across a District of 338.6 km2, advice received was easy to understand. and has talked to nearly 1,000 people this year.
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The reasons people came to us
The services they talked about
The top 5 primary care issues
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proposed new model for paramedic and urgent care. Overall, people were supportive of the new model and thought it could reduce pressure on emergency services. Please find here a list of the reports we have provided over the year. If you are reading this Children and Young People's Voice Report July 2016 online the titles contain links to the full reports and recommendations, which are also available Children and Young People's Vulnerable Groups Report July 2016 on our website. We have included a short summary of how we used them to suggest how Children and Young People's Case Studies Report July 2016 people’s health and care services might be We worked with 14 voluntary sector partners to improved, and if that happened. ensure that the voice of children and young people 2016 in our district was heard within the Future in Mind programme. This has led to a far better Urgent and Emergency Care Engagement Report understanding of the barriers to engagement faced November 2016 by many, and has led to the funding of a network In partnership with West Yorkshire and Harrogate of community-based frontline support workers to Healthwatch, we engaged with people on the enable better access to support. reasons they attended Emergency Departments across our patch. We attended 31 outreach Public Voice Report July 2016 We produce an annual report for the Health and sessions at local hospitals and used Facebook, Wellbeing Board that brings together engagement Instagram and third party website advertising. intelligence from all major providers and Over 84,000 people saw the advert and we commissioners in the district. We ask them to tell collected 1,306 surveys. This information was used us what people are saying that is good, not so by West Yorkshire and Harrogate STP to help good and what they think could be improved shape their understanding of emergency care. about the way that we support their health and Wakefield Emergency Department Survey Report wellbeing. This report is used to support decisions November 2016 about the Health and Wellbeing Board priorities Following on from the work above, we focused on for the next year. our own Emergency Departments in Wakefield and talked to 218 people. 42% said they were CAMHS Enter and View Report June 2016 attending for a medical emergency, 20% to get This Enter and View was undertaken in response to tests and 10% because they couldn’t get a GP ongoing concerns raised by children, young people appointment. 35% of the people we talked to had and their parents and carers about the long been told to attend the Emergency Department by waiting times, eligibility and transition a health professional. arrangements in our local Children and Adolescent Mental Health Service (CAMHS). Due to the nature Hear See and Treat Engagement Report of provision, we only spoke to a few people during September 2016 Over an 11 week period we worked with our West the visit and we requested as part of our Yorkshire and Harrogate Healthwatch colleagues recommendations that CAMHS support a closer to gather views from 2,585 people about a investigation of people’s experiences of waiting.
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This was agreed to and a further piece of work was care needs. We wanted to talk to people whose undertaken in partnership with the provider. needs weren’t high enough to trigger statutory Wakefield Carers Experiences of Connecting Care support but who still had substantial need. Report June 2016 Although we worked closely with the Local This evaluation was undertaken in partnership Authority and Social Care Direct service, we only with Niche Health and Social Care Consulting. We managed to talk to 46 people, 17 of whom agreed undertook qualitative interviews with 53 carers to be followed up. We found that although 75% of who were supporting people receiving Connecting these people had tried to follow up the advice Care services. We heard of some fantastic well provided by Social Care Direct, 50% were unsure if integrated service provision, some very poor this was what they needed and 67% felt they were experiences and some mixed. This detailed report in a worse situation than when they originally describes the physical and mental impact asked for help. experienced by people in a caring role and the Patient & Service User Engagement and absolute necessity of supporting these carers. Evaluation of Integrated Care Report January Summary of Connecting Care Carers Survey 2017 This report summarised all the public engagement Results June 2016 We produced a summarised version of the above and evaluation activity that Healthwatch Wakefield report to send to carers, telling them what we had and partners had delivered around integrated care found and what we wanted commissioners and in Wakefield District. It also brought together all providers to do in response. the key findings from the various strands of work in relation to Connecting Care and the move locally 2017 towards an Accountable Care System through Vanguard funding. It was used to inform NHS Healthwatch Wakefield Enter and View Visit England and wider system partners. Report Wensleydale Unit with Provider Responses Connecting Care Summative Report January 2017 We undertook this visit in partnership with the This evaluation and report was led by Niche Health CCG and CQC in response to concerns heard within and Social Care Consulting, with Healthwatch the system about the home. Our visit found that Wakefield providing the patient / service user although the basics of care seemed to be covered evaluation. We spoke to 680 people in their own and residents on the whole were happy, the unit homes over the course of 2 years. We showed that did not provide a comfortable and homely living the majority of people valued the integrated care environment, nor did it seem particularly dementia provision and felt that it had met their needs and friendly. We made a number of recommendations had positive outcomes for their health and their and the provider has undertaken an already ability to cope at home. Although the data did not planned refurbishment which subsequently took show that integrated care service resulted in fewer into account our feedback. admissions to hospital and shorter length of stay, it Healthwatch Wakefield Care Act Report January did show that both patients/servicer users and 2017 staff like working in a joined up way. We wanted to understand what impact the changes of the 2014 Care Act would have on people trying to access support with their social
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Throughout the year we have promoted and We use a collaborative approach with service supported the involvement of local people in the providers, commissioners, regulators and other commissioning, provision and management of local system partners to bring about change. local health and care services. We do this We work with the Care Quality Commission through: (CQC) and share information and evidence with Engagement with communities of both them which informs their work when monitoring geography and interest and inspecting local services. Survey work with local people in for example their General Practice or local hospitals We also have a seat on, or work with the: Interviews with people in their own homes Health and Wellbeing Board or over the telephone, especially where Wakefield Safeguarding Adults Board people find it hard to leave the house New Models of Care Board Consultations on proposal to change services Evaluation of services with service users Connecting Care Executive Board Partnerships with local community groups Connecting Care Health and Social Care Individuals who come to us Partnership Board People who use services but don’t live in the NHS Wakefield Clinical Commissioning Group District who often attend our hospitals Probity Committee for primary care Our volunteers commissioning Our representative on the Health and Wakefield District Safeguarding Quality Wellbeing Board, who we support to be Intelligence Group effective by giving them with the views of NHS Wakefield Clinical Commissioning Group local people and discussing Quality Intelligence Group recommendations for change. West Yorkshire Healthwatch Forum Community Engagement Partnership Learning Disability Partnership Board Dementia Action Alliance Dementia Strategy Board
94% of stakeholders in our 360° Quality Statements Review July 2016 strongly agree or agree that Healthwatch Wakefield enables local people to actively participate in the commissioning, delivery and scrutiny of services.
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100% of stakeholders in our 360° Quality 100% of stakeholders in our 360° Quality Statements Review July 2016 strongly agree or Statements Review July 2016 strongly agree or agree that Healthwatch Wakefield brings added agree that Healthwatch Wakefield bases its insight value to their work due to its unique perspective on the experiences of local people and and has collaborative relationships with key demonstrates added value through its work decision makers within their organisation. They engaging local people, paying particular attention confirm their organisation understands the to seldom heard groups. Lots of evidence has rationale behind local Healthwatch priorities. The been offered to support this in the open open responses are all extremely positive, responses. Acknowledgement has also been made significant words used are: recognised; key input; of the difficulties faced by many organisations respected and transparent. who are trying to engage seldom heard groups.
Healthwatch Wakefield 360° Quality Statements Review In 2016, Healthwatch Wakefield took the opportunity to review the quality of our services against the Local Healthwatch Quality Statements that were produced by Healthwatch England in partnership with Leeds Beckett University. Each local Healthwatch has its own priorities and challenges however there are many areas of common work. The Local Healthwatch Quality Statements are designed to help build an understanding of the work and develop consistency across the Healthwatch network. The review can be done in three ways, and we chose to undertake a 360 degree review, asking key partners and stakeholders, both external and internal, to respond to the Quality Statements survey. 19 external stakeholders responded to our survey, two of whom remained anonymous. We were delighted that partners from almost all relevant health and care sectors were willing to contribute their thoughts.
Dr Philip Earnshaw, NHS Wakefield Clinical Commissioning Group, Chair Andrew Balchin, Wakefield Council, Corporate Director, Adults, Health and Communities Andrew Furber, Public Health, Director David Melia, Mid Yorkshire Hospitals NHS Trust, Chief Nurse, acting Deputy CEO Ruth Unwin, Mid Yorkshire Hospitals NHS Trust, Associate Director Stakeholder Engagement Lisa Wilcox, Wakefield Council, Service Manager, Learning Disabilities and Mental Health Anna Middlemiss, Public Health, Deputy Director Laura Elliott, NHS Wakefield Clinical Commissioning Group, Head of Quality and Engagement Justine Bilton, Carers Wakefield, CEO Kevin Dodd, Wakefield and District Housing, CEO Alison Haskins, Nova Wakefield District, CEO Vicki Whyte, Wakefield Council, Transformation Manager and Healthwatch Wakefield Commissioner Jeanette Miller, NHS Wakefield Clinical Commissioning Group, Senior Engagement Manager Anne Moran, Wakefield Council, Neighbourhood Coordination and Engagement Officer Sheena Woodard, St George’s Community Association Linda Fielding, City of Sanctuary Clare Elliott, Wakefield Council, Service Manager, Policy and Partnerships
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To run a programme of ongoing engagement and outreach activities To reach and represent diverse and underrepresented groups * To investigate areas of concern/interest through surveys and other engagement methods To collect intelligence from partner engagement to match our activities and inform our work
Regular engagement Community events Information talks
Alzheimer’s Society Forget Me Not Airedale Neighbourhood Agbrigg and Belle Vue Health Cafes * Management Group Trainers Havercroft and Ryhill Community Alzheimer’s Society Side by Side All Saints Community Centre Learning Centre Project Launch Event Altofts Community Book Hemsworth Community Centre CCG Care Home Event after visiting Scheme Kinsley and Fitzwilliam Learning and 12 local care homes Chapelthorpe Carer’s Group Community Centre CCG Healthy Wakefield & AGM Coffee & Chat at Normanton, Kinsley and Fitzwilliam Pharmacy CCG Market Place Event Kirkthorpe, Featherstone and User Group CCG Public Event on Healthcare and Castleford Meet ‘n’ Eat Diner Planning Expert Patients Event The Well Food Bank * City of Sanctuary Coffee & Cakes Expert Patients Winter One Stop Shop at Hemsworth Event Wellbeing events at Pontefract, Library Crofton Family Fun Day Wakefield, Castleford, and South Kirkby One Stop Shop at Pontefract Library GP Networking Event Forget-Me-Not Café at Ossett One Stop Shop at South Elmsall Lightwaves Event Library Forget-Me-Not Café at National care Home day Pontefract Pinderfields Hospital Nova Market Place Event Hemsworth Slimming World Saint Catherine’s Centre Queens Park Play Day Lift Up Friends Group Spectrum’s Wednesday Café for Saint George’s AGM Vulnerable Adults * Monday Group Saint George’s Summer Event Voiceability Lift Up Friends Self Mothers’ Union Meetings Advocacy Group * SEND Festival Over 50’s Group St Michaels Wakefield City of Sanctuary Drop-in Shape Your Life Groups Church for refugee and asylum seekers at Sloppy Slippers Event at Altofts, Parkinson’s UK Wakefield the Quaker Meeting House * Normanton, Standbridge Lane Group Community Centre, and West Wakefield City of Sanctuary Portobello Over 50s Wakefield Welcome Café for refugee and Simply Leisure Group at St South Kirkby Party in the Park asylum seekers at St Michael’s * Swithun’s Community Centre Wakefield and District Housing Wakefield District Learning Disability Westfield Centre & Autism Partnership Board * Event WOFAG - Wakefield Over Wakefield District Sight Aid * Wakefield District Sight Aid AGM Fifties Action Group Well Women’s Centre * World AIDS Day Event Yorkshire Coalmining Resource World Health Day Event Pontefract Centre at Thorneycroft Library Yorkshire MESMAC *
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So what? Well, we have raised concerns that some of the Vanguard initiatives, although accepted by patients, may not actually be having the impact they need to have. Care navigation, Wakefield District received funding from NHS diverting patients to health professionals other England for both a care homes Vanguard and than GPs, for example, is showing from the a multi-speciality community provider (MCP) quantitative data that it is having a significant Vanguard. Local health and care partners are impact on diverting people from GP working towards the creation of an appointments, whereas only 7% of the 517 Accountable Care Organisation or system by people we spoke to had accepted an alternative aligning the successful elements of these appointment. initiatives. We found that care home residents on the Healthwatch Wakefield has been commissioned whole did not see any improvement in their to support patient/service user engagement and quality of life from the Vanguard interventions. to evaluate services from their perspective. We Although their care generally had improved with have worked with partners in CCG, Local reduced visits to hospital and ambulance call Authority, Public Health, NHS England Evaluation outs, the quality of their everyday life did not Team and North of England Commissioning seem to have got any better. This has focused Support Unit. attention on some of the holistic Vanguard We delivered 8 focus groups to over 80 interventions and how the voluntary sector people asking their opinions on the could be more closely involved in care homes. proposed new ACO/S. We talked to people about sharing healthcare We visited 16 GP practice waiting rooms 32 records and 73% of people agreed they would times and talked to 720 patients about the new MCP Vanguard primary care services be happy for their own health and/or care and asking their opinions. This included care records to be shared. Concerns about sharing navigation, physio first, pharmacy in general health and/or care records included the risk practice and extended operating hours. We that decisions detrimental to us might be also talked to 32 people who visited the pop up primary care ‘HealthPod’ for a health made based on what people see in our check. records and that opening up records to a wider audience might make information We visited 127 people (service users and carers) in their own homes to ask them more open to misuse. about their experiences of integrated care Self care is increasingly high on the agenda initiatives under the MCP Vanguard. and we asked people whether we should take We talked to 112 residents in care homes more control over our own health. 78% of before and after the Care Home Vanguard people agreed that people should take more services had gone in, and how these had impacted on their quality of life. responsibility for their own health and wellbeing. However, only 45% said they were Over 1,000 people have been interviewed by likely to take advantage of support to Healthwatch Wakefield or have taken part in a improve their own health - the majority were facilitated focus group to have their say. unsure or said it was unlikely that they would.
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And, not to avoid the difficult question, we “Healthwatch have been a critical asked what people thought about merging partner in supporting Wakefield to existing services into a single contract. 85% of evaluate our new models of care. people agreed that organisations should work They have delivered robust together more closely and 78% agreed that evaluation to inform new services they thought this would make their care that have been developed within more effective. But people were generally the District and they have unsure whether fewer organisations supported us with significant delivering care under one contract would evaluation of our care home make our care more effective, with significant vanguard, Connecting Care Hubs concerns about what this step might lead to and MCP primary care schemes in the future and the fear of large scale developed through the vanguard. privatisation. Our data showed how social isolation is Wakefield CCG value having correlated to poorer health outcomes, which Healthwatch expertise at all of our has supported the creation of work streams local Health and Social Care within integrated care focusing on community partnership meetings and their cohesion, volunteering and befriending. commitment to this agenda is evidenced through their willingness Information has been passed back to the CCG to test new engagement and other partners in the form of ongoing approaches and recently leading on feedback and reports which have been used some focus groups on our new to modify or adapt the approach to various elements of the ACO. All our work so far has model of care which was an been circulated in independent and objective interesting process and created reports. These have been used by local health some invaluable patient feedback and care commissioners and providers to to Wakefield CCG.” inform their understanding of patient / service user voice. The reports have been Melanie Brown, CCG Commissioner for shared with people who took part where Integrated Health and Social Care possible, although some have not yet gone through the assurance process.
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We then held an event with local partners to launch three reports produced from this work and to present findings: Where do you start when you’re approached to be involved in a national initiative which has Voice: a survey of almost 900 local young people ambitions to transform the design and delivery of Vulnerable Groups: a scoping exercise of 18 local services for children and young people with different vulnerable groupings in the District mental health needs? You start with local Case Studies: 8 case studies explaining children and young people… experiences of mental health issues and trying to get help and support “You shouldn’t have to fight to say The event was attended by 70 people including help me.” young people, colleagues from local voluntary groups, mental health services, our hospitals, the They had been talking to Healthwatch Wakefield Youth Offending Team, West Yorkshire Police, through Young Healthwatch for some time about Wakefield Council, local councillors, and the problems they were facing with their mental commissioners for both health and care. Speakers health and wellbeing and trying to access help. included the Head of Children’s Integrated We had been asked to be a part of the ‘Future in Commissioning and the Children's Commissioning Mind’ work in our District and to create an Manager from NHS Wakefield Clinical ongoing relationship with children and young Commissioning Group. We also had support from people and to feed their views into service design Alice Proctor, a young actor born in the District, and review. The aim was that services would be who did a marvellous job of bringing the voices of designed to meet the needs of young people and local young people to life. that engagement with them would be improved. “I don’t ask for help or support, I just At the same time we undertook a scoping keep things bottled up. How would exercise effectively identifying vulnerable and someone help me stop stressing?” hard to reach groups, and the barriers they faced in accessing services, and identified solutions to We complemented this work with a survey of overcoming these. young people on the CAMHS waiting list and an “It just felt like the rug had been Enter and View visit to their services. pulled from under my feet.” “I was suffering with depression and I didn’t want to be here anymore.” We carried out a number of case studies with local young people who had experienced mental As a result of the Future in Mind work, Wakefield health issues and how they had tried to get District now has seven Community Navigators advice or support; hearing in depth about their working across seven early help localities that are experiences and giving them a voice. in contact with Primary Practitioner teams and “I had to get a criminal record before schools in their areas. There is a menu of training something was done.” programmes that will be offered by third sector organisations, and where gaps are identified
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additional training will be commissioned. The understanding and patient, we do appreciate this Community Navigator team work to overcome as we know your time is valuable. I am sorry if I barriers for young people in accessing services, chewed your ear off but I am passionate about holding cases, and leading 1-1 work. The caring for our young people and I want the best Navigators also advocate for children and young for them as I think they deserve it. Mental Health people, overcoming barriers to access and is a major issue for our service users as they have supporting attendance of and access to services. complex and difficult pasts and they really do The CCG are developing a volunteer programme need help from professionals to work through available in each of the localities coordinated by historic issues, abuse to be able to move forward the Navigator there, and the training and with their lives. I think as a society we owe them workforce development programme will also be priority, easy access to services which will meet available to volunteers so they can develop their their needs, at the very least. Once again thank you so much for taking time to listen, it means a knowledge and skills. lot to us and our young people.” Future plans include extended counselling resources and further support for children at risk of child sexual exploitation.
The three reports with links are: Children and Young People’s Voice Children and Young People’s Vulnerable Groups Children and Young People’s Case Studies
Please click the link below if you would like to view the CAMHS Enter and View Report, which can also be found on our website. CAMHS Enter and View Report
Someone who works with vulnerable young people said:
“It has been a fight to navigate the system and we “Statistics and data analysis have supported our young person to do this, but are vital but often it's easy there will be many more who have not got this to detach them from the kind of support, what happens to them?” subject of research. My work on the day acted as a “Thanks so much for coming out to see our young reminder that the research person… I think she was in a bad place when you is about real people. An came on Monday, but this is sometimes how it is opportunity to speak turns with the young people we work with which in of phrase that cannot be quantified. Immediately those numbers become itself makes accessing services really difficult. personal by simply giving voice to the subjects of They don't particularly like strangers and find it the research. It was a pleasure to tell just a bit of hard to discuss situations with others, particularly those young people's stories.” around mental health…. Thanks for being Alice Proctor
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Healthwatch Wakefield 2016-17 27
Wakefield Intermediate Care Unit (WICU) 1 We will listen to patients and their friends and family at Queen Elizabeth House, the Wakefield Intermediate Care Unit (WICU), to find out about their experiences and work with Mid Yorkshire Hospitals NHS Trust so see if any improvements can be made.
Autism Services for Children and Young People 2 We will follow up on ongoing concerns from patients and families on the autism assessment and pathways, especially the transition from children to adult services.
Health inequalities 3 We will extend and develop our work with BME communities, seldom heard groups, and those who are underrepresented across our District.
Social care 4 We will develop our work on social care complaints and systems and look at what support and advocacy is available for local people.
Quality accounts 5 We will continue task group work on quality accounts for Mid Yorkshire Hospitals NHS Trust, South West Yorkshire Partnership NHS Foundation Trust, and Yorkshire Ambulance Service NHS Trust.
CAMHS: Child and Adolescent Mental Health Services 6 We will continue to work with children and young people to find out about their experiences of local mental health services and how they can be improved.
Dentistry 7 We will continue our work on the children’s dental survey at Mid Yorkshire Hospitals NHS Trust in partnership with Public Health.
Care homes 8 We will finalise our work on the Care Homes Vanguard evaluation and make public our report.
MCP: Multi-speciality Community Provider 9 We will continue with our evaluation work for our local Multi-speciality Community Provider Vanguard, as it works towards becoming an ‘Accountable Care System’.
Primary care 10 We will complete our Vanguard work to evaluate patient experiences of physio first, pharmacy first, care navigation, the Healthpod, extended hours, and ‘hub’ patient and carer experience.
Cancer patients 11 We will find out about the experiences of cancer patients and their relatives and carers and work in partnership with the Yorkshire Cancer Patient Forum, Macmillan and Yorkshire Cancer Alliances.
Neurology 12 We will be talking to people and getting their feedback about what they’d like to see from local neurology services and what is most important to them. Our work plan is flexible and we expect to add new projects throughout the year in response to local people’s issues.
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Healthwatch Wakefield 2016-17 29
Effectively manage risk, cost and resources to achieve our aims Achieve all contract outcomes Healthwatch Wakefield started the year by taking over accountability of our core contract Our Board in 2016-17 on becoming an independent company and charity registered in England and Wales. Richard Sloan, Chair Throughout the year our Board have worked Lee Wood, Vice Chair hard to ensure our governance and decision Andrew Kent, Treasurer making has remained sound. Healthwatch John Hyde Wakefield Trustees are local people who have a Gary Jevon passion for improving health and social care for Frances Kinchin Wakefield District communities. The board meets in public on a six weekly basis and Peter Skinner decisions are taken in an open and transparent David Stephens way. Board meeting minutes are available to Carol White read on our website. Our Staff Our decisions to prioritise the work of Healthwatch Wakefield are based on evidence Nichola Esmond, Chief Executive Officer we hear from local people, both from the engagement work that we do and intelligence Laura Brown, Community Research Assistant (from end of April 16) we gather from our partners. Wendy Dodson, Healthwatch Adviser based at Our Trustees are volunteers and lay people who Citizens Advice work with the staff team to make decisions Gaynor Endeacott, Connecting Care Officer about our priorities which are documented and available to the public. Kate Honeyman, Young Healthwatch Coordinator Jill Long, Macmillan Engagement & Our Governance aims Communications Officer, Yorkshire Cancer Patient Forum (from mid March 17) Govern ourselves effectively in accordance Ann Marie Maguire, Engagement Officer with our values and behaviours John Parkes, Administrative Assistant (until end Maintain our clarity of direction of August 16) Attract, support and develop a committed Safeen Rehman, Volunteer Officer and Young and skilled board and a high quality staff Healthwatch Coordinator team Maintain a positive culture and healthy Emily Strong, Community Research Assistant working environment where staff and (until middle of March 17) volunteers flourish, communicate well and Helen Watkiss, Communications Officer are valued Sustain our core funding and ability to Emily Castle manages Young Healthwatch perform our statutory functions Mandy Larder manages the Healthwatch Ethically grow and diversify other sources of Wakefield Advice, Information and Signposting income service at Citizens Advice
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Volunteers took part in our volunteer week celebration and networking event. Quality Account Task group successfully completed draft statements which were returned to the following Trusts: Mid Yorkshire Hospitals NHS Trust, Yorkshire Ambulance NHS Trust and South West Yorkshire Partnership NHS Foundation Trust. A number of volunteers successfully took part in the hospital PLACE inspections and participated – Pinderfields, Pontefract, Dewsbury, Queen Elizabeth House, Methley Park and Wakefield Hospice. Volunteers have asked for training on Infection Control for when they do this work again next year and we are currently in discussions with the Trust if and how we can arrange this. Patient safety walkabouts happened on a monthly basis and volunteers enjoyed attending these with the Clinical Commissioning Group. The CAMHS Enter and View visit took place. Our volunteers helped with the Future in Mind Young People Survey. Hear See and Treat Engagement Work saw volunteers inducted and trained to carry out this work. They did six sessions at Pinderfields and Pontefract Hospitals and there were two group sessions with South Asian Men and Women’s groups at Agbrigg Community Centre. Total surveys completed across West Yorkshire: 2,585 The Quality Account Task Group met with Mid Yorkshire Hospitals NHS Trust. Healthwatch volunteers met regularly with Methley Park Hospital regarding the new building extension. CCG Patient Safety Walkabouts happened with volunteers at Gate 32, Gate 46, Pinderfields Eye Centre, and Gate 43. The Mid Yorkshire Hospitals NHS Trust Access Meeting in July included Healthwatch volunteers. They also took part in the work for the Trust on Patient Transport and the Blue Badge Survey Report. Mid Yorkshire Hospitals NHS Trust Travel and Transport Meeting included Healthwatch volunteers and was also held in July. Following the Enter and View Visits to CAMHS a meeting with Director Carol Harris took place to discuss recommendations in the report. It was agreed that a patient survey should be carried out. Volunteers helped with and attended the Future in Mind event hosted in July. Volunteer Training on Dementia Awareness took place in August and September. A Volunteer Macmillan Coffee Morning was held in September. The Emergency Department Survey took place with volunteers trained and inducted then carrying out four sessions at Pinderfields and Pontefract Hospitals. Total surveys completed were 218. The Quality Account Task Group had their meeting with senior personnel at Mid
Healthwatch Wakefield 2016-17 31
Yorkshire Hospitals NHS Trust. Volunteers met regularly with Spire at Methley Park Hospital regarding the building extension. CCG Patient Safety Walkabouts took place: Team 1 at Gate 18 Maternity, Team 2 at Gate 32 Surgical Assessment Unit, Team 3 at Gate 45 Respiratory, and Team 4 at Gate 33 General Surgery. Mid Yorkshire Hospitals NHS Trust Access Meeting took place in October with volunteers. Mid Yorkshire Hospitals NHS Trust Travel and Transport Meeting also took place in October. The Dementia Strategy Board Meeting happened in November with our Representative present. Volunteers participated in the Enter and View Visit to West Ridings Care Home. The Future in Mind Event that Young Healthwatch hosted took place in October with young volunteers. A volunteer information and training session on wellbeing was delivered by Turning Point in December. An Induction Session on Patient Safety Walkabout was held at Healthwatch in January with volunteers. A Walkabout took place in Pontefract in January at Elective Orthopaedic, Intermediate Care, and A&E with volunteers. Another walkabout took place at Pinderfields in March at A&E, Gate 41 Elderly, Gate A2 Stroke & Neurology, and Gate 31a Cardiology. Wakefield College Engagement Sessions with students on level 1, 2 & 3 Health and Social Care courses took place in January with a total of 80 students. Volunteers participated in our Stroke Engagement event in February. Children’s Oral Health Surveys with Public Health took place in January and February with four sessions. Travel and Transport Meeting at Mid Yorkshire Hospitals NHS Trust in January with one volunteer. The Access Meeting at Mid Yorkshire Hospitals NHS Trust attended by volunteers took place in January. The Hospital Car Parking Meeting with volunteers took place in January. A volunteer and staff member attended a conference in York with the British Red Cross on Volunteering in February. Induction sessions on PLACE happened in March with PLACE visit in then taking place in March 2017 at Pontefract and at Pinderfields, both with two volunteers. Six volunteers looked through and commented on the Strategic Plan 2017-2018 at a Safeguarding Session with Wakefield Adult Safeguarding Board in March. A Quality Account meeting with Mid Yorkshire Hospitals NHS Trust took place at the end of March organised by Healthwatch Wakefield with volunteers and the Overview and Scrutiny Committee.
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Our core contract for 2016/17 remained at the original level of £217,268. We are delighted that our local council has been supportive of our work to the extent that we have not seen the cuts that have happened in other areas of the country and we would like to extend our thanks to Wakefield Metropolitan District Council and other partners for their support during the year. Expenditure against our core contract for 2016/17 is shown in the table below.
Income £
Funding received from local authority to deliver local Healthwatch statutory activities 217,268
Expenditure £
Operational costs 86,566 Staffing costs 105,399 Office costs 17,564 Total expenditure 209,529
Balance brought forward 7,738
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Registered Office: 11-13 Upper York Street, Wakefield WF1 3LQ
01924 787379 for staff and volunteers 01924 234007 for advice, information and signposting
www.healthwatchwakefield.co.uk
@healthywakey
/Healthwatch Wakefield
Address of sub contractors Citizens Advice, 27 King Street, Wakefield WF1 2SR Young Lives Consortium, Lightwaves Leisure Centre, Lower York Street, Wakefield WF1 3LJ
We will be making this annual report publicly available on 30 June 2017 by publishing it on our website and sharing it with Healthwatch England, CQC, NHS England, Clinical Commissioning Group/s, Overview and Scrutiny Committee/s, and our local authority.
We confirm that we are using the Healthwatch Trademark (which covers the logo and Healthwatch brand) when undertaking work on our statutory activities as covered by the licence agreement.
If you require this report in an alternative format please contact us at the address above. © Copyright Healthwatch Wakefield 2017
Registered Company No: 09907848 and Charity No: 1166797 Registered in England and Wales
Healthwatch Wakefield 2016-17 34
“Healthwatch have provided some very helpful and insightful reports on Trust services that we have used to guide future developments and improvements.”
“Healthwatch Wakefield insight reports are unbiased and give praise and raise concern in equal measure where possible.”
“They represent the public views in a way that the commissioners never heard before.”
“I think Healthwatch works hard to co-ordinate work which complements rather than duplicates that done in other settings.”
“Healthwatch work in a constructive manner which makes them a positive partner.”
“Positive approach to reviewing service provision and appropriate involvement of commissioners of services.”
“Clear and visible at the events and friendly knowledgeable staff.”
“I have positively experienced Healthwatch making contact around significant issues encountered by individuals in order to try to enable a more constructive response to be put in place.”
“Healthwatch is a very valuable organisation for the local people of Wakefield but equally, has a vital role in the Trust (Mid Yorkshire Hospitals NHS Trust) developing better quality services. The Trust should try and include Healthwatch more in its normal business.”
“The quality of the work and the products delivered by Healthwatch Wakefield is excellent. The staff team work well together and with partners, always happy to offer help and advice when necessary.”
360° Quality Statements Review
Healthwatch Wakefield www.healthwatchwakefield.co.uk Registered Office: 01924 787379 11-13 Upper York Street, Wakefield WF1 3QL [email protected] Registered Company No: 09907848 @healthywakey Charity No: 1166797 Registered in England and Wales facebook.com/Healthwatch Wakefield