Care Homes – keeping in touch with loved ones

Care home lockdown: how are you keeping in touch with your loved one?

As we enter a further period where visiting relatives in care homes is restricted, we want to hear how this is affecting you and your loved ones. What information have you had about keeping in touch and maintaining communications about care and wellbeing?

We are particularly keen to hear if you managed to be tested and have an ‘in person’ visit during December.

We would like to know your experience of:

  • Using video calls (FaceTime, Zoom etc.) or telephone calls – does the home support these? How many times a week and how long? Does a member of staff help your loved one with the call?
  • Socially distanced visits – does the home support ‘window’ visits.  How many times a week and how for long?
  • How does the home keep you informed about how your loved one is getting on (apart from necessary issues about their care or health), for example, manager updates, photographs, videos
  • Does the home have a programme of group and one-to-one activities? Has your loved one taken part?
  • Has the home asked you what, within the current restrictions, would make this time easier?
  • What, within the current restrictions, would make it better for you and your love one?
  • When restrictions are eventually eased (not totally lifted) what would help you and your loved one?

You can tell us your experiences at one of the ways here on our contact page, text us on 07413 385275 to make an appointment to speak to one of our team, or come along to our public online forum around these issues on Wednesday 27 January, 1.00pm – 2.00pm.

If you would like to take part in the forum please contact Laura Haugh: laurah@healthwatchnorthumberland.co.uk, or call 03332 408468.

Covid-19 and NHS dental care

Healthwatch England is calling for action to address widespread issues with access to NHS dental care following an unprecedented surge in concerns. Healthwatch experienced a 452% increase in feedback on the issue in the second quarter of the year, with continuing accounts of people being left in pain, resorting to ‘DIY’ repair methods and in some cases even extracting their own teeth.

The review of 1,300 people’s experiences of accessing dental care found that:

  • More than 7 in 10 people (73%) found it difficult to access help and support when they needed it.
  • Access issues were caused by dentists not taking on NHS patients, as well as conflicting advice from different parts of the NHS about what help is available.
  • Many people were offered treatment if they went private, despite research indicating that 40% of people would struggle to afford private dental care.
  • The impact of not being able to access care led many people to experience pain, discomfort and further complications.

The increase in feedback comes after the British Dental Association reported that treatments delivered by NHS dental services in England are at a quarter of pre-COVID levels, with over 14.5 million fewer procedures taking place.

Laura Floyd, from West Berkshire, was part-way through significant dental treatment when it was cancelled due to the lockdown in March. The new mother explained: “As we went from April to May, I had an abscess develop on the tooth which was still awaiting treatment. I did receive care over the phone and a course of antibiotics which helped ease some of the pain and swelling but this never fully went away, I just lived with it as cautiously as I could. Sadly my eight-month-old wasn’t as cautious when reaching out and grabbing my face!”

Laura, who was entitled to free NHS dental care for 12 months after the birth of her child, did then receive some emergency treatment for a further painful cavity but is still waiting for her main treatment to be completed a year on from her initial diagnosis.

Sir Robert Francis QC, Chair of Healthwatch England, said: “The COVID-19 crisis has impacted on many areas of NHS support but, problems in dental care appear to be particularly acute.

“Even before the pandemic, people were telling us about problems in accessing NHS dental appointments but since the start of the summer these reports have hugely increased.

“If we don’t improve access to NHS dental care, not only do people risk facing far greater dental problems in the future but it also puts pressure on overstretched hospitals and GPs. Untreated dental problems can lead to pain, infection and the risk of long-term harm, which is comparable with other medical conditions.

“Health and care services are working hard to deal with the pandemic, but we believe the Government and the NHS should give more attention to resolving both long-standing and COVID-related issues in dentistry.”

While the report accepts that the overall treatment backlog caused by the pandemic will take time to clear due to limited industry capacity and COVID-related restrictions, it makes several recommendations including:

  • providing more accurate and up-to-date information for patients
  • providing clarity over NHS dentists’ obligations relating to patient registration
  • making more resources available to improve patient access to
    dental care and;
  • reviewing the overall cost to patients of NHS dental care, particularly with a 5% price increase set to take effect before Christmas.

Healthwatch is also calling for people on low incomes who are forced to travel long distances to access dental care to be reimbursed.

Read more on the Healthwatch England website

If you would like to tell us about your experience of accessing dental care during the pandemic you can tell us your story here.

AGM draft minutes and Q&As

Answers to many of the questions raised before and during our AGM in October can be found below. We are still waiting to hear back from the NHS Trusts in response to some of the questions raised and will add these as soon as we can.

The draft minutes from the AGM can also be found below.

 

Questions for Healthwatch Northumberland

Q:  My husband has multiple health conditions. Since March, paramedics have been called four times (via NHS 111/999 or GP). We have been told consistently that they would not take him to hospital, e.g. for a high temperature. Are paramedics instructed to routinely give this message, consequently deterring people from seeking help? We know from past experience when his breathing is normal for him, but cause for concern, and when he is deteriorating and likely to require intervention.

This whole experience leaves us feeling it is wrong to call for help. This is exacerbated by other consultations (GP and hospital) which feel ineffectual for a person with multiple comorbidities.

A: North East Ambulance Service said:

The staff who answer 111/999 calls are not routinely instructed to inform patients that they would not take him to hospital. Each individual is assessed in their own right and the context of their presenting symptoms. If an individual is identified as needing hospital access then we would recommended that. Where an individual can safely be transferred to hospital without ambulance intervention that will be recommended. This saves ambulances for those people where there is an absolute need to transport the patient with supported care on route.

During the period since March 2020 we have had different thresholds for answering calls depending on how severe COVID-19 has been. Things may change in times of high demand and depending on the changing government guidance as we learn more about the virus.

On some occasions we have advised people not to access hospital care, the outbreak of COVID19 meant hospitals may not be the same safe environment for people with weak immune systems as they were previously. In these cases, where care could safely and effectively be given at home that would be recommended.

Q: Why have mammograms for women over 71 been stopped with no indication of when they will start again. Newcastle Hospitals advised there is only a four month backlog.  I have booked a private appointment. Also have GP surgeries been told to stop advertising the service.

A: This question has been submitted to Newcastle Hospital Trust and we will publish the answer as soon as we have it.

Q: I have seen that Being Woman charity gives out devices to people to access digital services. Is this service only for black, Asian and minority ethnic people or can anyone in Northumberland also access their service to get digital devices. One of my acquaintances in Amble has one and she was guided to connect up to GP services.

A: Thank you for your feedback and query around Being Woman. If you are looking for support around digital skills or would like to have a device to access digital resources we recommend you get in touch with them directly, either through their website: www.being-woman.org.uk contact them on 01670 857167.

Live questions:

Q: Where would I find more details about the Healthwatch Northumberland vacancy? Will there be a link available?

A: Derry answered. Yes we will make the link to our website available after the event or you can email info@healthwatchnorthumberland.co.uk to find out more.

Q: Do you have a view about the recent Look North feature about designated care home dementia spaces?

A: Derry answered. This is a policy decision and we don’t have a view in advance of the patient/carer experience but we are keen to find out more and hear from people about this if it is implemented.

Q: Are there any Clinical Commissioning Group (CCG) plans to communicate the Primary Care Network plan to the wider community?

A: Derry answered. HWN is always keen on how issues, changes and developments are communicated to the wider service user group so we will put this to the CCG and publish the answer.

 

Questions for our guest speakers from Northumbria Healthcare NHS Foundation Trust, Dr Alistair Blair and Judith Stonebridge, Public Health Consultant

Q: How accessible is digital in healthcare for the visually impaired, and have they been consulted and involved in the planning on digital healthcare? In addition, a lot of self-care promotion is on digital and this adds to health inequalities.

A: Judith answered. This is a really important question and definitely needs to be considered. The pandemic meant a rapid change overnight and there wasn’t much time for engagement, but we are doing that now and are keen to work with Northumberland County Blind Association. A significant amount of appointments are by telephone rather than computer so this may help and face-to-face appointments are still available if appropriate. We are keen to be as inclusive as possible, not just with appointments but with materials too.

Alistair added in regard to the self-care resources that digital resources are in addition to existing materials. Nothing has been taken away, talking books and Braille resources are still available.

Q: Are there any hospital sites or GP practices providing virtual group clinics in Northumberland? There are many patients who attended face to face group clinics who are now isolated and unsupported because of Covid.

A: Alistair answered. We need to separate group support, group education and group consultation. At present none are happening because it hasn’t been possible to get multiple people on to a secure platform. Zoom doesn’t meet the secure standards of the NHS. We’re looking into how group support and education could be delivered but it is harder to provide group consultations as there are issues with confidentiality. There is no way of knowing whether someone is recording the session. However, there are definitely opportunities here.

Q: What about increasing digital engagement and capacity building to facilitate digital engagement, especially those most at risk of poor health outcomes?

A: Judith answered. She said this is an issue which was discussed pre-Covid and inspired her to think about how people experiencing financial difficulties might not differentiate between letters in plain white envelopes from the NHS and elsewhere. There are plans to try to understand why people are not coming to appointments and what is preventing access. The pilots for the community hubs should help people develop digital skills. The Trust is also trying to make the language clearer on any letters sent out and will keep looking at data to help make improvements.

Q: Younger people might find digital engagement difficult if home is not a safe place or in cases of domestic abuse. How sensitive are services to these issues and how will it be addressed?

A: Alistair answered. There is a higher rate of mobile phone ownership and usage among young people. This is quite empowering as it is easier to make a quick call away from home rather than attend a face-to-face appointment which may be difficult if living with a controlling person. There are ways which people can signal over video if they are being threatened. The greater worry is that there are people who aren’t accessing health services at all.

Q: I recognise the value of digital consultation but it is still necessary to have face-to-face appointments. Can you reassure people digital appointments are not going to be the poor relation?

A: Alistair answered. If you need to examine someone you can only really do that by physical contact. People shouldn’t think of remote consultation as second class. It’s often just as good for information and sharing as face-to-face and the same amount of time for the clinician. It’s about choosing the right tool for the job.

Q: What about those practices who don’t have video links? Is connectivity in GP practices an issue?

A: Alistair answered. 90% of remote consultations are over the phone and all practices have phones. Every practice is also wired up for video consultations. Connectivity is more of a problem at the patients’ end. Sometimes image quality can be quite poor on video so texting a photo can be clearer.

Q: Is Northumbria Healthcare willing to look at the confidentiality agreements regarding virtual group clinics? There are many examples of virtual group clinics with confidentiality agreements templates in place.

A: The Trust is in discussions with Attend Anywhere (the system we use for virtual consultations) and they have confirmed they are planning to introduce a module for group consultations.  They are hoping to have something in development this year with a plan to introduce next year.  We are also looking into Microsoft Teams to see if this could be an option.  We would be interested to see an example of one of these confidentiality agreements and what platform is being used.

 

Healthwatch Northumberland AGM 21 October 2020 draft minutes

Care Home Visits in Northumberland

Our public forum on care home visits in November produced some really interesting and insightful discussion. We talked about how people are keeping in touch with loved ones in care homes during the pandemic, the effect on those in the homes, particularly those with dementia, and the effect on relatives, plus what would help, going forward and throughout the winter to make the situation easier.

Further to the issues raised at the forum, where people told us they were unclear on what care homes can or can’t do in terms of visits, we asked Liz Morgan, Director of Public Health in Northumberland for information. She shared the guidance on visiting that has been sent to every care home in the county, which can be found below.

We are hoping to hold another Zoom forum around these visits in the coming months, and in the meantime please keep sharing your experiences of care home visits.

Tell us your experiences of:

  • Using video calls (FaceTime, Zoom etc.) or telephone calls – does the home support these? How many times a week and how long? Does a member of staff help your loved one with the call?
  • Socially distanced visits – does the home support ‘window’ visits.  How many times a week and how for long?
  • How does the home keep you informed about how your loved one is getting on (apart from necessary issues about their care or health), for example, manager updates, photographs, videos
  • Does the home have a programme of group and one-to-one activities? Has your loved one taken part?
  • Has the home asked you what, within the current restrictions, would make this time easier?
  • What, within the current restrictions, would make it better for you and your love one?
  • When restrictions are eventually eased (not totally lifted) what would help you and your loved one?

Get in touch

Care Home Guidance on visits November 2020

Letter to Care Homes November 2020

Let’s Talk: Audiology Services Report

After receiving significant feedback from people in Northumberland about the end of the Hear to Help service provided by charity Action on Hearing Loss, we decided to investigate the potential impact on service users.

Hear to Help was a drop-in service delivered in community locations including libraries and GP surgeries. The drop-in service provided advice and information for people experiencing hearing loss, as well as performing general hearing aid/s maintenance, such as replacing tubes and batteries.The Hear to Help service stopped on 30 April 2019.

Feedback we received suggested that some people appreciated the service and did not want it to be withdrawn. We took a deeper look at the impact, if any, of the withdrawal of this service and to build a greater awareness and understanding of what people in Northumberland want and need in services to support with hearing loss.

It should be noted this work was done before the Covid-19 pandemic and the resultant change to services. However, the issues raised by respondents, particularly about communication, remain relevant now and in the future.

 

Aims

We wanted to find out:

  1. What do people in Northumberland think of audiology services?
  2. What audiology services are available for the people of Northumberland?
  3. What is good about audiology services in the county?
  4. What could be better about audiology services in the county?

 

Summary

Location of hearing loss services was a key area of discussion

  • More than 50% of people we asked said it was easy for them to travel to an audiology clinic
  • Some people were happy they did not need to travel to Newcastle
  • Some people said the clinic was in a bad location with accessibility issues, seasonal transport issues, and public transport combined with limited clinic opening hours
  • People who found it easy to access clinics used a range of different transport modes
  • We are unlikely to have heard from the most isolated, vulnerable people in the county People who live rurally, with mobility issues, or limited social networks, and lower incomes, are likely to find it hardest to access hearing care clinics
  • Some patients were supported by a carer or friend to attend a clinic or understand their care – a gap for patients in accessing or receiving hearing care independently
  • Few people told us they used patient/community transport services to access a clinic

Information about and awareness of services was another key area of discussion

  • We signposted people to: transport services, audiology clinics, and voluntary groups (like Carers Northumberland), showing a lack of awareness/information availability
  • Some people were aware of hearing aid/s battery locations, whilst others were not
  • One patient spoke about an information form given with their hearing aid/s used to support them to live with hearing aid/s. Contrastingly, 48% of people said they had not been offered training, advice, or support for living with hearing loss
  • Some people believed the onus was on the person experiencing hearing loss to ask rather than professionals to let them know what support was available
  • 10 of 11 people in our focus group did not know of the hearing aid/s postal service
  • Some people were not physically able to clean or retube their own hearing aid/s due to dexterity problems, vision impairment, or not feeling confident enough
  • 23% of people we asked agreed they had felt isolated as a result of their hearing loss

Drop in vs appointments

  • Most people preferred drop-ins to appointments, finding them easier or more convenient
  • In our focus group most patients preferred appointments to drop-ins
  • Many patients were satisfied with the current audiology appointment system
  • Interestingly patients gave similar reasons for their preference of either appointments or drop-ins – ease of managing transport arrangements as a priority
  • 42% of patients would like to be told it was their turn to be seen by someone calling out their name. Some patients liked the idea of having a board with their name on
  • 62% of patients we spoke to agreed the waiting time for their appointment was reasonable 71% of people agreed their appointment gave them ‘time to talk’
  • 52% of people said they had their hearing aid/s serviced at the right time for them

Regular hearing aid/s maintenance and NHS audiology services

  • People were positive about the quality of care provided in audiology clinics. People praised the staff and were satisfied they got what they needed from the service
  • It is advised that hearing aid/s tubing is replaced every three to six months. 42% of patients had their hearing aid/s maintained in the last six months, and 46% had not
  • Many people we spoke to were able to clean and change batteries in their hearing aid/s but could not change their tubes
  • Some patients said they had waited a while to receive their new hearing aids
  • People told us that not all hearing aid/s batteries/tubes were available everywhere
  • Some patients said they found face to face communication easiest. Many services now offer a phone appointment system, a barrier to people with hearing loss

Hear to Help service

  • Hear to Help was an important service for people experiencing hearing loss
  • People at the Bell View focus group said the service had helped to show them how to maintain their hearing aid/s, and given them tube cleaners

Read the Full Report

four mugs in a row

We’re recruiting for an Engagement and Insight Officer

We’re looking for an Engagement and Insight Officer to join the Healthwatch Northumberland team.

  • £23,685 
  • Full time
  • Permanent dependent on funding
  • Closing date 5.00pm 27 November 2020
  • Based in Hexham with travel across Northumberland (note all staff currently working from home but under review in line with pandemic guidelines)

Healthwatch Northumberland is the independent champion for health and social care across the county.  As our Engagement and Insight Officer you will listen to people and turn what you hear into compelling information that will help those with the power to make change happen.

It’s the job for you if you like people, numbers and making a difference for our communities.

If you would like an informal discussion about the role and Healthwatch Northumberland, contact Derry Nugent, Project Coordinator- derryn@healthwatchnorthumberland.co.uk

Interviews will be on Wednesday 16 December 2020 by Zoom

 

Job Description and Person Specification

Healthwatch Northumberland Strategic Plan

Healthwatch Northumberland Staffing Structure

Healthwatch Northumberland Annual Report 2019/20

Application Form

What you told us – July to September 2020

As a listening organisation working across Northumberland, Healthwatch Northumberland is interested in what people think is working well in services and what can be improved. We act on what people are saying, sharing their views with those who have the power to make change happen. We also help people find the information they need about services in their area and record this as ‘signposting’.

People who use health and social care services tell us about their experiences throughout the year. This report shares a summary of the feedback collected from July to September 2020. During this period we have continued to work in different ways due to the continuation of the Covid-19 pandemic. The next report will cover October – December 2020.

This quarter we received feedback and enquiries from:

  • Telephone calls, emails and social media (87%)
  • Talking to people at online engagement events (7%)
  • Through a third party (7%)

Covid-19 has meant changes have been made to health and social care services. Patients and carers’ experiences and signposting requirements are likely to have been different during this time.  For this reason we have also chosen to focus on any feedback we receive which is related to Covid-19 and these changes.

Between July and September 2020, we received feedback from 27 individuals from talking to people at online engagement events, telephone calls, emails, our website, surveys, and other sources. We signposted 15 of these people to services, and provided information or advice to five people. In total we were in contact with 29 people who gave us feedback or were signposted.

Read the Feedback Report for July to September 2020

Watch our online AGM and Review of the Year

Thanks to everyone who came along to our online AGM last week. We hope you enjoyed hearing about our work over the last 12 months, and also from our guests from Northumbria Healthcare NHS Foundation Trust, who spoke about accessing healthcare via digital means, assuring quality of consultations, and what the future holds.

The event can be viewed below. There is still time to ask a question – about our work, about digital access to services, or anything to do with local NHS and social care services. Get your questions to us by 30 October; we will publish all questions and answers here in the next few weeks.

 

Healthwatch Northumberland AGM and Review of the Year 2020

 

Hospital discharge during COVID-19

A new report from Healthwatch England and the British Red Cross looks at how well the new hospital discharge policy is working for patients, carers and healthcare professionals.

In March 2020, the Government introduced a new hospital discharge policy to help the NHS free up beds by getting people out of hospital quickly. This meant anyone who may need out-of-hospital support to help them recover would now have their needs assessed after being discharged, rather than in hospital.

The report shows significant numbers of people are not receiving follow-up support after being discharged from hospital under new policy, leading to unmet needs. Read a summary of the report below.

What did people tell us?

Overall patients and families were very positive about healthcare staff, praising their efforts during such a difficult time.

However, while the speed at which people were discharged from hospital was important, it often led to a lack of support for some patients leaving hospital.

Key findings

  • 82% of respondents did not receive a follow-up visit and assessment at home and almost one in five of these reported an unmet care need.
  • Some people felt their discharge was rushed, with around one in five (19%) feeling unprepared to leave hospital.
  • Over a third (35%) of people were not given a contact who they could get in touch with for further advice after discharge, despite this being part of the guidance.
  • Overall patients and families were very positive about healthcare staff, praising their efforts during such a difficult time.
  • Around a third (30%) of people faced an issue with delayed COVID-19 test results, potentially putting family and carers at risk, or in a care home, other residents and staff.

What are we calling for?

To improve hospital discharge for patients, their carers and healthcare professionals, ahead of winter and a second wave of COVID-19 admissions, we’re calling on the health and care sector to:

  • Roll out post-discharge check-ins by phone or in person
  • Develop a discharge checklist, including questions about transport and equipment needs
  • Improve communication by assigning a single point of contact for patients and carers
  • Link patients to voluntary sector partners or community pharmacists to deliver medicine and avoid delays.
  • Boost community care capacity and recognise the value of voluntary care sector in hospital discharge.

Read 590 people’s stories of leaving hospital during COVID-19 

 

Mental Health Summary Report

In our Annual Survey 2020, mental health services was the second most chosen area where people thought we should focus our attention in the coming year. Mental health services had a high dissatisfaction rating – of those that use them 79 people said they were dissatisfied with mental health services (54%) – this was the only time more people said they were dissatisfied with a service than said they were satisfied with it. Respondents told us about a wide range of issues they had with mental health services.

People felt there could be more local mental health services
Respondents specifically mentioned Berwick Infirmary, where they felt there could be more mental health services. Respondents also called for more mental health services for autism in Hexham and Haltwhistle.

Responses from patients and staff alike highlighted a need for more resources to be put into mental health services
Patients told us there is a lack of mental health emergency beds and trained psychologists, and described Talking Matters Northumberland (TMN) as a stretched service. They also told us there is an increased demand for mental health services and that there needed to be more support for men at risk of suicide, as well as for young people. The Community Mental Health Team (CMHT), TMN, Cumbria, Northumberland, Tyne and Wear NHS Trust (CNTW) and Children and Young People’s Services (CYPS) were specifically mentioned by patients and staff alike as services that would benefit from more resources.

 

Healthwatch Northumberland Mental Health Services Report 2020