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Consultation Report

1 April 2011 – 31 March 2012

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Contents Page

Contents Acknowledgements


1. Introduction


2. Completed consultations: April 2011 to March 2012 • • • • •

Cluster-wide NHS Calderdale NHS Kirklees NHS Wakefield District NHS Kirklees & NHS Wakefield District

6 14 24 34 40

3. Ongoing consultations as of March 2012 • • •

42 44 48

NHS Calderdale NHS Kirklees NHS Wakefield District

4. Planned consultations: April 2012 to March 2013


Acknowledgements We would like to thank all of the individuals and organisations who have taken part in our consultation and engagement activities over the past year, and shared their experiences of using local services. Your contributions have helped to inform our commissioning decisions, ensuring your local NHS continues to provide quality and responsive services. This report gives us the opportunity to tell you what consultations have happened over the last year, what you told us in those consultations and what we have done with the comments you made.

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1. Introduction About us The Calderdale, Kirklees and Wakefield District Primary Care Trusts (PCT) became a cluster in June 2011. Each PCT is still a statutory organisation in its own right, but all three are managed by a single Board which came into being on 1st October 2011. The PCTs are responsible for making sure that the people of Calderdale, Kirklees and Wakefield District have access to the health services they need. NHS Calderdale covers a population of over 210,000, NHS Kirklees more than 400,000 people and NHS Wakefield District in excess of 321,000 people. Under section 24A(1) of the NHS Act 2006, PCTs have a statutory duty to report annually on engagement activities relating to commissioning decisions. This is the third year that PCTs have produced a consultation report but the first such report produced on behalf of the Cluster. It covers the period from 1 April 2011 to 31 March 2012, as well as including details of planned engagement activity for 2012-2013.

Our Approach The views of patients, carers and the public matter to the NHS. We want to involve them, as well as doctors, nurses, other healthcare professionals and managers in the decisions we make. By working with patients, carers, patient organisations and the public, we are able to develop services which meet the health needs of our community. “A high-performing organisation does not see involvement as an isolated activity or a hoop to jump through. It sees its users as a valuable source of information, who are able to provide an insight into their needs and wants, and feedback on their experiences.� (Real Involvement - October 2008) A shared communications and engagement service for the Cluster has been operating since June 2011, which has strengthened resilience and made the most effective use of resources across the NHS CKW footprint. This has ensured that there is sufficient capacity and capability to continue to deliver high quality patient and public engagement in all aspects of work and ensure the Cluster PCTs meet their statutory duties in this respect. This includes two major transformation programmes, one across Calderdale and Huddersfield and the other for the Mid Yorkshire health economy, which require significant engagement support. We have continued to strive to deliver the highest standards of engagement work, using a wide range of methods and approaches, tailoring these to the needs of those we are involving and supporting people to be able to participate effectively. Activity is also designed to ensure all the nine protected characteristic groups are effectively represented, in line with equality and diversity legislation, and that it reflects the demographics of local communities.

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Changes to NHS commissioning The Health and Social Care Act 2012 sets out the governments proposals to modernise the NHS. There are two simple principles at the heart of the Act – that patients should share in every decision about their care and those responsible for patient care should have the ‘freedom and power to lead an NHS that delivers continuingly improving care’. As part of the changes, GPs will be taking over commissioning responsibilities from primary care trusts. This will mean that NHS Calderdale, NHS Kirklees and NHS Wakefield District will be replaced by four local clinical commissioning groups (CCGs): Calderdale CCG, chaired by Dr Alan Brook; Greater Huddersfield CCG, chaired by Dr Steve Ollerton, North Kirklees CGG, chaired by Dr David Kelly; and Wakefield CCG, chaired by Dr Phil Earnshaw. The CCGs will be responsible for planning and buying most NHS services for patients including community services, mental health and hospital care. They will be overseen by the National Commissioning Board (NCB) who will hold the CCGs to account for the quality of outcomes they achieve and directly commission services such as primary care. The CCGs will need to demonstrate to the NCB that they are working closely with patients. It is expected that this will be achieved by providing a report in a similar format to the current Report on Consultation. During 2011-12, the CCGs began the process of authorisation which will allow them to become public bodies. As part of this work they have started to outline how they will involve patients and the public in their decision-making processes and develop plans for ensuring this is central to their commissioning. The continued involvement of patients and the public is very much welcomed and details of how to get involved in the CCGs’ work going forward is available from the Shared Communications and Engagement Team (please see contact details at the end of this section).

Duty to report requirements The information required is set out in ‘Real Accountability’, the guidance published by the Department of Health in 2009. This not only applies to formal consultations on service changes, but to any activity where patients or the public are asked for their views on particular proposals or issues before a decision is made. The duty to report requires PCTs to report on consultations undertaken: • by the PCT, NHS trusts or NHS foundations trusts, that are independent of the PCT, but where the outcome will influence the commissioning decisions of the PCT; • by the specialist commissioning group for the strategic health authority area, which will have an impact on the commissioning decisions for the PCT; • by GP practices as part of the Practice Based Commissioning programme (or shadow Clinical Commissioning Groups) which have an influence on the commissioning decisions of the PCT; or • jointly with another organisation through an integrated management arrangement, such as with a local authority, on commissioning decisions by the PCT.

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The report includes all consultations that have been undertaken and completed during 2011/12, including any that started before 1 April 2011 or that started during the period of this report, but are not yet completed. It also includes details of the consultations planned for 2012/13. The guidance stipulates that the following information needs to be included for each consultation: • • • • • •

Who has been consulted. The issues or proposals were people asked to give their views about. Information made available to people during a consultation. A summary of the feedback obtained or received and the range of views expressed by different people. Commissioning decisions and relevant decisions taken by the PCT following the consultation. An explanation as to how views were taken into account when decisions were made and how feedback influenced the decisions taken. This should include whether anything was commissioned differently as a result of the feedback received and main issues considered on which it was not possible to act, and the reasons why.

The Report on Consultation When there are decisions to be made which affect how local NHS services are commissioned, we make sure we talk to those patients who will be most affected and for those larger pieces of work we make sure the general public are made aware of any proposals so they too have the chance to have their say. We carry out one off pieces of work as well as involving patients and the public on an ongoing basis through the partnership arrangements each PCT has in place with local patients and communities. The Report on Consultation is split into three sections. The first two sections cover consultations completed between 1 April 2011 and 31 March 2012 and those still ongoing as at 31 March 2012, with information on each of the points stipulated in the guidance. The final section gives a list of the consultations we anticipate carrying out in the next financial year, where these are already known.

For further information about the consultations and services included in this report, please go to: or contact the Shared Communications and Engagement Team:; 01924 317784

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2. Completed Consultations April 2011 – March 2012 Cluster Wide West Yorkshire Urgent Care Service review January 2012 West Yorkshire Urgent Care Service (WYUCS) and NHS Calderdale, Kirklees and Wakefield District Cluster (CKW) reviewed the West Yorkshire Urgent Care Services as the relevant contracts are due to expire March 2013. Who did we consult? A number of organisations, including representation from all of the nine protected characteristics, and individuals were contacted across the cluster. These included: • • • • • • • • • • • • • • • •

Calderdale Asylum seekers and Refugee Network Ward Forums VAC VAWD Faith groups Disability and sensory impairment groups BAME Older people LINk MPs and local councillors Patient groups LGB and T networks Wakefield Patient Reference Group Network Maternity groups Carer groups Children and young people groups

The feedback report includes an equality monitoring section of participants. What information did we give? An engagement document was produced explaining what urgent healthcare services were. This document also included findings from previous engagement work which had been undertaken in 2007 and information about the new NHS111 service which will replace the current West Yorkshire Urgent Care telephone service. A feedback form was developed (both paper-based and on-line versions on each of the three PCT websites and staff intranets) and included questions about what is important to patients and the public in terms of urgent care service.

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What did we ask? Stakeholders were asked their views on the following via a questionnaire and at meetings: • Are you aware of the WYUCS? • Have you previously used the WYUCS? • Which services have you used? (out of hours, unscheduled dental service, minor injuries unit) • How easy was it to contact WYUCS? • If you had an appointment, how easy was it to find your way to it? • How satisfied were you with the service? What did they tell us? The main themes from the public feedback included: • WYUCS is seen as a valued and essential service by those who have used it. • There is a lack of public awareness about WYUCS with many people calling for more effective awareness-raising of the service. • There appears to be some confusion between different urgent and emergency care services as NHS Direct and A&E. • The majority of people engaged with had a good experience of the service, receiving quick, effective treatment and good advice and information from helpful staff. • A small number of issues were raised about slow or no call backs. • A small number of people stated that there had been reluctance to undertake home visits from the service on occasions. • People were keen to ensure that this service was local and accessible to those who did not have, or were unable to use, their own transport. What did we do? Commissioners are pleased that members of the public see the WYUCS as a valued service so it will be re-commissioned and improved. Feedback about lack of public awareness is useful and we will ensure that a robust communications plan is implemented with the provider once the contract has been awarded. We would wish to involve the public to test future communication materials. In relation to confusion between different urgent care services, by doing engagement and communication work, we hope to resolve this issue. Our aim is that the majority of calls can be dealt with in one call resulting in the patient knowing their next step which should improve the slow or no call backs with the service. We are clear that where face to face consultation is necessary, the service should ensure that it assesses the most appropriate methods for the patients’ clinical need. This might be home visit or coming to a primary care centre. A feedback report has been sent to all stakeholders and individuals who we initially engaged with.

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CCGs will be responsible for this service and as such have been involved in the development process for the service specification and key performance indicators (KPIs) etc. Their Boards have also signed off these KPIs and the business case for this procurement. Each PCT has had nominated GPs involved who were crucial to the development and the evaluation of the service Where can you get more information about this work? For further information please go to:

Extending Patient Choice of Provider (AQP) September/October 2011 In August 2011, the Department of Health (DH) published Operational Guidance to the NHS: Extending Patient Choice of Provider (DH, 2011) in which it outlined the Government’s commitment to extending the patient choice of Any Qualified Provider for appropriate services with the intention “to empower patients and carers, improve their outcomes and experience, enable service innovation and free up clinicians to drive change and improve practice” (DH 2011, p. 6). In preparation for 2012/13, commissioners were required to have engaged with patients, patient representatives, healthcare professionals and providers on local priorities for extending choice of provider by 30 September 2011 and by 31 October 2011 to have used the feedback to identify three or more community or mental health services for implementation. Who did we consult? The following stakeholders were engaged as part of the process: • Patients, carers and relatives, general public • Voluntary and Community Groups • GPs, practice staff and patient reference groups • Local Involvement Networks • Staff • Health and Wellbeing Boards • Providers • Clinical Commissioning Groups • Town & Valley Committees / Ward Forums • Elected members / Councillors • Overview and Scrutiny Offices • Local Medical Committees, Local Pharmaceutical Committees, Local Dental Committees and Local Ophthalmic Committee • Media

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What information did we give? We produced a • survey • letter with a link to the survey • a feedback letter detailing the outcome and the commissioning decisions in respect of the services to be offered as part of AQP. What did we ask? People were asked to select three services from a given list where they would like to see a wider choice of providers offered and rate these by priority. We also asked for their views on the benefits they felt patients would get from having wider choice of providers. This was largely done using a web-based survey, which was promoted via a range of channels including press releases, social media, intranet and internet sites. In addition, existing external networks were used to distribute information and support the engagement process. To ensure this survey was accessible to those without access to the internet, hard copies were provided upon request and disseminated at public events, and a freepost address was used for replies. People were also given the option to speak to one a member of the Engagement Team to complete the survey over the phone. The survey commenced on 16th September 2011 and ended on 7th October 2011. The design of the survey took into account the Department of Health operational guidance as well as local priorities. The short-list of services people were asked to consider was developed after discussions with Health and Wellbeing Boards and local clinical commissioning groups and taking into account internal intelligence. These were: • The eight services identified in operational guidance; however to reflect the local need, musculo-skeletal services were considered in general rather than specifically for neck and back pain. • Dermatology • West Yorkshire Sexual Assault Referral Centre • Phlebotomy • Community Ultrasound • Cataracts In order to be able to fully analyse the data and offer an opportunity for more localised intelligence, participants were asked for part of their postcode. What did they tell us? Across the Cluster area, feedback identified diagnostic tests and scans closer to home and adult psychological therapies as the top priorities for services to be open to more choice. Responses were also considered by clinical commissioning group area to further identify the views of the local populations. A summary of the findings was produced (see link below) and a statement of outcomes was published and distributed to local groups, participants and the media.

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What did we do? The process brought together current information and feedback from the public and key stakeholders in order to select the most appropriate services both across the Cluster and within specific areas. The findings of this work were presented to the Cluster project team and contracting leads to inform the selection of local priorities for consideration. Based on the feedback, the list of options was narrowed down to three to take forward. Based on the response to the survey and feedback from the Strategic Health Authority, the following services were opened up to any qualified provider in 2012/13: Diagnostic tests and scans closer to home – cluster-wide Adult psychological therapies – Calderdale Adult hearing services – cluster-wide Where can you get more information about this work? Please go to:

Equality Delivery System (EDS) March 2012 The Equality Delivery System (EDS) has been designed by the Department of Health to help NHS organisations measure their equality performance and understand how driving equality improvements can strengthen the accountability of services to patients and the public. It will enable NHS Calderdale, NHS Kirklees and NHS Wakefield District to identify local needs and priorities, particularly any unmet needs of populations, and allow them to assist in the commissioning of services to deliver better health outcomes. At the heart of EDS is a set of 18 outcomes grouped into 4 goals; 1. Better health outcomes for all 2. Improved patient access and experience 3. Empowered, engaged and well supported staff 4. Inclusive leadership at all levels Two workshops were held in each PCT area. Who did we consult? We spoke to community groups, voluntary organisations and members of the public with an interest in equality or who represented equality groups and the 9 protected characteristics. These included: NHS Calderdale • Age UK • Calderdale Interfaith Council

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• • • • • •

Basement Project Calderdale Council Older people People with a learning disability People with a disability Carers project

NHS Kirklees • Auntie Pam’s • SWYPFHT • Breast feeding support • Blind and Visually Impaired Society • Kirklees Council – Mental Health • Milen Day Care Centre for Older People • Indian, Muslim Welfare Society – Health Committee NHS Wakefield District • Carers Wakefield District • Fit4funding • Kidzaware • Next Generation • Wakefield Gay group • Local Authority • West Yorkshire Police • Wakefield District Housing • South West Yorkshire Mental Health Trust • Wakefield College • Voluntary Sector • West Yorkshire Probation Service • South West Yorkshire Foundation Trust • Joint Public Health Unit • Carers Wakefield District • GRASPED • Wakefield District City of Sanctuary • Wakefield and District Schools and parenting Co-ordinator • Youth work company • Older peoples forum (CAVE) • Turning point • Wakefield District Site Aid • Voluntary Action Wakefield District (VAWD) • Normanton Disabled Peoples Partnership • People from protected characteristics What information did we give? • Presentation on EDS and background • Organisations’ self-assessment and grading • Background details of each protected characteristic • Local data Page 11 of 50

• • •

Joint Strategic Needs Assessment Public Health reports Questionnaires

What did we consult? We asked people to assess the organisation’s equality performance against 2 goals using one set of criteria: • Better Health outcomes for all • Improved patient access and experience Within the 2 goals there are also 18 outcomes and the objective of the activity was to grade the organisation as; • Underdeveloped • Developing • Achieving • Excelling We did this by talking about current services and thinking about how these services met the needs of the local population. Specifically, this aimed to: • Find out what the perceived barriers are to goals 1 & 2 • Identify gaps in evidence where the public perceived that more should be done to improve equality performance What did they tell us? Key issues highlighted were: • Need to engage better with those protected under legislation (protected characteristics). • Our information needs to meet the needs of all our communities (accessible information to all). • Commissioners need to understand the needs of those with protected characteristics. • People with protected characteristics need to be involved in the design and commissioning of services. • Commissioners/providers need to understand the communities they serve – equality and diversity training for all. • Appointment systems are generic and do not recognise the needs of patients with disabilities. • Mental Health Services need to recognise that some cultures do not like to disclose or discuss mental health issues. • Older people are not always taken into account in the design and delivery of services when providers focus on the medical condition instead of the individual pathway. • Services do not always recognise the transition from children’s to adult services. • Need to set up faith forums for engagement purposes. What did we do? Feedback has helped to develop the organisations’ equality objectives and priorities as required by the Equality Act 2010. These objectives have been published on our Page 12 of 50

websites and will guide the organisations and future organisations as to the local priorities for equality and diversity. The EDS grades have been reported to NHS Calderdale, Kirklees and Wakefield District and have been approved by the clinical commissioning groups in each area. Where can you get more information about this work? For further information please go to: ity

It’s My Health Day March 2012 This is an annual event for individuals with learning disabilities and their carers within the Cluster area. The event aimed to provide information on health and wellbeing and to gain their views on local NHS services currently provided. Who did we consult? Individuals with learning disabilities and their carers. What information did we give? Feedback forms and consultation cards were issued prior to the event. In addition, these forms/cards were available on the day for individuals who had not previously received them to complete. A staff member also ran a stall which actively promoted the forms/cards in an effort to gain opinions and views on current health services. What did we ask? Individuals were given the freedom to comment on whatever health services they wished. What did they tell us? Overall, 20 individuals reported receiving a ‘good experience’; 10 an ‘okay’ experience and 4 a ‘bad’ experience. The 4 ‘bad’ experiences related to different services so did not identify a particular problem/service What did we do? All comments were fed into the learning disability health subgroup to ascertain if there were any health issues which need a particular focus. The feedback was also sent to NHS Yorkshire & The Humber as part of the self-assessment process. We also looked at recurrent themes to establish trends and themes. As a result the health sub group undertook a dental service review with community and high street dentists. A trawl of good practice within high street dentists was undertaken with a view that in 2012/13 this be disseminated across all high street dentists. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement

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Calderdale Calderdale Community Dental Service November 2011 NHS Calderdale was advised that from 1st April 2012, the Laura Mitchell Health Centre would no longer be available to provide NHS services, meaning the Community Dental Service would have to be moved. After looking at a number of alternative buildings and solutions, it was proposed to improve the facilities at St John's Health Centre, Lightowler Road, to enable the service to be provided from there. NHS Calderdale Clinical Executive Committee was keen to ensure patients and stakeholders were kept fully informed and given the opportunity to comment. Who did we consult? All patients who had accessed the service in the previous 12 months The Disability Partnership The general public via our website What information did we give? • a letter advising of the changes with a questionnaire inviting comments • posters displayed at the Laura Mitchell Health Centre • patient information leaflets • information about the move and the questionnaire on our website What did we ask? The questionnaire asked two key questions, and gave people the option to add extra comments: 1. What are the most important things that we need to consider when moving the service to St John's Health Centre? 2. Do you have any concerns about the move to St John's Health Centre? What did they tell us? 102 responses were received, achieving a 10% response rate. Respondents felt that most of the options provided to them on the questionnaire were important, with ease of making appointments, available parking, and access to the building (including waiting and treatment rooms) being considered most important. Most of the respondents (71.4%) stated that they were not concerned about the move. For those respondents who were concerned (22.4%) the main issues related to the location of St John's Health Centre and how they would be able to access it via public transport. What did we do? Feedback from patients was considered to inform changes at St John's Health Centre. The impact of the consultation supported improvements to the internal and external access to the building, including work on the décor to ensure it met the needs of visually-impaired people.

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Where can you get more information about this work? For further information, please contact the Shared Communications and Engagement Team on 01422 281417.

Equitable Access to Primary Care June 2011 - February 2012 The equitable access project had to re-tender existing services to identify a potential provider. Consultation with patients at the two affected practices provided under the equitable access service focused on asking what patients wanted from a new provider prior to the procurement process. Who did we consult? The registered patients, aged over 16 years, at the two Equitable Access practices: Park Community Practice and Calder Community Practice. What information did we give? • Letters • Questionnaire • Equality data collection form What did we ask? The PCT was seeking the views of patients about the GP services currently in place and the proposed changes from 1st February. Drop in sessions were organised where patients could discuss any aspect of the service with PCT staff. What did they tell us? Over 3,000 letters with questionnaires were sent and 141 responses received. Key points raised were: • Respondents liked late evening access and weekend appointments • Want to have choice of GP within their locality • Preponderance of locum GPs is a concern What did we do? • Weekend access was included in the procurement plan for Saturday morning opening. • The PCT is committed to continuing to commission and provide choice to patients and has done so since the retirement of the local single handed GP in 2008. • The PCT cannot directly act on the feedback regarding locum GPs as staff recruitment is the provider's responsibility. The PCT does however promote the employment of permanent staff by including this in the contract key performance indicators (KPIs) as a measure of performance which is linked to financial reward. Where can you get more information about this work? For further information, please contact the Shared Communications and Engagement Team on 01422 281417.

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NHS Calderdale and Calderdale Council

Young HealthWatch

Ongoing discussions throughout 2011-12 The aim of the project is to ensure young people’s voices are represented in the development of local HealthWatch. Who did we consult? • Regional Youth Parliament for Yorkshire and the Humber • Calderdale Youth Parliament What information did we give? Information about the change from LINks to Local HealthWatch. What did we ask? We asked what people thought about the current national involvement structures. What did they tell us? An issue of concern was raised nationally, regionally and locally that the views of children and young people would not be taken into account when planning services. What did we do? A decision was made in April 2011 that one of the Regional Youth Parliament for Yorkshire and the Humber campaigns would be to support the transition from LINk to Local HealthWatch. This was supported by members of Calderdale Youth Parliament. Mechanisms that are now developing – Calderdale Young People’s Assembly and Calderdale Children’s Assembly - will provide a consultation platform among with other engagement mechanisms At present the development of Local Health Watch is at an early stage of procurement. Listening to the views of children and young people is built in to the service specification for this contract. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01422 281417

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Parks Consultation with children and young people – Healthy Lifestyles Project

NHS Calderdale Calderdale Council

Phased between April 2011-March 2012 We worked with the Parks Department who had some funding to develop local parks. Our role in this programme was to consult with as many children and young people in schools local to each park and local youth work settings as possible and to engage them in the development of these parks. Who did we consult? We spoke to over 250 local school children and young people at youth care settings What information did we give? Information available to the children and young people included: • Budget limitations •

Pictures of the types of equipment available within the budget

The time scale for development

The consultation was done as creatively as possible using age appropriate mechanisms, photographs, group work discussions, drawing and collage. What did we ask? The children and young people were given some choices as to the type of equipment they would like to see in the parks. They were also asked if there were any health and safety issues in the parks and how these could be overcome What did they tell us? Each project was individually developed. The children and young people influenced the layout of the parks and chose some of the pieces of equipment, including equipment suitable for children with a disability. Children and young people also identified some health and safety issues with the existing parks: inadequate surfaces/flooring, corroded or damaged equipment and broken protective railings. What did we do? We purchased equipment according to the comments and feedback from children, young people and the wider community. Continual feedback was given to the children and young people on progress and they were all invited to the launch event for each park. We replaced hard flooring with rubber flooring and put fencing round parks to prevent dogs and joy riders from entering the parks. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01422 281417. NHS Calderdale Health and Well-being Outcomes

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Calderdale Council August 2011 Stakeholders were asked to consider if the proposed Health and Wellbeing outcomes for Calderdale would be effective. Who did we consult? We engaged with the local voluntary sector, using our third sector database which has details of over 700 groups in Calderdale. As this was a generic approach we did not log the protected groups that we reached, however the membership of our database is inclusive and far reaching. We were also a stakeholder ourselves, replying to consultations and taking part in the Assembly meetings. What information did we give? We sent out an bulletin email with consultation papers attached and we highlighted the work in our newsletter. What did we ask? Groups were asked to review the proposed outcomes and add comments about whether they agreed with them or not. They were also asked to supply evidence to support their reasons. What did they tell us? The groups told us that they agreed with the health and well-being outcomes. What did we do? The consultation resulted in the original outcomes remaining and the groups who were involved being invited to relevant outcome development sessions. These sessions will further support the Health and Well-Being Board by advising on actions and activities which need to take place to ensure health and well-being improvements in Calderdale. This work will be ongoing throughout the forthcoming year. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01422 281417.

Calderdale Council NHS Calderdale

Health Watch

September 2011 The aim of the consultation activity was to ensure that the third sector had an opportunity to influence the proposed structure for HealthWatch. Who did we consult? We engaged with the voluntary sector via our third sector database. All the groups were invited to attend an event to further influence the future model for Calderdale. What information did we give?

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We sent out bulletin emails with consultation papers attached, we highlighted the work in our newsletter and promoted the focus groups sessions to groups. We dealt with one-to-one enquiries about what HealthWatch is/means for Calderdale to enable groups to respond effectively. What did we ask? Stakeholders were asked to consider if the proposed HealthWatch for Calderdale would be effective. Groups were asked to review the proposal and add comments about what they might like to see HealthWatch looking like. What did they tell us? Organisations told us that they would like the functions of HealthWatch to be provided under one umbrella organisation but were happy to have specific aspects subcontracted to the most appropriate provider. Groups also told us that they wanted HealthWatch to build on current arrangements rather than reinvent the wheel. What did we do? Following the focus groups and the questionnaires a service specification for HealthWatch is being drawn up, taking into account the feedback received, and will be going out in the near future. Where can you get more information about this work? For further information please contact the Communications and Engagement Team on 01422 281417.

Joint Strategic Needs Analysis (JSNA)

Calderdale Council NHS Calderdale

April 2011 onwards The aim of the project was to ensure that the Third Sector had a voice in the development of the JSNA information and website. Who did we consult? We engaged with the voluntary sector about the content of the JSNA and whether it reflected an accurate local picture. We held specific focus groups with the protected groups as well as generic groups around with specific areas of interest eg children, long term conditions etc. What information did we give? We provided copies of previous JSNAs and abbreviated versions relevant to the specific group to review and add to.

What did we ask? Page 19 of 50

Stakeholders were asked to consider if the JSNA truly reflected their experiences/understanding of needs of clients within their organisations. Groups were asked to review the current information (from 2010) to update this and add anything they felt was missing. We used a mixture of questionnaires, telephone interviews, one-to-ones and focus groups. What did they tell us? Specific changes were made regarding the LGBT community, who completely updated this section of the JSNA and new needs from the Polish community were added, as this was the first time we had engaged with this particular group. What did we do? All the data provided has been included in the current version of the JSNA on the NHS Calderdale website. Evidence provided has been added to the JSNA and we have fed back to groups when this has happened to ensure the information that they provided was reflected correctly. Some groups did not understand the JSNA and further engagement work took place to ensure they could contribute by understanding what the JSNA hoped to achieve. By working with groups this closely the information gathered further improved the intelligence on the website. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01422 281417.

Inclusion Development – Disabled Youth Forum

NHS Calderdale Calderdale Council

November 2011 – December 2011 The aim of the project was to involve young people in health lifestyles and make them aware of current services. Young people were asked their views on services and provide feedback on how they would like to be engaged.. Who did we consult? The disabled youth forum members who are young people aged from 13-19 who have a learning difficulty, physical disability or complex needs. What information did we give? Specialist services to meet with the young people to ensure they get the most correct, relevant and clear information.

What did we ask?

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A variety of consultation mechanisms were used including quizzes, a questionnaire, small group discussions, pictures and activities to discuss the following issues: • 17/11/11 –emotional well being, anti-bullying part 1. • 1/12/12 –anti bullying Part 2 – watching a video about experiences of being bullied and how to make it stop. • Half term activity- planning, shopping and preparing a healthy meal Future plans for this group include:• Oct ’12 – fire safety, fireworks with fire service staff • Nov ‘12 – drug and alcohol awareness, safe use of both, respect for the potency of drugs, peer pressure, learning to say NO! and stick with it. • TBC - Sexual health and Relationships (with the consent of parents/carers). What did they tell us? Feedback covered a wide range of issues, such as healthy eating. What did we do? As a result of this work members of the Disabled Youth Forum now continue to participate in a variety of youth initiatives. In addition, engagement with the Disabled Children Team has resulted in paperwork and approaches being reviewed to ensure young people feel valued. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01422 281417.

Calderdale Council NHS Calderdale

Young Inspectors

March 2012 This project supports the involvement of young people in a scheme that works in a similar way to ‘mystery shopping’. The scheme trains up young people to update an assessment of services questionnaire. The questionnaire assesses the appropriateness of a service for young people against a set of criteria. The Young Inspectors are 25 young people from Park Lane Learning Trust who have been trained and were working with us during 2011/2012. The students are from the Inclusion Unit and STAR group at this school. The majority of these students struggle with academic work and have behavioural issues within the school setting. Contraception Advice and Sexual Health (CASH) and Branching Out are two of the health related services which were inspected in 2011/2012 by these young people. Who did we consult? The inspectors ask managers and service users to review the service. What information did we give? Before each inspection the Young Inspectors met to look at information documents, posters, flyers and any other detail needed for the inspection e.g. opening hours. What did we ask?

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Young people at each of the projects were interviewed by the Young Inspectors. 5 core questions (based on 5 criteria) were asked by Young Inspectors at each inspection. The questions were about; • Accessibility • Information • Staff attitude and skills • Generic question on service user experience • Confidentiality/ safe guarding What did they tell us? Issues and ideas brought forward were:• CASH – very friendly, approachable staff, a confidential service, good, up-to-date information • Branching Out – young people friendly, appropriate services. What did we do? The findings were shared with the assessed organisations who are asked to complete an action plan of improvement. This plan is shared with staff and updates are reported to the Young Inspectors Group. One significant change was the improvement to the height of the reception desk which young people felt was too high. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01422 281417.

NHS Calderdale and Calderdale Council

You’re Welcome

Bi monthly during April 2011-March 2012 Five services were assessed against the You're Welcome customer service criteria: • Chlamdyia Screening Scheme (CHLASP) • Boulevard GP Practice • Branching Out – young people drug and alcohol service • Barnardos - counselling, children’s rights and emotional well being. • CASH – sexual health service ( September 2012) Who did we consult? The Young People’s Assessment Panel assessed each of these services under the 10 You’re Welcome criteria. Young Inspectors have also inspected Barnardos, Branching Out and CASH. What information did we give? For each of the assessments. information was provided to the Young People’s panel in the form of an evidence file divided into sub headings appropriate to the 10 criteria. For 3 of the assessments additional information was made available in the form of a Young Inspectors report. The Young Inspectors base their report on 5 basic questions covering safeguarding, attitude of staff, accessibility, information and environment. What did we ask?

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The ten criteria ask questions in the following categories - Access, Publicity, confidentiality and consent, environment, staff training and skills, joined up working, monitoring and evaluation and involvement of young people, health of young people, sexual health and counselling. Each of these assessments has been recorded in the form of a report. What did they tell us? • CHLASP – assessed as a very good service, far reaching, confidential and young people friendly. • Boulevard – a brilliantly presented file, great photos, a clean modern environment, very friendly staff, a specific young people’s area and bright informative leaflets and posters; • Branching Out – great, approachable staff, outreach work, non-judgemental, confidential and flexible service. • Barnardos – difficult to assess as not much feedback from young people, good staff attitudes. • CASH – to be assessed September What did we do? Once the service has been assessed a report is presented to the service and the service is either given a pass, which is a certificate which can be displayed to show the service is young person friendly. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01422 281417.

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Kirklees Minor Ailments Scheme Evaluation

Lead organisation Greater Huddersfield CCG

April – July 2011 In 2008, a Minor Ailments Scheme was commissioned from community pharmacies on a pilot basis. The scheme was offered to the patient population of 7 GP practices in the Fartown/Birkby area of Huddersfield and provided by 10 community pharmacies in the area including pharmacies in key locations such as supermarkets. The service aims to provide an alternative route for patients into primary health care, and includes consultation, provision of patient advice leaflets and over-the-counter medication on prescription for patients exempt from prescription charges. An evaluation was undertaken in 2012 to inform the future of the Minor Ailments Scheme and whether the scheme should be continued, expanded or ended. The evaluation also sought the views of service users to ensure that patient experience was taken into account. Who did we consult? Users of the Minor Ailments Scheme. What information did we give? Questionnaire distributed to community pharmacies providing the service What did we ask? The questionnaire asked the users of the service about their experience, what could have been improved and whether they would use the service again. What did they tell us? 100 questionnaires were sent out to pharmacies participating in the Minor Ailments scheme and 26 were completed and returned by service users. All 26 respondents found the service good or better, with 17 rating the service as excellent. The respondents also said they would use the service again in the future. 25 of the 26 respondents agreed that the service had helped them to manage their own condition without having to see the GP. Patients reported that the Minor Ailments Scheme improved access, with respondents finding it quicker than a GP appointment, and that the location and opening hours of the pharmacy were more convenient. What did we do? The evaluation was undertaken on behalf of Greater Huddersfield CCG. The completed evaluation was discussed by the Clinical Strategy Group, which requested it to be further developed with a view to a decision on the future of the scheme being taken in the autumn. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01484 464024 / 464025.

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A Review of The Adult Weight Management Service: identifying reasons for non-completion 3 May – 26 June 2011 The service aims to help people manage their weight through lifestyle changes such as healthy eating and regular physical activity. It offers a range of programmes to support people living in Kirklees to achieve and maintain a healthy weight. The purpose of the engagement was to identify areas where improvements can be made to the Adult Weight Management Service (AWMS) so that it continues to meet the needs of the target population.

Who did we consult? People consulted during the review were ‘non-completers’ from the Kirklees Adult Weight Management Service. A ‘non-completer’ is either someone not starting their chosen weight management program or who started their weight management program but did not complete the full 12 weeks. Primary care practitioners who refer to the service were also asked to comment on their experience of referring. What information did we give? A questionnaire was sent to 150 people and followed up by in-depth discussions with selected service users. What did we ask? Key sections of the questionnaire covered: 1. If people were given sufficient information about the Kirklees Adult Weight Management Service (KAWMS) at the point of referral. 2. If people felt their first meeting with the KAWMS Gateway Worker provided them with enough information and support to make an informed choice about the service they would attend. 3. The reasons for dropping out of the weight management programme. 4. The reasons for not starting the programme. The patients who were happy to discuss their experiences further were contacted by telephone and asked questions regarding: • The support received from their healthcare practitioner; • What had promoted them to seek help about their weight; • If it would have made a difference to their attendance if the scheme encouraged participation among family members. Primary care practitioners were asked to comment on: • The referral process; • Feedback from the service about their patient; and • Feedback from patients about their experience of the service.

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What did they tell us? • The majority of people were happy with the information provided on the Adult Weight Management Service; • Of those who participated in a weight management programme, the majority were happy with their experience and made positive comments about the service; • The main reasons for non-completion were health problems other than obesity, unsuitability of the times of the sessions, and personal problems; • The main reasons for not completing the programme were: length of wait; convenience and unmet need. What did we do? Key recommendations have been developed from the feedback: • The relationship between the Adult Weight Management Service and service users could be strengthened by the allocation of a named gateway worker (healthcare assistant) to the service user. This would be in line with other behaviour change programmes, such as the Stop Smoking Service. This gateway worker would be the main point of contact for the service user should they have any questions or issues about the service they have chosen. • Service users should not feel they have to make a decision about which weight management service to choose at their first appointment. An ‘opt in’ service should be available where the service user contacts their gateway worker to inform them which service they wish to join. The gateway worker should then follow-up those who have not made a decision/not contacted them within 4 weeks. • Evening and weekend weight management courses/1:1s should be made available to accommodate those who work or have daytime caring duties. • When service users are being allocated to a specific weight management programme, they should be able to choose from a selection of venues and times. The review and recommendations were presented to the service manager from KAWMS and the Public Health programme board. The service has reviewed and improved delivery to reflect the recommendations made and retention rates on the programmes have improved. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01484 464024 / 464025.

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Evaluation of the women of child-bearing age pregnancy support pilot - Auntie Pam’s April 2011 – March 2012 Auntie Pam’s is a Kirklees-wide project based in Dewsbury that has been designed for local women of childbearing age. Social marketing approaches were used to develop insight into how local women think and feel about, and currently respond to and use maternity services. The centre offers support about a range of issues including pregnancy, health, housing, relationship issues and benefits. Visitors are able to relax in a comfortable and discreet environment and are offered support to recognise their own issues and find solutions that meet their needs. This encourages and enables women to increase their confidence, motivation and capacity to positively engage with appropriate services. Auntie Pam’s is staffed by award-winning peer supporters who are trained volunteers with personal experience of pregnancy and parenthood. All volunteers are from communities within Kirklees, and recruitment aims to reflect the diversity of the population. The Auntie Pam’s service and volunteers have a shared commitment to offering a “gold” standard service for visitors, and to supporting the aspirations of volunteers to progress through learning pathways such as NVQ, degree-level learning pathways and health setting specialist training. Previous engagement activity Findings from the 12 month pilot evaluation (2010 – 2011) indicated a need to revise our marketing materials and awareness of the service locally. Findings from our second phase of evaluation highlighted further need to revise our marketing materials to be more specific about services offered and clearly state that it is for women who are planning to be or are already pregnant. Also, the premises themselves needed to be more visible with clear signs regarding what the service offers and ensuring the inside can be seen through the window. It was felt that numbers accessing the service were low because marketing had been developed to be discreet. During 2011–12, 73 clients registered with the service and 82 women registered to train as volunteers. Who did we consult? All visitors and volunteers applying to train are asked questions about their experiences with maternity services, from accessing midwifery services to visiting local hospital units. Women also return to Auntie Pam’s post-natally and share experiences with the service, so that this can be collated and shared with a wider commissioning and delivery audience. What information did we give? Peer supporters discuss service users’ experiences with them individually. The agenda is set by the client and women are encouraged to identify issues, and supported in dealing with these in order of priority for them. Supporters signpost clients to other services as appropriate, often making phone calls, or on occasion accompanying them to appointments. The aim is to help women gain confidence to deal with issues themselves.

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What did we ask? Volunteers are trained to ask specific questions of clients, including details about the pregnancy, what access to services have already happened, how successful that contact has been and whether women have accessed key health interventions such as Healthy Start, screening and appointments with key clinicians where appropriate. Women are also asked about their own lifestyles, and if they feel that changes would be beneficial for them at this time, as well as what they think of the service, what help it has offered and how we might improve. All responses are collated and considered so that the service is continually improving and planning for long-term sustainability. What did they tell us? • The scope of the service fulfils the information and advice needs for the target audience. • The volunteers themselves work particularly well as an intermediary to more formal sources of advice and other services. • The environment of Auntie Pam's is largely conducive to visitor needs, helps both allay fears about the initial interaction and promotes confidence in returning. • Some marketing materials offer a base from which to develop materials that can meet needs more effectively. • Visitors who have used the service appear largely satisfied with the experience but also have benefited directly as a result. For example, the client database demonstrates that women attending the centre have become connected with other health and non-health support services such as housing or benefits, either through being signposted to them or facilitated directly in connecting with them. This can include help with contact, making appointments, filling out forms, explaining benefits. • Received and reportedly acted on advice regarding health issues, eg how they might think about smoking or nutrition during pregnancy. • Received and reportedly acted on advice regarding wider confidence issues, eg what they might ask a health professional, how they can ask questions, talking through issues in engaging wider family. What did we do? Since the ending of the 12 months pilot, Auntie Pam’s has taken account of the views wider client base that had been initially attracted. Many of the initial visitors have returned to become trained peer supporters, and through this route the service has refreshed its marketing and publicity strategy to attract the wider community. The pilot had a defined age range target group, and this has now expended. The service has included a small lending library, a clothing swap shop and small equipment store, for those needing immediate support. Senior volunteers have been trained to deliver smoking cessation, chlamydia screening support, healthy diet and breastfeeding and weaning support. Volunteers are also keen to address their own aspirations through confidence gained as a volunteer, and many take up further and higher education routes supported by the Auntie Pam’s mentoring and learning network.

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An Auntie Pam’s website has been developed and now meets the needs of many clients who wish for on line access to contact details, web based information and links with local service networks. Where can you get more information about this work? For further information please go to: and

Annual health check consultation for individuals with Learning Disabilities and their carers Throughout 2011-12 - Ongoing work as each health check is set by individuals in conjunction with their GP practice Under the terms of the Learning Disability DES, individuals with learning disabilities are entitled to receive an annual health check. As part of this, feedback forms for patients and their carers are being used to gain their views about the consultation they have received from their General Practitioner. Who did we consult? To ascertain the quality of the annual health checks, coupled with documentation completed by the GP practice, individuals and their carers are asked for their opinions on the annual health check they received. What information did we give? All individuals receiving an annual health check, along with their carers were given feedback forms to complete. What did we ask? The easy-to-read form was designed to gather information regarding the delivery and content of the annual health check from both a service user and carer point of view. What did they tell us? There was a low return rate of the forms. Those forms that have been returned have all stated that individuals had a positive experience. What did we do? Results from the survey helped to triangulate the quality of annual health checks given by the GPs by identifying how carers and patients were treated throughout their annual health checks. The LD DES is led by the Learning Disability Health Subgroup (subgroup of the Learning Disability Partnership Board) which is attended by the lead clinicians of the CCGs. In addition, the LD DES forms part of the workplan which has been discussed and agreed by the CCGS. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team 01484 464024 / 464025.

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Learning Disability Self Assessment Framework April 2011 As part of the annual Learning Disability Self Assessment, individuals were asked to comment on the assessment of service provision produced by NHS Kirklees. The self assessment, together with the views and scoring by lay representatives were submitted to the Strategic Health Authority for input and validation. Who did we ask? Service users and carers sitting on the Learning Disability Partnership Board. What information did we give? The self assessment framework was presented at the meeting for individuals to comment on. What did we ask? Individuals were asked to agree Red Amber Green scores for the Learning Disability Self Assessment devised by the Strategic Health Authority. Individuals were given the self assessment and worked in groups to discuss what responses they felt best reflected Kirklees’ status. What did they tell us? The scores were agreed and submitted to the SHA who confirmed them verbally at a validation meeting on 4th July. What did we do? We submitted the self assessment document together with the scoring from individuals on the Learning Disability Partnership Board to the Strategic Health Authority. Their views and feedback has now been received. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01484 464024/464025.

Care Home Support Service 24 October - 11 December 2011 There are currently around 126 residential and nursing homes in Kirklees with approximately 3156 residents. Care can often be provided in isolation of specialist assessment and mainstream health and social care services. This can lead to care being inconsistent, reactive and based around crisis management, resulting in inappropriate GP callouts, A&E attendances and emergency admissions. NHS Kirklees is proposing to offer a new service to all individuals living in care homes. This would offer each individual a health review up to three times a year and will support care home staff and other health providers in meeting the changing health needs of individuals.

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Funding has been secured through national re-enablement monies to support the commissioning of a new Care Home Support Team. One of the aims of the service is to prevent unnecessary hospital admissions by facilitating timely access to the appropriate health advice and interventions. The Care Home Support Team may include a number of different health professionals such as a pharmacist, a GP, an advanced nurse practitioner and a physiotherapist. The purpose of the engagement activity was to receive feedback on the proposal. Who did we consult? • Care home residents • Care Home managers and staff • Provider organisations • Healthcare providers • Voluntary and community sector organisations. We attended the following stakeholder groups: Kirklees Older People’s Partnership Board; Kirklees Learning Disability Partnership Board; an Expert Patient Programme Group in Huddersfield. Attendance at a smaller number of Care homes to discuss and collate feedback from residents, carers and staff. What information did we give? • Written information to Care Homes • Questionnaire which invited stakeholders to have their say in shaping the initial proposals and consider what this new service might additionally offer. What did we ask? We invited them to have their say in shaping the initial proposals and consider what this new service might additionally offer. The questionnaire was available to complete online or as a paper based copy with a freepost return address. What did they tell us? The recommendations based on feedback are: • The proposed service is widely seen as a useful service that has the potential to improve the health and wellbeing for residents of care homes. • All agencies to work together to anticipate problems early and avoid hospital admissions (providing excellent quality care, as soon as it is required). • Consideration needs to be given to the integration of pathways and information sharing with GPs and other local services. • Good communication and coordination between the proposed service, care homes and other health services is seen as essential in order to make the service accepted and a success. • Consideration of residents’ specific individual needs must be taken into account, including an understanding of conditions the patients will have and how this may affect communication with individuals • Information about medication should be provided to patients and staff explaining the medication purpose and the impact it will have on their condition. Regular medication reviews with a written element to reference would help to address these issues.

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What did we do? Feedback from the Care Home engagement visits and the questionnaire has continued to shape the thinking around the new service to take into account functions important to residents, eg access to dentists and podiatry, re-enforcing the need for integration with existing services and avoiding duplication. There is a need for further engagement in relation to the most appropriate provision and access to proactive, anticipatory services for some groups. The Care Home Support Service proposals have been developed in partnership with the CCGs, including the engagement and communication plan, the overall project plan, the questionnaire, workshops to shape and develop the proposals. The Care Home Support Service Specification Group initially included CCG leads from both CCGs - this group has now split into 2 separate groups, still with CCG leads. One of the CCG clinical leads participated in some of the engagement visits to Care Homes. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01484 464024 / 464025

Development of the Kirklees Adult Weight Management Service section on website March 2012 The Kirklees Weight Management Service provides a range of programmes to support people with a body mass index (BMI) of 30kg/m2 to achieve and maintain a healthy weight. A website has been developed to support the delivery of the Weight Management Service. The aim was to develop a new section for the website focussing on the monthly support groups that are facilitated by the Dieticians who work as part of the service. Who did we consult? Kirklees Adult Weight Management Service monthly support group and the dieticians who facilitate the support groups. What information did we give? Access to the website. What did we ask? Participants were asked to suggest possible sections or items they would like to see on the KAWMS support group section of the website which will be developed after the consultation with patients and the dieticians based in the KAWMS who facilitate the support groups. The group were also given the opportunity to look at the website and respond with comments or suggestions.

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What did they tell us? Participants of the support group suggested the following items were added to the Support Group section of the website: • Calendar of events • Forthcoming speakers at Support Group Meetings • Discussion Forum • Recipes What did we do? These suggestions are currently being included in the website development and will be published later this year. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01484 464024/464025.

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Wakefield District Closure of Ash Grove Surgery’s Ferrybridge Branch 23 May 2011 – 1 August 2011 The practice contacted the PCT to seek permission to close its branch surgery in Ferrybridge. A 10 week period was allocated to run the consultation process. The practice worked closely with the patient reference group and a steering group was developed with two members of the practice’s patient reference group on the panel. The purpose of the steering group was to discuss and plan the consultation action plan. Who did we consult? • Patients and members of the public in Ferrybridge and Knottingley • Ash Grove Patient Group • Steering group (included 2 members of the patient group, community development worker, lead GP, practice manager, PCT engagement and communications representatives) • Wakefield LINk • Local MPs • Local councillors • Overview & Scrutiny Committee • Over 60s group, Ferrybridge What information did we give? • A leaflet outlining the reasons for the branch closure and including a comment form was sent to over 1100 patients. • A public meeting was held to give people an opportunity to talk to the GPs and practice manager about any concerns. • Information was featured in the local paper and on the local radio station. • Posters and leaflets were displayed in the main practice and branch surgeries. • GPs and practice reference group members manned a stall at Knottingley Carnival to raise awareness of the proposal and the public meeting. What did we ask? People were asked for their views on the proposed closure and for details of any concerns they might have about this. What did they tell us? There was a 15% response rate to the questionnaire: 8% of patients said they supported the closure of the branch surgery 7% were against the proposal. The main concerns raised were regarding the lack of public transport between Ferrybridge and Knottingley; that patients would have to travel to Ash Grove to order their repeat medication; and whether Ash Grove would offer telephone appointments?

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What did we do? The practice manager met with Metro to raise people’s concerns regarding public transport. Metro is looking into the bus service and will discuss route changes with Arriva and M travel with a view to re-routing some services to accommodate patients who reside in the Ferrybridge area. If the bus service cannot be re-routed the practice will review its appointment system to attempt to accommodate patients who are limited to certain times of the day due to bus times. In view of comments made regarding repeat prescriptions, the practice has made a number of options available so that patients can order their medication without having to attend the practice. These include: - Via the internet - Via post - Via telephone to the main surgery on a dedicated prescription line. The practice is continuing to operate a telephone consultation system Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01924 317646.

Interpreting and translation procedure November 2011 The Wakefield Deaf User Partnership (WADUP), which is a group of service users, was invited to give its views on the guidance for the Interpreting and Translation Procedure. Who did we consult? Wakefield Deaf User Partnership (WADUP) What information did we give? We provided service users with a draft of the policy for them to comment on. What did we ask? People were invited to give their views on the guidance for the Interpreting and Translation Procedure. What did they tell us? After looking at the procedure WADUP made the following recommendations: • the use of family and friends for interpreting is not covered by the National Register of Communication Professionals working with Deaf and Deaf Blind People and this would need to be added to the principles • a specialist feedback form for deaf people is given out by BSL/English interpreters, and this be added to the principles • WADUP is available for training staff to ensure that all staff understand how to

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• •

recognise the need for, and to book BSL/English interpreters and which communication is required. on the list of service providers palentypists or note takers should be split as two separate providers advice around loop systems to be added into the procedure

What did we do? All of the above recommendations were taken on board and included in the Interpreting and Translation procedure. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01924 317646.

Engagement with Local Communities to Inform Sexual Health Communications Campaigns (2012) December 2011 - March 2012 The purpose of the study was to engage with groups at increased vulnerability to unintended pregnancy, sexually transmitted infections (STIs) and human immune deficiency virus (HIV) in the development of evidence-based sexual health campaigns Who did we consult? The key stakeholders consulted were: • Men who have sex with men (MSM) • Black Africans • Lesbian, Gay, Bisexual, Transgendered and Questioning (LGBTQ) young people • Young people • Vulnerable migrants eg asylum seekers, trafficked women and migrant workers • Residents of the priority neighbourhoods in Wakefield District What information did we give? Information was made available about the sexual health website for Wakefield, What did we ask? The key questions asked were: • What are the causes of unintended pregnancy? • What are the methods of preventing unintended pregnancy? • How do you find information about contraception? • How do you find information about STIs and HIV? • What is the best protection against STIs and HIV? • Do you know where to get free condoms? • Do you know about the sexual health services in Wakefield District? • Where do you find information about sexual health services? • Do you know the sexual health website for Wakefield District?

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We wanted to find out how stakeholders accessed information on contraception, STIs, HIV and sexual health services in Wakefield. People were specifically asked to comment on the best ways of communicating sexual health campaign messages to each of the targeted groups. What did they tell us? Key findings from the feedback received were: • Young people recommended campaigns to increase awareness of good condom use and C-Card scheme for Under 19s. • Campaigns to increase awareness of good condom use, HIV and early HIV testing to be targeted at Black African communities and the wider community. • Campaigns to improve general sexual health communication and promotion of services to be targeted at vulnerable migrant communities eg asylum seekers, refugees and migrants from the EU. • The sexual health website for Wakefield should be actively promoted and a mobile version of the site developed to increase use by mobile devices. • Build upon the recently launched national campaign, ‘I Do it Right’, which is targeted at the Black African community. • Developing a series of leaflets, posters and credit cards in Farsi, Kurdish, Arabic, Tigrinya, Eritrean and English to be targeted at migrant communities with the aim of increasing access to general health services. What did we do? The views of the groups and people who participated in the engagement exercises have been used to develop the following campaigns: • Awareness of good condom use and C-Card scheme for Under 19s • Awareness of good condom use, HIV and early HIV testing to be targeted at Black African communities and the wider community • Improvement of general sexual health communication and promotion of services to be targeted at vulnerable migrant communities e.g. asylum seekers, refugees and migrants from the EU • Awareness of the sexual health website for Wakefield,, and development of a mobile version of the site The findings and recommendations of the engagement report were presented to the Wakefield Sexual Health Network. The network includes a prominent GP and the clinical lead for the contraception and sexual health service. They welcomed the initiative to commission evidence-based sexual health campaigns because they would promote the services available in the District. It was agreed that the engagement or consultation should be carried out periodically to assess the changing needs of the targeted populations. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01924 317646.

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Falls and Bone Health Programme

NHS Wakefield District

February 2012 (continuation from engagement work in 2010/11) The Falls and Bone Health programme aims to implement a systematic approach to falls and fractures, focusing on the prevention of falls and fractures. A number of workshops have been held over the past few years to involve people in the development of the falls and bone health programme to ensure the needs of the public are met. The Falls Health Needs Assessment (HNA) was completed in October 2011, which drew on the findings from a series of interviews and focus groups. Six key areas of work were identified and the next stage of engagement was to involve people in taking these forward. Who did we consult? • Older peoples forum groups • Voluntary and community organisations (Age UK Wakefield District, Carers Wakefield District) • Wakefield LINK • Mid Yorkshire Therapy Team • South West Yorkshire Partnership Foundation Trust • PPI groups • Wakefield council family services • Older peoples forum groups • Wakefield council family services • Members of WISE • Age UK Wakefield District • Carers Wakefield District • Wakefield District Housing What information did we give? Falls Health Needs Assessment What did we ask? An event was held to engage patients, the public and professionals in discussions about each of the key work areas: • • • • • •

Institutions and fallers Raising awareness Support after a fall Falls prevention Risk assessment Women falling

The Falls Health Needs Assessment recommendations were discussed at the event. Participatory appraisal was used to organise the issues and solutions that were identified in the discussions in each workstream.

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What did they tell us? • There needs to be more falls screening and falls risk assessments in the community. • We need to develop awareness-raising strategies and local material around osteoporosis and bone health. • There needs to be more preventative action, such as raising awareness of falls, and highlighting the risk factors and positive actions that can be taken to reduce them. • Findings highlighted the need to address fractures in women in the longer term What did we do? • We are planning to pilot (subject to approval) an integrated community falls pathway in Normanton for 1 year which will support falls risk assessment and prevention work •

We have developed a ‘boost your bones’ campaign that ran during falls awareness week (June 12) and focused on positive steps that can be taken by staff working in care homes to boost residents bone health. ‘Boost your bones’ is now being expanded to include other ‘at risk’ groups such as pregnant women and under 5s and BME communities.

We are planning a pharmacy campaign in November/December 2012 on falls and medicines management. We are developing a Staying Steady in the Home campaign for October 12 which helps to identify potential hazards in the home and ways to address them.

We are working to write a service specification to help improve local access to DEXA scan services that measure bone density and develop local guidelines for the diagnosis and management of osteoporosis.

Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01924 317646.

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Kirklees and Wakefield District Mid Yorkshire Clinical Services Strategy October - December 2011 The Trust provides services at three hospitals in Pontefract, Dewsbury and Wakefield. However, the current service configuration across these hospitals is unsustainable in the longer term, both clinically and financially. The health economy which includes Calderdale, Kirklees and Wakefield Cluster Partnership, The Mid Yorkshire Hospitals NHS Trust and primary care providers used the engagement process to reviewing services that may form part of a service reconfiguration. Who did we consult? All local stakeholders including patients, the public, community groups and staff. Activity was particularly focused on two key groups: • •

Patients of existing services and the public (primarily via questionnaire and data capture form, and collation of existing data and feedback regarding relevant services). Staff (primarily via open staff meetings).

What information did we give? Activity was advertised through posters in the three hospitals and other health care settings, as well as through the local media. Letters were sent to key organisations including MPs and local councillors and a number of briefings took place. A dedicated website was also set up to provide information and another way for people to give their feedback. The information given to the member of the public was through a one to one interview or focus group, links provided an open forum in both Kirklees and Wakefield to share presentations on the changes. What did we ask? A questionnaire was developed to gather feedback on current services where it was considered that changes might be identified. These services were: • Accident and Emergency • Children and Young People • Haematology • Maternity and Neonatal • Neurology – outpatients • Neurology Rehabilitation – outpatients • Neurology Rehabilitation – inpatients • Neurology ward • Spinal Injuries Unit • Surgery • Stroke Patients Experience 2010 • Stroke Patients Experience • Planned Orthopaedic Surgery

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Each service was asked two questions under six general headings or themes. These themes were used to report on the clinical standards of care as part of the current inpatient surveys. A question on access was also asked which explored the issue of service location. The themes for gathering intelligence were be based on the following aspects of care: • • • • • •

Access – how people will travel and how far, convenience versus quality. Care close to home. Waiting – how long is acceptable, reducing waiting, convenience. Safe, high quality care – patient- reported outcomes, expectations, transfers. Co-ordinated care – seeing the right person at the right time, staffing on weekends, evenings, bank holidays, assessments and diagnostics. Clean, comfortable, friendly environment – standard of amenities/facilities, privacy and dignity, experiences of visitors and carers. Personal focus – individual needs and comments.

The themes were used to ask questions about the recent patient and carer experience of a service. Two questions were asked under each of the headings: • What works well? • What could be improved? What did they tell us? The main emerging themes are consistent across the three areas of engagement. • The majority of people want to keep services ‘local. ’ • Those that are willing to travel do not want to travel more than 30 minutes. • If they have to travel further they want services to run on time and systems such as the discharge process to work as smoothly as possible. • There is a perception that there are staff shortages in some areas. • Current quality of services expected to be maintained or improved. • If specialist services are relocated then want it to be on a like-for-like basis. • The quality and the quantity of the food needs to be improved. • People are accustomed to provision in certain locations or patterns and therefore need to be convinced of the need for change or the potential improvements that could be gained by changes. What did we do? Feedback was shared with the individual services to drive improvements. The key themes emerging are being used to shape the development of options for consultation, as well as some specific outcomes, which include: • • •

The decision to leave the Spinal Injury service in Pinderfields Hospital due to the public responses. The decision to re-open Pontefract A&E department overnight while plans are being developed. Development of proposals for orthopaedic and neurological rehabilitation services (for further engagement during Summer 2012)

Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01924 317646.

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3. Ongoing Consultations Calderdale School Nursing Service Started March 2012 The overall aim was to test out the School Nurse Service against the 10 You’re Welcome criteria. Focus groups were held so that we could hear first hand the experiences of children and young people when accessing the service in their individual schools Who did we consult? • Young people from the You’re Welcome assessment panel. • Focus groups from the following schools; Park Lane Learning Trust, Todmorden High, Shade JNI, Cornholme JNI, Ferney Lee JNI, St.Joseph’s JI, Todmorden C of E. • Representatives from Calderdale Youth Parliament, Young Inspectors, and the Disabled Youth Forum (July 2012). • A Young Inspectors inspection is planned for Sept/October 2012. What information did we give? • The 10 criteria set out in the You’re Welcome standards. What did we ask? The objective of the Young Inspector’s inspection was to check out if improvements have been made to the service in 2 of the weaker areas identified by the You’re Welcome assessors. What did they tell us? Significant weakness were identified in the involvement of young people in the planning, development and improvement of the service and in the documentation, leaflets and posters used. Feedback from focus groups varied according to the individual student and their individual school service. We will hear from the wider consultation group once the final report is produced. What did we do? The School Nursing Service achieved a ‘weak’ pass from the You’re Welcome Assessment Panel of young people. The service will be re-assessed once the Young Inspectors have produced their report. Once the Young Inspectors have produced their report we will re-visit the You’re Welcome standards to look for improvement. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01422 281417.

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Accident and Emergency Project January - March 2012 This was a QIPP project to support the reduction of A&E use and identify appropriate messages to support future communication initiatives. The objective was to understand the public's views and knowledge around A&E. Who did we consult? • Intermediate Tier Reference Group, which is made up of patients, carers and members of the public who took part in the initial consultation on the Intermediate Tier and wished to be involved in the redesign work. The group was made up of men and women from a range of ages and included one person from a BME community. • Calderdale Disability Partnership, comprising people from a range of ages with a range of disabilities. What information did we give? The groups were given a copy of the questions below. What did we ask? Focus groups were held to consider: • Why people use A&E when they don’t need to? • How could we make sure people use A&E for the right reasons? What did they tell us? • There is a problem with the attitude of some receptionists at GP practices and some people feel they are not taken seriously or cannot get an appointment when needed. • If treatment received locally is not working, sometimes people feel they have no choice but to go to A&E. • Transport and parking are easier at A&E than at some local services. • There is never enough relevant information about where to go with what condition and people who are new to the country are not sure about what to do if they feel unwell. • There is a problem with some services being local but others central, for example, an x-ray can be undertaken at Todmorden but if a pot is needed, the person needs to go to the hospital. How could we make sure people use A&E for the right reasons? • Educate young people. • Use phone books and Yellow Pages to make sure people contact the right place. • Try as many different ways as possible to get the message across (eg different language formats) and ensure the needs of people with a disability are met. • Information about services for specific groups of people eg. Burnley specialist arrangements for unwell babies. • Make people more aware of wider range of services provided - people should be triaged and directed towards more appropriate services. • A&E should not deal with people with minor problems.

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The feedback also indicates that patients are rarely informed of their options and have little knowledge of how to access new or existing services. This suggests that professionals also need to be better equipped with the knowledge and understanding of the services available to be able to signpost patients to the right services. What did we do? This is part of ongoing work on the use of Accident and Emergency services and will inform the development of alternative pathways/services. An action plan is being developed which will become part of the Calderdale and Huddersfield Transformation work in Unplanned Care. The findings from the work were used in the introduction to a PENPALS (protected learning for GP practices) session held on 15th February 2012. They were also used to inform ‘Making a Difference’, an event for health and social held for health and social care professionals on 29th May 2012, which was led by Dr Azeb. The event also involved two other GPs from the CCG Board, Dr Alan Brook and Dr Peter Davies. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01422 281417.

Kirklees NHS Kirklees & Kirklees Council

CLiK 2012 Survey

March – May 2012 CLiK (Current Living in Kirklees) 2012 is a large postal survey of a random sample of households across Kirklees. It is part of a joint programme of surveys work being undertaken by NHS Kirklees and Kirklees Council, with the aim to collect vital information about the health, wellbeing, quality of life, support needs and wider social factors affecting adults across Kirklees. Who did we consult? A random sample of Kirklees residents aged 18+ years via a postal survey. This survey was distributed to 55,000 residents between 19th March 2012 and 18th May 2012. What information did we give? • Information on Involve NHS Kirklees’ involvement network) • Frequently Asked Questions • Pre-survey communications (internal and external), posters to publicise the survey • Contact number for Ipsos MORI (commissioned to undertake survey on behalf of NHS Kirklees and the council) • Questionnaires available as on-line versions and in large print/ Braille/ languages other than English. • Information sheet

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What did we ask? The overall aim of this exercise was to monitor and assess the health and wellbeing of the adult population in Kirklees. The survey included questions about health and lifestyle behaviours, attitudes and beliefs; health problems/ conditions; support needs; caring responsibilities; local community and place issues; employment and household composition. What did they tell us? Over 12,500 completed surveys were received from adults across Kirklees – an overall response rate of 23%. Key findings included: - Two in three adults (65%) rate their health positively, a smaller proportion than the national average. - Overall, mental wellbeing appears to be lower than the national average. - Almost half of adults (49%) say they have at least one long-term health problem and three in ten (30%) say they have a health condition that limits their day-to-day activities. - The majority (78%) of adults drink alcohol and 69% of drinkers are potentially drinking at increasing or higher risk levels. 82% of drinkers are not concerned about the amount they drink. - One in five residents (19%) is a current smoker and the majority of these (78%) intends to stop. - One in ten adults (11%) needs help or support to live in their current home. - One in five (19%) of adults is a carer (provides care and support to someone else because of their health problems or old age). One in five carers assists more than one person. What did we do? The results provided NHS Kirklees and Kirklees Council with a huge amount of information about the health, wellbeing and quality of life of the local adult population. This will help us to commission and provide appropriate support and services where they are needed most. The CLiK survey is a key element of local needs assessment, linking with the JSNA and therefore an intrinsic part of the partnership commissioning cycle. The findings will be used to inform commissioner and provider services to ensure that services/ interventions/ campaigns are intelligence-led. Where can you get more information about this work? A copy of the poster used can be found at: An information sheet was also produced for participants and this can be found at: For further information please go to Involve at:

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Learning Disability Friendly Award 2010/11 formalised criteria 2011/12 delivered training session and piloted 2012/13 taking forward by promoting uptake from GP practices This project aims to design a learning disability friendly award for use with local GP practices who can actively demonstrate practice ‘above and beyond’ reasonable adjustments. The project involves local groups in designing the approach and making recommendations on the criteria to be adopted. Who did we consult? Kirklees Involvement Network (a health advocacy group for adults with learning disabilities) and Wakefield service user group. What information did we give? We tasked the service user groups with drawing up 10 criteria which they considered to be going above and beyond. We validated the criteria to make sure they were SMART objectives with 1 GP practice What did we ask? We contacted KIN to see what they felt would be a ‘gold standard’ service from their local GP. What did they tell us? They came up with 10 criteria to determine whether or not the GP practice achieved ‘learning disability friendly’ status: 1. Offer annual health checks for people with learning disabilities 2. Have easy to access, bright and welcoming premises 3. Issue and use Health Action Plans and VIP cards 4. Offer tours of the surgery for people with learning disabilities to lessen fear 5. Use communication aids to help understanding 6. Allow double appointment booking for people with learning disabilities if needed. 7. Have staff who are trained in customer care and learning disability awareness 8. Have a learning disability champion 9. Have evidence that you share good practice 10. Have a good example of where you have actively supported someone with a learning disability or their carers. What did we do? To date one GP practice has currently been awarded learning disability friendly status. Individuals with learning disabilities were trained to undertake GP practice assessments. We have received positive feedback from their involvement. Further promotion of the award to engage other GP practices is underway. It is hoped that the award can be adapted to suit other NHS providers such as dentists, optometrists etc.

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The Learning Disability (LD) friendly award is led by the Learning Disability Health Subgroup (subgroup of the Learning Disability Partnership Board) which is attended by the lead clinicians of the CCGs. In addition, the LD friendly award forms part of the workplan which has been discussed and agreed by the CCGs. Also, 2 practice managers had some input into agreeing the final questions to ensure that the criteria devised by service users was achievable. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team 01484 464024 / 464025.

Case studies undertaken as evidence of effectiveness of Start & Mend 2-4, 5-7 & 7-13 and Kirklees Adult Weight Management Service Ongoing As part of the evaluation of weight management provision in Kirklees participants have been invited to provide feedback through the use of case studies. The aim is to gather case studies of successful participants who have attended either children’s or adult weight management programmes in Kirklees to demonstrate their effectiveness. Who did we consult? Participants who feel they have made substantial progress (weight loss/maintenance, improved self esteem, reduced medication etc) are invited to be a case study to demonstrate the effectiveness of the programme they have participated in. What information did we give? The participants were advised that their case study could be anonymous or they could include a photograph for publicity purposes. What did we ask? 1:1 meetings were held with the participants to look at: • What were their reasons for wanting to change behaviour? • How did they find out about the service/programme? • Background of health concern? • What have they achieved? • How they have found the experience? • What does the future hold for them? What did they tell us? The case studies highlight a wide range of benefits that participants experience. In addition to weight loss and a reduction in Body Mass Index these include: • Increased confidence and self esteem • Improved relationships with family and friends • Increased opportunity to try a wide range of new activities in a safe environment resulting in a sustained increase in physical activity • Improved understanding of diet, nutrition and portion sizes

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What did we do? The details of the case studies will be used to inform commissioning and promote the services. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01484 464024 / 464025

Wakefield HMP Newhall Engagement Project on behalf of Spectrum CIC Engagement event on 20th April 2012. The aim of the event was to provide residents with information on health and wellbeing, advice and support and an opportunity to share their experiences of the current health provision within Newhall. Who did we consult? Residents of HMP Newhall What information did we give? During the planning stage of the event, posters were distributed around the prison asking residents what information and stalls they would find useful to be included on the day. An Experience-Based Design tool was used on the day to collect information about residents’ experiences of health services. A feedback form was also used to measure how residents found the overall health event. What did we ask? Residents were encouraged to tell their stories of how they felt during each touch point of their health pathway journey. The touch points for residents at Newhall are: • Health questionnaire • Health check • Myers briggs personality test • Leaflets provided • Speak to a listener • Medical/nurse practitioner • Integrated drug treatment system wing In order to gain as much meaningful information from the residents and to keep their interest, an experience-based design approach (EBD) was used. EBD uses real experiences to improve services and is unique in the way that it focuses strongly on capturing and understanding a person’s experience of services. The approach deliberately draws on the subjective personal feelings a person experiences at crucial points in the care pathway. It does this by encouraging and supporting people to tell their stories.

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What did they tell us? Following analyses of the data, the following themes were highlighted. 1. Health questionnaire – Some residents found it hard to understand. 2. Myers Briggs test – Many people had not been offered the test. 3. Listening service – This was extremely well received with successful outcomes. 4. Leaflet – Not everyone received the leaflet and residents who did, did not find it clear or could not read. 5. There are delays getting appointments with medical and dental practitioners 6. The name of the Integrated Drug Treatment System Wing is misleading because it does not mention alcohol in the title What did we do? A final report with recommendations has been sent to Dr Linda Harris, Chief Executive of Spectrum for her attention. Where can you get more information about this work? For further information please contact the Shared Communications and Engagement Team on 01924 317646.

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4. Planned Consultations April 2012 to March 2013 Issues on which we anticipate consulting patients and the public during 2012-13 include:

Calderdale and Kirklees •

Calderdale and Huddersfield Health & Social Care Strategic Review - major review of local health and social care services focusing on four main areas: planned care, unplanned care, long-term care and children’s care.

Wakefield and Kirklees • • •

Changes to ophthalmology, orthopaedic and neuro-rehabilitation services in Mid Yorkshire Re-design of the Low Vision Aid Service and change of location Mid Yorkshire Clinical Service Strategy – development of options for how local health services are delivered across the three hospitals and local communities, which will be subject to formal consultation in 2013.

Calderdale • • •

Emotional Wellbeing – Anti Bullying projects Substance Misuse Service Redesign Calderdale CCG branding

Kirklees • • •

Introduction of the Electronic Prescription Service (release 2) Diabetes Service Redesign Review of intermediate care services and development of new intermediate tier service

Wakefield • •

Primary Care Transformation Scheme – marketing campaign Refresh of the Joint Strategic Needs Assessment

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