You said, we did
Find out how we have used your feedback and insight to make a difference.
The Bradford Maternity Partnership (also known as the Maternity Services Liaison Committee) works with providers and commissioners to make sure maternity services meet the needs of women, parents and families in the Bradford district and Craven area.
At the beginning of 2015, the partnership asked local people for their feedback about maternity services, the choices offered and if care was personalised to their needs.
This report summarises the feedback received and the recommendations made as a result
We’ve put together a brief update about what we have been doing in response to feedback received from patients and carers between January and March 2015. You can read it here.
Tissue viability is the area of health care that covers all aspects of skin and soft tissue wounds, including surgical wounds, leg ulcers and pressure ulcers (referred to as bed sores). A leg ulcer is a long-lasting (chronic) sore on the leg or foot that takes more than four to six weeks to heal.
We were aware that treatment and referral routes to tissue viability services in Craven were different to those in Airedale and Wharfedale. We decided to review the tissue viability service in Craven and so asked patients about their travel to appointments and their preferences for the location of new services.
What has happened since?
A new service specification for tissue viability has been developed. The service specification describes what the tissue viability service will do and what standards of care it will deliver. Our Executive Group, which is clinically-led, approved the new service specification.
We made sure that the new service specification took into account what patients and the public told us.
You told us:
Some people were having to travel for long periods for their appointments. 91% of people with a disability felt it had an effect on their travel arrangements. Patients said that the distance of the tissue viability service from their home was important.
What we’ve done:
The new service specification says that as much as possible, care should be provided closer to home. This should reduce the amount of travel that patients have to do.
Leg ulcer clinics will be held at least four times per week and will be held in community locations across the Airedale, Wharfedale and Craven localities. This should reduce the amount of travel that patients have to do.
People will only be treated in a hospital setting for as long as they need to be. When their condition has improved, their care will be delivered in a community setting. This means patients don’t have to travel to a hospital for their appointments unless they need to.
You told us:
Patients at the Wound Healing Unit at Bradford Teaching Hospitals told us that they felt they had to wait for too long before they were referred to a leg ulcer clinic and so their condition worsened.
What we’ve done:
The specialist tissue viability team will provide expert advice and teach other staff in the community, hospital, and GP practices and social care staff about tissue viability. This will help health and care staff to look after patients with pressure and leg ulcers so that their condition does not worsen. Staff will be trained to recognise when ulcers are worsening or need specialist care by the tissue viability team, so that they refer patients quickly when needed.
Patients will be supported to be involved in their care and decisions about their care. Patients will have a personalised management plan. This will help patients to manage their condition so that it does not worsen or reoccur in the future. If their ulcer does reoccur, patients will be able to self-refer back to the service, so that they can be seen quickly.
Patients who need to be seen urgently by the tissue viability service will receive an appointment quickly. If a patient in the community is urgently referred to the tissue viability service, they will be reviewed within one working day and offered an appointment within two working days of the review. Patients in hospital will receive a visit within two working days of referral if they need to be seen urgently.
The CCGs in Bradford, Airedale, Wharfedale and Craven have developed a strategy that describes how urgent and emergency care services in will develop over the next five years.
We worked with a range of different people – including the public, through market research, focus groups and other discussions – and organisations to compile the strategy. We then asked patients and the public for their views about it.
We have now written a report about what people told us about their experiences of urgent care and their views on the strategy.
Between November 2013 and February 2014, we asked people to tell us about their experiences of the Child Development Centre, as part of a review of the service.
This report contains a summary of people’s feedback and the recommendations that were made as a result.
The next stage is that we will publish a report on this page on what actions we have taken in light of the recommendations.
The Bradford District and Craven Maternity Partnership, which has representatives from commissioners, providers and service users agreed to hold a series of discussion groups to gather feedback from parents on community midwifery services. This report summarises the feedback from the groups and the recommendations as a result
We have launched a scheme called Pharmacy First – it means your local pharmacy can give you advice and, if needed, medicines for common illnesses, so you don’t have to make an appointment with your GP. As part of this scheme we developed some leaflets on antibiotics and coughs that pharmacists can give to members of the public.
We wanted to sense-check the leaflets with members of the public to make sure that they were clear and understandable.
This document explains who we talked to, what they told us and what we have done as a result.
Thanks to all who joined us in Ilkley and Keighley for the Have Your Say events earlier this year. We wanted to hear from you about your ideas for what your local health services should look like.
Feedback fell into two general themes with the following key messages:
In addition, there were a number of comments and ideas about saving money and making the most of resources.
A number of people did raise the issue of A and E services continuing to be available locally, though this was a result of being prompted in discussing emergency care.
The way the CCG itself communicates and engages with people was discussed. Comments included:
The single biggest challenge/issue facing the NHS was seen as money. All forms of communication, including face-to-face meetings and social media were seen as useful.
Here are responses to specific questions.
Put patients first, make sure our care is joined up
We are doing:
It is our top priority to make sure care for patients is joined up. This starts with how patients access services in the first place and runs through to getting care and treatment in different places, such as hospitals, specialist centres and social care. This is not as easy as it sounds because of the complexity of the systems and processes used by different organisations. We are currently working very closely with the local authorities in Bradford and North Yorkshire, as well as Airedale and Bradford hospitals and Bradford District Care Trust to make sure all our services are joined up.
Listen to patients
We are doing
As a CCG we have established a number of ways you can talk to us about local health services in general and your health in particular. You can tell us via our patient feedback leaflets or our contact form on our website. As the commissioner of health services, we have mechanisms in place to make sure that those who provide services to you, such as hospitals, demonstrate that they are listening and acting on what you are telling them and us.
We know that being listened to is one of the most important issues you have raised, so we will continue to develop ways of hearing what you have to say and acting upon it. We will then tell you what has happened as a result.
We’re worried that you’ll cut accident and emergency at Airedale Hospital. As it is, there’s increasing demand.
We are doing
There is no intention to cut the accident and emergency service at Airedale; it plays an important part in providing urgent and emergency care for the people in the district. We are currently working with the CCGs in Bradford to produce a strategy for urgent and emergency care that will improve how people can access urgent care quickly and conveniently. The draft strategy will be published shortly, we hope you will read it and let us have your comments.
We want better end-of-life services to include respite care and support for carers. Could there also be consideration of assisted euthanasia?
We are doing
We have funded a seven-day-a-week palliative care nursing service, and a service called the Gold Line, which offers 24/7 access to a team of nurses for patients at the end of their life. We do work closely with Bradford and North Yorkshire councils and are aiming to procure a new service for carers, which includes carers’ needs assessment and support packages. We are also working with them on providing joined up respite care across health and care services through our new integration programme
Euthanasia and assisted suicide are not legal in the UK and so are not considered by the CCG when commissioning services.
We need to know what services are available to us
We are doing
We have developed a number of ways to inform you about services including using the local newspapers, information in surgeries and other public places, the internet and social media such as Twitter and Facebook. We want to work with you on how this can be improved to better meet your needs so please let us know your thoughts.
Can’t the NHS make better use of technology to communicate with patients and with it so we don’t have to repeat our stories over and over again?
We are doing
We would like to explore different ways of communicating with patients, such as using Skype and telephone consultations. And of course we continue to roll out telemedicine and consultations by email.
Joined-up IT systems are a national issue, led by the Department of Health. A key priority for us is working with health and social care providers to improve the joining-up of services and ensuring appropriate needs assessment is undertaken and care packages put in place. Working with Bradford Council we are developing an integrated health and social care record so that clinical information can be shared between providers
Mental health services should be more accessible. Loneliness and isolation are contributing factors.
We are doing
Mental well-being is a priority area for us and we know we have a lot of work to do in this area to make improvements. Over the next two years we intend to have a particular focus on dementia, learning disabilities and liaison psychiatry.
The integrated community teams include social care and mental health professionals which enable holistic assessment of people’s needs and takes into account issues such as isolation and loneliness. The health navigators and village agents which we have commissioned will signpost to voluntary services to help those who are lonely and isolated.
It’s difficult to get a GP appointment, particularly on a Saturday morning. Then there is inconsistent GP provision, or GPs don’t know the family.
We are doing
We do get many comments about access to GP appointments and are aware of the demand for appointments. We have a responsibility for securing continuous improvement in the quality of primary medical care. We work with NHS England as commissioners of primary care to assess just how good those services are and what action needs to be taken for improvement, for example funding additional opening over the winter period and on Saturdays. Some surgeries will continue to open on Saturday mornings.
Patients over 75 and those with complex needs should have one accountable GP who is responsible for their care, this is a national requirement. We are also joining up a range of services in community teams and we have introduced health navigators, who are people that can work with patients and healthcare professionals in accessing services across the voluntary and community sector.
We are also in the process of introducing a new scheme called Pharmacy First which allows people with certain minor ailments to go straight to their pharmacist to receive a consultation without needing to visit their GP to get a prescription first. The pharmacist may offer a private space to discuss your minor ailment, provide advice and, if necessary, treatment. This will be free of charge if you are exempt from prescription charges, just like if you went directly to your GP.
If you do have a particular issue with your GP practice you could raise it with the Patient Participation Group.
There should be more information about self-care
We are doing
Self-care and prevention are part of our strategy for the future, but we do need help from local people to determine what this should look like.
In the meantime, we have funded some important schemes, including health promotion managers in two practices in Craven, community health navigators across Airedale, Wharfedale and Craven, health promotion equipment in GP practices, diabetes education folders and village agents for health.
Couldn’t you work more with voluntary organisations?
We are doing
The CCG works with the Airedale, Wharfedale and Craven Health and Wellbeing Hub to determine where we have gaps in local services and identify some of the solutions we could put in place. A number of the schemes mentioned in the question concerning self-care are provided by voluntary organisations.
Transport is a real issue
We are doing
We do recognise there are issues, in particular in rural areas and will work with the local voluntary and community sector (VCS) to address some of these. We are also having talks in North Yorkshire with the Passenger Transport Executive.
How do you monitor the quality of hospital services?
We are doing
We monitor and work closely with all of our providers to review the quality and safety of their services. For our main hospital provider, Airedale NHS Foundation Trust, we sit on their patient and public experience group to support the trust in looking at areas for improvement based on feedback from patients.
We are reviewing community nursing services in the Bradford district and Craven areas to make sure they meet the needs of our local population. As part of this review, we asked people who had used the services for their feedback. The review is still ongoing, but this summary gives an update of what we have done so far.
In 2013, NHS England set out ‘a call to action’ to staff, public and politicians. The call was to help the NHS meet future demand and tackle the funding gap through honest and realistic debates.
We asked the public for their comments and the report below summarises what you had to say and what actions we are taking.
Throughout July and August 2017, Healthwatch Bradford and District worked on behalf of local partners to create a ‘big conversation’ with local people about the future of health and social care.
They wanted to find out what mattered most to people, where there might be areas for compromise, and what people think could be done differently in the future. Over 800 people gave their views.
People shared lots of comments and ideas, not only thinking of their own needs but often wider issues and needs of the whole population.
They heard about GP practices more often than any other aspect of health and care, particularly about access to GP appointments.
Some other common themes were:
People often raised concerns about the funding of health and care, and shared fears about central government approach to the NHS and local authorities.
They heard strongly that people would support change in health and care if there was evidence that care would be improved.
For more detail about people had to say, see the full report.
The report is being presented to the Bradford Health and Wellbeing board on 19 December 2017 and being used to directly inform the local plan for the future of health and care in Bradford District and Craven.
This plan sits within the West Yorkshire and Harrogate Health and Care Partnership. You can find out more about this here.
Healthwatch Bradford and District - 01535 665258 or firstname.lastname@example.org