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You said, we did

2018-19

You said

We did

“There seems to be a lack of enthusiasm and a lack of knowledge about PPGs. Who do we turn to for support? Who can provide information for patients?”

Worked with Chair of Canberra Old Oak PPG, Professor Lis Paice (medical educator and coach) and local residents to start developing a leadership training course for PPG members and people interested in joining their PPG.

“NHS staff can be awkward around gender identity, fluidity, and sexual orientation. All staff should be trained around this.”

The CCG’s engagement lead and our LGBT Network have worked with young LGBT people to develop an LGBT awareness training pack for North West London commissioning staff.

When you have learning disabilities, it’s really hard to find mental health support yourself. We’d like to know more about what’s available.

Created an Easy read mental health signposting leaflet and edited it based on feedback from Safety Net People First.

BAME women need more support around cancer screening and awareness.

CCG clinical staff have supported WAND’s cancer screening workshops in the community.

Several community groups fed back via CCG engagement events, PRG and Community Champion baseline surveys the need for more emotional well-being signposting and support, particularly for certain groups such as BAME community.

The CCG worked with all six Community Champion projects in Hammersmith and Fulham to co-design a mental health awareness and support campaign, with particular focus on the BAME community.

Need a stronger process for reporting “you said we did” activity

The engagement team seeks consent from all engagement event attendees to keep them updated on the outcomes of their feedback. The team then creates a ‘you said we did’ document summarising how their business case / new or redesigned service / project reflects the feedback received at the events, and the engagement team sends this information across to attendees. We also publish selected activity on the website for wider viewing, tweet, and include “you said we did” in our quarterly reports to Patient Reference Group.

“The unified diabetes service specification should have more focus on patient experience outcomes. More advice should be given on language during consultations and end of life care.”

The provider(s) responsible for delivering the service specification from April 2020 will be measured by the outcomes chosen by patients. This has been added as an appendix to the document.

 

Language Matters, and NHS England programme that had support from NWL people with diabetes has been added to the clinical guidelines, as well as an area concerning end of life care.

“It would be helpful to produce culturally appropriate materials and information about diabetes with people from South Asian, Arabic, Caribbean and African communities (who have a 4-6 times higher rate of diabetes).”

Coproduced a book and app (called World Foods), which is a pictorial resource for BAME communities. World Foods helps to highlight the effect on blood glucose of the common meals, snacks and drinks from those communities. We engaged with a sub-set of people from the four main communities involved in the book (Arabic, South-Asian, Caribbean and African). People created food diaries and gave feedback as to which foods, drinks and snacks should be included within the book. We had over 1200 responses to our design survey. The name for the book “World Foods” was chosen at a workshop led by the BME Health Forum.

 “People don’t talk about poor mental health in BAME communities, though many are suffering. A space needs to be found for those who are struggling. A closed, confidential well-being group is needed run by professionals and people who understand the language. ”

The Improving Access to Psychological Therapies (IAPT) service will reach out to coproduce a tailor-made emotional well-being workshop approach for BAME groups with BAME CVS representatives.

“Most people still don’t know what services are actually available to them in Hammersmith and Fulham, beyond A&E.”

Started designing a service signposting campaign with the Queens Park Rangers Football Club, West London Health Partnership and Healthwatch CWL.

“Too many documents are still written using jargon rather than plain English.”

In addition to our wider engagement with Healthwatch and the public to sense check our documents where possible, a patient kindly now volunteers with the CCG once a week to test readability.

“Need tailored care for the homeless community in Westminster, Hammersmith and Fulham and Kensington and Chelsea.”

Set the following equality objective for 2019-2023: ‘To ensure that commissioning and provider staff understand how to make services accessible for people who are homeless (particularly to encourage GP registration, health need assessments and signposting), using the resources available in the Healthy London Partnership Homelessness Programme.’ Engaged with homeless health service providers and clients to inform how this will be actioned.

“LGBT awareness training needed for frontline healthcare staff, particularly GPs, receptionists and mental health professionals, and to include a focus on challenging assumptions, and understanding of non-binary and transgender definitions and what this means for care.”

We are working with the LGBT Foundation to roll out the Pride in Practice support initiative across NW London. The initiative includes a wide range of support including awareness training, support around connecting the practice with their LGBT community and promoting cancer screening etc for this group.



Employment & Wellbeing Service Procurement: ‘You Said, We Did'
Full programme work can be found here

You said We did
1 “There should be more collaboration of the services with employers to address barriers and stigma and support people to stay in employment. One of the elements of the service will be an Individual Placement & Support (IPS) Supported Employment programme. This is based around eight principles, one of which is that employment specialists “systematically develop relationships with employers”.
2 There should be peer support and group work, including a depression support group.” The service specification states that the service should deliver a peer support element and this should include a programme of groups which are based on the needs of the population and should be reviewed regularly.
3 “There should be practical advice and support which helps attendees to build on and develop new skills, especially support with housing, benefits, CVs, and letter writing.” The service has been designed to ensure there will be support available in the areas listed.
4 “The mindfulness, yoga and creative classes such as writing, art, museum trips, and gardening should continue.” The peer support and befriending elements of the service will be designed so that groups and activities which have been most well used in the past can be continued.
5 There needs to be better communication between services (e.g. so that drop in sessions for one service do not clash with another), and also primary & secondary care (including different referrals and prescriptions).”

The new service has been designed to bring together lots of smaller services into one coordinated offering. This should reduce the duplication and ensure the service is delivered in a more organised way.
There is on-going work between primary and secondary care to address these issues; however, this is outside the scope of the service specification and procurement work.

6 “There should be flexibility of appointments that can fit around work patterns/ life demands, including providing later appointments.” As regards opening hours, the service specification states that the new service is expected to demonstrate flexibility in relation to the changing needs of the population. This may include some level of access at weekends and in the evening and the development of online facilities or self-support tools
7 “We need information about and signposting to services.” There will be an advice and navigation element to the new service.
8 “We need support once in employment and longer term follow-up, not just help to find work”. The IPS model emphases that support should be flexible in order to meet people’s needs and support people to maintain employment. The service specification states that support should continue to be available when people are discharged from secondary care.
9 “How about the design and delivery of a legal help line open 24 hours that can help people with mental health problems before, during and post-employment.” The service is not able to have a legal helpline, but employment advisors will be able to offer advice on accessing legal help if needed. There will be help and advice available out of standard 9-5 hours.
10 “GPs should receive more training on mental health and where/when to refer" We are working with our GPs to ensure that they are confident in supporting individuals with mental health problems in primary care, where appropriate, and in referring on when necessary. This is on-going, and outside the scope of this service specification and procurement exercise 
11 “The service should support carers and relatives.” The service has been designed to offer support to carers and relatives of individuals with mental health problems
12 “Lots of people with mental health issues do not feel able to come forward. Will the service provide help to people who don’t have a serious mental health diagnosis?” The service will span primary and secondary care and be available to all people with mental health difficulties, regardless of severity.
13 “Will referrals be from GPs only? If so, this might present issues for those who have a more difficult relationship with their GP or English as a second language. The service will accept self- referrals, referrals from health and social care professionals and from voluntary sector organisations.
14 “The service should support both people in work and those trying to get work.” The employment pathway covers: helping people to stay in work; offering wider advice and support; and providing more intensive support to those with long term mental health concerns, who are not employed, to help them develop the skills to find and maintain employment
15 The service should help get young people involved in volunteering.” The service has been designed to include supporting people to engage in volunteer work.



2017-18


You said 

We did

“You need to advertise your involvement opportunities more widely and more creatively.”                                                                                                                                                                                                   

Explored and started testing new ways of advertising involvement opportunities, including: sending SMS via GP practices directly to patients; piloting the use of a Patient and Public Engagement Network form so people can tell us what areas of health they are interested in being contacted about; building new relationships with organisations such as Young Hammersmith & Fulham Foundation.

“The text messages for your GP service evening and weekend appointments would be much clearer if you changed the wording.”

Changed the wording and sent the new text messages out to GP practices to share with patients.

“We don’t really hear about the evening and weekend GP appointments from our GP practices.”

Trained H&F receptionist and administrative staff in signposting people to evening and weekend GP appointments on Tuesday 4thJuly 2017.

“We would like the CCG to pilot digital technologies in general practice.” 

Worked with technology suppliers to pilot the use of an app that will allow symptom checking and video consultations with a GP. Hoping to launch the pilot during 2017 with a number of practices.

“Involvement opportunities should be advertised in a more accessible way.”

Worked with Healthwatch to make our template for advertising involvement opportunities more accessible. 

“Why is it taking 3 months or more for people to be seen by the Improving Access to Psychological Therapies services?” 


We asked West London Mental Health Trust what they were doing to reduce the waiting times and they said:

  • running additional evening clinics to screen all those waiting;
  • planning a series of group interventions to cut down waiting times;
  • setting new targets for clinicians to ensure services are running optimally 

We shared this information with our Patient Reference Group and the community groups who raised the issue.