Online event – Diabetes UK

Online event – Diabetes UK

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Join us on Friday 13 September to hear from Susan Bathgate from Diabetes UK. In this free, online public event Susan will provide information about the different types of diabetes with a focus on type 2 diabetes and how to manage and live well with the condition.

We will also hear about national and local support available from Diabetes UK. There will be a chance to ask questions after the presentation.

This session is suitable for public and professionals who want to know more about diabetes and the support on offer through Diabetes UK.

This event has now passed. Sign up to our newsletter to hear about future events or visit our online events page to watch the recording.

How easy is it to give feedback to your GP?

How easy is it to give feedback to your GP?

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In October 2023 we undertook a ‘health check’ of all GP practice websites in Northumberland across seven primary care networks (PCNs). There are 36 practice websites representing 45 individual surgeries. This was to see how easy it was to find information about how to raise a concern or give positive feedback and to see if signposting information for support in raising a concern was up-to-date and factually correct.

Why we did it

Patient feedback is an important part of improving patient experiences and outcomes, enabling the service provider to identify potential problem areas. Having clear processes also gives the opportunity for concerns to be dealt with swiftly to prevent escalation and to avoid undue confrontation with practice reception staff.

In most GP services complaint situations, the appropriate course of action is for a patient to initiate a complaint directly with their GP practice. Patient feedback to Healthwatch Northumberland has shown that many people seem unaware of how to resolve a complaint or concern through their GP surgery and what support options are available to them.

There have been recent changes to advocacy support in Northumberland, with VoiceAbility taking on the NHS Independent Complaints Advocacy Northumberland (ICAN) service, as well as national changes, with Integrated Care Boards(ICBs) now handling NHS primary care complaints – these were previously dealt with by NHS England.

We wanted to explore if these changes had been reflected on GP practice websites. We also wanted to gather evidence of the need for consistent messaging in order to ensure that the process of raising a concern is easy from a user’s point of view, and that signposting information is factually correct, so that patients have a clear understanding of their rights and options.

How we did it

Our staff and volunteers carried out research by visiting each GP practice website to review its complaints information. All of the websites were accessed via desktop computers and, where possible, using smartphones (29 out of the 36 websites) to ensure equal accessibility.

We are aware of other accessibility issues, for example, language barriers, and will carry out further research on this.

What we found

  • Nearly 60% of GP websites were found to be equally accessible from both desktop computer and smartphone.
  • There was a 50:50 split on whether or not information and support for raising a concern was easy to find on the websites – some information was found under different headings on the websites rather than on the main complaints page.
  • Complaints information, support options and signposting information was very muddled. Even where correct support organisation details were given, they weren’t always accompanied by the correct contact details or explanations of how the service could help.
  • In some cases, there were additional steps that needed to be taken when making a complaint online, for example, having to download forms, which could be a barrier to patients making the complaint.
  • There was a lot of variation in information and processes even between practices within the same PCN, for example, within one PCN, two practices have almost identical looking websites, but one practice directs patients to send complaints to NHS England, whereas the other directs them to the ICB.
  • Within another PCN, again, four practices have very similar looking websites, but two of them require the patient to attend the surgery in person to collect a complaint pack, one requires the patient to put a complaint in writing by post and only one practice offers the option of making a complaint online via email.

Read our full findings and recommendations

Have your say on eye care services

Have your say on eye care services

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Have your say on eye care services

We would like to know if you are getting the eye care you need.

Healthy vision is something many of us take for granted – until there is a problem. An estimated 50% of sight loss is avoidable. That is why people need access to regular eye tests and, if there is a problem, get the help they need.

Tell us about your experiences and help improve eye care services for everyone.

This survey is now closed

Disabled people could be missing out on social care support

Disabled people could be missing out on social care support

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Up to 1.5 million working-age disabled people in England could need social care support but are not accessing it. This means they are likely to be missing out on help with daily activities such as washing, cleaning, socialising, and going to the shops. Healthwatch England polled 1504 working-age disabled adults in England and found one in four, 28%, could be eligible for support under Care Act criteria but have never had a social care needs assessment. You can read about the poll and the results below.

Why people don’t receive social care

The people who took part in the poll had unmet social care needs— they said they are eligible for social care under the Care Act but had never received social care due to multiple factors:

  • They didn’t think they could get any support (65%); 
  • They didn’t know where to go for support (34%); 
  • They were unable to afford to pay for care or contributions (26%); 
  • They found it too difficult to get support from councils or the NHS (14%);
  • Their local service closed (2%).

People who were excluded from the estimate include:  those who are waiting for a social care assessment, have been told they are ineligible for social care support, are supported by unpaid carers, access state benefits, or simply do not want any support. 

Also excluded were those who currently access care, which according to NHS figures is around 300,000 working-age disabled adults receiving publicly funded care and an unknown number of people funding their own care.

When people receive social care, they report positive experiences

Out of 20% of respondents who said they currently receive social care, over three quarters, 78%, agreed that the care they receive helps them live the life they want, compared to only nine per cent who disagreed with the statement. 

Two-thirds (62%) of the respondents who receive social care said it helps them stay healthy, while over half, 51%, said it helps them do the activities they enjoy. 

Just under half, 47%, said that their care enables them to keep themselves and their home clean, and the same number said it supports them to eat and drink properly. Just over one in five, 22%, of people said that their care supports them in working, studying, or volunteering.  

Eligibility issue

Under the Care Act, people may be eligible for social care support if their needs arise from a physical impairment or illness that negatively affects their ability to perform tasks quickly, independently, and safely, while also affecting their wellbeing. 

However, the research shows the extent to which eligibility might apply to more disabled people will remain unknown until people can easily interact with social care services or access assessments.

Annanya’s story: I struggle with routine household tasks

Annanya, 21, is a part-time student and ambulance call centre worker from Liverpool. She has several health conditions, including mental health problems, dyslexia, ADHD, suspected autism and diabetes. Together, these conditions make it difficult for Annanya to maintain her home and to run chores, and she needs support with daily tasks.

Annanya reached out to her local social care provider for support. However, the council told her that her needs were a medical issue.

“They kept me on a waiting list for six months just to get an assessment, then they called me to say they can’t help me”, she explained. “The assessment was also done remotely – nobody visited me at home. I live alone and struggle with household tasks and planning. Having some extra support could really help me manage these challenging aspects of my life”.

Louise Ansari, Chief Executive at Healthwatch England, said: 

“Social care can be transformative and change people’s lives. Our research highlights a really positive message, that for so many people care has helped them live independently, leading the lives they want to live, how they want to live them.

“Yet, social care in England is under financial strain, facing a workforce crisis, and requires major reform.  Our findings clarify those challenges, showing that the hidden demand for support could be as high as 1.5 million working-age adults in England. Not all these people will be eligible for publicly funded care, but far too many clearly live with some form of unmet need and don’t know where to turn for support. 

“We need to make sure there is more support for disabled people, and that this support is easy to understand and to access. Not only will this help people with their emotional and physical needs, but it will also help people who have told us they’d like more support to get into work, and it will contribute to taking pressure off NHS services.” 

We need to make sure there is more support for disabled people, and that this support is easy to understand and to access.

Call for reform

Healthwatch is calling for a fully funded and long-term reform plan for social care that will address workforce issues, offer more support for unpaid carers, and a focus on early prevention.

As part of the reform plan, Healthwatch England has set out three recommendations:

  • The Government should fund local authorities to raise public awareness of social care and find potentially eligible individuals through proactive outreach to disabled people.
  • Government should also dedicate funding to boost capacity and support councils in addressing existing care assessments and care package backlogs. 
  • There needs to be greater investment to ensure all disabled people accessing social care assessments are offered a Care Act advocate who can help them understand the assessment process and their rights.

Read the report in full

Tell us your experiences of accessing social care support at home

Trends in feedback January to June 2024

Trends in feedback January to June 2024

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Between January and June 2024, we received feedback from 417 individuals from talking to people at face-to-face events, telephone calls, emails, our website, social media and other sources. This is approximately the same as the previous six months (we heard from 422 individuals between July and December 2023). Between January and June 2024, we signposted 65 people to different organisations for further support. This is up slightly from 59 during the previous six months. Our social media content had a reach of 110,000 and almost 7000 engagements, and our website had 23,000 views, compared to a social media reach of 77,000, over 7,000 engagements and 16,000 website views between July and December 2023.

The feedback we have had for the past six months has mainly been around three service areas:

GP services

29% of all feedback received in January to June 2024 was to do with GP services (roughly the same proportion as July to December 2023). The main issues we received feedback on were difficulty getting an appointment and poor service. However, approximately one in four comments we received about GP services were positive which is an increase on the previous six months (one in five comments were positive between July and December 2023).

Hospitals
25% of all feedback received during the six months was about hospital services. The biggest concerns were around the distance to travel and lengthy waiting lists. There were also concerns raised about poor communication and poor quality of care when people got to hospital. However, just under one in three of the comments we received about hospitals were positive.

Dentists

Dentists were mentioned in 7% of all the comments we received. The vast majority of feedback was to do with the difficulties getting an NHS appointment. About 10% of respondents who fed back about dentists reported that the dentists they had spoken to were only accepting private patients. Approximately one in ten of the comments we received about dentists were positive.

These three categories made up almost two thirds (just over 61%) of the feedback we received in January to June 2024. This is up from the previous six months when these categories amounted to less than half of the feedback received (48% in July to December 2023).

Over a quarter of the feedback for GP services was about three particular GP practices. We will contact these practices individually to discuss the themes that have been raised in the feedback.

Signposting/requests for information

16% of the contacts we received in January to June 2024 were requests for information or signposting support. The top three areas were:

  • Adult social care – enquiries were mainly about getting care in the home and care assessments
  • Cost of living support – this included requests for information around benefits advice
  • COVID-19 vaccinations – enquiries were around eligibility and vaccination sites

Read more in feedback trends for January to June 2024 report.

 

Getting the most from your surgery

Getting the most from your surgery

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GP surgeries have changed the way they work to meet patient needs and increased demand. There is now a wider range of medical staff at surgeries and different ways to get help such as telephone, video, and online consultations, as well as face-to-face appointments.

Access to GP services is an issue we hear about regularly at Healthwatch Northumberland. In our ‘getting the most from your GP surgery’ booklet we explain more about the range of staff roles at surgeries, different ways to access healthcare and how to make the most of your GP appointment.

Why do I have to tell the receptionist so much about my concern?

Reception staff need to ask enough questions to make sure you get the best appointment with the right person. This may not always be your GP, as there are specialist services that may be more appropriate for your needs, for example, a dietician for
concerns around food allergies or intolerances.

Who might I see at the GP surgery?

Your GP surgery will employ some or all of the healthcare professionals listed below.

Advanced Practitioners: include nurses, pharmacists, paramedics, physiotherapists, occupational therapists, dieticians or podiatrists. They can help with a variety of health conditions and can prescribe medication and make referrals to other specialist services.

Clinical Pharmacists: can carry out medication reviews, particularly for long-term and chronic health conditions. Some can also prescribe medication and manage prescriptions.

Care Coordinators: ensure patients have more joined-up care and that their care needs are met, particularly for those who are frail and/or elderly, and people with long-term health conditions

Dieticians: diagnose and treat dietary and nutritional problems, give advice on food and nutrition, and offer support with diabetes, digestive issues, food allergies and intolerances and weight loss/gain.

General Practice Nurses: can do many of the same tasks as GPs. They assess and treat people of all ages, provide wound care, screenings and blood tests, as well as vaccinations. They also offer advice on contraception, women and men’s health issues, weight loss and stopping smoking.

Health and Wellness Coaches: find solutions or lifestyle changes to enable people to lead happier lives. They help people to form a personalised health and care plan to achieve their goals.

Mental Health Practitioners: support people with severe mental health illness to live well in their communities. They can work with patients whose mental health needs cannot be met through, for example, talking therapies, but who may not need care from more specialist services such as psychiatric care. They can often help children and young people as well as adults and can help make referrals to suitable services for support.

Occupational Therapists: work with ill, disabled or injured patients,including those who have returned home following a hospital stay. They help with adaptations to people’s homes so they can continue to live independently.

Physician Associates: work alongside GPs. They cannot prescribe medication but can prepare prescriptions for GPs to sign and can diagnose, order tests and make referrals.

Physiotherapists: work with patients who have joint or muscle problems including those recovering from serious injuries or illness and those with new injuries. They can book scans and tests and are trained to recognise when a joint or muscle problem may be a sign of something more serious. Patients can often make an appointment with a physiotherapist directly themselves (self-refer) or can be referred by a GP or other healthcare professional.

Paramedics: can provide a rapid response to patients with long-term conditions, minor injuries and minor illness. They can supply a range of medicines and support patients who require wound care, have fallen, or have musculoskeletal problems, and can treat some types of infections.

Podiatrists: can diagnose and treat foot and lower leg conditions and provide foot care for short-term or long-term conditions.

Social Prescribing Link Workers: help address the non-medical issues that may be affecting your health and wellbeing. They can connect you to local services and community groups for practical or emotional support.

 

Find out more by viewing our ‘getting the most from your GP surgery’ booklet or download as a pdf.

 

Tell us your experiences of making appointments and visiting your GP surgery.

 

 

 

Health visiting services in Northumberland

Health visiting services in Northumberland

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Growing Healthy: Hearing people’s experiences of health visiting services

Last year we started to hear a small increase in concerns from local families and those supporting them about health visiting services. To get a better understanding of people’s experiences we asked people in Northumberland who were pregnant or had pre-school aged children for anonymous feedback about their experiences of the health visiting service, delivered by Harrogate and District Foundation Trust (HDFT), including what is working well and what could be better. We also wanted to understand people’s awareness of the health visiting service and any barriers to using it, including those who were not routinely taking advantage of the services on offer.

Summary

During this piece of work we looked at people’s awareness of how to access the health visiting service and what it offers, whether they were routinely accessing the service, as well as how happy they were with the support provided.

Whilst most people we heard from were aware of how to contact the health visiting service there were many others who were not very clear on how or who to contact. Around half of people responding were also unsure or did not know who their child’s named health visitor was, either due to staff changes or not having had recent contact with the service. Those who did have a named health visitor and who saw them at each appointment were generally happier with the support received from the health visiting service than those who did not, with many mentioning continuity of care or having a good relationship with their health visitor.

Many people had a good awareness of the universal offer in terms of key developmental reviews or if not, how they could find out about it, but there were still some who had limited awareness of when they would next expect a review or whether they may have missed a key review. Similarly, some people had a limited understanding of other possible targeted support and advice on offer outside of the key developmental reviews, for example, around parenting and other topics. These people told us they would not think to contact health visitors outside of reviews, or more generally were unaware that the health visiting service could provide this. Positively, many parents had used the health visiting service for targeted advice and support, particularly around feeding, nutrition, growth and development.

Most people we heard from had either not heard about the new Growing Healthy app, or had heard about but had not used the app. Many of those who had heard of but hadn’t used the app seemed unaware of its functionality. Those who had used it gave mixed feedback but were generally positive about the health chat feature and
self-help articles and information available.

In terms of how happy people were with the support from the health visiting service most selected the ‘partly’ response. Those who were completely happy praised the support given by the health visiting service or their named health visitor using words like ‘supportive’ and ‘helpful’. Many who did not necessarily have routine or regular contact were still completely happy as they felt confident in being able to make contact and get support should it be needed. Those who were less happy with the service generally had concerns around staffing, having limited support, being unaware of how to access support and being unhappy with a particular health visitor or specific advice given. We also received multiple comments around accessibility and availability of clinics and concerns these were no longer a ‘drop-in’ facility.

 

Read all of our findings and recommendations in Growing Healthy: Hearing people’s experiences of health visiting servicesordownload a pdf version.

 

Share your own recent experiences of health visiting services in Northumberland.

 

Physician Associates

Physician Associates

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The NHS plans to triple the number of Physician Associates it employs. But how much do patients know about this role, and how can their role be safely expanded?

In recent years, the NHS has expanded the use of ‘medical associate’ roles to help tackle staff shortages and improve access to care. One of these roles is the Physician Associate (PA).

With plans to employ 10,000 PAs by 2037, Healthwatch England looks at how aware patients are of PAs and how NHS staff and medical regulators can improve their understanding and experience. 

What is a physician associate?

PAs are healthcare professionals who work under the supervision of a senior doctor and can assess, diagnose, and treat patients within certain limits.

They don’t prescribe medication or request X-rays, and they are supposed to supplement – and not substitute – fully qualified doctors.

PAs are not a new role.

Physician Associates have worked in England since the early 2000s, but the number employed in the NHS has grown significantly in recent years.

The Faculty of Physician Associates found that 2,833 PAs were working in England in October 2022, more than double the number recorded three years earlier.

The previous Government asked the General Medical Council to take on formal regulation of PAs alongside its main role of regulating doctors. This move aimed at assuring patients, clinicians, and employers that PAs have the knowledge and skills to work safely and that they can be held to account if serious concerns are raised.

With the regulation of PAs due to start at the end of 2024, we have looked at what patients have told us about PAs and the lessons the NHS and the GMC can learn from our evidence.

What patients and the public think 

It is challenging to accurately gauge people’s experience and understanding of PAs. There are still not many PAs practising in the NHS, and there is little national data about which services employ them and in what capacity.

To establish the first national picture of the patient experience of this new role, we commissioned a poll of 1,914 adults living in England . We also spoke with Local Healthwatch services about the stories people had shared with them.

The previous Government asked the General Medical Council to take on formal regulation of PAs alongside its main role of regulating doctors. This move aimed at assuring patients, clinicians, and employers that PAs have the knowledge and skills to work safely and that they can be held to account if serious concerns are raised.

With the regulation of PAs due to start at the end of 2024, we have looked at what patients have told us about PAs and the lessons the NHS and the GMC can learn from our evidence.

Key themes

General awareness is mixed

In our polling, we found a mixed picture on awareness of PAs.

In our polling, we found a mixed picture on awareness of PAs. Over half of those surveyed (52%) agreed or strongly agreed that they “understood the difference between a PA and a doctor”.

However, there were differences when it came to age.

Respondents aged between 18-34 were more likely to agree with the statement (58%) than those in older age groups (47% of 34–54-year-olds, and 49% of those aged 55+ agreed).

Some Local Healthwatch explained that while patients might have heard of PAs and understood that they were not doctors, understanding what they can and can’t do is more limited.

In many cases, patients were not aware of the local presence of PAs and often only found out about the role when given an appointment with a PA.

Knowing who you are seeing is key

Where people knew they had received care from a PA, their experiences tended to be positive. People particularly valued that they could have their needs addressed quickly when they saw a PA.

“My appointment with the physician associate went wonderfully well. She answered all my questions, was very thorough in her examination and had a lovely manner. I am very happy with the service provided.”

Story shared with Healthwatch Solihull

However, we heard about several cases where patients were not made aware of who they were seeing before or during their appointment. In some instances, patients had specially asked to see a doctor but were instead assigned to see a PA.

“I was in a lot of pain and was surprised to be offered an appointment the next day. I specifically asked for a doctor as I wanted to discuss having an operation but when I got there I was told I was seeing a physician’s associate and all I got was a year’s supply of opiates. It has put me off contacting the surgery except for repeat prescriptions and I have now paid to go privately for assessment and treatment. I have no faith in the practice now and no longer feel cared by them.”

Story shared with Healthwatch Richmond

Guidance from the National Institute for Health and Care Excellence (NICE) states that staff must explain their role and responsibilities while interacting with patients.

Our research revealed significant support for this among the public. Over three quarters (76%) of the survey respondents thought it was ‘important’ or ‘very important’ that the person providing their care ‘explains what their job involves’.

However, our evidence suggests that not all staff are following the NICE guidance. Only 60% of those surveyed said that during their last NHS appointment, the person providing their care clearly explained their role.

It is vital for every clinician to state and explain their role, and clarity is more important than ever as more roles like PAs are used across the NHS.

Five steps to improve clarity

In partnership with the Patients Association and National Voices, we’ve made five recommendations to policymakers and regulators about how they can better support the roll-out of PAs. A commitment to clarity about the PA role underpins these recommendations.

1. Clarity in direct patient care

Practising PAs and those in training must explain their role to all patients they see. Providers of education and training, including medical royal colleges, should make clear that informing patients about roles and responsibilities is core to providing high-quality care.

2. Clarity on choice

While PAs can provide high-quality care and improve patient access for more straightforward health problems, national and local NHS organisations must make clear that patients have a choice e to request an appointment with a fully qualified doctor if they prefer.

So people can make an informed choice, services should tell patients before an appointment:

  • The types of clinicians available to see them
  • The lengths of time they may have to wait to see different professionals, and
  • If they see a PA, the PA may have to refer the patient to a GP or other senior doctor if the patient’s problem falls outside their scope of practice

3. Clarity on training and regulation

In our polling, we found that the factor which made the public most confident in the person providing their care had ‘their skills and knowledge regularly reassessed’.

National bodies, including the Faculty of Physician Associates and the General Medical Council should be clear about the scope and content of the initial training of PAs and their ongoing assessment and revalidation.

4. Clarity of communication

Given the increasing use of new roles in services, NHS England and other national bodies should adopt a proactive approach to communicating with the public in this area.

Alongside broader awareness campaigns, Integrated Care Boards should set up patient forums to explicitly examine the deployment of new workforce roles. Patients and their representatives must be centrally involved in all future discussions about the use of PAs and other new roles.

5. Clarity on effectiveness

NHS England and the General Medical Council should commission a formal evaluation of patient experience of PAs in GP and hospital settings. This research would help to learn lessons to inform the expansion of this role and provide assurance that PAs are being used appropriately and not as substitutes for fully qualified doctors.

Want to learn more about Physician Associates?

Find out what care they can offer you and how their role differs from fully qualified doctors in this article from Healthwatch England.

Tell us your experience of Physician Associates

Online event – NSPCC Building Connections

Online event – NSPCC Building Connections

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Join us for our next free online event on Friday 9 August, 1pm-2pm, with NSPCC’s Building Connections service.

Research shows that 73% of young people between the ages of 16-18 do not feel equipped to deal with loneliness (Vote for Schools survey, 2023). The NSPCC’s newest service Building Connections is looking to change that.

Ellen Watling and Jess France from Building Connections will share how their service is supporting young people to overcome and manage feelings of loneliness.

This presentation will last around an hour including time for attendees to ask questions at the end. It is suitable for public and professionals who want to know more about the support on offer through the NSPCC’s Building Connections service.

This event has now passed.

Sign up to our newsletter to hear about future events or catch up with previous events.

Have your say on SEND services

Have your say on SEND services

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Northumberland County Council would like to hear your views on services for children and young people with special educational needs and disabilities (SEND) in Northumberland.

Families are invited to complete an online survey sharing their experiences about what is working well and what needs to change.

The survey has been developed with the Northumberland Parent Carer Forum and a group of parents and carers who are working with Northumberland County Council and NHS commissioners. The feedback will help to set the county SEND partnership’s vision and priorities over the next three years.

You can complete the survey online, or if you require a paper copy please contact sarah.elliott@northumberland.gov.uk and a copy will be posted to you.

​If you would like support to complete the survey over the phone, give us a call on 03332 408 468 (option 3) or text 07413 385275 for a callback.

Please leave your feedback by Friday 20 September 2024.

This survey is now closed