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Engagement

What you think, your experiences of healthcare and your ideas are really important to us. We want to make sure the decisions that we make and the services we provide are shaped by you.

We want you to have the opportunity to be involved in the decisions we take and want to ensure that the idea of ‘no decision about me, without me’ (part of the NHS constitution) becomes the way we routinely work.

Below are some of the main engagement activities we have undertaken in the past year, and how your views have helped shape what we do.  

Community Phlebotomy

Project overview

The new Community Phlebotomy Service, commissioned by NHS Wirral Clinical Commissioning Group, commenced on 1 July 2018. The Community Phlebotomy Service will support the Healthy Wirral agenda as part of the Wirral Plan 2020 by helping to support Wirral residents to keep as healthy as possible and reduce health inequalities. Community Phlebotomy is an important service for all Wirral residents, making public feedback vital in redesigning the service.

How did we engage?

In May 2017, daytime and evening stakeholder events were held.

A public survey was also undertaken in May 2017. This engagement was supported by local partners and stakeholders such as Healthwatch, WIRED and GP practices via patient participation groups. A total of 505 responses were received, demonstrating the level of interest in the service amongst the local population.

What did people tell us?

  • They wanted to access the service at both local GP Practices and hub locations
  • They wanted a choice of pre-booked appointments and drop –in sessions
  • They wanted longer opening hours
  • They wanted shorter waiting times
  • Parking and good transport links was also important

How have we used the feedback?

The CCG contracted with all 51 Wirral GP practices for them to provide a Community Phlebotomy Service on behalf of their patient population.

Practices are either delivering the service in-house or working with their GP Federation

The new model now offers:

  • More clinics available across Wirral, based in local GP Practices and hub locations  A combination of pre-booked appointments and drop-in clinics
  • Longer opening hours from 8am to 6pm (depending on location)
  • More appointment slots and drop in sessions to aid shorter waiting times

Patient and public communications advising of the changes commenced one month prior to service launch. This included a press release to the local media, information on the CCG website and social media, information for GP Practices to use on websites, and a ‘You Said, We Did’ poster and leaflet for providers to populate with their respective delivery models.  This was alongside wider stakeholder communications.

Patients were advised to contact their respective GP practice for further details on how they access the service from 1 July 2018. 

Next steps

Monthly performance reporting is required from all providers.  Any issues in service delivery will be raised as part of the formal contract monitoring process.

Reporting

The CCG gave an update on phlebotomy to the Wirral Adult Care and Health Overview and Scrutiny Committee on Wednesday 12th September 2018. 

Agenda, report and minutes  

Planned Community Appliances Engagement

Project overview

NHS Wirral CCG Commissioners sought to engage with patients and the public to inform the procurement of the planned Community Appliance service.

Planned community appliances include orthotics and wigs. The service is accessible to all patients registered with a Wirral GP practice (all ages). 

NHS Wirral CCG currently commissions the planned Community Appliance service on a cost per case basis from Wirral University Teaching Hospital (WUTH) and Opcare for the assessment, provision and review of planned appliances. The contract for the service was due to end in September 2018 and an extension was agreed until end of March 2019 to enable a full nt review of the service.  

WUTH continues to be responsible for the provision of unplanned appliances, which are not included in the scope of this procurement. In addition, WUTH provide a wig service to non-cancer patients. Diabetic patients are also sent to WUTH.

How did we engage?

A member of the commissioning team attended the Patient and Public Advisory Group to provide an overview of the current service and the proposed engagement activities.

During a 2 week engagement in July 2018, questionnaires for patients and public were made available on the CCG website through Survey Monkey. The link was also shared on social media and sent to GP Practices to share with patients and Patient Participation Groups.

A hard copy of the patient questionnaire was also issued to patients by providers via orthotics clinics.

Commissioners from the CCG also attended a clinic to discuss any issues and concerns with patients.

What did people tell us?

There were 4 patient/public responses to the online Survey Monkey questionnaire and 119 patient/public responses to the hard copy questionnaire. People told us:

  • They were very positive about the service
  • There were some quality issues such as children’s footwear being too heavy
  • They would like an automatic booking system for follow up appointments, especially with regard to children’s appointments
  • They would like specific appointment times
  • Community locations were important

How have we used the feedback?

The feedback has helped inform the development of the service specification, which will address the following key messages:

  • clear pathways, not lots and levels
  • domiciliary support for patients
  • ensure quality of appliances
  • improved referral pathways
  • ensure timed appointments
  • ensure urgent appointment available
  • Link to the Policy of Low Clinical Priority (PLCP)
  • Advice to patients on purchasing low level appliances
  • Follow up appointments to meet clinical needs
  • Consider automatic booking system
  • Rapid re-access for patients already known to the service

Next steps

For any future commission the name of the service will change to Children and Adult Community Orhtotics and Wigs Service as this better describes the service delivery.

Further engagement has taken place with health professionals including physios and GPs on the future commission of the service.

Engagement has taken place with the Clinical Lead for Planned Care and Clinical Lead for the MSK Service who have been involved in the development of the service specification.

 

 

 

Project overview

NHS Wirral Clinical Commissioning Group (CCG)’s current contract term for Primary Care Mental Health - IAPT (Improving Access to Psychological Therapies) ends in March 2019.

Before re-commissioning this service Mental Health commissioners undertook patient and public engagement to help inform a re-design and develop the IAPT service specification to ensure services from April 1st 2019 meet the changing needs of the people of Wirral and are sustainable for the future. 

How did we engage?

Mental Health commissioners undertook patient and public engagement from Wednesday 27th June – Tuesday 17th July 2018. Using a multi-method approach to collect people’s views, approximately c400 people participated in the engagement. People provided their views via:

  • Online Questionnaire (completed by 344 people)
  • Easy Read questionnaire (8 Returns)
  • Workshop with third sector organisations (18 attendees)
  • Workshop with current IAPT service users (10 attendees),
  • Telephone conversations (approx. 10)
  • Written feedback via post (approx. 8)

Posters and flyers were distributed to community locations including One Stop Shops, charity organisations and GP Practices. Paid for advertisements were included in the local newspaper, the Wirral Globe and a press release was also distributed to wider stakeholders. A targeted social media campaign via Facebook and Twitter was launched along with links to the online survey. All materials developed as part of the engagement exercise were shared with key stakeholders electronically with a request to share with internal partners.

The Mental Health commissioning team also attended numerous health and social care committees including the NHS Wirral CCG Patient and Public Advisory group to inform of the engagement activity, NHS Wirral CCG governing Body and Wirral’s Overview and Scrutiny Committee.

What did people tell us?

  • The key themes of the engagement have been summarised in the image below:

 

 

  • Increasing access was the most important thing to survey respondents. Access should be timely, flexible, according to need and priority.
  • Services should be located in accessible, welcoming locations including non-clinical and clinical settings be easy to access by public transport and have onsite parking.
  • Services should have flexible options - weekdays (including evening appointments) and weekends.
  • People that have previously accessed IAPT services, discharged but require further support later should be ‘fast tracked’ to avoid crisis situations.
  • A holistic, joined up approach allowing access to a wider combined support network and better links between Primary, Secondary (including crisis support when needed) and Community organisations is key.
  • Accessibility of the service for adults and older adults, those with long term conditions including physical disabilities, people from BAME community, carers, LGBT community, armed forces (including veterans), pregnant and new mothers, those with learning disabilities and Autism/ASD is important.
  • Services need to consider the whole person, their physical and social needs as well as their mental health needs, linking in with other community agencies, to treat patients as individuals and adopt a person centred care model.
  • More specific therapies outside traditional CBT (Cognitive Behaviour Therapy) should be offered, allowing a wider range of approaches appropriate to need.
  • Communication was a key theme of those who participated. This involves:
  • communicating well throughout the entire therapy process including after discharge,
  • having a trusting relationship with a single professional,
  • organisations better communicating with one another,
  • better signposting,
  • promotion of local mental health services, and requesting and acting upon patient and carer feedback.
  • People accessing services want a single point of contact.
  • Efforts should be taken for meaningful consistent engagement with people who access services.
  • Quality of intervention should be the focus of treatment length rather than time to recover.
  • Better use of technology for referrals and initial help while waiting for treatment.
  • Mental health should be treated with a parity of esteem compared to any other type of health issue.

How have we used the feedback?

The feedback received informed the service specification that was shared as part of the tender process.

The service specification outlined that the future IAPT service needed to place IAPT treatments into a wider social, cultural and economic context, by:

  • using a wide range of approaches appropriate to need
  • increasing access to the service
  • improving recovery rates
  • offering a flexible and responsive service
  • communicating well
  • embedding equality, diversity, and inclusion
  • taking a person centred, holistic approach (i.e. thinking about the whole person including physical and mental needs)
  • a strong focus on relationship building between Primary, Secondary (including crisis support when needed) and Community organisations was required from the provider

Next steps

Following a robust tender process, NHS Wirral CCG awarded Insight Healthcare the contract for the delivery of IAPT services across Wirral.  The new contract commences on 1st April 2019. To support the wider network of providers and services working together, Insights Healthcare will work in conjunction with wider partners through Talking Together, Live Well Wirral.

Their clinical model is based on:

  • Client-centred
  • Evidence-based pathway
  • NICE compliant
  • Stepped Care – least intrusive, most effective intervention first
  • Flexible – allowing clients to be stepped up and stepped down as appropriate to their respective needs
  • Their model also allows for a team leader to be assigned to each of the four localities in Wirral (Birkenhead, Wallasey, South Wirral and West Wirral), to better support place based care.

Insight Healthcare’s bid was heavily focused on collaboration and relationship building. They will work in partnership with the following organisations to deliver IAPT services:

Cheshire and Wirral Partnership NHS Foundation Trust, Age UK Wirral, The Open Door Centre, Involve North West (Community Connectors), and Cruse Bereavement Care. These subcontract arrangements are designed to ensure IAPT is effectively delivered in Wirral and meets the needs of our population.

A wider piece of work is being undertaken through Talking Together partnership board to ensure collaboration across all Wirral partners to deliver emotional health and wellbeing services; the Board consists of both statutory and voluntary sector partners with the voice of people accessing services represented. 

 

Reporting 

An update was given to the NHS Wirral CCG Governing Body Meeting on Tuesday 10th April 2018. 

Agenda and minutes

As part of our Healthy Wirral Programme we worked in partnership with AGE UK Wirral to understand what is important to people to enable them to age well In Wirral.

We want to work with our partners to ensure that people get more tailored access to local support services as they get older so they can stay well and reduce the risk of them becoming frail and unwell.

This is an important part of our Neighbourhood development programme as part of our Healthy Wirral Partnership which sees all health and care organisations working with the voluntary and community sector.

Age UK Wirral are a valued partner in this work and they completed a series of community conversations across Wirral, the feedback from people is helping the Healthy Wirral programme consider its planning priorities for 2019/2020 and beyond.

 View a presentation from the day