As with all of the engagement work that we carry out at DDES CCG, we ensure that we close the loop and feedback the findings of our work.
The projects listed below demonstrate what engagement has been carried out and how the conversations with patients, carers and other stakeholders have helped to shape the services moving forward and how we have fed back to those who were involved.
Engagement patient around stroke services took place over August, September and October 2017.
The aim of the engagement was to understand what services and information patients received on discharge from hospital.
Packs including a letter, a questionnaire and a freepost envelope were sent to patients via their GP practice. The questionnaire was also available on line via survey monkey https://www.surveymonkey.co.uk/r/Strokecountydurham, which closed on October 12th.
The CCG worked in partnership with Healthwatch who also organised one to one appointment sessions across Barnard Castle, Stanhope, Chester le Street, Stanley, Peterlee and Tudhoe.
The Engagement Teams of Durham Dales, Easington and Sedgefield and North Durham CCGs attended stroke groups to have face to face conversations which stroke survivors. These groups were attended by people who had experienced a stroke over a year ago and some as many as fifteen years ago.
The questionnaire and the above appointment sessions were also communicated via our social media platforms and Healthwatch. A total of 155 patients and or carers responded to the survey.
The full engagement findings were written into a report by Healthwatch and the CCG detailing recommendations for the future service. All of these recommendations were accepted by the CCG Executives and are being implemented in the service moving forward from March 2018.
Patients who were involved in the engagement were sent a thank you letter and a short explanation of the results of their feed. They were also given the option to have a full report sent out to their home address.
The full Healthwatch and CCG report is available: Research into patient access to stroke support services in County Durham
Mental Health Crisis
As part of the review into the Mental Health Crisis Service and Home Treatment, engagement was an integral part of this process. The conversations with patients and carers focused on understanding their experiences were when using the service.
An online survey was created along with a paper version and this was shared widely via groups and social media. The team went along to meetings such as the County wide mental health forum, Cree Groups and also Home Group Happy clubs which are groups where people who have or have had mental health issues attend and get involved in physical activity.
Overall 26 surveys were completed. Due to the sensitive nature of the patients and the subject matter combined with the time of year, a small number of returns were expected.
The key points from conversations have been gathered and analysed. These findings will be detailed into a wider report which also covers details of the engagement with GPs, Mental Health Crisis Service staff and service managers and also wider stakeholders.
During January and February 2018 a series of conversations took place regarding local Dementia service provisions. This piece of work was undertaken as part of the routine review of contracts and local services taking place.
Due to the nature of the target audience attempts were made to ensure that as many conversations could happen directly through face to face conversations as possible. His involved attendance at local dementia arts projects, memory cafes, dementia cafes, relevant groups involved with Beamish museum, the Alzhiemers’ Society and others.
To help provide relatives and family carers with a flexible method of responding an online version of the questions was also produced and circulated out through all of the above networks, plus our usual distribution channels including the support of Durham Dementia Action Alliance (DDAA) and the Area Action Partnerships across the County.
A summary engagement report was made available to groups who had participated and out through the DDAA network. This report clearly outlines the outcomes of the discussions and how these have fed into the decision making process. The comments and suggestions indicated what types of support and the personal outcomes that were most important for individuals using the services available. From this Commissioners have been able to consider what locally based provisions would be most effective.
In line with the launch of the guidance from NICE in November 2017, patients across County Durham were being repatriated out into appropriate community based services to receive their routine monitoring appointments. To support this transition we looked to work closely with County Durham and Darlington Foundation Trust (CDDFT) in order to talk directly to the affected patients. Sessions were arranged to visit the relevant Ophthalmology clinics across each of the three sites that they are delivered from in County Durham.
The purpose of these conversations was to better understand what potential barriers or concerns patients had about the transition so that they could be addressed. Information was provided to the patients being repatriated at multiple points in time throughout the process of transition about; where they could access support in the future, who to contact if they had a query and confirmation that they would continue to receive the appropriate level of clinical care but closer to their homes.
As part of the re-procurement of the Community Services contract across County Durham and Darlington a range of conversations were undertaken throughout September 2017. A key focus of the conversations sought to understand how care in the future could be better integrated and co-ordinated to support staff and the patients they were caring for, rather than any direct alterations to provisions.
The engagement targeted GPs, Practice nurses, a wide range of community services staff (Community nurses, District nurses, Vulnerable Adults Wrap Around Service and others) as well as patients using these services.
To enable the information to reach as far and wide as possible the CCGs worked alongside staff within Community Services to help reach out to the individual teams across the geographical patch. The Practice Nurse links across the three CCGs were also vital to communicating with and engaging these staff groups. The engagement also benefitted from the fantastic support of Community services staff who engaged directly with patients they were visiting and the views of friends, relatives or family carers involved with that individual.
The key findings from the report were fed back to the Director leading the re-procurement process and the team involved. The summary engagement report was also published on the CCGs websites as part of the regular updates about the progress of this project. The same report was also fed into the County Durham Integration Steering Board as part of the work that is being developed to bring Health and Social Care services closer together.
The outcome from the engagement was that the information provided was used to shape specific parts of the future service requirements that were used as part of the measures within the re-procurement process and the closer integration of local services.
Annual Health Checks
The County Durham CCGs worked in partnership with Durham County Council and Healthwatch County Durham to understand what the barriers are for people with learning disabilities going for their annual health checks.
The aim of the work was to increase the number of people with learning disabilities who take up their free health-checks as people with learning disabilities have poorer physical and mental health compared to others – but this doesn’t need to be the case.
Healthwatch County Durham (HWCD) spoke to 100 people with a learning disability and from the feedback one area was the invite letter.
An ‘Easy Invite’ was developed with all partners, Including People’s Parliament within Durham County Council, and was sent to all people with an learning disability in County Durham. The aim was to for the letter to be clear to understand so people can read it themselves and will any anxiety about going for a health check. People with learning disabilities often have difficulty in recognising illness, communicating their needs and using health services.
The aim of the letter was to encourage more people with an learning disability to be registered on their GP learning disability register – giving them the chance to access more support and have an annual health check, which might detect health conditions which otherwise go unnoticed.
Following the Healthwatch County Durham recommendations, Shinwell Medical Group are piloting offering health checks in a community setting. People aged 14 and over who have been assessed as having moderate, severe or profound learning disabilities, or people with a mild learning disability who have other complex health needs, are entitled to the free check. The Annual Health Check is also a chance for the person to get used to going to their GP practice, which reduces their fear of going at other times.
Health checks involve a general physical examination, including:
- checking their weight, heart rate,
- blood pressure and taking blood and urine samples;
- asking questions about their lifestyle, and mental health;
- a check for epilepsy;
- a check on their prescribed medication;
- a check on whether any chronic illnesses, such as asthma or diabetes, are being well managed; and a review of any arrangements with other health professionals, such as physiotherapists, speech therapists, dieticians or other specialists.
It is also a good time to check you are up to date with immunisations, flu vaccine and any screening tests for cancer.