rutland link newsletter - spring 2013

Rutland LINk Newsletter - Spring 20132

Rutland LINkNewsletter

Spring 2013

Healthwatch Rutland NHS 111 Children’s Services

Focus for Action GroupLINk Events

Inside this issue...

“the local body that involves the public in Health and Social Care”


Another very busy six months. As you may know, Rutland LINk will be replaced by a new consumer champion for health and social care services on 1 April 2013. As I write this message, I am worried by the lack of progress in establishing Healthwatch Rutland (HWR). The LINk Steering Group is committed to the work LINk has undertaken to bring the voice of the Rutland community to the heart of some of the key decision making boards. We are committed to establishing that work under HWR. Everyone has agreed to continue for six months if required from 1 April to ensure an effective handover. At present there is a high risk that HWR will not be established before 31 March. That means the active volunteers in LINk will not have an umbrella organisation and so the work they are involved in will come to a halt and will be very difficult to re-establish. Experienced active volunteers will lose motivation and simply disappear. It is imperative that a way is found to establish HWR as quickly as possible while ensuring it meets the expectation of the Rutland community.

As this is the final Newsletter of Rutland LINk, I would like to thank Communities in Partnership, our Host team, led by Mark Grant (CEO) and Jen Lovegrove (Engagement Manager) for their work in providing support to LINk. I am sure you would all wish to join me in thanking the members of the Host team who were familiar to us in Rutland - Gill Wollerton, Gemma Hammond, Julie Hodder who was replaced by Jenny Darlow and Cathy Henley, who although in the background kept our finances in order and made sure our expenses and bills were paid.

Sincere thanks must also be extended to the commissioners and providers of health and social care services and to the voluntary sector in Rutland. It has been a privilege to work with you. I hope the working relationships that we have established will continue with HWR. I would like to express my sincere gratitude to all present and past members of Rutland LINk who have devoted their time during the past four years in helping to monitor and improve health and social care services in Rutland. Finally, my thanks to the Steering Group who have worked so hard to ensure Rutland has a voice when decisions are made and who have made a difference by getting better services for our community.


Message from the Chair...

Kathy ReynoldsRutland LINk Chair31 January 2013

Healthwatch was created by the Health and Social Care Act 2012 (the Act) which paved the way for a national body, Healthwatch England (HWE), and a local organisation for each local council in England with social care responsibilities; Local Healthwatch (LHW). This is described more fully in the Summer 2012 Newsletter.

The role and purpose of LHW is to ensure involvement at all stages of the commissioning cycle, from initial vision through strategic planning, procurement, service delivery and evaluation.

An effective LHW must be independent, constructively and authoritatively bringing the voice of local people on what matters most to them into the heart of the decision making process.

Local authorities including Rutland County Council (RCC) are responsible for commissioning LHW. Specifically they have a statutory duty to make contractual arrangements for a LHW organisation which will ensure the involvement of local people in the commissioning, provision and scrutiny of health and social services.

Healthwatch Rutland...

So what is the current situation in Rutland? A brief answer would be that we lag some way behind our nearest neighbours, some have already announced their LHW providers. However, Rutland is catching up and much work has been undertaken in the last two months or so with Rutland LINk taking a leading role. In November, the LINk organised two public meetings to provide an opportunity for local people to express their expectations of

Healthwatch Rutland (HWR). The key messages, which shone through in both meetings have been passed to RCC as it considers how to set up and support HWR. RCC has employed a consultant to help them formulate their policy on HWR, he has spent time talking to the various stakeholders and produced a report. We understand that RCC is now holding discussions with various groups as they develop their plans. More information on RCC’s approach to HWR should be available in the coming weeks. The key findings, those on which broad agreement was reached among participants in two public meetings, are as follows:

3Your Voice in Health & Social Care...

• Be locally based, run by people with localknowledge

• Be transparent, independent and publiclyaccountable for its effectivenessaccountable for its effectivenessaccountable for its ef

• Be properly funded and resourced• Have no conflict of interest with its funding

agency• Be a physical, visible and accessible one stop

shop for the community • Have a skilled, knowledgeable and responsive

workforce using language accessible to all users including young people

• Be well-informed, well-structured and effective• Give equal focus to both health and social care• Enjoy a high public profile across all sectors of

the community • Be an active, influential and valued partner of

service delivery agencies and other relevant stakeholders

• Ensure cross-boundary work and liaison withneighbouring healthwatch organisations to enable effective monitoring of services enable effective monitoring of services enable ef

• Not be a commercial entity, but ‘keep the best ofLINk’, with some paid professional staff

The expectation for HWR can easily be summarised:“People will expect the new HWR to be a locally based independent and influential organisation with a high profile in the local community. It will have a crucial role in monitoring changes in health and social care which come into force in April”.HWR, as specified by the government, will not be viable unless it is properly funded. Rutland LINk looks forward to handing over to a fit for purpose HWR that meets the expectations of the Rutland community it serves.

Healthwatch Rutland Needs To:

www.rutlandlink.co.uk


New Group to Run Our Local Health Service...In the summer 2012 Newsletter we gave an overview of Clinical Commissioning Groups (CCGs). The Health and Social Care Act 2012 set out a number of changes to healthcare provision that will see local GPs, working as CCGs, take more control of budgets and make decisions about what services their local communities require. East Leicestershire & Rutland CCG (ELR CCG) our local CCG had started working as a shadow group and was taking on more responsibility from the Primary Care Trust (PCT).

So what progress has been made in the last six months?

ByApril2013,PrimaryCareTrusts(PCTs)willbeabolished and CCGs will have full responsibility for commissioning most local healthcare services. In December 2012, ELR CCG was among the first in the country to receive official authorisation to act as a statutory NHS body from April 2013 and so will take over responsibility from the PCT for commissioning healthcare services for residents inBlaby,Lutterworth,MarketHarborough,Rutland, Melton Mowbray, Oadby and Wigston and surrounding areas. The CCG will also have responsibility for managing an NHS budget and monitoring contract performance of the services it commissions. To support this responsibility, ELR CCG has produced an Integrated Plan which describes the context within which the CCG operates, and details their commissioning strategy, setting strategic and operational priorities for 2012/13 and beyond.

The main areas of focus include:

• Long-term conditions - enhance quality of life for people with long-term conditions, such as Chronic Obstructive Pulmonary Disease (COPD) and diabetes.

• Community services - finding ways to improve the number and quality of services on offer, increasing patient choice and providing care delivered closer to home.

• Improving services from GPs - undertaking work on opening hours, telephones and appointment booking processes to provide more effective services to patients, also focusing primary care activities more on prevention rather than cure alone.

• Integrated health and social care - extending integrated working across health, social care and voluntary organisations to enable seamless care pathways.

The Integrated Plan will be updated annually toreflecttheyearlyNHSPlanningFramework,emerging local health trends and the needs of local people. This year’s refresh of the plan is currently underway and ELR CCG will be seeking views on their plans. We’ll share details when we have them.

Rutland LINk congratulates ELR CCG on obtaining authorisation and looks forward to working with them to achieve their goal of improving health services for our community.

NHS 111 is a new FREE telephone service Coming Soon across Leicester, Leicestershire & Rutland to make it easier for the public to access local health services when they need help quickly. In future if people need to contact the NHS for urgent care there will only be three numbers:

999 for life-threatening emergencies; their GP surgery; or 111 when it’s less urgent than 999. The NHS 111 service is driven by the need to provide an improved and more efficient journey for patients through the healthcare system that

focuses on patient satisfaction, quality care, and will be coming to Leicester, Leicestershire and Rutland by Summer 2013.

This is later than other areas that are going live in April 2013 to ensure that our CCGs can deliver a first class service for their patients.

NHSCALL111


In the newsletter of September 2011, Kathy Reynolds outlined the scope and responsibilities of the Rutland Shadow Health and Wellbeing Board which had been set up in response to theHealth and Social Care Act 2012.

The board is still meeting and planning and has recently been assigned a consultant to help further development. Three development sessions have been planned which should lead to the establishment of the full board, as a sub-committee of the Council, by May 2013.

In the meantime, the board has not been idle but has either initiated or approved development in the following areas:

• Changes in the ambulance service

• Challenging the small budget allocation for rural communities

• Outlining a strategy for carers

• Outlining a strategy for Staying Healthy in Rutland

• Planning for Healthwatch to be the guardian of patients’ carers’ and public interests

• Establishing a way of working with CCGs

• Considering emergency planning

• Responding to the Director of Public Health’s Report on the future needs of people in this area

• Consideration of relocation of some hospital services into the community

This year the Director of Public Health’s Annual Report focuses on older people. An interesting observation he makes is that although generally, older people are significant users of health and social care services, their overall contribution in manning the voluntary sector and using spending power, far outweighs their use of resources.

We have one member, Joyce Marston on the board of The Children’s Trust. The board meets quarterly and involves all

the agencies within the county who have any dealing

with children or young people, (from birth to 25 in certain circumstances) from health, education and housing to police. The board has recently been concerned with the arrival of Army families into the area. Housing isn’t a major concern in the short term but the knock-on effect could be significant. Schooling was a real planner’s nightmare with the local school going from less than 60 pupils to almost 300 virtually overnight. There was little worry over medical cover for the There was little worry over medical cover for the extra families as one of the Army units is medical. extra families as one of the Army units is medical. extra families as one of the Army units is medical. There are a few “troubled” families in Rutland but There are a few “troubled” families in Rutland but There are a few “troubled” families in Rutland but the numbers are low however it was noted that the numbers are low however it was noted that the numbers are low however it was noted that they do need a lot of support, which is available.

Children’s Trust Better Care Together...Better Care Together Programme Board (BCT)

We are maintaining strong links with the BCT andthe LINk is also very active on a wide range of boards and committees that feed into the BCTprogramme. Why is BCT important? Looking tothe future, patients’ increasing healthcare needs will place significant pressure on NHS funding across Leicester, Leicestershire & Rutland (LLR).The LLR health and social care teams want to provide integrated, high quality services, delivered in local community settings where possible, whilst improving the emergency and acute care provided to the people of the area. This programme is central to the future decisions of those who purchase and provide our services. It may require service changes and is the single most significant priority for the local NHS over the next three years. The LINk is working to make sure that years. The LINk is working to make sure that quality of service is maintained, that access to quality of service is maintained, that access to services is improved and that our community is services is improved and that our community is properly consulted about any planned changes to services.

Shadow Health & Wellbeing Board



At the request of national parent groups and NHS clinicians, the NHS began reviewing how it delivers congenital cardiac services to children in England and Wales in 2009. The aim was to attain better outcomes for children with congenital cardiac disease. On 4 July 2012, a Joint Committee of Primary Care Trusts (JCPCT) met in public to decide the future configuration of children’s congenital cardiac services. Having considered 12 different options they decided that the best quality care would be provided if congenital cardiac networks were structured around Specialist Surgical Centres. ThesecentreswouldbeinBristol,Birmingham,Liverpool, Newcastle and Southampton along with Great Ormond Street Hospital for Children and Evelina Children’s Hospital in London.

Disappointingly, this means surgical services at the internationally respected East Midlands Congenital Heart Centre based at Glenfield HospitalwilltransfertoBirmingham,oneof7surgical centres designated to lead the networks by 2014. In the immediate future, specialist surgeons will continue to perform surgical operations at Glenfield Hospital.

As a member of the Joint LINks Paediatric Congenital Cardiac Care Group (PCCCG) Rutland LINk has worked closely with Leicester City LINk and Leicestershire LINk who chaired the group to allow the local community to voice their concerns. We quickly realised the decision by the review board to remove Paediatric Congenital Cardiac Surgery from Glenfield Hospital would also have serious impact on other related services; namely the Extra-Corporeal Membrane Oxygenation (ECMO) unit and Adult Congenital

Cardiac Surgery which is now also under review. Therefore the LINks welcomed the

decision of the Leicestershire, Leicester and Rutland Joint Health Overview and Scrutiny Committee to ask Jeremy Hunt, Secretary of State for Health to refer the decision to the Independent Reconfiguration Panel (IRP). A full review of plans was subsequently ordered by Jeremy Hunt. The IRP

has been asked to look in detail at how the decisions were reached and

to report its findings by 28 February.

The PCCCG has also worked with other LINks in the East Midlands affected by the decision. As a consequence, Eric Charlesworth, Chair of the PCCCG was invited to present the public and patient views on behalf of the nine East Midlands LINk’s at the IRP hearing held 26-28 November. Eric reports that the panel was highly professional, well informed, showed great understanding, and actively encouraged the sharing of concerns, facts, and the presentation of robust supportable evidence. The LINks will continue to work in the interest of the local community until a final decision is reached.

ECMO is a system that puts oxygen into the blood outside of the body, giving the patient’s lungs and heart a chance to rest and recover from illness or surgery.

Children’s Congenital Cardiac Services



NHS Leicester City, Leicestershire County and Rutland continue to run a regional campaign aimed at encouraging people to choose better when it comes to their health care options.

People in Leicestershire and Leicester are among the highest users of A&E services in the country. Butmanyshouldhavegoneelsewherefortheircare. Some GP practices are now phoning or writing to patients attending A&E during normal GP surgery hours and who could have been treated in a more appropriate place. The aim is to help them understand the full range of alternatives available.

Patients who use A&E inappropriately put extra pressure on emergency department staff who should be dealing with serious, life-threatening

cases. They also cost the NHS money which could be better spent elsewhere. For every A&E attendance with subsequent discharge, the costs rangefrom£59to£117dependingonthelevelof care given to patients. In contrast, the average cost for visiting a GP is £23 per appointment.

Rachana Vyas, Leicester, Leicestershire and Rutland Programme Manager for Urgent Care, said:‘WeaskthepublictothinkbeforetheygotoA&E or call 999. These services need to be free to deal with real emergencies and should only be used in genuine emergency situation. Telephone services such as NHS Direct are designed to offer answers, reassurance, advice and the support you need as well as being convenient and open around the clock’.

Encouraging People to Choose Better...


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The LINk attend a wide range of multi-agency Boards or Planning Groups toensure the views of patients, carers and the public are represented. Through our LINk Representatives we are able to directly influence and improve local Health andSocial Care Services. These are some of the groups where the LINk is represented:

Representatives regularly attend the Boardor Planning Group meetings and report decisions back to the LINk. Feedback reports are available at www.rutlandlink.co.uk/reports.html

During the passage of the Health and Social Care Bill through the House of Lords in 2011 anamendment was debated to introduce a “duty of candour” – a statutory obligation to be open with patients when things go wrong and cause harm. The charity Action Against Medical Accidents, has led a campaign for such a requirement. It is called Robbie’s Law in honour of the family of Robbie Powell, who have campaigned since his death 21 years ago, and an alleged attempt to cover-up by GPs.

The public inquiry into the failings at Mid Staffordshire Foundation Trust provides evidence of cover-ups to match the appalling standards of care given to patients. Despite the NHS Constitution and various guidance, the existing system, while not condoning cover-ups, effectively tolerates them. In the CQC’s registration regulations, which are statutory, there is a requirement to (anonymously) report to the CQC incidents that cause harm but there is no corresponding duty to tell the patient. The former chief medical officer, Sir Liam Donaldson, told the Mid Staffordshire Inquiry that a duty of candour should be statutory. The Government has made clear that hospitals need to be open about mistakes and always tell patients if something

has gone wrong. The current drafting of the NHS Constitution contains a pledge to acknowledge mistakes, apologise, explain what went wrong and put things right quickly and effectively.

Unfortunately that proposal for a strong statutory duty of candour did not make it to the final version of the Health & Social Care Bill. The governmenthas consulted on a version of the duty which limits it to a “contractual” obligation. This proposal, for a contractual obligation, implemented through the NHS standard contract, covers NHS hospital, ambulance, community and mental health care providers. There is no reference to it covering GPs at this stage although the consultation included a question on extending the duty to GPs and the response was overwhelmingly positive.

At last there appears to be consensus that something needs to be done to end the culture of cover-up and denial that still afflicts parts ofthe NHS. As the Government are committed to giving full consideration to the findings of the Mid-Staffordshire Inquiry there may be a need for further change if the Inquiry comments on the Government’s proposals for just a contractual duty of candour. The introduction of a duty of candour could make a significant advance in patient safety and patients’ rights.

Duty of Candour in the NHS

LINk Representatives...

Planning/ Commissioning GroupsRutland County Council Shadow Health & Wellbeing Board (HWB)Rutland Staying Healthy (Subgroup of HWB)Rutland Children’s Trust (Subgroup of HWB)East Leicestershire & Rutland CCGEL&R CCG Minor Injuries Unit (MIU) Project BoardL&R Joint Strategic Needs Assessment BoardLLR Dementia Joint Commissioning Board LLR Frail Older People’s NetworkLLR Emergency Care NetworkLLR NHS Reconfiguration BoardLLR Diabetes Transformation Operational GroupEL&R CCG Elective Care Bundle Steering GroupLeicestershire Partnership NHS TrustUniversity Hospitals of Leicester NHS TrustLPT Students in Higher EducationPeterborough City Hospital Community Engagement Leicestershire and Lincolnshire Quality Surveillance GroupPLACE Inspections


Carers...This area involved carers especially and we held two Carers events in 2012 which involved “pampering” and giving out information, on what is available to help people and also their rights as carers.

General Practitioners...We have carried out a survey on GPs and their surgeries. BothOakhamandUppinghampracticeshaveadoptedanew system of booking in order to help patients get to see a doctor or at least speak to one.

Ambulance Services...We held a Rutland Ambulance and Non-Emergency Patient Transport Services Event in May, which was well attended. Representatives from both the East Midlands Ambulance Service (EMAS) and Ambuline Limited (now known as Arriva Transport Solutions) gave presentations and answered questions from the LINk members present. Topics discussed ranged from the cleanliness of EMAS ambulances to the new Non- Emergency Patient Transport services being provided by Arriva. There was also a new ambulance available to for us to examine. Rutland LINk has representatives on the Joint LINks Ambulance Task Group which monitors the services of EMAS and Arriva Transport Solutions.


Focus for Action!When we began Focus for Action ten months ago we identified five main areas of concern to focus our attention on. They were: Ambulance Services, Social Care Improvement, General Practitioners, Local Hospitals and Carers.

We have worked hard over the last ten months to educate members about these issues and to work with the service providers involved to find solutions.

Social Care Improvement...This was sub-divided into three areas:

Hospital discharge; we now have the hospital discharge procedure from Rutland Memorial and Leicester Hospitals as well as from Peterborough and Stamford Hospitals. We also have the documents on official complaints. We have been given assurances from Rutland Memorial Hospital that there will not be any patients discharged in the evening.

The co-ordination of therapists; we have been given some assurances that there is “joined up” therapy within hospital but we are aware that there can be a short fall when the patient comes home.

More care and attention to the patient and whether or not they have the capacity to make their own decisions; this is a priority with all our hospitalsand it is their aim to treat each patientsensitively and they each have a carepackage when they are admitted.

We have been reassured that Rutland Memorial Hospital is viable and has a vital role to play in the care of local people. The minor injuries unit has limited hours but there is a 24 hour unit available in Corby. Stamford Hospital is undergoing “development” and we have had members attend meeting about the proposals.

Local Hospitals... In addition to these main areas of focus, we have also have members taking active roles in new areas such as environment inspection training with Leicestershire Partnership Trust (LPT), PLACE and the Reablement Service being established by Rutland County Council and LPT.

We have had a very busy first ten months and our work is continuing in earnest with Mental Health and End of Life Events being planned for the beginning of 2013.


10

Task Groups...Are you interested in shaping future Dementia services across Rutland, LeicestershireandLeicesterCity?Whynot consider joining the Joint LINk Dementia Task Group.

At present work is being carried out across four workstreams, with a view to implement support services and ensure that the identified areas of needs are appropriately being addressed, and take

into consideration the needs of people with Dementia and their carers.

As a member of the group you will have the opportunity to work collectively alongside

individuals, carers, service providers and decision-makers who all share the same passion in ensuring

that future Dementia services are appropriate. More importantly, not only will you be representing Rutland but will

be key in identifying local issues and needs, and be a strong voice in how local services ought to be shaped and delivered.

For more information, contact Yasmin Shaikh, Engagement Officer on 0116 229 3050 or email [email protected]

Dementia

The Task Group was set up in February 2011 to review a number of areas of concern relating to the East Midlands Ambulance Service (EMAS) that had been raised by members of Leicester, Leicestershire and Rutland (LLR) LINks.

The first meetings reviewed the structure of the group, agreed the Terms of Reference and established the main areas of concern. These were encapsulated into six work streams and a member of the Task Group was identified to lead each area.

The Task Group engaged widely with the stakeholders through a number of meetings held through 2012/13 on all the work streams:

Having completed work on the original work streams the Task Group agreed that it would not hold regular meetings but re-convene when issues arose.

EMASlaunched,forconsultation,its’‘BeingtheBest’strategyinNovember2012.Thedocument represents the Trusts proposal for

reviewing their estate and how the service will be delivered. The Task Group re-convened to receive a presentation on the proposals and to raise concerns with the Divisional Managers. This was one of many meetings across the area attended by representatives of EMAS. The concerns of members of the three LINks have been included in a formal response to EMAS.

Ambulance Services

1. Re-bedding of patients within UHL2. Turnaround times of ambulances at UHL3. Cleanliness of vehicles

4. Mobilisation times5. Patient Transport Service (PTS)6. Patient safety and incident reporting


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Past LINk EventsIn November 2012, Rutland LINk held two Healthwatch Rutland events. At the events, the participants made it clear they expect the new Healthwatch Rutland to be a locally based independentandinfluentialorganisationwithahigh profile in the local community.

It will have a crucial role in monitoring changes in health and social care which come into force in April 2013. Many of the 58 people who attended the public meetings expressed strong views that Healthwatch Rutland should provide a visible and accessible one stop shop for the community.

Rutland LINk is part of Rutland County Council’s Healthwatch ProjectBoard(HWPB).TheHWPBhasreceivedthe report and they will use it to inform decisions about setting up Healthwatch Rutland. A full report is available on our website.

There are lots of carers about who do not see themselves as carers. A husband or wife looking after the other one, a parent looking after a sick or disabled child, a child looking after a sick parent - all these are Carers. A person living on their own – is a Carer albeit of themselves! So, the next time we have an event for carers please take “Time Out” for yourself - come and join us. Bringthepersonyoucareforifyoucan,andifyou can’t, we may be able to help you fund a temporary Carer.

The Rutland LINk Carers’ Rights and Relaxation Event was held on Friday 30th November at The Falcon Hotel in Uppingham to mark Carers Rights Day. Starting at 10am, people were offered information from local organisations, refreshments and “Pampering Sessions”.

Theeventhadbeenadvertisedbymeansofflyersand posters in Drs Surgeries, Chemists, Age UK, Uppingham Churches, Libraries, Post Office and Neighbourhood notice boards.

We had over 20 Carers who took up our invitation and joined us on the day. At first, some were reluctant to have a pampering hand or neck massage but with a little encouragement, people took advantage of this and were highly delighted with the result. In addition to the therapists there were representatives from other organisations who support Carers, including Rutland’s Dementia Advisor,Rethink,CitizensAdviceBureaux,RCCYoung Carers Team and Age UK. We are indebted to all of them who supported this event and would like to give them a big vote of thanks.

Carers’ Rights & Relaxation Event

Are you a Carer?

Healthwatch Rutland

Your Voice in Health & Social Care...www.rutlandlink.co.uk

What’s On...

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�Telephone: 0116 229 3103 �[email protected] �www.rutlandlink.co.uk

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Thursday 28th February 2013, 10am - 12noon

The Gover Building, Voluntary Action Rutland, Lands End Way, Oakham, LE15 6RB

Join us to hear from Hospice at Home, MacMillan Nurses and Marie Curie Services as well as East Midlands Ambulance Service who will be giving presentations about their services and will be available to answer your questions.

Kathy Reynolds, Chair of Rutland LINk said: “Having a conversation about end of life choices can be difficult - death is often regarded as a taboo subject. Ensuring we are able to make choices about our care, treatment and where we want to die is essential if we are to have a ‘gooddeath’. Knowledge and planning also allows spouses, family members and others to make the most of their time with a loved one.”

If you are interested in finding out more about the End of Life Services in your area, or you have questions that you would like to ask then please book your place!

For further details and to book your place contact Jenny Darlow on 0116 229 3018 or email [email protected]

End of Life Event

Following the publication of the Francis Report into the care provided by Mid Staffordshire NHS Foundation Trust, Rutland LINk will be considering the report carefully to ensure that any lessons for public and patient involvement organisations are acted upon by the LINk and are handed on to HWR as part of our Legacy.

Keep up to date with what’s happening at www.rutlandlink.co.uk

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rutland link newsletter - spring 2013

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