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The information and insight you give us makes a huge difference to the work that we do. You give us a picture and understanding of what local patients, carers, the public and other stakeholders need from local services. Here are just some of the areas where your input has made a big difference:

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Grass roots reporting

The feedback you give us goes into our Grass Roots reporting. Grass Roots gathers information from a wide variety of sources, including: 

  • Patient Opinion
  • NHS Choices
  • Healthwatch
  • Complaints, comments and compliments
  • Social media
  • MP and public feedback
  • Community and voluntary sector services

Our Grass Roots reports is produced every month and is fed into our Joint Quality Committee who take a regular "deep dive" into different areas of our work to ensure that your feedback is shaping what we do. 

In the past year just some examples of the work that has informed Grass Roots have included:

  • the urgent care strategy,
  • access to psychological therapy services,
  • children’s experience of hospital services, and,
  • maternity services.

Maternity partnership

Each year the Maternity Partnership holds a series of focus groups to listen to the views and experiences of new mums and mums-to-be. Everyone who contributes to these groups helps the Maternity Partnership identity what's important for local women and make improvements. 

The Maternity Partnership is made up of members of the public as well as health professionals who work together to improve maternity services across Bradford, Airedale, Wharfedale and Craven.

The latest focus group looked at the theme of personalisation and choice, looking at three specific areas:

  • antenatal period including planning for a baby,
  • labour and birth,
  • postnatal period 

Our CCGs use the feedback you give us from the Maternity Partnership to understand your experience of having a baby so we can improve services, highlight areas of good practice and where things haven’t gone so well, look at how this can be avoided and improved. 

You can read the full report, which includes the findings here

Flagging patients' needs in medical records

Using the feedback you give us that goes into our Grass Roots reporting, we could see that we needed to improve the experiences of people who use health services and need accessible information. 

Some of the specific experiences we identified from Grass Roots included:

  • appointment letters sent to people with visual impairments,
  • translators for language or British Sign Language (BSL) not being arranged at clinics, 
  • information not provided in a way that can be used.

What we did

A project group was set up to look at this area. This group included four GP practices from Bradford City and Bradford Districts CCGs, CCG staff and patient groups. The outcome was that the group identified a way of flagging disabled patients’ access needs in SystmOne, the patient record system used by local GP practices. 

As a result, the patient record system used by local GP practices has been updated so that where a patient has a need for accessible information, this can be flagged within their patient record. A questionnaire, developed by patients, acts as a guide for practice staff when talking to patients about their access needs and what reasonable support is needed.

This project has been shared with NHS England as a key way for practices and CCGs to ensure they meet the requirements of the new Accessible Information Standard introduced in 2016. We have now set up a new joint group wiht the local authority and NHS Trusts to see how this can be implemented more widely. 

Women's health network

The women's health network identifies and addresses health issues and inequalities affecting women and their families living in Bradford. The network has been set up by Bradford & District Community Empowerment Network (CNet), with support from Bradford City and Bradford Districts CCGs. 

The women's health network will create the opportunity to establish and maintain dialogue with our local community on the issues that are most important to them. This will then help us to develop women's services. 

Women's health network

The women's health network and our CCGs will: 

  • identify and better understand the issues that impact on why women choose to access health services and why they choose not to;
  • identify gaps in services;
  • work collectively with the Bradford CCGs to design and develop services which meet the needs of local women;
  • work with local communities and organisations to ensure assets (resources, properties, skills and talents) within communities to improve women's health are used well;
  • make sure important health messages are clear, easy to understand and are shared effectively;
  • create opportunities to help women improve not only their own health and wellbeing but that of their family and friends;
  • have a strong, open and transparent relationship and use the outcomes of the Women's Health Network to achieve better health outcomes for the women of Bradford. 

Further information

You can read more about the Women's Health Network below, including their final report and how they identified their clinical priorities.

Clinical priorities workshop, 25th May 2016

Interim progress report

Final report

Women's Health Network website

NHS Citizen and NHS Youth Forum

Patients from the network and our funded projects have attended and been involved in NHS England’s Youth Forum and NHS Citizen.

In November 2015, young people delivered a workshop at the first national NHS Youth Forum conference. Patients, carers and public representative members attended the NHS Citizen Assembly to represent local views on access to primary care services, young people’s health, mental health and self-care.

Mental health - future in mind

Feedback and insight from young people helped develop our strategy for young people’s mental health and wellbeing - Future in Mind.  We listened and incorporated into the strategy some key areas of insight gained from children, young people and their families. These included: 

  • young people’s feedback on services through our voluntary and community partners,
  • hearing and exploring young people’s voices and experiences,
  • sharing good practice for youth engagement,
  • working with schools – including parents and those responsible for child health
  • young women and use of health services – particularly focusing on experiences of self-harm and self-esteem
  • access to primary care services
  • use of urgent and emergency care services

You can read more about how children and young people contributed to the Future in Mind strategy here.

Thrive website

Young people in Bradford have helped developed the Thrive website which supports the mental health and wellbeing of young people. The idea came from consutlation with young people who wanted more information and help regarding their emotional health and mental wellbeing. The Thrive Bradford website has been developed with specific content and information for young people. It also signpostes to services and gives real stories and scenarios. 

You can find out more about the Thrive website here, including stories from some of the young people who were involved in creating it.

thrive-people

Children's takeover day

Children's takeover day gives young people the chance to work with adults for the day and to experience and learn in ways that connect them with our CCG’s work and raise their personal aspirations to be involved in the future.

In November 2015, members of Barnardo’s discussed their experiences of health services with our governing body. They took part in meetings and helped to plan our visit to NHS Citizen Assembly.

Young people's engagement event

Getting young people interested and involved in shaping local health services was the key theme of an event attended by over 500 young people in October 2015.

At the event, which was jointly hosted by local NHS organisations, each person received a health passport and was challenged to collect ‘info zone’ stamps from a range of stalls focussing on careers, getting involved, staying active and keeping healthy.

The zones covered issues such as emotional health and wellbeing, sexual health and relationships, drug awareness, the effects of smoking and drinking, and NHS careers.

We raised awareness of local campaigns such as Bradford Beating Diabetes and Bradford’s Healthy Hearts with the ‘selfie’ stalls proving highly popular, drawing young people in to talk about their health and experiences of health services.

We trialled a new commissioning game known as The Commissioning Maze and workshops at the event were delivered by rap artist Marcus Lee based on young people’s views of healthcare.

Patient and public voice in governance

So that we hear the voices of patients and the public all levels, and that our commissioning decisions are informed by listening to those who use and care about services, we have embedded patient and public representatives in several of our governance structures.

Where possible, several patient and public representatives take part to enable diverse perspectives.

Involvement in governance includes: 

  • the appointment of lay members to our governing body,

  • representatives involved in clinical board meetings,

  • representatives involved in our communications, engagement and equalities reference group,

  • representatives involved in the network steering groups and advisory groups covering areas of strategic priorities such as improving patient experience, diabetes, heart disease; and,

  • recruitment of permanent staff to the CCG. 

Individual participation

Our CCG learns from patients in a variety of ways. One of the main ways that we do this is through our governing body hearing first-hand from patients and their families about their experiences of NHS services and how they can be improved.

Recently, our governing body have heard about experiences including;

  • the need for accessible information
  • how improvements for diabetes services are progressing,
  • the experience of women accessing community services,
  • the impact of isolation on health and mental health. 

You can read the patient experiences heard by our governing body in the governing body meeting minutes. These can all be found in our governing body papers

A recent example of one of the stories given to our governing body is below.


 

The need for accessible information

Samantha Allen, Tom Walsh, and Sue Crowe from Bradford Talking Media attended our governing body meeting in October 2015 to tell us about their experience of the need for accessible information. 

The CCG started with an update on the new Accessible Information Standard (which will be implemented in July 2016 by NHS England). This has been developed to ensure people who have a disability or sensory loss receives the right information in the correct format. Bradford Districts CCG has been overseeing a pilot on flagging patients’ access needs in primary care and in September an event was held in Bradford to look at what the standard means for local people. An awareness campaign is also planned by Healthwatch and Care Quality Commission to encourage people to give their views. 

Samantha Allen was born deaf, she has lived in Bradford all her life and her first language is British Sign Language (BSL). She shared her experiences with the governing body via her sign interpreter, Alex. Samantha raised the following key points: 

  • there is now touch screen arrival installed in her GP surgery to check in, which makes it much easier than talking directly with a receptionist. 
  • her GP surgery now also has a digital display board which displays a patient's name, it has alleviated a lot os stress as she no longer needs to ask for assistance whilst waiting for her appointment. This would be a useful tool to have in all hospitals (although it does not completely remove all issues with a frontline reception desk).
  • some hospitals now offer a ticket number system where you take a ticket with a number and when the number flashes on screen you go through to the allocated room. This again is a good system to reduce the anxiety of having your name called.
  • GP appointments can only be booked 1-2 weeks in advance to accommodate those who need an interpreter. This is not always appropriate when a GP appointment is needed urgently. Confidentiality becomes an issue when deaf or hard of hearing patients have to have an interpreter, especially if the appointment concerns highly sensitive issues.
  • home visits are usually booked to schedule an interpreter to attend at the same time, however on some occasions the nurse has not attended or arrived late and the interpreter has needed to wait or leave for another appointment. It would have benefited both parties if the nurse was aware that a BSL interpreter would also be present.
  • asking members of staff to be aware when talking to a deaf or hard of hearing patient, not to shout or use exaggerated lip patterns which makes lip reading almost impossible.
  • more work is needed around discussing the options available for babies born with hearing loss.

Sam added that hopefully the new flagging system will help reduce some of the issues raised and staff will be informed of the patients’ access requirements, bearing in mind that not all deaf people have the same access needs. 

Tom Walsh is a wheelchair user with a learning disability who is passionate about access. Tom has also worked as part of a team on other subjects including heart disease, living with dying, sexual health, diabetes and making accessible information. Tom also gave feedback to the governing body. Tom raised the following key points:

  • information given by a GP or hospital is usually not in easy read and uses long words and medical terms. Very often the size of the text is too small and not bold enough for him to read. Appointment letters and information about his treatment should be in this format with simple words and pictures but it should not be made to sound childish.
  • Tom gave an example of a letter he had received from his dental practice, which stated that he was due a dental check-up and that it was important that he keeps his teeth healthy. He felt that this was very patronising, and that he was being treated like a child. This was rectified by the dental surgery once they were aware of the problem.
  • Tom has received good experiences from Airedale Hospital where he was scheduled for an endoscopy. He noted that even though the leaflet was not in Easyread it was clear and to the point, with a larger font which made this easier to read.
  • When Easyread information is available Tom doesn’t need to ask for assistance. This is necessary when it is personal and he doesn’t want anyone else to know.
  • accessible information needs to be rolled out across the whole of the care pathway, from appointment letter to information about the treatment and finally any further information needed post treatment.
  • Tom also raised the need for healthcare professionals to know he has a learning disability before speaking to him so that they will be more understanding. He feels this is really important so disabled patients can manage their own lives.

Our governing body then responded to Sam and Tom:

  • would they would be happy if the flagging information could be shared with other organisations i.e. social care organisations/voluntary community sectors. Sam and Tom both agreed this would be a good idea, with Tom noting that he wouldn’t have to keep repeating himself if this was available.
  • agreement with Tom that Easyread should be as ‘standard’ within every organisation.

 The outcomes were that the governing body:

  • note the introduction of the accessible information standard and the requirements of the standard on the CCG as a commissioner and on member practices,
  • note the good practice already ongoing in Bradford Districts,
  • support the development of our implementation plan and ongoing approach to full implementation in July 2016.

You can read the full story in the meeting minutes, which can be found here

The big conversation - #oursaycounts

Throughout July and August 2017, Healthwatch Bradford and District worked on behalf of local partners to create a ‘big conversation’ with local people about the future of health and social care.

They wanted to find out what mattered most to people, where there might be areas for compromise, and what people think could be done differently in the future. Over 800 people gave their views.

What they found

People shared lots of comments and ideas, not only thinking of their own needs but often wider issues and needs of the whole population.

They heard about GP practices more often than any other aspect of health and care, particularly about access to GP appointments.

Some other common themes were:

  • growing the focus on wellbeing and prevention, which would reduce pressure on the system
  • protection of local services, especially GP services, emergency care, mental health services and social care support
  • sharing of good practice, especially in primary care
  • increasing staff levels across services
  • innovation in care and information provision, making use of technology
  • growing community-based services and protecting existing voluntary and community sector services, which people feel provide invaluable support.

People often raised concerns about the funding of health and care, and shared fears about central government approach to the NHS and local authorities.

They heard strongly that people would support change in health and care if there was evidence that care would be improved.

For more detail about people had to say, see the full report.

What next?

The report is being presented to the Bradford Health and Wellbeing board on 19 December 2017 and being used to directly inform the local plan for the future of health and care in Bradford District and Craven.

This plan sits within the West Yorkshire and Harrogate Health and Care Partnership. You can find out more about this here.

Further information

Media release 

Full report 

Healthwatch Bradford and District - 01535 665258 or info@healthwatchbradford.co.uk