We want to make sure we make the most of patient feedback and listen to our population so that we can improve local services. Below are some examples of how we have changed the way we do things in response to public feedback.
The Whalton Unit
During September and early October 2019, people in Morpeth and the surrounding area were given the opportunity to have their say about the temporary relocation of the Whalton Unit to Wansbeck General Hospital.
The findings from both the independent research and engagement activity were collated and shared with the Northumberland Health and Wellbeing Overview and Scrutiny Committee in November 2019 who agreed with the recommendation from the CCG’s governing body and the Trust that the unit should permanently relocate to Wansbeck hospital.
Rothbury Community Hospital
In November 2018 the CCG received a letter from the Secretary of State for Health in relation to changes to Rothbury Community Hospital following the CCG’s public consultation in early 2017. The Secretary of State shared the advice from the Independent Reconfiguration Panel (IRP) with the CCG which found that further action was required locally to resolve the future of the hospital.
In April 2019, the Rothbury Engagement Group was set up and its membership included representatives from the Save Rothbury Hospital Campaign Group, Healthwatch Northumberland, a county councillor, parish councillors, the Rothbury practice patient participation group members, a member of the National Community Hospital Association as well as the CCG and Northumbria Healthcare NHS Foundation Trust.
Following extensive meetings and discussions over a period of six months the engagement group co-produced a proposal referred to as ‘the art of the possible’ which would introduce a flexible bed model – with inpatient beds available within the hospital for short-term rehab and end of life care. The proposal, represents a bespoke solution to the challenges faced by Rothbury residents. The Trust continues to engage with the local community to deliver this model which is expected to be fully operational by April 2020.
A new hospital for Berwick
The CCG held a listening exercise in spring 2018 in partnership with Northumbria Healthcare NHS Foundation Trust and Northumberland County Council for people in Berwick and the surrounding area to give their views on the possibility of a new integrated hospital development.
The following links provide updated information from our partner Northumbria Healthcare NHS Foundation Trust (NHCFT) about a new hospital for Berwick.
Berwick needs an Endoscopy service – the impact of travelling for this procedure, especially for elderly people, is significant.
The new hospital will have a JAG accredited endoscopy suite and work is underway to see if there are any other services that could be provided locally – either face to face or virtually – to reduce the number of miles patients have to travel for routine appointments.
Berwick needs more pre-op appointments.
The emphasis is on delivering as much as possible, as safely as possible, as close to patients as possible. More pre-op appointments are now available at Berwick and Northumberland CCG and the Trust are working hard to provide more.
When are gynae services coming back to Berwick?
The gynae clinic at Berwick has now been running since November 2019.
Berwick residents don’t want a joint development and support a stand-alone hospital on the current site with 20 beds.
Following extensive joint public engagement, Northumberland CCG and the Trust have listened, responded and worked together to come up with a new plan that meets all of the needs identified by the local community.
What will be done to reduce the number of journeys to other hospitals (Wansbeck, The Northumbria etc.) that people from Berwick have to make?
We’ve listened to the local community’s concerns that they have to travel too far, too often for relatively minor or routine appointments. Eradicating the need to travel for minor or routine appointments is a driving force behind plans to ensure the number of miles patients have to travel on a yearly basis is tracked and published, with a clear aim to make significant reductions in this travel for patients through a combination of new technology (telemedicine etc.) and new ways of working.
Northumberland Joint Musculoskeletal and Pain Service
The CCG held a period of engagement on the potential development of a new joint musculoskeletal (MSK) and pain service in the county. The public and GP practices were asked for their views on current MSK and pain services.
An MSK Feedback Report was produced and presented to the CCG’s Governing Body as part of a procurement strategy. On the decision by the CCG’s Governing Body to proceed to the procurement of a new service, the feedback was used to inform the new service specification.
The engagement feedback was on the whole favourable of current services though key themes show there is room for improvement. Patients indicated that they want to feel more listened to and that medical professionals have a good understanding of their symptoms so they can have access to the right treatment.
A strong message was that they want quicker access to appointments and referrals, recognising the positive impact this has on patients’ diagnosis and treatment. Patients also want to have more regular reviews with their medical professionals to ensure their care and treatment continues and is the best option for their needs.
These themes were echoed in the GP practice responses. The engagement insight has helped the CCG to understand local patient experience of NHS services to support people with musculoskeletal conditions and those who are experiencing pain, and what needs to improve.
The CCG developed the service specification based on the feedback from patients in the following ways:
- Support patients to self-manage their long-term MSK and pain conditions
- Align MSK and pain services for joined up holistic care of patients
- A single point of access for MSK related conditions and pain issues
- Provide a timely triage service with quick access to treatment when required
- The service should provide an alternative to hospital for the majority of patients referred for MSK conditions and pain
- Offer de-medicalised MSK and chronic pain management – where clinically appropriate and based on patients’ needs – placing less reliance on medications and back injections
- Enable patients to take ownership and empowerment in managing their condition, allowing them to lead as fulfilling and independent life as possible
- Identify patients who are appropriate for referral to hospital
- Offer choice of care and which hospital to attend, should hospital care be required
- Patients to have access to their care plan and for this to be available to other appropriate clinicians as well
- Support carers to help patients with access to websites and smart phone Apps
- Reduce handovers between care settings by one provider managing care plans and diagnostics
- Access to advice to manage a patient’s condition via telephone, the Internet and Apps
- Offer treatments based on the latest evidence and best practice
- Care offered by suitably trained staff who are friendly and responsive to patient’s needs
The CCG completed the procurement process to commission the Joint Musculoskeletal and Pain Service (JMAPS) in April 2019. Following the Governing Body approval of the preferred bidder, the CCG announced that Northumbria Healthcare NHS Foundation Trust (the Trust) had been awarded the contract to provide JMAPS in partnership with Connect Health. Subsequently the CCG worked with the Trust and Connect Health to ensure the new service was up and running by July 2019 and patients using existing services would experience a seamless transition.
Following the launch of the new MSK service (JMAPS) the CCG met with PPGs in Wooler to discuss the impact of the service on rural communities. It soon became apparent from their feedback and from the views of CCG member practices and parish councils, that the initial service delivery model did not include a number of valued rural services that were previously available.
In recognition of this feedback the CCG immediately entered negotiations with the new provider to revise the service delivery model to include almost all of the original sites.
Joint Health and Wellbeing Strategy (JHWS)
The JHWS 2018 – 2028 is an aspirational plan which sets out how NHS Northumberland Clinical Commissioning Group (CCG) and Northumberland County Council (NCC) will work together to improve the overall wellbeing and health of Northumberland residents and reduce inequalities over the next ten years.
A two-month period of engagement was launched in July 2018 with a JHWS survey which gathered a total of 392 responses and over 1,000 comments from people who live or work in Northumberland. An online survey was uploaded onto Northumberland County Council’s website, a link was also provided on the CCG’s website and it was promoted on both organisations’ social media and though the local press. There was also a paper version that was promoted in one practice in each of the four CCG Northumberland localities. CCG staff engaged with patients at Union Brae in Berwick, Burn Brae Medical Group in Hexham, Seaton Park Medical Group in Ashington and Railway Medical Group in Blyth.
A series of focus groups for Northumberland residents took place in Northumberland Hall in Alnwick, North locality, Morpeth Town Hall in Central locality, Hexham Abbey in West locality and Isabella Community Centre in Blyth Valley locality. Approximately 25 people attended the focus groups in total.
We worked with Healthwatch Northumberland to reach seldom heard groups and Healthwatch took copies of the JHWS survey to Children Centres in Ashington and Bedlington and the Bellingham Show. The survey was also discussed at a SEND network meeting attended by parents, Action on Hearing Loss Group, Living Well Beyond Cancer Network and Glendale Mental Health Forum. A link to the online survey was sent to the Ageing Well Network which was in the middle of its ‘Winter Warmer’ community events and Healthwatch Northumberland engaged with people at an event in Prudhoe.
As a result of this engagement a comprehensive JHWS Engagement Feedback Report was produced by the CCG and as a result of people’s feedback, a small amendment was made to the children and young people theme to include families; and more notable amendments made to the wider determinants theme including the removal of digital connectedness and the addition of transport as priorities.
Below are links to press coverage in the Northumberland Gazette showing residents how the engagement and your feedback have been used:
Harder to reach groups
Members of the community and voluntary sector said in the 360 Patient Survey 2017/18 that they felt that the CCG could engage more with ‘harder to reach’ groups and act on the feedback it receives.
We have commissioned Healthwatch to engage with the community and voluntary sector on our behalf for the Joint Health and Wellbeing Strategy (JHWS) engagement which was held during summer 2018. Northumberland Council Youth Service was involved in this engagement exercise and returned surveys with young people’s feedback. We are also recruiting members of seldom heard groups to our new MY NHS Patient Involvement Network (PIN) and specific work is under way with representation from carers in the first recruitment phase.
Locality Patient Participation Groups (LPPGs)
At the CCG’s Patient Forum in April 2018 GP practices’ Patient Participation Groups (PPGs) including Glendale PPG asked if the CCG would reinstate the Locality Patient Participation Groups (LPPGs) in each locality area. The groups were historically organised by the CCG every quarter to give PPGs the chance to link in with neighbouring patient groups and the CCG and to have a shared voice.
We have reconvened the North Locality Patient Participation Group (LPPG) where outline Terms of Reference and potential future ways of working to ensure two way engagement and communication were discussed. The resulting model will be discussed with the other three localities in the West, Blyth Valley and Central with a view to re-energising PPG engagement across the county. The CCG views the re-engagement with PPGs as a priority which links into the overarching Communications and Engagement Strategy objective to ‘involve the public, stakeholders and staff’.
We engaged with practices on the formation of LPPGs through discussion at practice locality meetings, and information sent via the Locality Bulletin for sharing with PPG members.
Quarterly LPPGs in the North, Central, West and Blyth Valley localities aim to enable the discussion and debate of a full range of primary care topics and potentially encourage the sharing of PPG best practice/innovative ideas.
Primary care access – Collingwood Medical Group
Kathleen Nisbet, councillor for Croft Ward in Blyth, invited the CCG to attend an over 50s group in the in Blyth to discuss access to GP practices. There were also wider concerns about sustainability after Collingwood Medical Group gave notice to close in Blyth and the neighbouring GP practice Patient Participation Groups (PPGs) asked for attendance from the CCG at their meetings.
The CCG’s senior head of commissioning for Primary Care and Urgent & Emergency Care Pamela Phelps, along with the CCG’s engagement manager Audrey Barton, visited the Over 50s group in the Comrades Club. The topics discussed included concerns around how to retain GPs in the local area and issues with getting a GP appointment. The information gathered from the event is being fed into the CCG’s primary care sustainability work package.
Pamela, along with the CCG’s Strategic Head of Corporate Affairs Stephen Young also visited two PPGs – Railway and Marine – to talk about concerns around a local practice closing and to advise how patients can register with other practices.
This was part of the wider engagement strategy for the closure of Collingwood Medical Group in summer 2018. The CCG wrote to patients to inform them of the closure and offer advice on how to register with a new local GP practice and included a list of practices, FAQs and details of three drop in sessions.
The drop in engagement events were held in Blyth in partnership with the CCG, Healthwatch Northumberland, the Patient Advice and Liaison Service (PALS) and NHS England for any patient to attend to ask questions and find out more information. The partnership working enabled the CCG to broaden the engagement for patients who sought information and advice.
The CCG worked to identify the demographics of the people who would be affected. We worked with Healthwatch to identify organisations which have contact with specific groups of patients and shared information with them to ensure they were fully briefed on the situation and the drop in sessions.
Information was available on the CCG’s website with contact details for any inquiries or further information. The proactive approach to communications and engagement on this matter meant that any anxiety and concerns from patients was kept to a minimum as they had access to information and the opportunity to speak to people for advice. The patient feedback helped to shape the content in the letters which went out to patients and any issues raised were addressed in FAQs. After the first letter went out the CCG and partners received calls from concerned patients, which significantly reduced once the drop in sessions and further communications had taken place.
GP Patient Survey
The NHS Northumberland CCG GP Patient Survey 2018 was published in August 2018 with information measuring patients’ experiences across a range of topics including:
- Making Appointments
- Perceptions of care at appointments
- Managing health conditions
- Practice opening hours
- Services when GP practices are closed
The annual GP Patient Survey is used by the CCG’s Quality team and is triangulated with other sources of feedback including the Friends and Family Test, reports from Healthwatch Northumberland and CQC Reports to develop a fuller picture of patient experience. The Quality Team uses the information to build a picture of GP practices and discusses the feedback opportunistically during engagement visits to practices.
The information is also fed into modelling of schemes like the Primary Care Commissioned Services which helps the CCG to support practices to become more sustainable and resilient whilst continuing to deliver high quality safe services for patients.
The GP Patient Survey 2018 results were communicated via a press release to the CCG’s local media.
Patients are able to give their feedback about the care they have received in hospital or provided by the ambulance service through surveys like the Friends and Family Test.
The CCG has an overview of patient experience feedback at hospital trusts Northumbria Healthcare NHS Foundation Trust and Newcastle-upon-Tyne NHS Foundation Trust, mental health specialist Northumberland, Tyne and Wear NHS Foundation Trust and the North East Ambulance Service NHS Foundation Trust.
Quarterly patient experience reports are produced by the CCG quality team which include common information such as the Friends and Family Test, and other different methods of capturing patient experience such as the Patient Experience Improvement Framework by NHS Improvement, which is based on an analysis of Care Quality Commission inspection reports, particularly focused on the differences between trusts rated as outstanding and inadequate.
The CCG focuses on three areas of care delivery: emergency care, inpatient and outpatient and based on the available information, the overall patient experience at all Trusts for quarter two ‘good’ with some variations across sites or services.
This information is shared with the CCG’s Clinical Management Board which is made up of GPs and nurses along with NHS managers. The CCG monitors the trends and works with Trusts to address the issues where necessary through regular meetings across quality and contracting.
Attendance at Accident and Emergency
Healthwatch Northumberland, in partnership with Healthwatch North Tyneside, carried out a survey in November 2018 to find out more about why people go to the A&E department at The Northumbria Specialist Emergency Care Hospital. Healthwatch staff and volunteers asked people about their experiences of the A&E department and why they are choosing to use this service.
A joint meeting is to be held with Healthwatch Northumberland, Northumbria Healthcare NHS Foundation Trust and the CCG to review the responses to the survey, to help understand what is working well and what can be done differently and agree an action plan going forward.