Reports and Feedback

Travelling for health and care services (2021)

WHAT HAPPENED?

In February 2020 we started a project to talk to local people about their experiences of travelling for health and care services. Within our Locality Plan, “Happy, Healthy People”, we talk about our ambition to have care closer to home, whilst also recognising that in the future people might have to travel a little further for more specialist health services. We know from previous work that transport and travel can be a real barrier for some people so we wanted to get a better understanding of the issues people can experience.

To undertake this project, we had a survey that was available online and we also visited some community groups and events. In March 2020 with the COVID-19 pandemic we were unable to do some of our planned face to face engagement but we kept the survey open and encouraged people to engage with us digitally.

What different did people make?

You can read a full copy of the engagement report below

Travel Engagement Report – Final

This document has been shared with staff within Wigan Borough CCG who are responsible for commissioning services on behalf of residents. It will also be taken into account when we are looking at our local estates and where services will be located. The information will also be used to promote more flexible approaches within services to take into account the issues people can experiencing travelling for services.

What’s next

We would like to thank everyone who took the time to complete our survey, share a story or talk to us at one of the events. The information we have gathered during this project will help us when planning health services in the future. If you would like to be kept up with local services you can join our Shape Your NHS community by clicking here.

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What happened?

The local NHS is working to improve urgent emergency care service and to help people to access the right care at the right time. Emerging from some of our conversations with local people was the fact that some people don’t know about NHS 111 or when they do, they aren’t sure exactly how they can help. In collaboration with Healthwatch Wigan and Leigh we undertook a quick snapshot survey to gather some recent experiences people have had when using NHS 111.

You can find more information about NHS 111 here.

What difference did people make?

You can read a full copy of the engagement report below.

Experiences of using NHS 111 Engagement Report

This document has been shared with colleagues who lead on the work around urgent and emergency care services.

What’s next?

The information will also be used by the Communication and Engagement Teams when considering how better to promote the NHS 111 service locally. This is an ongoing piece of work.

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Lilford Park and Pennington Park Surgery (2021)

What happened?

Lilford Park Surgery and Pennington Park Surgery are currently separate practices based in Leigh. Although separate, the practices have been managed by the same team for years. Dr A & S Weerasekara’s are contract holders for both Lilford Park Surgery (11 years) and Pennington Park Surgery (3 years).

They have had well established management and clinical structures in place across both practices and want to merge into one bigger practice. Both practice locations would remain open as they do now.

Through March and April 2021 we supported the practice team to engage with their registered patients about this proposed change. Give the COVID-19 restrictions in place at the time our engagement focused on:

• Having the information online and promoting across the practice social media channels;
• Posting out the information and a survey to a sample of patients across both practices;
• Reception handing out the leaflet and survey to people going in to the practices;
• Meeting with the Patient Participation Group (PPG) and getting their views.

The purpose of the engagement work was to find out what people think of the proposal to merge the practice and if they do have any concerns exploring what they are and how we can reduce them.

What difference did people make?

You can read a full copy of the engagement report below.

Pennington and Lilford Merger

Where patients could see benefits these mainly related to having the opportunity to attend either practice location in the future, having more flexible appointments, removing duplication of functions and the surgery being able to offer more services in the future.

Where patients had some concerns these mainly related to the potential impact on appointments and the way appointments are run, being able to get through and concern that one of the locations may close in the future. There is no intention to close either location.

Within the engagement report the practice included a “you said, we listened” section in which they responded to each point.

What’s next

The CCGs Primary Care Commissioning Committee has received a formal application from Dr A & S Weerasekara to formally merge the practices. The engagement report will be part of the evidence reviewed before the decision is made. Patients registered with the practice will be notified of the decision.

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Mental Health service and support – views of staff

What happened?

In November 2020 we launched an engagement project to speak to staff and stakeholders about mental health services and support. This work was done on behalf of the Mental Health Clinical Reference Group to help inform the design of services. Our aim was to understand what people think is best about local services, how they work well together and what we can do to support improvement. We also wanted to identify learning and best practice.

We approached this engagement work in two ways:

1. An online survey

Promoted across various partner communications and over our social media channels. We invited any staff working in or supporting people with mental health to complete our survey.

2. Focus groups

We held a number of focus groups online via MS Teams. These were themed on different topics such as patient transition and support, working with the voluntary and community sector, mental health and wellbeing in schools and referring people into services.

What difference did people make?

You can read a full copy of the engagement report below:

Mental health engagement with staff and stakeholders

10 key themes emerged from the work:

1. Staff across other health and care services, schools, police and voluntary sector would find it useful to have access to more training to help them to support people with low – moderate mental health issues.
2. We should think about the wellbeing and mental health support available to staff, particularly in smaller organisations who are supporting residents sometimes under challenging circumstances and staff across schools.
3. The pandemic has really had a negative impact on the amount of community support/groups/services on offer in the borough, it can be hard to get people the support that would help for example if they are isolated or feeling lonely. We should have a strategy for investment in VCSE.
4. Some of  our voluntary sector organisations are describing that they are supporting more and more people with complex mental health problems. There seems to be a gap of support when people are waiting for help from the NHS and sometimes people are discharged from services before they seem ready.
5. More focus should be put on preventative services, particularly in light of the ongoing pandemic and likely increase in mental health issues.
6. It can sometimes be confusing or difficult for staff in non-mental health services to refer people in to mental health services. Some people descried having to ring around to find out what is on offer and the best place to refer someone. They asked to consider whether we could look at a single point of access or contact for professionals across different services. A directory of services was also suggested.
7. Staff in some of our health services and police felt it would be useful to have access at least to a summary of mental health records as this would support them to support residents and reduce time spend ringing round making enquiries.
8. We were asked to address the waiting times in some mental health services, for example CAMHS and generally felt that mental health services should get more funding in the borough to increase resources.
9. The move to remote working and consultations has been good in some areas but had an impact on particularly vulnerable people during the pandemic, e.g. vulnerable children and young people unable to have face to face appointments.
10. There was a lot of support for our schools and colleges and recognition that teachers are under a lot of pressure at the moment. There was however feedback that is currently a postcode lottery with regards to SENCO. Some schools are better than others at supporting mental health and it was felt one of our priorities should be to achieve a standard across the board

What’s next

The valuable feedback from this work will help to shape our local mental health transformation work under the following areas:

• Community;
• Children and young people;
• Substance Misuse;
• Specialist services.

Our transformation of mental health services is an ongoing piece of work. There is currently some more in-depth work being done with local partners around our neuro-developmental pathways for example. We will continue to share opportunities to help shape mental health services.

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Accessing GP and wider urgent care services

WHAT HAPPENED?

Due to the pandemic, the way services have been delivered to patients has significantly changed. Whilst the CCG has been able to have some engagement with active local groups, there are groups and people who are harder to reach or historically have had limited engagement with the CCG. Whilst some of these groups the CCG may have had the opportunity to engage with on specific topics, the current restrictions on physical engagement have led to gaps in understanding the extent to which changes to services have been received by patients.

NHS Wigan Borough CCG has commissioned BMG research to speak with members of the public living in Wigan and Leigh, to understand their views and attitudes towards health and social care services provided in their area.

The focus of the research is to provide insight on any barriers and impacts across the borough and to establish how people expect to access services moving forward in particular, GP Practices.

WHAT DIFFERENCE DID PEOPLE MAKE?

BMG received 2,230 responses to an online survey which was sent out to residents living in Wigan, Ashton and Leigh.

BMG carried out 14 in-depth interviews via telephone or video call with residents living in Wigan, Ashton, and Leigh, and medical members of staff.

This research with local people has helped us to:

1. Determine how residents of Wigan, Ashton and Leigh feel about access to NHS services;
2. Compare and contrast that to thoughts and feelings of staff from stretched NHS services;
3. Allow us to test communications and messaging around the new normal and access to NHS services;
4. Identify preferred channels and messaging with different resident groups.

WHAT’S NEXT?

We are working with a small group of patient volunteers to develop a report to reflect the broad characteristics that will aid us to:

1. Create a campaign and resources with the aim of targeting specific messages and closing the gaps in knowledge and informing for changes.
2. Carry out continuous primary care engagement and in particular reaching the maximum people who do not normally share experiences and views with the CCG. Allowing for the exploration of preconceptions.
3. Think about future changes and the how they are communicated and provide considerations for those designing changes to services.

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Dr Esa & The Avenue Surgery Merger

What happened?

In April and March 2020, we engaged with patients on proposals to merge Dr Esa’s practice and the Avenue Surgery in Leigh Health Centre. Dr Esa was the contract holder for both practices. He became the sole contract holder of The Avenue Surgery when Dr Khaing retired at the end of 2019.

In terms of day to day running, the practices were already working as one big team but being separate practices meant they had to have separate clinical systems and do certain tasks twice. They wanted to merge the practices into one bigger practice.

The purpose of the engagement work was to get feedback from patients on the proposal to merge the practices and understand if they had any questions or concerns.

What difference did people make?

Many of the patients who gave feedback could see the benefits of merging the practices. Where people had concerns, they mainly related to wanting to be able to see the doctor of their choice or concern over whether the practice would become much busier. You can read a full summary of the feedback in the report below:

Dr Esa The Avenue Surgery – April 2020 engagement report FINAL

The practice decided to go ahead with an application to merge the practices and this was approved by the CCGs Primary Care Committee.

Within the feedback report the practice was able to give assurances about many of the concerns expressed by patients.

Patients would continue to be able to see the GP they are currently registered with. So Dr Esa’s patients would keep Dr Esa as their registered GP and The Avenue Surgery patients would keep Dr Patel as their registered GP.

The practice gave assurance that merging the practices would not mean that they suddenly become busier and they had no plans to change the staff. Due to the way that the practices were already working, most of the change would be behind the scenes and they would save time and resource not having to duplicate certain tasks.

What’s next?

The practice merger has now taken place. The engagement report with feedback from patients formed part of the evidence that was reviewed by the CCGs Primary Care Committee when making a decision.

If you have registered at this practice and have any feedback about it please get in touch and let us know.

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Travelling for health and care services

What happened?

In February 2020 we launched an engagement project to talk to local people about travelling for health and care services. The issue of travel and transport is something we recognised comes up when we are talking to people about how we can improve services and so we wanted to explore it in more detail.

Through this engagement project we aimed to find out:

• The usual method of transport that people use;
• The different areas/places people travel to and from;
• The general experiences people have had travelling for health and care services;
• If people have experienced difficulties when travelling for healthcare and if they require support with getting to appointments;
• What is most important to people when travelling for health and care services;
• If there are any individuals or groups who experience barriers when travelling.

Some of our activities were cut short in March 2020 to the COVID-19 pandemic. However, using a mixture of online, face-to-face engagement and a survey we had over 558 contacts.

What difference did people make?

You can read a full copy of the engagement report below:

Travel Engagement Report – Final 

The information we’ve gathered during this project about some of the common barriers and issues people face when needing to travel will be considered by the CCG in any service change or development that involves the location of services.

We have already been able to use this information this year when undertaking Equality Impact Assessments (EIAs) on a couple of projects around changes to urgent and emergency care and diagnostic services.

What’s next?

The information will be made available to teams across the CCG to refer to and we will update this page with any additional feedback.

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Flu Vaccination Programme

What happened?

In June 2020, we launched a survey asking residents how they were feeling about getting a flu jab this year and what we could do to encourage them to get it. The survey was published online, posted on our social media, and sent out to our engagement membership.

What difference did people make?

1146 people completed the survey which was a fantastic response.

90% of people said they would get the flu jab this year. We asked people if Coronavirus would affect their decision this year and 552 people said it made them more likely to get a flu jab this year.

When we asked people what would encourage them to get the flu jab some of the feedback was around safety of the clinic, more flexible appointments and if they had more information about it.

You can read a full copy of the results here:

Flu Survey 2020 – Summary of results FINAL

The information we gathered from this survey helped us to plan our Flu Vaccination Programme with local GP practices. We were able to set up 4 mass vaccination clinics across the Borough and ensured that they had robust social distancing and COVID-19 safety measures in place. We also set up a dedicated flu page on our website that had key information about the vaccine and frequently asked questions (FAQs).

We worked with residents and staff on a public campaign to encourage people from across the priority groups to get their flu jab. Here is an example of one of the graphics:

At the end of November we were delighted to announce that over 75% of people aged 65 and over in the Borough have already had their flu vaccination this season.  This puts the Borough over the national target months earlier than normal.

For this age group, achieving good uptake of the vaccine has been particularly important this year so they remain as fit and well as possible and ready to fight COVID-19 should they have to.

So far (at the end of November 2020), across all the age groups, practices across the Borough have vaccinated approximately 70,000 patients, helping to keep all those patients’ flu-free this year.

What’s next?

The flu vaccination programme continues, and we would like to remind people in the following groups that there is still time to get a vaccination.

• People with a long-term health condition like diabetes, a heart problem, a chest complaint or breathing difficulties, a kidney disease, liver disease, a neurological condition, had a stroke or a TIA, have a lowered immunity due to disease or treatment
• People with a learning disability
• People on the NHS Shielded Patient List and anyone who lives with them
• Pregnant ladies
• Children aged, 2&3, all those in primary school and those in year 7 at high school
• Care home residents and staff
• Carers
• Health and social care staff

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Wigan Borough Engagement Group (2020)

What happened?

The Wigan Borough Engagement Group is a group of patients and residents who meet to discuss local services. Members use their experiences to look to see if services can be improved, simplified and standardised across the Borough. The group advises on patient and public involvement work and help us plan and review feedback from different projects.

Part way through 2020 when we went into lockdown our meetings became virtual. The focus of the group has been slightly different this year as we have been covering a lot around the COVID-19 pandemic.

What difference did people make?

The group has achieved a lot in 2020.

Early in 2020 our main project was to engage with local people about travelling for health and care services. The group helped us to design the survey and identified key groups to visit in the Borough, for example by linking us in to a local U3A group.

One of the key achievements of the group has been to help develop strong working relationships between partner organisations such as Healthwatch Wigan & Leigh and Wrightington, Wigan and Leigh NHS Foundation Trust who, by working together contribute to the engagement work.

From March 2020 the focus of our meetings changed slightly and the group played a really valuable role. Throughout the pandemic they have brough us feedback from residents and identified areas they think we, the local health and care economy, need to do more communications and engagement work. They’ve been able to give us regular feedback about how services are working and any issues people have been facing.

Here is a list of some of the things we’ve achieved:

• Early on in the pandemic the group gave feedback from local people around some of the confusion around shielding. Particularly those who are at increased risk versus those at the highest risk being asked to shield. As a result, we put out further public communications to clarify the difference and regular communications on the support available to those shielding.
• The group gave us feedback about dental services and some of the issues people have experienced accessing dental care during the pandemic. Dental services are commissioned by NHS England and the feedback was passed on. Locally, we were able to get more information out in the public domain to help people understand how they can access dental services.
• The group gave us feedback that some people believed that some services were closed and we not seeking help which led to us working with them to develop a “here for you” campaign. Through the year there have been various iterations of this campaign covering key services like GP practices and cancer services.
• They worked with us to develop more information about how GP practices are working differently during the pandemic. We were able to do more communications to explain how GP practices are working and we produced a poster to explain the COVID-19 safety measures in place.
• On the back of feedback about people in the community feeling isolated, particularly those who aren’t online, we produced a mental health booklet that was included within the Borough Life Magazine that get’s posted out to all households in the borough.
• With many of our GP practices in the borough starting to use Ask My GP, we worked with the group on a mini campaign to raise awareness of Ask My GP and how to use it. They have also brought us regular feedback from their own experiences and the experiences of people they know around remote consultations.
• A couple of members have been involved as Lay Representatives on procurement exercises within the CCG.
• The group helped us develop this year’s Flu campaign with some members starring in it. Members also helped to get the campaign out into their local communities, for example members from Standish putting posters out in key community locations.
• Members contributed to the production of our Annual Patient and Public Involvement Report for 2019-2020.
• The group have feedback around the NHS 111 First programme and new model of triage in A&E with information fed into the Equality Impact Assessment.
• The group gave us feedback on experiences of the first COVID-19 vaccination clinics, leading to further public communications and assurance abut how the future clinics would work.

What’s next?

The group will continue to meet in 2021. If you think you might be interested in joining us you can click here  for more information and links to apply.

One of the priorities for later in 2021 will be to support our network of local patient participation groups (PPGs) with plans for regular webinars and information.

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Digital health services

What happened?

In 2019 we talked to patients and residents about digital health services. Our aim was to find out what kind of technology and access people have and what kinds of digital health services people would be willing to use.

What difference did people make?

 The COVID-19 pandemic has accelerated our digital health programme and we are pleased to share this “you said, we listened” with you now.

Download a copy of the “your said, we listened” here:

Digital Health Services Engagement – You Said We Listened Dec 2020 

What’s next?

We’d be keen to hear from anyone with experiences of using digital health services, particularly to access GP practices. If you have feedback to share please get in touch with the CCGs Engagement Team on 01942 482711 or shapeyournhs@wiganboroughccg.nhs.uk.

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What happened?

Our Equality Reference Group is made up of CCG staff, patients, residents and voluntary sector colleagues who come together to work on equality and diversity matters. Everyone has a common interest in making sure that everyone has a voice in local services. They provide advice, feedback and scrutiny to the local NHS.

What difference did people make?

There were 8 meetings in 2020. There was a brief pause to our meetings at the start of the COVID-19 pandemic and then we moved our meetings online:

• 26^th February 2020
• 13^th July 2020
• 11^th September 2020
• 28^th September 2020
• 13^th October 2020
• 28^th October 2020
• 18^th November 2020
• 17^th December 2020

Throughout the year we have worked on different projects together and achieved the following:

• We’ve enabled people to network with each other and raised awareness of different groups in the Borough. This has enabled people to cascade important information out into different groups and services.
• The development of our Locality Plan, Happy Healthy People 2020 -2025, helping us to make sure it reflects the needs of the local population.
• Helped us to develop a new Equality Impact Assessment (EIA) template that would be used by staff within the NHS to assess how any service change or development would impact on people from different protected characteristics.
• Talked to us about their experiences of travelling for health and care services and providing insight into some of the common issues and barriers experiences by people with disability in particular.
• Worked with us on the equality impact assessment around diagnostic services, specifically MRI, Hearing Loss and Non-Obstetric Ultrasound that are being re-procured by Wigan Borough CCG. Helping us to understand how the procurement and potential change to service will impact on different protected characteristic groups. The group also suggested some mitigating actions that we are going to be able to pick up in the service specification, e.g. training.
• Worked with us on the equality impact assessment for the implementation of NHS 111 First services and the enhanced triage model at A&E. They helped us to understand how the service change would impact on people with different protected characteristics. The information gathered from the group is being used in developing the services and with the communication to patients.
• Met with developers One Group who are currently working on a proposed scheme to build a new health centre in Aspull. The group received a presentation from the architect about the new scheme and were able to suggest a number areas to help make sure the building is accessible and works for people with different characteristics. Permission to develop this scheme is being sought in early 2020. If it gets approved, the group will continue to be involved to make sure the building is accessible.
• Throughout the pandemic the group has given us feedback around how COVID-19 has impacted on people in the Borough. As services have moved to work remotely, particularly GP practices, any issues that have been reported to us have been shared with the primary care team and addressed with practices where necessary. The group continues to play a key role in giving us feedback from members of the community to help us make sure no one is unfairly disadvantaged during this time.
• Members helped us to develop and starred in our Flu Vaccination Campaign 2020.

Here is some feedback from one of our members Debra:

“There are many blessings to being a volunteer with the NHS. I have always believed if you want to make a positive change to the services, we all rely on, then you must put the effort in to let your voice be heard. The Equality Reference Group does that. We as a collective group come together to advise the NHS on how to included every character in the human race and to respect their choices, no matter what that maybe. As it stands, we follow the law – and sometimes pioneer the law – to include everyone with dignity and respect. If you want to make a positive difference to how your services are delivered, we would love you to join us. Everyone is welcome, with no judgement on how YOU see the world you live in. It doesn’t take up too much time either, just a couple of hours every few weeks. (via video link – all training will be given). The more the public have their say, the more influence you can have on how the NHS is run. And Personally – it gives me a purpose in life to make a positive difference to a human society.”

What’s next?

The Equality Reference Group will continue to meet in 2021. We will be looking to expand our membership so that we have more protected characteristics represented at the meeting.

You can find more information about the group and how to join on our get involved section.

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Evaluation of LOCAL COMMISSIONED GP SERVICE FOR HOMELESS RESIDENTS

In response to the COVID-19 pandemic, in March 2020 local authorities were given funding for an emergency scheme to provide shelter for homeless people. Wigan Council set up a hub at the Mercure Hotel in Wigan Town Centre and working together with the Brick, the NHS and other key agencies were able to give residents access to a broader health and wellbeing offer.
Part of the offer for residents was a GP in reach service that was commissioned by NHS Wigan Borough Clinical Commissioning Group (CCG). When residents moved into the Mercure Hotel they were supported to register with one of two nearby GP practices if they wanted to and were provided with weekly “in reach” sessions and an enhanced nurse check.

wHAT HAPPENED?

In July 2020 we visited the Mercure Hotel to speak to some of the residents and hear their stories. The purpose of the work was to understand their experiences and what they thought about the GP service. In line with the COVID-19 restrictions in place in July 2020 and taking the necessary public health measures, we were able to go in and speak to people in person.
We’ve attached a summary of the feedback below.

July 2020 stories from Mercure residents and staff

Some key themes emerged from our conversations.
• Medication seemed to be one of the most common issues for people
• Many of the people we spoke to reported mental health issues
• As part of the GP “in reach” calls were taking place in the booths within the restaurant areas of the ground floor. It wasn’t particularly private and put people off accessing this
• Some of the residents were finding it difficult to do conversations with the GP or nurse over the phone and felt that face to face or video would be better

wHAT DIFFERENCE DID PEOPLE MAKE?

Based on this initial feedback immediate steps were taken to secure a private space for residents to be able to have conversations with the GP. We also made sure that residents had access to the technology needed to enable them to have a video call / face time rather than just speaking on the phone.
The majority of the residents who were part of this GP in reach scheme have subsequently moved on to other accommodation and the CCG is working with Wigan Council to do some follow up work with them.

wHAT’S NEXT?

We’ve still got work to do to develop the service from April 2021. We want to do some more work with local homeless people and services that support them to understand what the GP service should look like moving forward. If this is an area of interest for you please get in touch with the CCGs Engagement Team on 01942 482711 or shapeyournhs@wiganboroughccg.nhs.uk.

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What happened?

The Wigan Borough Maternity Voices Partnership (MVP) is a group of parents and staff who meet every few months to review, improve and shape maternity services based on local peoples feedback and experiences. The group was formed back in 2018 and continues to go from strength to strength.  This year the group have been able to keep in touch and continue their work via online meetings.

What difference did people make?

We provide regular feedback to the group about how their feedback, experiences and ideas have influenced change in maternity services. The poster below summarises the groups achievements in 2020 and some of the things they will be focusing on in 2021.

 What’s next?

The MVP group will continue to meet through 2021 and beyond. If you’re interested in getting involved please contact us on 01942 482711 or shapeyournhs@wiganboroughccg.nhs.uk.

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If you would like help understanding this information, or need it in a different format (large print, easy read or braille, for example), please contact us on 01942 482711 or shapeyournhs@wiganboroughccg.nhs.uk