Making change happen

Healthwatch Kirklees aim is to help people to make changes in the system, to the benefit of everyone.

This is how we will measure how successful we are as an organisation.

What patients told us about their experience

From October 2014 to December 2014, Healthwatch Kirklees and Healthwatch Wakefield spoke to 749 patients who were attending outpatient clinics.  The findings from this piece of work are in this report:

Speaking to Outpatients in Kirklees and Wakfield

In December 2014, Healthwatch Kirklees and Healthwatch Calderdale spoke to 333 outpatients in hospital clinics.  The results can be found here:

Speaking to Outpatients in Calderdale and Huddersfield

The reports raised questions for both Mid Yorkshire Hospitals NHS Trust and Calderdale and Huddersfield NHS Foundation Trust.  We have received a response from Calderdale and Huddersfield NHS Foundation Trust:

FINAL – Response from CHFT re outpatients report

We are awaiting a response from Mid Yorkshire Hospitals NHS Trust and this will be shown here once this is received.

Patients can reduce the cost of visiting

The concessions that Dewsbury Hospital currently offer are:

Free parking Disabled drivers (blue badge holders)

Long stay discounts Seven day visitor parking permit charged at day rate To obtain this permit, patients and/or visitors should purchase a £6.50 ticket from the pay and display machine and take this with a signed temporary parking permit application from the relevant ward to our General Office.

Acute care Units such as intensive care, coronary care etc have the authority to issue parking permits free of charge for close relatives or carers

Oncology day units Clinic staff have the authority to grant full day parking at one hour rate

Maternity and paediatrics Senior nurse in charge has authority to issue permit free of charge for parents or direct carers attending daily and/or overnight Other regular attendees would be expected to use the long stay discount rate.

Welfare/hardship discretion General office staff have welfare/hardship discretion to issue free of charge permits Such requests will be validated on a ‘case of need’ basis We would also recognise social service benefit claimants.

Unexpected admission Service users who are unexpectedly admitted to hospital from outpatients or A&E will have their parking fee waived for 48 hours. The senior nurse should provide details of the vehicle to security Stays beyond 48 hours will be considered on a case by case basis.

Hospital Travel Cost Scheme Patients who are in receipt of certain benefits, or who are the dependents of those in receipt of such benefits, may be able to claim a refund for travel costs to the hospital (refund not applicable for visiting).

For further advice please contact the Benefits Agency on freephone 0800 666555. Any refunds can be claimed from the General Office at each hospital.

Issues around NHS dentistry in Kirklees

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In July & August 2013, one of the key issues that people discussed with Healthwatch Kirklees was the struggle to get access to NHS Dental Services and problems with the service they received. In September 2013, our Trustee Board approved a piece of work to investigate why so many people report that they are unhappy with NHS dentists in our area.

Healthwatch Kirklees found that:

  • Patients are routinely given misleading information about the availability of NHS dentists in Kirklees, leaving them confused and frustrated.
  • Significant numbers of patients in Kirklees are struggling to find an NHS dentist for routine NHS treatment.
  • Unequal access to NHS dentistry across Kirklees may be contributing to the wider issue of health inequalities.
  • NHS dental contracts appear to be inflexible, based on historical demand and not an objective assessment of need, demand or accessibility. There is currently no NHS Dental Access Strategy for Kirklees.
  • There were examples of poor practice which need to be raised with NHS England, the commissioner for NHS dentists.
  • There is a developing issue specifically around dentures for older people, linked to the ageing population in Kirklees.

You can download and read our full report below

Access to Dentists in Kirklees February 2014

For people with Diabetes in North Kirklees

For a list of GPs and pharmacies in North Kirklees who will dispose of sharps bins, click GP Practices and pharmacies list – sharps disposal in North Kirklees or for a list of pharmacies across the whole of Kirklees, click here.

After being approached by a group of parents and carers of children and young people with diabetes in North Kirklees, it became clear that people who attend the group are struggling to dispose of their sharps bins (needle bins) in a safe way.

Up until 2 years ago, they were able to exchange full sharps bins for empty ones when they saw the diabetic nurse, however, this service was withdrawn, and they were told to contact Kirklees Council, who provide a sharps bin collection service from people’s houses. This service is designed for patients who are housebound, and access to this is now very restricted.

For some people, their local GP or pharmacy will dispose of full bins, but this isn’t the case across the board. Healthwatch Kirklees have completed a survey with GP surgeries to understand where you can dispose of full sharps bins in this area, and to understand why GP surgeries might be choosing not to offer this service to their patients.

Part of our aim is to give individuals with diabetes and their carers a clear picture of where you can go to dispose of sharps. As such, we have developed a list of GP surgeries that have told us they will dispose of sharps for their own patients. NHS England have developed a list of pharmacies that will dispose of sharps bins for patients. We have combined both of these lists and you can download that as one document through the link at the top of this page.

Healthwatch Kirklees have written a report summarising the findings of this research which has been shared with North Kirklees Clinical Commissioning Group and NHS England to share feedback. Through enhancing their understanding of the perspectives, we hope that they will be able to better support GPs and pharmacies to continue to offer the sharps bin disposal service. To read the report, please click here. Please contact Helen Wright to discuss this further.

Barriers to attending cervical screening

Healthwatch Kirklees is looked into understanding what the barriers are for South Asian women aged between 25 and 49 when accessing cervical screening in North Kirklees. We asked which factors act as barriers or motivators, and how these barriers can be overcome to improve uptake.

To find out more about this piece of work, please download our report here. This has been shared with the Clinical Commissioning Group in North Kirklees, and will be presented at their Clinical Strategy Group.

Sharing the stories of people in Kirklees

Tens of thousands of people are potentially being sent home without proper support when they leave hospital or care home. People can be left isolated and end up in crisis that could have been prevented.

Through this special inquiry, Healthwatch England want to get a deeper understanding of what happens to people who experience ‘unsafe discharge’ from a hospital, nursing or care home, or mental health setting in England and how it was that they were able to fall through the gaps.

Healthwatch Kirklees understand that this is a complicated issue. That’s why we worked with Huddersfield Mission to find out about the experience of different people who have been discharged from health or social care, in whatever way.

We wanted to hear it all, good and bad. We wanted to know what it was like for people who have been discharged, for people who work in these settings, and the impact that people being sent home without the right support has had on their family or friends.

Healthwatch Kirklees has now collected several case studies and has passed these to the national inquiry.

Healthwatch England have now published their final report Safely Home– What happens when people leave hospital and care settings.

Treating people equally

In August and September 2013, working in partnership with the Brunswick Centre and Healthwatch Calderdale we became aware of a number of patients who report feeling that they have been discriminated against when accessing Primary and Secondary healthcare services (e.g. GP appointments and dental appointments) due to their HIV status.

Healthwatch Kirklees found that:

  • Many HIV positive patients experienced judgemental attitudes and inappropriate questioning from medical staff about how they acquired HIV.
  • Patients’ HIV status was mentioned in wards and other public places in front of other patients.
  • Doctors (excluding Genito-Urinary Medicine doctors) not checking for possible drug interactions with anti-retroviral medication before prescribing other medication with potentially dangerous consequences.
  • HIV positive patients experienced problems with self-medication when in-patient at the hospital.
  • People not being tested for HIV despite having signs and symptoms of HIV due to value judgements by doctors about their situation based on their outward appearance.
  • Unnecessary delays- being put at the end of the list for medical procedures e.g. tooth extraction, dental surgery, and endoscopy.

Click here to read our report and recommendations.

Patients’, carers’ and professionals’ views

Over the last 6 months, Healthwatch Kirklees have been consulting with patients, carers and professionals, to gain a better understanding of their experiences of the use of Section 136 of the Mental Health Act 1983 in Kirklees.

These are the key things that we have learnt through completing the work:

  • There are discrepancies between the numbers of people recorded as having been held under Section 136 by the police and the Trust
  • There is too much variety in the way that people detained under Section 136 are dealt with by the police, with excessive force being reported in some cases. For some individuals with this experience, they feel criminalised
  • People with experience of being detained and their carers are frustrated by failures in the crisis support system (both current and historic) that mean that they, or their relative/friend, are not helped to address their mental health issues at an early stage, and then end up held under Section 136
  • Staff from all organisations involved feel that the way Section 136 is currently used overstretches their resources
  • Although protocols are in place, they are not easily accessed, and this leads to confusion as to who takes responsibility for what and variation in the way that Section 136 is used. In particular, this has been an issue with transportation

To find out more about what we found, and the recommendations that came from the work, please look at the reports below:

Understanding patients’ views of the use of Section 136 of the Mental Health Act 1983 in Kirklees – Summary Report 

Understanding patients’ views of the use of Section 136 of the Mental Health Act 1983 in Kirklees – Detailed Report

In the period to September 2013 Healthwatch Kirklees recorded 231 service user comments about difficulties in accessing doctors appointments. This issue received widespread coverage in the local and national media.

Summary

Access to GP appointments has been the defining issue for Healthwatch Kirklees since the service started in April 2013; negative comments have been regular and unending. The issue of access to GP appointments is not unique to Kirklees and is a concern nationally.

Between 1995 and 2008, the number of patient consultations rose by 75%, from 171 million to more than 300 million.

Primary Care, Urgent Care, Care Closer to Home programmes and changes to GP contracts will all impact on how GP services are delivered in future.

Clinical Commissioning Groups (CCG’s) in Kirklees are well aware of the issue and are working hard to put measures in place to address the problems.

There is evidence of GP’s in Kirklees using innovative ways of working which are proven to work well. This work will be championed by Healthwatch Kirklees.

Healthwatch Kirklees recognises the pressure that GP’s are under, and the increasing demands on their time. We’re encouraged by both CCG’s willingness to engage on this issue, and believe that all stakeholders are keen to see more accessible services. We’re really encouraged by pilots like the triaging approach used in Cleckheaton, and the results that are being seen there. Healthwatch Kirklees believes that the best way for us to support changes that address the issue of appointments is to support both CCG’s and practices who have looked at new ways of working. We will revisit this issue in 6 months’ time, in Summer 2014 to see what has changed.

You can read a full copy of the report here:

Why can’t I get an appointment with my GP?

Using people’s opinion to shape design and delivery

Kirklees Public Health Directorate are redesigning sexual health services in Kirklees.  Healthwatch Kirklees has been involved in the engagement and consultation around the changes.

You can view the Five Key Learning Points here

You can see the full report here

Reviewing hospital food in Calderdale and Huddersfield

Hospital food has an image problem and hospitals in the UK have worked hard to turn this stereotype around to improve the eating experience for patients. Nutrition and hydration play a vital role in recovering from illness as well as maintaining health, so when Healthwatch Kirklees received complaints about the food quality in Dewsbury and District Hospital, we wanted to look into the wider issue.

Following meetings with Public Health, Calderdale & Huddersfield Trust, and Calderdale CCG, Healthwatch Kirklees were asked to research and analyse patient comments on hospital food. This research was conducted at Huddersfield Royal Infirmary and Calderdale Royal Hospital by a team of Healthwatch Kirklees advisors who surveyed patients as well as speaking to visitors and staff. In total 141 patients were interviewed, providing answers and opinions on a wide range of food-related issues.

This research, along with in-house engagement by Huddersfield Royal Infirmary and a patient-led assessment of the care environment visit (PLACE Survey) in May 2014, enabled Healthwatch Kirklees to develop a balanced view of patient’s experience of food at these hospitals.

Our overriding impression was that patients were very happy with the food that they received in hospital.

We have in partnership with the Trust agreed areas for improvement and the Trust will complete an action plan to address these issues. We will revisit the Trust in 2015 and provide independent real time patient feedback that will contribute to the Trusts 2014/15 CQUIN target to better understand and improve hospital food.

You can download and read our full report below:

Patient Experience of Hospital Food at Calderdale & Huddersfield NHS Foundation Trust 

The NHS is changing. We were concerned that the pace of change in the new NHS may have left people who are deaf or hard of hearing behind.

During the summer of 2013 Healthwatch Kirklees picked up a number of concerns from people who are Deaf or hard of hearing in Kirklees that they are having mixed experiences when they access NHS health services. A lot of the time this was reported as being around the lack of BSL interpreters at GP or inconsistencies when people are at the hospital or other NHS appointments. People said there needed to be more awareness raising and understanding from health professionals about the needs of people who are Deaf or hard of hearing.

When it comes to using health services, it is important that people with hearing loss have the same opportunities of access as hearing people. This wouldn’t just be a nice thing to happen. Since 2010 it’s a legal requirement for organisations delivering NHS services to make reasonable adjustments to make their services accessible for people who have a disability. And it says they should think ahead and promote how they will make their services accessible – rather than just respond to complaints.

Healthwatch Kirklees wanted to have a better understanding the experience (including barriers) of people who are Deaf or hard of hearing when accessing NHS health services in Kirklees. This was to influence local decision makers to challenge discrimination, change attitudes and break down barriers faced by those individuals when using NHS services.

Healthwatch Kirklees considers the following recommendations will help organisations delivering NHS services to make reasonable adjustments to make their services accessible for people who have a hearing impairment / disability and so comply with the Equality Act 2010. They will help providers anticipate people’s communications needs and make their services accessible – rather than respond to potential complaints.

You can read our report below, in full or summary version.

Full report
Summary report

To find out more about our initial piece of work and the way we involved people who are deaf and hard of hearing, please watch this clip:

Kirklees Council asked Healthwatch Kirklees to undertake a piece of engagement work in relation to an All Age Disability Service (working title)

Over the next three years, Kirklees Council will be going on a journey to become a very different council. Their vision is ambitious; they are thinking big – they want to become a new council.

That means:
• supporting communities to do more for themselves and each other
• keeping vulnerable people safe and helping them to stay in control of their lives
• providing services – but focusing on the things that only the council can do

As part of how the new council work, they will be looking at their approach to supporting people with disabilities – children, young people and adults. They are exploring the opportunity of creating an integrated disability service or all An Age Disability Service (a working title), The aim is to bring together services for disabled children, young people and adults, in a way that will ensure a whole family, lifelong approach is taken to ensure consistency, clarity and ultimately better quality services and support for people living in Kirklees with a disability.

To view the report please click below

FINAL report AADS

Healthwatch Kirklees undertook a survey to understand why there was a low uptake of the hospice service (Kirkwood Hospice) amongst BAME communities in Kirklees.  We were asked to identify appropriate ways to improve access to specialist palliative and end of life care services. Your feedback helped identify ways in which service availability, access and quality could be improved.

A full copy of the report can be downloaded here.