Agenda item - Healthwatch - Adult Social Care and Health issues in Brighton & Hove

To hear from David Liley, Chief Executive Officer, Healthwatch Brighton & Hove.

314.1  David Liley (Healthwatch (HW) Brighton & Hove CEO), whose background is in public sector healthcare, introduced the presentation outlining that the vision is that ‘Healthwatch will be the independent consumer champion for the public – locally and nationally – to promote better outcomes in health for all and in social care for adults.’

314.2  There are many other voluntary and community organisations that carry out some of the functions that HW do in other parts of the country. There is a need to work in partnership with these organisations and an opportunity to focus on the areas where it is felt HW can make that greatest difference.

314.3  The following roles of the Local HW were outlined:

·         Information and Signposting – Supporting Individuals:

-       This is a responsibility of the whole healthcare system as HW are not able to operate a 24/7 helpline like other HWs do. An information line exists which has a low number of calls, likely due to other organisations such as CAB being more well known.

-       The HW website attracts a large amount of attention and signposting is done through this and via email.

-       Hoping to improve social media visibility in the near future.

-       ICAS (Independent Complaints Advocacy Service) supports individuals through health complaints procedure. This is provided by Impetus who has experience in advocacy.

·         Engagement and outreach – Engaging with Communities:

-       Engagement occurs frequently, going out to different organisations and groups in the community, listening to issues they have in regard to health and social care.

-       PIPs and support grant was an issue that came up a lot recently which has been picked up by HW. Case studies are being gathered and HW is taking the issue up with the organisations providing the service and will take this up with the Health & Wellbeing Board.

·         Intelligence and Evidence – Influencing Service Providers and Commissioners:

-       There is a cross over with engagement activities as feedback on emerging issues is gained from these which can be brought to the attention of the service providers.

-       Meet with people and directly gather their experience of health and adult social care to get a report to decision makers.

314.4  The priorities of HW are:

·         Gather and share evidence.

·         Improve services.

·         Ensure decision makers keep promises.

314.5  It is believed that HW does make a difference based on some of its previous accomplishments which include:

·         RSCH A&E department – HW provided evidence to put BSUH Trust into special measures and was part of the process which gained a £30m injection for a new A&E floor.

·         Gathered and reported evidence on the patient transport services where there was a fail by the service provider and commissioner. Coperforma have since been replaced and HW is continuing to interview patients on how the new service provider is performing.

·         Made recommendations for improvement of GP surgeries of which some are now being implemented.

·         Made recommendations for improvement of RSCH outpatient department. Some have been adopted as part of the safety and quality improvement programme at the hospital.

·         The physical environment in the Claude Nichols sexual health clinic was unacceptable – with no privacy for patients and general poor condition of the fabric of the building. This was brought to the attention of senior hospital staff immediately and improvements began the next day.

314.6  In regard to the legal side of HW, it created part of the Health and Social Care Act 2012 and, although not a governmental body, does have statutory powers.

314.7  The main duties of HW are to:

·         Provide people with and signpost them to information.

·         Represent local people.

·         Alert HW England to issues of local concern with national implications.

·         Have a seat on the Health and Wellbeing Board, a local authority committee.

·         Have a role in NHS equality delivery system to ensure it fulfils its quality duties.

·         Produce annual report on activities.

314.8  The role of HW England was briefly explained, outlining that they are there to support the local HW, no to report to, they lead national campaigns and organise the annual conference. There are 153 local HW organisations and HW Brighton & Hove is part of the South East region.

314.9  HW has the following values:

·         Independent (but not neutral).

·         Evidence based.

·         Consumer focussed.

·         Critical friend.

314.10 In response to questions from the public and members the following was clarified:

·         Other organisations watered down the Community Health Council’s work which may have been a reason they were disbanded, although not completely sure.

·         Defend the NHS is a community pressure group so will always be slightly ahead of HW however there are clear difference between the 2. HW does a lot of work behind the scenes including attending the STP working group which provides a good insight into what is happening. HW has an independent, not neutral, role so they can campaign when they see that something is failing local people but only on specific issues related to health and social care. There is room for HW and Defend the NHS as well as other organisations.

·         It was agreed that not enough is being done about mental health. HW has a couple of volunteers that work tirelessly on mental health issues and HW have also advertised for a new mental health role and are encouraging more volunteers to come forward to put together an action group.

·         It was noted that the quality of typography in the HW magazine was poor and was agreed that this could be resolved.

·         The issue with providing a monthly publication is the lack of resources to do so, with little evidence that the right people are being reached. This will be reviewed and the thought is that the style be changed to a newsletter and then a monthly release can be considered.

·         It was noted that more could be done on reviewing service specifications as this is an important issue. This needs to be improved and people with the right skills recruited.

·         More time will be spent working on adult social care now the major hospital issues are being improved. Preparation that has been done for the next steps include meetings with CQC and adult social care team. CQC advised HW their time would be well spent focussing on the elderly population in their own homes with complex care packages as the CQC were concerned they weren’t reaching this constituency of people. David is meeting with Rob Persey later in the week to discuss the best way for HW to reach this constituency. Another project HW plans for the next year is to work with the Food Partnership on how to support elderly people leaving hospital in terms of nutrition and hydration.

·         David Liley attends the Sustainability Transformation Partnership (STP) board where his role is to provide any evidence if required, to encourage the STP to wider conversation and to more democratic accountability and to provide assurance that STP follows proper processes and adheres to best practice.

·         In regard to breast feeding service cuts, HW plans to hold a learning event around children, young people and maternity as there have been issues surrounding this over the last 6 months. This is for HW and other external organisation HW feel relevant. On this occasion there is a mother that has shown interest who will be invited to attend.