Healthwatch NEL Annual Report 2013/14
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Š Healthwatch England 2013 The text of this document (this excludes, where present, the Royal Arms and all departmental and agency logos) may be reproduced free of charge in any format or medium providing that it is reproduced accurately and not in a misleading context. The material must be acknowledged as Healthwatch England copyright and the document title specified. Where third party material has been identified, permission from the respective copyright holder must be sought. Any enquiries regarding this publication should be sent to us at enquiries@healthwatch.co.uk You can download this publication from www.healthwatch.co.uk
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Contents
Contents 2 3
Chair’s Remarks Introduction
4-5 6—9 10—13
Vision, Mission & Values. Our Work & Performance Working Together
14 15 16 17
Enter & View Financials Looking Ahead & Office Team Appendix
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2 Annual Report
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Chair’s Remarks
Chair’s Remarks Healthwatch North East Lincolnshire (HWNEL) is now one year old. As a relatively new organisation it is probably worth reminding ourselves of what we are here for: `Healthwatch is the new independent consumer champion created to gather and represent the views of the public. Healthwatch will play a role at both national and local level and will make sure that the views of the public and people who use services are taken into account.’ (Care Quality Commission) One of the main priorities this year has been to make sure that people know about us and that they understand our 'independence'. I hope that message is becoming clearer so that anyone can be confident in coming to us with their views and
concerns about local services. It has been a busy year establishing our team, our services and our efforts to represent the views of the people across the borough on a multitude of issues. We have started to record what people think about services in North East Lincolnshire - what people tell us is good about local health and social care services, and what is not so good. HWNEL has completed its first survey on peoples' views of local services, and soon our programme of 'Enter and View' will start to tell us more about your experiences as our team of volunteers begin to visit the places people tell us about, but we need to keep up the conversation. Your information could be that vital 'early warning' for services which are not as good as they should be, and together we can do something about it, earlier rather than later. There is much that we can do to help the voice of people in North East Lincolnshire to get improvement and the best from local health and social care services. In preparing this first annual report for HWNEL, I need to thank our office team who so swiftly got our
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services up and running, and who now provide the excellent support both at our offices in Foresight, and out and about across North East Lincolnshire. Their commitment to the people of NEL and to the work of Healthwatch is exemplary. I also want to thank our board who, although they have not been long in office, have helped tremendously in getting us settled and established in our way forward. Finally, and most importantly, I want to thank those patients, carers, service users and members of the public who have already come forward to work with us, either as volunteers or to give us their concerns and views about their experience of local services. You are the ones helping to make a difference for us all - thank you. We look forward to working with you all in the coming year to make sure your voice is heard by those who need to hear it. -Kathleen Young
3 Introduction
Introduction The reporting requirements for this first annual report for Healthwatch North East Lincolnshire are set out in accordance with the Local Healthwatch Annual Reports Directions 2013. These directions aim to ensure that annual reports:
Are open and transparent and able to demonstrate that public money is being well used.
Enable scrutiny of how we are delivering our statutory activities and using our statutory powers and the impact of this.
Show how our statutory powers are being used.
Identify whether other organisations are enabling us to fulfil our role effectively.
These reporting requirements apply to the North Bank Forum, the `host body’ that was awarded the contract by North East Lincolnshire Council to deliver Healthwatch in North East Lincolnshire. It does not directly apply to the contract for Independent Complaints Advocacy (ICA) which, in North East Lincolnshire, was separately awarded to the Carers Federation. However, information on ICA activity is included in this report as an appendix as they are delivering a key element of local Healthwatch activity and are working closely with the local team in supporting people who need to complain about health and social care services. Healthwatch England was established in
October 2012 and is the body that enables the collective views of people who use health and social care services to be heard at a national level. Healthwatch England reports into the Care Quality Commission but is independent of it. In addition to providing leadership, guidance and support to local Healthwatch, Healthwatch England also provides advice to the Secretary of State for Health, the NHS Commissioning Board, Monitor and local authorities across England to which they must take account. HWNEL was one of 152 local Healthwatch established from 1 April 2013. The team moved into offices in the Foresight building in Newmarket Street, Grimsby, in early April and we thank Foresight for continuing to support us by making office space available. The new Foresight building close by on Freeman Street is close to completion and we look forward to moving into new and larger offices with a clear, visible frontage. This will help us to open our doors to even more people who want to speak to us as we plan to have more volunteers manning the desk and phones, waiting to hear about people’s experiences with local health and care services. HWNEL has taken over the work of the Local Involvement Network (LINk) with additional responsibilities specified in the Health and Social Care Act 2012. Our responsibilities and activities are captured in the section on Performance below.
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Vision, Mission & Values
Vision, Mission & Values 4
Vision, Mission & Values
The Executive Board has agreed the following points as the vision, mission and values for HWNEL: Vision Our vision is that local communities and service users are provided with safe and high quality health and social care services which are developed and responsive to community and service user needs. Mission Our mission is to give a strong voice to local people and community and voluntary groups so they can influence the way their health and social care services are planned, purchased and provided.
Accountable – we will be driven by the commitment of local volunteers and the passion of our Board and we will share information about the organisation widely.
Integrity – we will rise above individual and single organisational interests and ensure that all that we do is for the benefit of the public and health and social care service users.
Values Everything we do in Healthwatch NEL will be driven by the following values and principles:
Leadership – we will ensure that everything we do contributes to positive improvements in health and social care services.
Independence – HWNEL will be an independent organisation, transparent, accountable and trusted to represent the communities of North East Lincolnshire.
Critical friend – we will be constructive as well as challenging with commissioners and service providers, ensuring that we provide evidence to support what we say and do.
Committed to excellence – we will ensure that all of the work that we do meets national quality standards.
Inclusive - we will support those communities who are not normally heard to have a voice and challenge inequality.
Many of us don’t know where to go if we have a problem or concern to raise
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Our Work & Performance
Our Work & Performance Involving local people in the planning and provision of local health and social care services We have involved local people in meetings to consider: The draft North East Lincolnshire Carers Strategy. Pre-engagement session on Healthy Lives Healthy Futures. The temporary transfer of hyperacute stroke services from Diana Princess of Wales Hospital, Grimsby to Scunthorpe General Hospital. Healthy Lives Healthy Futures commissioning strategy (stakeholder issues).
In addition, we have used our newsletters and emails to subscribers and our web pages to seek responses and involvement in a range of other issues including:
Case Study 1
Proposed relocation of two pharmacies in the area. Survey of experiences of health and social care services. Waiting times for GP appointments. Health and social care transport issues. Council consultation on controlled drinking zone. Healthy Lives Healthy Futures engagement activity.
The survey activity included direct interviews of users of disability and older people’s day services and in supported living accommodation.
Helping local people to monitor standards and influence improvements
The four meetings described in 1 above are examples of this as set out in the following case study:
As a result of concerns raised over a decision taken by Northern Lincolnshire and Goole Foundation Trust to transfer hyperacute stroke services from Diana Princess of Wales Hospital to Scunthorpe General Hospital, a public meeting was called attended by representatives of the Trust, the North East Lincolnshire Clinical Commissioning Group and East Midlands Ambulance Service in September 2013. A wide range of issues were raised including understanding what temporary relocation meant, risks to patients, quality, resources, the lack of public consultation and transparency of decision-making, and impact upon ambulance response times and delivery of timely and effective interventions. As a result, recommendations were made for:
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Greater publicity to be given to the temporary nature of the transfer and the benefits derived. Greater involvement of patients/carers in service planning and decision making. Greater transparency over matters discussed in private that are clearly in the public interest. Inclusion of the findings of the meeting in the post-Keogh review planning at the Trust.
Our Work & Performance
Finding out people’s needs for and experiences of local health and social care services We carried out a survey of local people’s experiences of health and social services from 12 November 2103 to 28 February 2014 and received and analysed 419 responses. The survey was posted on or web-pages and widely circulated through our newsletter and organisational contacts and their subscribers an estimated audience of over 4,000 people. It was also promoted at our regular stands and through interviews of recipients of day services and supported living accommodation. Focussing on 166 responses on areas where people thought improvements could be made, three key themes emerged: 71 people identified problems within the G.P. services (primarily waiting time for GP appointment, practice opening hours and booking appointment system). 39 people identified problems within the NHS/Hospital/Emergency Care Centre services (mainly waiting time in Accident & Emergency and
waiting time for hospital appointments.
13 people identified problems with Social Care in North East Lincolnshire, mainly around carer services.
The survey findings have been included in published reports to our Board and included in a dedicated newsletter and posted on our website. The Executive Board agreed in March 2014 that terms of reference for a review on access to GP appointments should be drawn up in the new financial year.
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Our Work & Performance
Nearly 95% of people think their health is ok or good
Reports and recommendations about how local care services could be improved The comments on the draft Carers Strategy (see 1 above) included a number of recommendations, most of which were reflected in the final version. The meeting about the temporary transfer of hyperacute stroke services included a set of recommendations about greater publicity about the temporary nature of the current plan and the benefits derived, greater public involvement in such planning and decision-making and that greater transparency is given on decisions taken in private that outweigh public interest considerations. A further example is given below:
Case Study 2 In December 2013 we were alerted by patients of delays of over three weeks for an `ordinary appointment’ for patients at a local medical practise. These concerns were discussed with the NHS England Local Area Team. Although practices are not required to report to NHS England on such areas, the Local Area Team agreed to investigate these concerns and were able to report back on system changes that had already been taken to improve access. The practice acknowledged issues over GP resource in the face of significant growth in registered patients and is taking steps to recruit a further GP and Nurse Practitioner to meet demands.
Case Study 3 At our initial Executive Board meeting on 21 January 2014, a question was made about the lack of escort support for people with visual impairments to out-patient clinics at Diana Princess of Wales Hospital, Grimsby. The issue was raised with Northern Lincolnshire and Goole Foundation Trust who acknowledged the need for support for patients with disabilities by setting up a volunteer `Ambassadors’ escort scheme, implemented from 7 April 2014.
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Our Work & Performance
Providing advice and information Since June 2013, we have held regular monthly stands at Grimsby Central Library, Cleethorpes Library and Diana Princess of Wales Hospital. We have seen 354 people who raised 201 enquiries during the year at these sessions and through other contacts. We have produced bi-monthly newsletters from May 2013 which have been distributed to an average of 412 subscribers (excluding the twitter feed).
from 262 individual views in Q1 to 734 at Q4. Our Executive Board meetings, established from January 2014, are all held in public and include a `Question Time’ where issues can be logged, initial advice given and follow-up actions agreed. In the period from January – March 2014, 10 questions were recorded and feedback provided through our board meeting reporting.
We have set up a twitter account in Quarter 2 which has grown from 196 followers at end Quarter 2 (30 September 2013) to 388 by the end of Quarter 4 (31 March 2014). Our web-pages have seen an increase
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Our Work & Performance / Working Together
Making recommendations to Healthwatch England and other bodies HWNEL has provided information on its activities and concerns but has not formally made any recommendations to Healthwatch England in 2013/14. We did raise concerns about care treatment at one local residential establishment with the Care Quality Commission, where we received assurance that the issue was already subject of investigation. During this period HWNEL has requested information from the following: Organisation NHS England Clinical Commissioning Group Northern Lincolnshire & Goole Foundation Trust NAViGO Care Quality Commission
Issue(s) Access to GPs at one medical practice. 1. Work of Drug and Prescribing Committee. 2. Continuing need for walk-in medical facility. 3. GP appointment waiting time. 1. Rheumatology Services. 2. Escorts for people with visual impairments. Access to psychology services. Awareness of care concerns at a local residential home.
In all matters, these bodies have been prompt and supportive in their information and responses. There were no agencies who did not respond to our request for information.
Working together
Working with local people and communities Hearing the views of local people and reflecting this in our work with local commissioners and providers of health and social care services is critical to the local Healthwatch fulfilling its key tasks. We have also given presentations about the work of Healthwatch to the following: Healthier Communities Group Independent Mental Health Forum Safeguarding Adults Practitioner Forum Divisional Independent Advisory Group Brigsley Parish Council Community Forum Older People’s Collaborative Grimsby Institute – Child Care students (3 classes) NHS Staff Voice Group Cancer Collaborative Scartho Methodist Church Wives Group. 10
Working Together During the year we have provided information and advice at a number of settings including:
Monthly stands at Grimsby Central Library, Cleethorpes Library and Diana Princess of Wales Hospital Multi-cultural Mela at Meridian Park Freeman Street Market New Waltham Village Fete Big Red Heart Appeal Grimsby Institute Age UK North East Lincolnshire (5 information stands in September) Eng-Age AGM NAViGO AGM Alzheimer’s Society (Memory Cafes) Older People’s Day (Cleethorpes Memorial Hall) Stirling Street Medical Centre Carer’s Rights Day.
Our approach, stressing that we are independent of other local health and social organisations, is to allow people to share their stories, anonymously if they wish. In securing the views of a wide range of local people, we are required to specifically report on the following:
People under 21 – our work at Grimsby Institute with a stand and in presentations to students have mainly been with people under 21. Our survey was completed by 55 individuals aged 24 and under but we cannot accurately break this down for under 21’s. People over 65 – our stands and contacts with Age UK locally and Alzheimer’s society have primarily been with people over 65. Our survey included visits to interviews of those attending the Curzon Day Centre which is primarily for older people and a total of 83 older people completed the survey. Disadvantaged people – the Healthwatch office is located in the East Marsh Ward, the second most deprived ward nationally. We have held stands at the local Freeman Street market located in East Marsh and have met and worked with other organisations located in the area health, social care on community needs. Vulnerable people – Our survey of experiences of health and social care services targeted users of day services and supported living. One issue raised in direct contacts was the lack of continuity of support in home care. Seldom heard people – the Healthwatch team was engaged with a number of other organisations in an effort to secure seldom heard voices. This has included our sessions at Age UK North East Lincolnshire with older people which has highlighted concerns over hospital discharge and through visits to Memory cafes run by the Alzheimers Society. We have also met with carers support representatives to look at issues affecting carers supporting people with mental health illness. As part of our survey, we targeted organisations delivering support to homeless people and people from ethnic minority groups.
The NHS sees over a million patients every 36 hours
That’s over 27,000 patients every hour
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Working Together
Working with other organisations HWNEL has established working relationships with a diverse range of health and social care bodies as set out in the table below: Table of activity with other organisations and groups Organisation/Group Healthwatch England Care Quality Commission North East Lincolnshire Council
Health Scrutiny Board Clinical Commissioning Group
Northern Lincolnshire & Goole Foundation Trust
Care Plus Group NAViGO VANEL Healthier Communities Group Dementia Action Alliance
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Activity Point of contact with Area Team for raising concerns Quarterly Assurance meetings with CCG Point of contact for raising issues Quarterly regional meetings National Advisory Conferences Contractual monitoring/ quarterly meetings JSNA (Joint Strategic Needs Assessment) Steering Group PNA (Pharmaceutical Needs assessment) Steering Group Ageing Better (Lottery Bid) project Agreed route for raising concerns through their programme of work Point of contact for raising concerns Healthy Lives Healthy Futures stakeholder group and Transport sub-group Quality, Safety & Assurance Group ACCORD – liaison meetings Agreed point of contact for raising concerns Healthwatch and Steering Group (joint working protocol with HW in North Lincolnshire and East Riding of Yorkshire) Membership Working Group Agreed point of contact for raising concerns Agreed point of contact for raising concerns Member with access to Disclosure & Barring Service brokerage and room bookings Links to Volunteer Centre Member Member with agreed action plan/contribution to DAA aims
Working Together
Health & Wellbeing Board HWNEL is a statutory member of the North East Lincolnshire Health and Wellbeing Board and has been represented by Kathleen Young, Chairman since her appointment. HWNEL has a 100% attendance record at HWBB meetings during 2013/14 either through the Chair or officer. The office team briefs the Chair on relevant agenda items and opportunity is given in these meetings to report back on Healthwatch issues and activities.
27,350
children and young people are in care arranged by their council
Working with volunteers HWNEL has an office team of 2.6 WTE (whole time equivalent) staff. HWNEL is building a strong base of interested subscribers which stood at 470 as at 31 March 2014. However, it cannot complete its mission without the active volunteering of members of the local community (Healthwatchers). As at 31 March 2014, HWNEL had recruited the following volunteers: Executive Board (Chair plus five Executive Board members) 6 x Enter and View Representatives 2 x Community Engagement 2 x Administrative Support 1 x Research and information
In addition to these roles, we are seeking volunteer support in establishing a Reader’s Panel. A Volunteer Handbook and Volunteer Pack is now available. Like many Healthwatch across the country, HWNEL has gone through a process of appointing a Chair during the summer and an Executive Board in the autumn of 2013. The Executive Board is made up of the following people: Chair (from August 2013): Kathleen Young Board members from November 2013 with lead roles:
Board Member
Lead Roles
HWB Strategy
Esther Smith
1. Inequalities 2. Volunteering Development 1. Primary care 2. Older People including Carers 1. Children & Young People including Carers 2. Mental Health including Carers 1. Northern Lincolnshire & Goole Foundation Trust 2. Disability including Carers 1. Public health 2. Adult social care
Addressing inequalities – regeneration, education, environment Supporting improved health – access to good quality services Securing the future – children and young people
Yvonne Clark Sam O’Brien Robin Barr Malcolm Morland
Taking wider action on wellbeing e.g. housing, transport Keeping people well – healthy behaviours
Notes: 1.Financial support to the Board is provided through Helen Schofield, Deputy Chief Officer, North Bank Forum. 2. Robin Barr resigned from the Board on 20 March 2014.
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Working Together/Enter & View
The Executive Board is entirely made up of volunteers appointed through a competitive interviewing process. There are two vacancies as at 31 March 2014. In addition to those named, the Board has agreed to the co-option of a Youth representative. The Board has met on three occasions: 21 January, 24 February and 25 March 2014. It is the decision-making body for policy-setting and determining strategic priorities and has agreed the governance arrangements for HWNEL.
The Board agreed a policy on volunteering including on enter and view at its first Board meetings in 2014. The volunteering policy includes implementation targets for increasing volunteer support as follows: Enter and View = 12 Community Engagement (Level 1) = 4 Community Engagement (Level 2) = 4 Research & Information = 3 Readers Panel = 4 Administrative Support = 3 Total = 30
Enter & View HWNEL has statutory powers to enter any health and social care premises providing publicly funded services (children’s services excepted). These visits are carried out to observe the quality of care received and to make observations and recommendations based on evidence on areas where improvements could be made.
independent assessment of dignity in these establishments. A programme of enter and view visits is being planned for early 2014/15.
In addition to active volunteers, HWNEL has a total of 470 subscribers (412 individuals and 58 organisations as at 31 March 2014. This represents a No visits under these statutory powers reduction from a combined figure of were conducted during our initial 644 at end Quarter 1 (at 30 June 2013) phase 2013/14. This period has been but this is mainly a result of a review used for staff to receive `train the of postal distribution and restricting trainer’ support from Healthwatch this to those who have formally England and in ensuring that all approved volunteers become confirmed their wish to continue as a authorised representatives by subscriber with us. All subscribers undertaking prescribed training including Safeguarding and are cleared receive our bi-monthly newsletter but subscribers on email circulation receive under the Disclosure and Barring Service national arrangements. additional mailshots between these newsletters. Agreement has been reached with North East Lincolnshire Clinical Commissioning Group that Enter and View will support the Dignity Challenge programme in local residential and nursing care homes by providing an 14
Financials Financials
Financials Financial statement 2013/14 Below is the income and expenditure analysis for 2013 – 2014. The NBF Board has agreed that underspend against the Responsiveness Fund will be carried forward into 2014-15 as additional spend for the Healthwatch Board to allocate to development activities. Audited accounts will be available later on in the year. INCOME
Q1
Q2
Q3
Q4
Total
Actual
Actual
Actual
Actual
Actual
Balance b/f NELs Contract Total
0 29,540
29,540
29,540
29,538
118,158
29,540
29,540
29,540
29,538
118,158
12,304 875
16,051 875
15,763 875
15,763 875
59,881 3,500
2,000 150 902 1,959 625 187 450 215 188 375 1,330 1,048 312 249 1,722 36 2,251 986 29
2,000 137 963 362 625 187 450 215 188 375 144 115 312 249 38 489 0 389 24
2,000 0 628 599 625 187 450 215 188 375 584 145 312 249 450 92 1,913 972 285
2,000 0 651 718 625 189 450 215 186 375 342 107 314 253 735 1,381 82 2,150 358
8,000 287 3,144 3,638 2,500 750 1,800 860 750 1,500 2,400 1,415 1,250 1,000 2,945 1,998 4,246 4,497 696
28,193
24,188
26,907
27,769
107,057
Healthwatch North East Lincolnshire Income and Expenditure for 2013/14 by Quarter
EXPENDITURE Salaries Premises Management Function Training Staff Expenses IT & Telephones Finance Function HR Function ICT Function Insurance Auditing Admin Postage & Stationery Equipment Utilities Contracts Office & Utilities Reprographics Website Responsiveness Fund Volunteer Expenses Total Exp
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Looking Ahead / Office Team
Looking ahead As we look to the year ahead there are grounds for optimism:
We will be moving into shop-front premises which will make us more visible and accessible to local people backed by an additional volunteer administrative support team. We will be joined in our new premises by the Independent Complaints Advocate which will allow for more joined up working on complaints. We will embark on our first Enter and View visits as a Healthwatch to add to feedback on local views. We will commence our first formal review and investigation into access to GP appointments locally. We will improve our partnerships with other organisations, especially in the voluntary and community sector, so that together we can capture the voice of local people and provide a greater influence on the shape of local services.
We still face challenges:
Recruitment to and development of our Executive Board including co-options. Developing an effective volunteer base to be more proactive and to deliver the full range of our responsibilities.
We remain both encouraged and optimistic that we can build on our first year foundation and make an increasing impact on behalf of local people.
Office Team The registered office team comprises: Paul Glazebrook – Partnership Co-ordinator Karry Stones – Research and Information Officer (part-time) Tayo Davenport – Project Officer The Team is based at: Foresight 60 Newmarket Street Grimsby N E Lincs DN32 7SF Tel. 01472 269666 Email: healthwatchnel@nbforum.org.uk Website: www.healthwatchnortheastlincolnshire.co.uk 16
The team is line-managed by Helen Schofield, Deputy Chief Executive, North Bank Forum and reports to Kath Jones, Chief Executive, North Bank Forum. North Bank Forum is based at: Goodwin Community College 63-71 Anlaby Road Hull HU3 2LL Tel. 01482 472458 Email: ali@nbforum.org.uk Website: www.northbankforum.org.uk
Appendix
ICA The contract for Independent Complaints Advocacy (ICA) in North East Lincolnshire during 2013/14 has been awarded to the Carer’s Federation. The Carer’s Federation also held the contract for the previous Independent Complaints Advocacy Service (ICAS). ICA is a means of providing practical support and information for people who need to make a complaint about NHS Services. In North East Lincolnshire that support is also extended to Adult Social Care Services. The advocate will help a person to pursue a complaint by themselves or give support through the complaints process. Advocacy is a system that uses experienced workers to help people speak up for themselves and to represent their own thoughts and feelings when things are difficult. They do not tell a person what to do or act on the wishes of others. That help includes:
Help in compiling all issues to raise in a complaint Help in writing letters to the right people Preparing a person for meetings and going to these with individuals if needed Answering questions to help a person make decisions Giving the opportunity to speak to someone independent of the NHS (or Adult Social Care) Helping secure face to face discussions to discuss and resolve issues Helping explain the complaints process and what a person can expect to An overwhelming achieve through complaining majority of the public Monitoring the progress of a complaint (94%) think NHS and Putting a person in touch with any other social care services people or services that might be of help could be improved Providing a self-help information pack.
As at 31 March 2014, ICA had 14 open cases having dealt with 15 new cases during Quarter 4 (to 31 March 2014) and having closed 7 cases. Advocate support is made through contacting: North East Lincolnshire Complaints Advocacy The Hub, Unit A1 Patrick Tobin Business Park Bolton Road Manvers Dearne Valley Rotherham S63 7JY Or by tel. on 08088023000 Or by email on:nelica@carersfederation.co.uk Or by website: www.carersfederation.co.uk/ icanel 17
Publication This Annual Report is published and made available on the HWNEL website: www.healthwatchnortheastlincolnshire.co.uk Hard copies will be made available on request by contacting the team office where requests for this report in other formats should also be made. Hard copies will also be made available in all local libraries. The Healthwatch Brand HWNEL is licensed to use the Healthwatch trademark (which covers the logo and the Healthwatch brand) as per our license with Healthwatch England and the Care Quality Commission.