Update. January 2015

Contents

Making A Difference....................................................................................2Work Programme........................................................................................9Community Investment Projects...............................................................13CRM Data and analysis of feedback on services.......................................15Community Engagement and Outreach Activity.......................................27Volunteers.................................................................................................29Citizens Advice in Dorset (CAiD)................................................................31

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Making A Difference

“EVERY ONE MATTERS” REPORT – FEEDBACK ON DORSET’S HOSPITALS

Dorset County Hospital has responded by identifying 8 areas for improvement and listing actions they are already taking or are going to take to address those areas

We have asked Royal Bournemouth Hospital and Poole Hospital to do the same by the end of January. We will put all the responses together and publish them

We have presented the report at meetings of the Dorset Health Overview and Scrutiny Committee (HOSC), Dorset CCG (Clinical Commissioning Group) Governing Body, Dorset County Hospital Board and Bournemouth & Poole Health and Wellbeing Board, thereby bringing the voices of patients and the public “into the boardroom” of decision-makers

As a result of our presentations, the Dorset HOSC has put it on their agenda to discuss the situation with regard to complaints about local hospital services and the CCG, as their commissioners, has asked to see the hospitals’ action plans, which they will follow up with them

N.B. The report has been downloaded from our web site over 500 times. BBC News online covered it and published a link to it on their web site.

“SOMETHING TO COMPLAIN ABOUT?” REPORT ON MYSTERY SHOPPING EXERCISE ON GP PRACTICES

Many practices responded to the original report, thanking us for it and setting out ways in which they were going to improve, including updating and refreshing their information both in hard copy and online, and arranging training for staff on how to handle enquiries relating to concerns or complaints

We have recently got back in touch with all the practices to: Thank those who have made the changes they promised Remind those who haven’t Offer our support to help them make changes Let them know that at the beginning of February we will publish

an account of actions that practices have taken Through this piece of work we improved the way in which GP

practices communicate about, and handle, concerns and complaints and made it easier and more accessible for people to raise concerns and complaints. It has also enabled us to help practices to see the benefit of taking a positive attitude to patient feedback, including concerns and complaints.

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“LOCAL HEALTHWATCH AND HEALTH AND WELLBEING BOARDS”

Our guide for local Healthwatch representatives on Health and Wellbeing Boards has been taken up by other local Healthwatch organisations and formed the basis of the Local Government Association’s new “On The Board” toolkit – a fact that they acknowledge at the beginning of their document: http://www.local.gov.uk/documents/10180/11309/L14-644+Healthwatch+on+the+board+toolkit/32853171-1a5e-4d2f-96a0-f918382434bd

DORSET CLINICAL SERVICES REVIEW (CSR)

We have influenced arrangements Dorset CCG has made in relation to engagement with the public, patients and service users about the CSR. Because of our interventions: The membership of their Engagement Leads Forum now includes

the voluntary sector and Healthwatch Voluntary organisations were given the opportunity to submit

feedback and intelligence they hold about people’s experiences and views on local services to form part of the process to draw up the “case for change”. Previously, this was going to be restricted to NHS bodies and Local Authorities.

We have emphasised the need to engage with “hard to reach” groups and given advice on how to do that (together with lists of contacts)

We have also emphasised the need to engage with the general public, not only with people who are already engaged. As a result, the CCG went out and engaged with people in the street to test out their “Need for Change” document

We have given advice on how to run focus groups, and the benefit of doing so

We have given advice on how the CCG’s communications could be improved, to make the CSR more accessible to the general public

The CCG has acknowledged publicly on a number of occasions the help and advice we have given them and what actions they have taken as a result

They have also publicly stated that one of their own tests of the success of their engagement strategy and activities will be Healthwatch’s approval

SAFEGUARDING/SERIOUS CONCERN ALERTS

We are receiving an increasing number of contacts from members of the public and from Healthwatch Champions reporting incidents (particular in residential care homes) which have led us to raise safeguarding alerts with the relevant Local Authority and to pass on information to the CQC

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Thereby, we not only help to ensure vulnerable people’s safety is protected but also help to build up the store of intelligence held both by local safeguarding teams and the CQC.

Action we take in response to concerns over a person’s safety can extend into other areas too. A recent example: Someone submitted a form through our web site detailing

difficulties she has been having for some time in accessing mental health services. In the course of it she spoke about her desperation and mentioned ending her life if she wasn’t able to get the support she needs. Having first spoken to the Local Authority’s Safeguarding Team, we spoke to the person’s GP to make them aware of the situation and the GP agreed to carry out an urgent assessment. The person came back to us to thank us for the “kindness shown” saying, “It means a lot”.

We were contacted by a couple who have been working for a care home. The care home owner has not been paying them the National Minimum Wage, After the CQC (Care Quality Commission) inspector told her to she then took money out of their wages for accommodation, increasing the deductions to £125 per month each. The clients feel aggrieved by this and just want to leave the job. Their main worry is that she has told them she wants one month's notice. If they do not give her that, she has said she will deduct "training costs". They fear she will not pay them. In addition the clients commented that the care home had residents with dementia, and was not always adequately staffed. This case has been raised with the CQC who are investigating further.

MEDIA AND ONLINE ACTIVITY

Over the last few months, there has been a significant expansion of our exposure in the media. This was partly due to interest in our report “Every One Matters” and partly because media came to us to comment on issues of local interest, particularly the Dorset Clinical Services Review, the news that the Royal Bournemouth Hospital was threatening to evict patients, and concerns about the pressures on A&E. As a result, we figured in a number of articles (and double-page spreads) in the Bournemouth Echo and Dorset Echo, in the Independent and on the BBC news web site. Also interviews on the following radio stations: BBC Radio Solent Wave FM Hope FM Bournemouth University Radio BBC Radio 5 Live (national) The Jeremy Vine Show (BBC Radio 2, national)

We have also appeared on television on BBC South Today (twice) and on BBC Breakfast (national).

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Online, the number of users of our web site in the period October – December 2014 increased 55.72% over the previous period.

NON-EMERGENCY PATIENT TRANSPORT

We contributed a report to Dorset Health OSC with feedback on the non-emergency patient transport service operated by E-zec Medical Ltd. Subsequently, we worked with E-zec to improve the way in which they engage with their service users, including the format and language of their printed material, to understand how they can use feedback to improve their service, and to help them set up a specific user group for people who are renal dialysis patients.

LIVING WELL WITH DEMENTIA

As part of our Community Investment Projects, we worked with Bournemouth University to make a video “Living Well With Dementia”, challenging misconceptions and misunderstands about dementia. The video is now used in the training of health and social care staff.

WE REGULARLY PASS ON TO SERVICE PROVIDERS ANY ISSUES AND CONCERNS WHICH LOCAL PEOPLE HAVE REPORTED TO US AND WHICH WE CONSIDER “SERIOUS”, ASK THEM TO INVESTIGATE AND RESPOND. An example:

“N has liver cancer and has been receiving treatment at Bournemouth Hospital for the last 3 years. Her experience of Bournemouth Hospital has been poor. She talked about being moved from ward to ward and not being kept informed. A couple of weeks ago she was on a general ward with 2 other women who both had MRSA (Meticillin-Resistant Staphylococcus Aureusis). She was scared & asked to be moved as she has terminal cancer - but she didn't feel like anyone was taking her concerns seriously. She told me about another experience a few weeks before that when she was an inpatient at RBH waiting for an operation to fire chemo into her liver. The operation is very invasive and she was really nervous, she was told the operation would be in the morning but she was waiting around for hours - no-one she asked knew when the operation would be so she was getting more & more anxious. She left the ward to call her mum from the corridor (so she could have some privacy) and told a ward nurse where she would be so she could be called if they came to get her for the operation. When she got back a nurse told her that she'd missed the operation because she hadn't been in her bed when they came to get her. She was so upset that she was crying on the floor, begging them to do the operation and eventually they did the operation that day but she felt like she had to fight for it. She asked to see PALS several times and she didn't find them very easy to access. When someone from PALS came to talk to

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her she said she was told that it would probably affect her care if she complained - so she didn't progress a complaint.” With the person’s permission we shared the story with the hospital.

(But the person didn’t want us to disclose her identity.) We had a number of exchanges with the hospital and here is their eventual response:

“As you are aware, with the scarce information it is difficult to review our data as to the individual circumstances and who dealt with them. Even more so, as we do not even have a time frame and therefore cannot review our log with any precision. That said, we have reviewed the log and there is no patient with end of life details, who could potentially collate with this complaint. However, I have discussed this with the PALs coordinator, and she in turn has also discussed this with all members of her team. I am sorry to say that on the information given, none of them remember talking with an end of life patient, or hearing of any complaint or discussing with any patients with cancer about quality of care. I am sorry that we cannot offer any more information. I would like to mention that the staff were extremely distressed that anything they may have said would have been interpreted as making a patient fearful of complaining. They have emphatically stressed that they would not and have never told any patient under any circumstances that any kind of complaint would ever impact on the quality of their care. We agree that the perception of the patient may be influenced by many things at such a difficult time and all the staff in PALs are very concerned that their words have been misinterpreted, this has been discussed at length between them as a team and additionally with me present. They will be ever more vigilant to check and recheck patient understanding. I noted that you mentioned the patient found it difficult to access PALs from the ward, we will review how we ensure patients are aware of the PALs service and if you could let us know which directorate, without breaching confidentiality we will ensure all Ward Sisters in that directorate are aware of this situation and all staff are reminded to encourage Patients to access the service and offer information as to the methods available to them to do that. We thank you and welcome your feedback, and have taken this feedback very seriously and reviewed it in detail.”

We have subsequently suggested a form of words the hospital can use in all its material relating how to raise concerns or make a complaint, to make it clear that nobody’s care will be compromised if they do so.

This example shows how it’s possible for an organisation to learn from a patient’s experience (even if they don’t know who the actual person is and when the incident/s took place) and use that learning to gain a better understanding of the patient’s perspective and improve the way they act and communicate – and make it easier for people to raise concerns.

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INFORMATION AND SIGNPOSTING

Every day our information and signposting service (through our telephone helpdesk and face-to-face in Citizens Advice Bureaux) is making a difference for people. Some examples: A mother called us. She has an adult son who has learning

difficulties. He is attending a new service at a community farm but his mother feels he is not getting the best out of it and asked for our advice. We gave advice and also signposted the other to Poole Forum. She subsequently came back to us to let us know that both she and her son felt more empowered, and that her son feels he is being listened to, is happier and more confident.

A 93-year-old lady contacted us to talk about how she felt depressed and isolated. With her permission, we referred her to Dorset POPP (Partnership for Older People Programme). A POPP Wayfinder visited her in her home and is supporting her to combat isolation and also arranging help with shopping.

We received several calls from someone who was very anxious and nervous and suffering from memory problems. By talking to them, we enabled them to express their concerns and their needs and to identify that they wanted help and information about Alzheimer’s disease. As a result, they were able to refer themselves to both their GP and to the Alzheimer’s Society.

The father of a son who has anxiety issues around going to school contacted us. Despite having changed schools, there has been no improvement and he is being treated “as though he is a naughty boy”. The boy has seen an educational psychologist three times and a paediatrician once (for 45 minutes). The anxiety is becoming worse and the child is becoming violent, hurting the parent. The parents are paying privately for a children’s therapy group and the mother is attending a parenting course. They are having difficulty getting a referral to CAMHS (Child and Adolescent Mental Health Services). We were able to signpost the parents to Young Minds, who are committed to improving the emotional wellbeing and mental health of children and young people. The parents did not know about this group and thanked us for introducing them to it.

Someone contacted us who is waiting for CAT (Cognitive Analytic Therapy) in Poole. She has a personality disorder and has been receiving psychotherapy for two years. She finds it helpful but it costs her £65 per week. She is looking for help with funding. We researched funding opportunities and signposted her to Turn 2 Us. She thanked us for being able to give advice and information she hadn’t found elsewhere and now has a route through which to apply for funding.

PLACE

(Patient Led Assessment of the Care environment) visits. Healthwatch Dorset Champions (volunteers) have taken part in assessments in 15

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hospitals (three Acute, 12 Community) and each hospital has drawn up an action plan in response to what the team had to report on their findings.Note: PLACE visits focus on non-clinical areas, including privacy and dignity, food, cleanliness and general building maintenance. The team undertaking the PLACE assessment in each hospital is required to include at least 50% members of the public, known as “patient assessors” and the hospital is obliged to invite local Healthwatch to provide some of those patient assessors. All patient assessors (including Healthwatch Champions) receive training from the NHS before the PLACE visit. Healthwatch Dorset’s Volunteers Officer supports them, both in the training and in the visit. Scores resulting from the 2014 PLACE visits can be found here: http://www.hscic.gov.uk/catalogue/PUB14780

A PROJECT WAS UNDERTAKEN (initially by the LINk, then passed on to Healthwatch) to find out the experiences of patients in side rooms at Dorset County Hospital. As a result, the Friends of the hospital have now funded 60 dementia friendly clocks (which are more easily recognisable for people who sometimes find numbers confusing or difficult to read) for all side rooms/wards at the hospital. The report on the project can be found here: http://www.healthwatchdorset.co.uk/resources/side-room-project

EXAMPLES OF INDIVIDUAL CONCERNS RAISED WITH HEALTHWATCH AND HOW WE RESPONDED:

A GP raised concerns about another practice “actively promoting” faith healing. We raised the issues with the Practice Manager and Partners. They are now no longer promoting such practices.

A number of patients raised concerns about GPs referring them for X-rays to a community hospital on days when the hospital was closed. We raised the issue with Practice Managers and as a result GPs were reminded of the opening times and Practice Managers are monitoring the situation.

A patient needed information about access to a particular service. They had not been able to get the information from the NHS. But Healthwatch was able to supply it, and the person told us “Many thanks for your help. It is very much appreciated. I have had more help in a couple of emails with you than I had in about 20 emails with the NHS!”

WE SET UP A FOCUS GROUP OF LOCAL PEOPLE to meet with the GMC (General Medical Council) to discuss the revision of their sanctions regime. So Dorset people have had a chance to make their views known and influence the way the GMC deals with concerns about

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doctors.

BY ENLISTING THE HELP OF THE LOCAL AREA TEAM OF NHS ENGLAND AND THE LOCAL PHARMACY COMMITTEE , every Practice and Community Pharmacy in Dorset, Poole and Bournemouth now displays material (leaflets, posters and comment cards) about Healthwatch Dorset, extending our reach.

OUR WEEKLY PROMOTIONAL STANDS in local community setting around the county enable us to reach the general public, to spread the word about local Healthwatch and directly gather feedback from people about their local services. They are also a direct source of recruitment of Healthwatch Champions.

OUR NETWORK OF OVER 200 VOLUNTEER HEALTHWATCH CHAMPIONS enables us to hear feedback from people in non-health or care settings. As well as increasing the breadth of our knowledge of people’s experiences, this has also enabled us to pick up particular cases of very poor care and raise safeguarding alerts.

TOGETHER WITH THE OTHER LOCAL HEALTHWATCH IN THE WESSEX REGION and the Local Area Team of NHS England we form the “Wessex Community Voices” project. An early outcome is that a series of workshops is now under way which are skilling local people to be involved in the commissioning of services.

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Work Programme

Description Rationale Timescale

Royal Bournemouth Hospital (RBH) Healthwatch Dorset stands

Healthwatch Dorset stands in public areas of RBH, to gather feedback on services.

Biggest body of feedback received from local people is about hospitalsCQC issued a critical report on RBH in Oct 2013 - caused concern for local people

Mar - Aug 2014

Bournemouth Hospital: Focus groups about discharge

Focus groups about discharge

Feeding into Healthwatch England’s Special Enquiry on discharge

Summer 2014

Poole Hospital: Healthwatch Dorset stands

Healthwatch Dorset stands (as in RBH)

Biggest body of feedback received from local people is about hospitals

Nov 2014 - May 2015

Dorset County Hospital: Healthwatch Dorset stands

Healthwatch Dorset stands (as in Poole and Bournemouth Hospitals)

Biggest body of feedback received from local people is about hospitals

Jun - Nov 2015

Review of hospital web sites

Volunteers to “road test” the web sites, particularly for accessibility and accurate information.

Feedback received from local people also suggests that people experience difficulties using websites

Nov 2014 - Jan 2015

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Dorset Healthcare Trust

Gathering feedback from users of Speech and Language Therapy services and Mental Health Crisis Care.

Trust in special measures until early 2014Joint Bournemouth & Poole Overview and Scrutiny Committee (OSC) requested report on local people's feedback on Trust's services. Resulted in agreement between Healthwatch Dorset, the OSC and the Trust that Healthwatch Dorset would target users of a specific service - will be either Speech and Language Therapy services or Mental Health Crisis Care because we hold feedback from local people expressing their concerns about both those services

Jan - Apr 2015

Dorset Clinical Services Review

Monitoring engagement and consultation undertaken by Dorset Clinical Commissioning Group (CCG) and advising and influencing CCG to make consultation as wide as possible.

Dorset CCG priorityIssue of major importance to local populationOpportunity for Healthwatch Dorset to influence how review carried out, particularly in terms of engagement and involvement

Oct 2014 - Oct 2015

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Domiciliary Care Gathering experiences of people receiving home care

No major project focused on a social care in our first year Throughout life of previous LINks there had been discussions about gathering data on experiences of people receiving domiciliary care, as identified as an isolated group (because service takes place in their own homes) and therefore potentially vulnerable. LAs also keen that we should do work with this group.

Dec 2014 - Feb 2015

Community Investment Projects

See below Focused on "hard to reach" groups, a priority for community engagement by Healthwatch Dorset

Sep 2014 - Mar 2015

Enter & View: initial series of visits with Dorset Clinical Commissioning Group (CCG)

Series of unannounced visits to local hospitals with Dorset CCG

Priority for Dorset CCG - requested that Healthwatch Dorset accompany themWill inform how Healthwatch Dorset undertakes visits in future

Sep - Nov 2014

General Medical Council (GMC) focus group

Focus group with GMC as part of their review of their Sanctions system.

GMC priority Nov 2014

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Perspectives Investigation into common mental health issues and assets (external research body commissioned by LINks to carry out the work)

A LINks legacy project, funded by LINks, It was left to us. And the LINks, with agreement of the LAs as their commissioners

Until Mar 2015

Mystery Shopping Follow up to GP exercise and new exercise focused on dental services (access and charging)

Complaints process one of first priorities of Healthwatch England.  GPs chosen as focus for first project as over 90% of general public's initial interactions with health services are with GP practicesDentists chosen as subject of next project as feedback suggests people do not know how to complain about dental services

Dec 2014 - Mar 2015

Wessex Community Voices

Pilot project, collaboration between the 5 Wessex local Healthwatch organisations and NHS England

Identified as priority by Wessex Area Team, NHS England

Until Jul 2015

ONGOING WORK

Health and Wellbeing Boards (2) Attendance

Health Overview and Scrutiny Committees (3)

Attendance

Better Together Board

Attendance

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Better Together Integrated Locality Teams workgroup

Attendance

Quality Surveillance Group Attendance

Road shows and community engagement/outreach

Organisation and attendance

Healthwatch Champions Recruitment

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Community Investment Projects

Name Project Area When

Toby’s Project

Project to work with young people, including young people from the Gypsy, Roma and Traveller (GRT) population.

Dorset

March 2015

Space Youth Project

Project to engage with Lesbian, Gay, Bisexual and Transgender (LGBT) young people about their experiences of health provision.

BmthDorsetPoole

March 2015

Body Positive

School project: running Body Positive workshops & delivering Healthwatch Dorset information. The first part of this community project aims to provide Consumer/User Testimony by supplying anonymised anecdotal accounts of HIV (Human Immunodeficiency Virus) service user engagement with health and social care: access, barriers, good stories, bad stories. The second part is a community based educational project.

BmthDorsetPoole

March 2015

Learning Disability Health Champions

Project will aim to support the provision and activity of Learning Disability (LD) Health Champions in Bournemouth, Dorset and Poole.

BmthDorsetPoole

Sept 2014

Jessica Akeb Survey on access to healthcare by people from Black and Minority Ethnic (BME) communities with focus on mental health.

BmthPoole

March 2015

BUDI Joint project with Bournemouth University Dementia Institute (BUDI), Alzheimer’s Association and Dorset Clinical Commissioning Group to produce a Dementia Awareness video. The video will raise awareness of what it’s like to live with and/or care for someone with dementia.

BmthDorsetPoole

Sept 2014

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Face2Face Mental health art project with Zoofish / Richmond Fellowship - Healthwatch Dorset funding will be used to fund the social media training costs, the promotion of the project through Facebook/twitter/e-News, etc. and advertisements for volunteers. In return the project will take Healthwatch Dorset leaflets to events & festivals, include Healthwatch Dorset links on Facebook and twitter and share data on the feedback Richmond Fellowship gather.

BmthDorsetPoole

Nov 2014

Chatterbox Disabled children’s art/tapestry project going into schools and youth clubs in Bournemouth and running some interactive workshops with young people. The workshops will give young people some square pieces of fabric in which they can draw and/or write their opinions/experiences about health and social care services they had accessed, as well as their suggestions about how to improve these services. Chatterbox will create two larges murals that can hang on the wall.

BmthDorsetPoole

Dec 2014

Intercom Trust

Survey of older Lesbian, Gay, Bisexual and Transgender (LGBT) people to identify health & care needs across Dorset

Dorset

March 2015

Access Dorset

Project that aims to share information and promote awareness of Healthwatch Dorset. Access Dorset will produce 5 films this year relating to health & social care issues.

Dorset

March 2015

Dorset Community Action (DCA)

Development of a Dorset voluntary and community sector health & care forum & database.

Dorset

March 2015

AFC Bournemouth (AFCB)

Community project aimed at promoting diversity and tackling inequality. AFCB (Bournemouth Football Club) currently seeking sponsorship for project.

Dorset

Currently no end date

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CRM Data and analysis of feedback on services

1st April 2013 to 31st December 2014Total Number of Comments Received – 2269

1. Number of comments received by month:

2. Commentator Type

Summary – the majority of comments received came from Service Users (68%)

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3. Origin of Comments

Summary – The single largest body (29%) of comments received were via the Healthwatch Dorset website.

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4. Origin of comments by Local Authority (where known) and by month Phone Website CAB Email C/Card Corres Face to

FaceConsultation

Third Sector

Event Other Monthly/ Quarterly Total

LA B P D B P D B P D B P D B P D B P D B P D B P D B P D B P D B P D

July 13

5 1 12 1 1 2 1 23

Aug 13

1 2 5 1 9

Sep 13

3 4 1 1 2 3 1 15

QTR TOTAL

9 5 13 3 2 8 0 0 0 1 0 2 0 0 0 0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 47

Oct 13 4 4 3 2 1 1 1 16Nov 13

4 3 7 1 2 5 9 31

Dec 13

1 1 7 3 2 2 1 15

2 34

QTR TOTAL

9 8 17 1 4 9 0 0 2 0 0 2 0 0 0 1 0 25

0 2 0 0 0 1 0 0 0 0 0 0 0 0 0 81

Jan 14 5 3 10 3 1 2 2 5 1 1 1 18

52

Feb 14

4 1 8 4 1 9 1 24

1 1 1 5 60

Mar 14

7 1 8 2 1 8 2 4 1 1 1 1 37

QTR TOTAL

16

5 26 9 2 3 9 3 37

2 0 1 1 2 10

2 1 18

0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 149

Apr 14 4 5 4 1 1 4 1 1 5 2 28May 14

10

4 8 2 1 1 9 1 2 2 1 41

June 14

3 6 8 6 6 2 2 1 1 35

QTR TOTAL

17

15

20 1 3 10

2 1 15

0 0 3 7 0 0 1 0 4 1 0 0 0 0 0 0 0 0 2 0 0 1 0 1 104

July 14

5 2 4 5 3 2 1 1 2 1 2 1 29

19

Aug 14

4 2 7 1 1 1 1 5 3 1 1 1 1 1 30

Sep 14

2 4 6 1 6 1 2 5 1 1 1 2 32

QTR TOTAL

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8 17 1 7 9 2 5 11

0 4 2 2 1 2 2 0 5 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 91

Oct 14 3 1 2 1 9 6 12

2 4 2 1 2 1 46

Nov 14

1 3 5 7 2 1 1 1 21

Dec 14

2 1 8 3 4 4 1 3 2 3 2 1 1 1 1 37

QTR TOTAL

6 5 15 3 5 9 17

1 17

2 0 6 4 3 1 0 0 1 2 0 1 0 0 0 0 0 0 0 2 1 2 1 0 104

On-going Total by LA

68

46

108

18

23

48

30

10

82 5 4 1

614 6 1

3 6 2 55 3 2 2 0 0 1 0 0 1 2 2 1 3 1 4

Overall

222 89 122 25 33 63 7 1 1 5 8 576

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(Note – Local Authority data is available for 576 of the comments – 25% of the total to date. Everyone who contacts us through the telephone helpline, face-to-face in Citizens Advice Bureaux, via our online feedback form or paper comment cards and feedback leaflets, is asked to give us at least the first half of their postcode, but some choose not to.)

5. Demographics (where known) ETHNICITY Pool

eBMout

hDors

etUnkno

wnTOTA

LArab 1 1White Irish 1 1Asian or Asian British - Indian 1 1 2Black British 2 2Black any other background 2 2White Gypsy/Traveller 1 1 2Mixed background 2 2 4Asian/Asian British (any other Asian background

2 1 2 5White European 3 2 6 11White any other background 2 2 15 19White British 35 56 97 419 607

AGE Poole BMouth Dorset Unknown TOTAL0-17 3 1 8 1218-24 1 1 15 1725-49 8 23 11 119 16150-64 13 19 28 140 20065-79 13 21 46 125 20580+ 5 6 30 41 82

SEX Poole BMouth Dorset Unknown TOTALTransgender 1 1Male 24 28 53 247 328Female 42 64 91 349 546

DISABILITY Poole BMouth Dorset Unknown TOTALLearning Dis 1 1 2 4Dementia/Alzheimer’s

6 6

Sensory Dis 1 1 8 10Unspecified Dis 2 5 2 14 23Mental Health 6 4 39 49Physical Dis 6 6 15 50 77Other 6 11 7 80 104

MARITAL STATUS

Poole BMouth Dorset Unknown TOTAL

Civil Partnership

1 1

Widowed 1 1 4 2 8Co-Habiting 1 2 9 12Divorced 2 4 2 7 15

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Single 2 7 7 48 64Married 6 3 25 41 75

PREGNANT/MATERNITY

Poole BMouth Dorset Unknown TOTAL

Pregnant 1 1

RELIGION/BELIEF

Poole BMouth Dorset Unknown TOTAL

Jewish 1 1Christian 1 1 2

6. Sentiment – Comments Overall

Summary – The majority of comments received (52%) were negative.Note for following analysis - the total number of comments received does not correlate to the total number of times a particular Topic, Sub Topic or service may be logged. For example, one individual patient/service user comment may refer to “the ambulance service were great and picked me up really fast but when I got to the hospital I had to wait 4 hours in A&E before I was seen”. This one comment will be logged with at least 2 Topics and Sub Topics relating to a positive experience of ambulance services and a negative experience of A&E.

7. Most reported Topic

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Sentiment of top 3 Topics:

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Note – the most frequently reported Sub Topic “Quality of Treatment” is a Sub Topic of the most frequently reported Topic “Quality”.Summary - Sentiment of top three Sub Topics:

“Waiting Times” is a Sub Topic of both the Topics “Access to Services” and “Patient Pathway” but have been grouped together here to show that “Waiting Times” is a particular issue overall.

8. Comments By Service Provider:

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Sentiment for most reported Service Provider Royal Bournemouth Hospital:

9. Most commonly reported Service Type:

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10. Most commonly mentioned Specific Service Area (where service mentioned more than 20 times) – as per above – the number does not necessarily correlate to the number of comments received i.e. one patient comment may refer to several issues related to a service – therefore that service will be logged more than once:

11. Summary:

11.1. Most frequently reported areas were Quality of Treatment, Staff Attitudes and Waiting Times

11.2. Service specific areas that received a higher percentage of negative to positive comments were:

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11.2.1. Acute Care11.2.2. Dentistry11.2.3. Inpatients 11.2.4. Mental Health and CMHT11.2.5. Orthopaedics11.2.6. Outpatients11.2.7. Primary Care/GP11.2.8. Assisted Living11.2.9. Care at Home11.2.10. Cancer services11.2.11. Care of the Elderly11.2.12. Nursing and Residential Care Homes11.2.13. Physiotherapy11.2.14. Urology11.2.15. Care Assessments

11.3. Service specific areas that received a higher percentage of positive to negative comments were:

11.3.1. A&E11.3.2. Ambulance services11.3.3. Cardiology11.3.4. Maternity11.3.5. Radiography11.3.6. Community Hospitals11.3.7. End of Life care

12. Outcomes of Issues Raised where knownSignposted – 344 (note – some will have been signposted to more than one place)

Where Signposted Number SignpostedNHS Complaints 68NHS Choices 56Local Authority/Social Services 40NHS PALS 35Dorset Advocacy 28GP 28Healthwatch website 18CAB (Citizens Advice Bureau) 17NHS England 15Local solicitors 11AgeUK 11AvMA (medical negligence) 10Dental Helpline 6NHS111 5Shelter 4General Dental Council 4

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CQC 3MIND 3Dorset CCG 3DWP (Department for Work and Pensions) 2BCHA (Bournemouth Churches Housing Association)

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Health Ombudsman 2Turn 2 Us 2E-Zec 2Diverse Abilities Plus 2Police 2Hospital Complaints 2Macmillan 2Autism Wessex 2Social Care in Action 2Elderly Accommodation Council 2DOTS Disability 1Kidney Foundation 1Dorset Home Choice 1Family Health Services 1Rethink 1Dorset Mental Health Forum 1Department of Health 1Samaritans 1Prison Support Group 1Family Rights Group 1Information Commissioner 1Steps 2 Wellbeing 1Young Minds 1Diabetes UK 1Gingerbread 1Red Cross 1SWAST (South Western Ambulance Trust) 1NHS Low Income Scheme 1Benefits Enquiry Line 1ACAS (Advisory, Conciliation and Arbitration Service)

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Carers Support Group 1Beaumont Society 1First Stop 1IMCA (Independent Mental Capacity Advocate) 1GMC 1

Information given (some will also have been signposted)

Type of Information provided Number of Times information providedVerbal Advice 211E-Leaflet 37Hard copy leaflet 23Fact sheet 22Other 18

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Community Engagement and Outreach ActivitySome of the events we’ve taken part in during this period. (D indicates an event which relates to a group with a protected characteristic or a group whose voices are seldom-heard, or which otherwise has a Diversity aspect):

(D) Full of Life Day events at the beginning of October including beach tai chi (featured on the cover of the national Older People’s Day online magazine:), a Poole Park memory walk & sheltered housing event (photos & updates on Facebook)

(D) Stand with information and activities at the Family Fun Day Kick It Out event aimed at young people on Sunday 19th October in Kings Park Athletics Stadium. The event promoted health, sport & wellbeing with anti-bulling & anti-racism messages to young people and their families, photo album on Facebook: http://goo.gl/RQrnXz

(D) Healthwatch information stand at Carter Community School as part of the Young Enterprise scheme

(D) Mental Health Awareness week promotions and stands with Bournemouth University

‘Speed Dating’ event in Bournemouth with local businesses organized by CVS (Council for Voluntary Service), which led to distribution of Healthwatch leaflets to staff at NatWest & Lloyds Banks across Dorset

(D) Teen2Adult events in Bournemouth & Dorchester, promoting Healthwatch to families through a joint interactive information stand with the Chatterboxes and Dorset CCG

Healthwatch talks at various Community Lunches across Dorset (D) Memory Cafés in Wareham, Ferndown and Poole to promote

Healthwatch and gather feedback on local services for people with Alzheimer’s and their carers

(D) Healthwatch drop in’s with Routes to Roots homeless support group in Pool

(D) Meeting with GP practice managers in Kinson, Dorchester and Wimborne to promote Healthwatch and support diverse and representative patient participation groups (PPGs)

(D) Healthwatch stand at Poole Youth Forum AGM (Annual General Meeting)

Dorset County Hospital open event in Bridport, promoting Healthwatch and taking part in the workshop on future delivery of community services

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Focus group meeting with the General Medical Council to consult on changes to GP sanctions, 10th Nov in Wimborne. The meeting was well attended by 27 people and the feedback was good.

North Dorset PPG network meeting in Sherborne: gave a Healthwatch talk and signed up 3 new Champions.

Domestic violence awareness conference in Bovington, ‘No Excuse for Abuse’

Series of regular Healthwatch information stands at Poole Hospital DHUFT (Dorset Healthcare University Foundation NHS Trust)

engagement event in Dorchester on 11th December (D) Equality and Diversity Forum (D) Unity in Vision: BME Carers Advocacy Project in West Dorset,

Weymouth and Portland. Delivered a presentation ‘Introduction to Healthwatch’ during the project launch at the Islamic Centre in Dorchester.

Poole Partnership Networking Event 2014. Meeting with Probation service re. access/provision of mental health

services and to discuss arrangements for the probation information ‘hubs’ for service users and HWD involvement

LSCB (Local Safeguarding Children’s Board) Annual Safeguarding Conference for Bournemouth and Poole

Supporting Stronger Voices (Dorset CCG) 6 monthly forums for CCG patients, carers and lay representatives to provide: information on how the views of local people are informing CCG’s work and insight to CCG Clinical Services Review

Voluntary Sector Health and Care Forum: Discussion on voluntary sector’s involvement and its role in the Clinical Services Review.

(D) Growing Well Collaborative Workshop in Weymouth: The Growing Well Collaborative is a Dorset County Council and Clinical Commissioning Group led approach to provide GPs in Weymouth and Portland with information about the services that are available for young people who live in the locality. The aim is to provide GP’s with alternatives to clinical pathways for young people who present in general practice by developing a menu of services and activities that they can refer and signpost to. Workshop was an initial discussion about current provision and needs.

Dementia Friends session as part of the disability awareness week at Bournemouth University

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Volunteers 

Healthwatch Champion Numbers – 218 Regular volunteer E-News to all volunteers, plus Parish and Town

Council Clerks and all of Dorset’s Councillors, and 214 community groups

Healthwatch Reading Group (HRG) – 22 members We are asked by NHS and Local Authorities to take a view on

various pieces of literature. The HRG feedback to the organisations directly with their views. They have fed back on 1 document in this quarter

Volunteer Activity Volunteers have attended a number of events and manned our

information stands.

They have also assisted during the engagement events at the Royal Bournemouth Hospital and Poole Hospital.

As well as meeting with the new champions our Volunteers Officer has attended various events and meetings to promote Healthwatch volunteering opportunities, including:

A number of lectures during Bournemouth Universities Mental Health Week

A homeless hostel in Boscombe to promote Healthwatch Dorset. Parliamentary Reception for local Healthwatch – attended with some

of our MP’s: Annette Brook M, Conor Burns, Christopher Chope Christchurch Community Partnership Volunteer Fayre Met with Jill Haynes, Cabinet Member for Adult Social Care, Dorset

County Council Attended Weymouth & Portland 'Working With You' Community

Lunch Networked at Bournemouth 2026 Trust AGM Attended and commented at an event in which we could view plans

that have been drawn up to develop Bridport Community Hospital site into " a centre for integrated Health and Social Care for local people...to provide co-ordinated services closer to home".

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Information stand in the Sovereign Centre – Boscombe Charities Forum in Bournemouth Attended and commented at Dorset County Hospital's vision for

joined up healthcare in Weymouth Purbeck Community Lunch – Stand BADSUF’s (Bournemouth Alcohol and Drug Service User Forum)

Open Day – Stand Worked on changing some aspects of the CRM to enable better data

collection. Health Event in Sherborne Volunteer Co-ordinators’ meeting for East Dorset Health Network meeting for Sturminster Newton Bournemouth Young Volunteer Celebration Event Home Safety Falls Prevention Event – Corfe Mullen Weymouth & Portland 'Working With You' Community Lunch Poole Health and Social Care Overview & Scrutiny Committee Dorset Community Action AGM – Dorchester Talked to some of Bournemouth’s young homeless people during a

drop in session Spoke at sex workers’ “victims of violence” event

 

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Citizens Advice in Dorset (CAiD)

Report Title CAiD/HWD - Report 7 Period covered Quarter 3: October, November, December

2014Report date 13 January 2015Author Caroline Buxton, CAiD

1: IntroductionCitizens Advice in Dorset is contracted by Healthwatch Dorset to provide information, advice and signposting on a face-to-face and walk-in basis, for the following:

1. a query relating to Health or Social Care that could be of any nature; 2. a request to record an experience with the intention that it will

inform the influencing remit of Healthwatch.

The delivery of this service is provided by the nine Citizens Advice Bureaux that serve Dorset Bournemouth and Poole, and come together as Citizens Advice in Dorset:

Dorset County Council:

Bridport CAB Christchurch CAB

Dorchester and Sherborne CAB East Dorset CAB

North Dorset CAB Purbeck CABWeymouth and Portland CABBournemouth Borough Council: Bournemouth CABBorough of Poole: Poole CAB

2: Activity summary, Year 2 - Quarter 3

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Client numbers and issues have again remained steady during this quarter. Three new Leads have been appointed and Caroline has met individually with them to ensure they understand their role and remit, and are working effectively. A Leads Meeting is planned for 12 January 2015, and this will include a review of cases on the CRM.

Caroline and Martyn Webster (Help & Care) have identified the need for people to have access to clear and impartial information on Residential Care – options, charges, meeting fees etc. The plan is to identify good sources of information and provide links to these from the Healthwatch Dorset website.

Roger Tilley (CAiD Trustee) and Caroline Buxton have attended HWD Board meetings.

3.1: Statistics – Quarter 3: October, November, December 2014

Data from the Citizens Advice ‘Petra’ system for this period shows that we have recorded 251 unique clients with a health or care issue, raising 371 separate issues. Comparison over the 7 quarters is as shown below:

Unique Clients Issues2013/2014 Qtr 1 Pre ‘Petra’ 158

Qtr 2 254 331Qtr 3 283 453Qtr 4 360 526

2014/2015 Qtr 1 308 454Qtr 2 294 456Qtr 3 251 371

Of the 251 clients, 228 are recorded as from our three areas, Bournemouth (36), Poole (27) and Dorset (165).

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3.1.i Client data

The following analysis of the 228 clients by authority uses the contract categories, and gives a good indication of the profile of CAB clients with a Healthwatch issue:

AgeB/mouth Poole

Dorset

18-24 2 625-34 6 1135-44 6 2 2145-54 7 4 3455-64 8 7 2365+ 5 11 56Not stated 2 3 14

GenderMale 21 10 63Female 15 16 102Not stated 1 EthnicityOther Black 1Other White 4 2 4W & Black African 1W & CaribbeanW & Asian 1 1White British 24 22 158

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White IrishCaribbeanNot stated 5 2 3Not completed DisabilityDisabled 3 3 26Long-term health problem 19 8 66Not disabled 10 12 52Not stated 4 4 21

Overall percentage of those with a disability/long-term health issue: 55%]

Percentage under age 35: 11% Percentage aged 65+: 27%

3.1.ii Issue data

Advisers record issues using specific codes; currently we have our existing health and social care codes, plus new Healthwatch specific codes, which mirror the Healthwatch England Hub categories. The breakdown below is a very useful overview of the main types of issues. Due to a change in the way codes are recorded it is now harder to pull out specific data on those issues that were only dealt with at a Gateway Assessment (‘level 1’: information / signposting) as compared with a full advice interview (‘level 2’). The most recent figures suggest an approximate 50:50 split between level 1 and level 2.

Advice Issues Comparison: Quarters 1, 2 and 3, 2014/15

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Issues raised over 8 times are listed below, and compared with quarters 1 and 2:

Qtr 3 Qtr 2 Qtr 1

Community Care (non mh): eligibility

17 11 16

NHS: travel charges 16 11 16

Residential Care: charges 15 27 21

Healthwatch Other: primary care/GPs

11 3 11

Dentists (general) 18 17 14

Dental charges 9 6 13

An issue with consistently low numbers is children’s mental health services; it would be useful to check if this reflects reality or is a mis-recording issue with these cases being listed under other mental health topics.

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3.2: CAB Case Studies

The following two cases have been submitted as CAB ’eBEFs’ (electronic Bureau Evidence Forms) as well as being put onto the Help & Care CRM; eBEFs are interrogated nationally by Citizens Advice to identify trends and it is important that evidence on health/care issues continues to reach Citizens Advice and be incorporated into reports on wider topics. Our evidence is still relevant here as it combines with evidence from those CABx in England and Wales that are not part of their local Healthwatch.[* Indicates a provider was named]

Key issue: Safety of medication / GP lack of transparency. Client has been receiving regular medication for problems with sickness and digestion for over 10 years, as prescribed by her GP at the * Practice. Recently it was stopped without explanation, and further research suggested that the drug has associated safety concerns, especially for long-term consumption. Client had not been made aware of this.

Key issue: Waiting times. Client has to wait 4 months for an operation on his knee following an injury. The current state of his knee is preventing him from working and also damaging his morale, meaning a 4-month wait is very problematic for him.

Key issue: inadequate information on financial contribution to day care. This elderly couple took up the suggestion of some day care for the husband who has dementia. They were told it would cost £4 a day for lunch. After several months they were visited and a financial assessment was carried out; they then received a bill for £936 for the cost of the day care service provided so far. They were obviously concerned that they had not been made aware of this earlier. We have not been able to pin down why this did not happen; however research by our bureau Lead has found that the information available is confusing. On MyLifeMyCare it says: 'Each Day Centre has its own charges and you should contact the centre for details.  In general, you can expect to pay from around £20 a day. We charge for attendance at our council run Day Centres and how much you pay will depend on your financial circumstances.  Following a financial assessment, we will be able to tell you how much you would be asked to pay'. In their downloadable fact sheet 'paying for non-residential care services’, it says 'maximum contribution £24.42 a session'.  Whatever the charge it is clear that clients need enough information

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at the outset  – not just online but clearly explained – to understand what they are committing to and that there will be a financial assessment of what they will need to pay, so that they can make an informed choice about taking up services.

The following case highlights a recurring theme – poor employment practice in care homes. There has been discussion as to whether this is a ‘Healthwatch’ issue; our feeling is that poor employment practices are likely to affect staff morale and therefore the level and quality of care, leading to potential safeguarding issues. We are therefore pleased to see that the Care Quality Commission (CQC) is taking further action.

Clients (a couple, EEA workers) have been working for a care home. The care home owner has not been paying them the National Minimum Wage, After the CQC inspector told her to, she then took money out of their wages for accommodation, increasing the deductions to £125 per month each. The clients feel aggrieved by this and just want to leave the job. Their main worry is that she has told them she wants one month's notice. If they do not give her that, she has said she will deduct "training costs". They fear she will not pay them. In addition the clients commented that the care home had residents with dementia, and was not always adequately staffed. This case has been raised with the CQC who are investigating further.

4: Next Steps – priority areasWhat Who When

4.1 Recording and ReportingOn-going support to Leads inputting cases Leads

C BuxtonA Dimmick

On-going

4.2 Keep CAB teams up to date with Healthwatch issuesLeads Meeting C Buxton 12 Jan

2015

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Leads to use Reports for briefings Leads On-going

Leads to continue to use bureau Petra views of all HW cases so they can see trends

Leads On-going

Delivery Team meeting? M Jewell Tbc

4.3 Raising public awareness that CABx are part of HealthwatchLiaise with H&C on on-going publicity events.

C BuxtonL BateC Wakefield

On-going

Liaise with H&C for greater linking of community HW ‘Champions’ and Bureaux Leads

4.4 Social Policy/Influencing workWork with H&C and DREC to identify how to demonstrate impact

C BuxtonM Webster

On-going; meeting 15 Jan 2015

Work with H&C on Residential Care information, with a view to include useful links on HWD website

C BuxtonM Webster

By end Jan 2015

Liaise with Dorset CABx Social Policy Campaign Group on relevant HW issues

C BuxtonA Evans

Meeting20 Jan 2015

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