E&V Visit to Ward 2 & Laurel Ward at Springfield Hospital
Posted on 22/05/2017
Our visit to Ward 2 at Springfield Hospital was part of a series of Enter and View visits to inpatient wards at South West London and St George's Mental Health NHS Trust. We visited the ward twice as our findings on the first visit were inconclusive, and spoke to 11 patients as well as to their friends and relatives.
Our findings on Ward 2 were very mixed and not always positive. However the ward management team has changed since our visits and the new team has plans for improvement. We were also able to make a number of recommendations for improvement which Springfield Hospital has responded to very positively. The report and action plan from our visit to Ward 2 are attached below.
We also visited Laurel Ward at Springfield Hospital and spoke to 8 of the patients. Our impressions of this ward were very positive overall; most patients were happy with their surroundings and with the treatment they receive from the nurses and other staff on the ward. Our recommendations for Laurel Ward were therefore very general in nature, but were well received and have either already been achieved or are in progress.
The report and action plan from our visit to Laurel Ward are attached below.
Those in attendance were: Mark Robertson (Mark Robertson, Head of Mental Health and Learning Disability Commissioning - Wandsworth Clinical Commissioning Group), Tarlochan Ghale (Strategic Health Facilitator- Wandsworth Clinical Commissioning Group, Yvonne Tester (Head of Community Learning Disability nursing – St George’s Hospital), Phillipa Brooks (Carer’s Participation and Volunteer Development Manager- Wandsworth Carers).
A comprehensive meeting with some great new initiatives and reports led by: the London Disability Learning Mortality Review, Health and Social Care Action Plan, Generate, and the Multi-Community Speciality Provider.
Of particular interest is the Dying Matters week in May which gives great timing to the NHS programme being run by the London Disability Learning Mortality Review on this sensitive subject.
The next meeting is on 20th April and Healthwatch will be looking out for reports from the Multi-Community Speciality Provider as they have been working with the Battersea GP Federation on issues like healthchecks, care planning and community services.
These are exciting steps forward - for more information on the above issues please read the report below by our Healthwatch Manager - Sarah Cook.
Wandsworth Clinical Commissioning Group Primary Care Committee Meeting
Posted on 22/05/2017
An interesting meeting attended by our Healthwatch Representative, some of the Clinical Commissioning Group Board Members, the Primary Care Team, NHS England and local Medical Representatives.
This was an encouraging meeting involving various persons responsible for the commissioning of Primary Care in the Borough. Key papers addressed the following:
All funding streams for primary care in the Borough, and funded expectations of the practise
The role of pharmacies in the Borough and how they are moving towards an integration with Practices in primary care.
Healthwatch will need to remain vigilant when it comes to the collaboration of both pharmacy and primary care services as accusations of 'cuts' is highly likely. (Please refer to the attached report which details both the pros and cons of in more detail.)
St George’s Hospital Quality Committee (QC) Meeting
Posted on 17/05/2017
The Quality Committee provides an excellent two-way opportunity for Healthwatch: we can be kept up to date with progress on key issues at the hospital as well as being able to make our views directly to the Executive Directors and NEDS (Non-Executive Directors). A huge step forward.
This was the second meeting of this newly established forum to discuss some serious weaknesses in quality assurance idenified by the CQC - Care Quality Commission. Those attending were: the Chair (Non Executive Director), Chief Executive (interim), Director of Medical Division (standing in for Medical Director), Director of Quality, Head of Governance, Quality Improvement Lead, Director of Estates and Facilities Corporate Secretary. Despite those present the meeting unfortunately was not quorate as it required two Non- Executive Director's to be present.
KEY ISSUES discussed were informative, reflecting both progress and areas in real need of monitoring and improving, as below:
The Report from the Patient Quality and Safety Board. Safe staff nursing, the current dual presrcribing system and IT ifrastructure were areas highlighted,
The Regulatory and Performance Matters in Paediatrics, the Quality Improvement Plan, Infection Control and Patient Feedback on hospital experience to name a few,
And Goverance in relation to the quality of water, responses to patient complaints, and Quality reports.
Please take a look at the very comprehensive feedback survey given by our Healthwatch Representative below.
South West London Healthwatch (HW) liaison meeting with South West London St George’s (SWLStG) Mental Health Trust
Posted on 15/05/2017
A large and busy meeting with much to talk about since the last review meeting in September last year. Those attending were the Trust's top management, representatives from all the South West London Healthwatch organisations (apologies on this occasion from Kingston). David Bradley (CEO) and Ranjeet Kaile (Communications Director) represented the Trust. The meeting was hosted and chaired by Merton Healthwatch.
Healthwatch took particularly interest in eight of the key items discussed, some of the highlights were as follows:
The new Lotus Assessment suite
It was agreed to hold a joint SWLStG/HealthWatch engagement event to discuss arrangements for the two Crisis Cafes being opened in April by voluntary sector providers.
Healthwatch would be invited to a launch event in late February
Healthwatch had been invited to comment on the Trust's Quality Priorities for the coming year - watch this space early February - the key priority being more emphasis on 'improving community services'.
GREAT NEWS! The Trust reported that waiting times for CAMHS services (Child and Adolescent Services) were now virtually all within the 18 week target except for the Neurological Assessment team.
One area of concern was that Merton mentioned complaints about cuts in the SUN project for people with personality disorders.
We will continue liaising with the Trust and raising areas in need of improvement. Wandsworth Healthwatch will be hosting the next of these meetings on 10th April. Please see our full response below.
A number of key issues were discussed and presented on at this meeting where our Healthwatch representative attended as an observer. It has been decided that in light of the presentations given that Healthwatch will take action in monitoring how the Trust's finances may impact these services, and move ahead with planned Enter and View visits where necessary.
The meeting was attended by Executive Directors and other senior managers from the Trust; representatives from the CCG (Clinical Commissioning Group) and NHS England who commission general and specialist services from the Trust. Some of the following were discussed after senior presentations were given:
A Presentation on the service for people with cancers of unknown primary (CUP service) - Staffing and funding were shown to present an issue, as 30% of the 2000 cancer patients treated annually are in need of more specialist care.
A Presentation by the Consultant Orthopaedic and Trauma surgeon on the hospital’s hip fracture programme. - This service is now meeting 46.7% of it's Best Practise Targets (BPTs), however concerns over theatre waiting times still remain an issue.
There was a second part to the meeting that remained brief, however, it called in to question the PALS service and the number of non-elective re-admissions. It was helpful to know that CQRG (Clinical Quality Review Group) are alert to the need for improvements in the various services.
For a fuller look at the report please read the attached PDF.
The workshop, which was jointly run by South West London St George's (SWLStG's) Mental Health Trust and Wandsworth Community Empowerment Network (WCEN), demonstrated how community organisations were involved in the set up of the new Talk Wandsworth psychological therapy service.
Representatives from the Trust, Gareth Jones and Darren Fernandes, outlined key features of the new service and presented specific ideas for strengthening the service's links with local communities.
Malik Gull of WCEN, along with local faith representatives and community organisations exchanged ideas and agreed that a clear framework needs to be outlined concerning:
Overcoming inequality in the uptake of therapy
The need for goverance by community partners
Additional funding streams
Our Healthwatch representative has outlined the importance of this workshop in the attachment below and will actively monitor the development of this service.
Wandsworth CCG (Clinical Commissioning Group) Patient & Public Involvement Reference Group
Posted on 08/05/2017
This was an informative and information based meeting chaired by the Clinical Commissioning Group (CCG) and attended by the PPI (Patient & Public Involvement) Team, Healthwatch and various local charities.
Two comprehensive presentations were given; the first by Lauren Ashley-Boyall on the Voluntary Sector Co-ordination Project and the second by representatives from the GP Federation (a group of general practices or surgeries working together as an organisation in the local community) on the history of the Federation & MCP (Multi-specialty and Community Provider), Claire Ratnayake and Chief Executive Jim Fenwick.
Healthwatch noted the staff changes taking place within Wandsworth CCG's Public Involvement Team and is committed to monitoring the commissioning and quality of services within the borough.
St George's University Hospital’s Foundation Trust Outpatient Service Re-design 2nd Workshop
Posted on 08/05/2017
Around 50 people attended this workshop, including patients and Governors who were well represented, together with some external stakeholders.
The purpose of the workshop was to present, and get feedback on, ways of improving appointment booking processes and dealing with clinical information. A number of core issues were highlighted and discussed:
Which software will be most effective? A simple and effective system will be set up and staff will be given training to use the system properly
Aim to have all GP appointments booked via the NHS e-Referral System (which used to be called 'Choose and Book')
The patient will have the freedom to view and change appointments and choose their preferred contact method
Patient needs, clinical pathways, and the implementation of hubs to consolidate clinics are all in process
Good communication between GPs and Consultants will be key to pulling this new system together. Healthwatch, and others present, highlighted the necessity of patient involvement throughout this process.
The next meeting will involve the Outpatient Transformation Team. These are exiciting changes for the benefit of patients and staff. Please refer to the comprehensive report below for more details.
St. George's Emergency Department Frequent Attenders Workshop.
Posted on 26/04/2017
Stakeholders and staff from many agencies concerned with Emergency Department patients attended this workshop. With 50 in attendance it was an opportunity to look at the problem of frequent attenders at the St. George's Emergency Department (ED), and to discuss ways to generate safe and appropriate out of hospital solutions.
The meeting was structured in to stages beginning with the numbers of active attenders over the last two years. It then progressed to why and what the conditions were and underlying problems. The question still asks - how best can the hospital address this?
From data gathered, 90% of approximately 280,000 people used the service once or twice with other users increasing to three or times.
A group of twenty-seven attenders were documented as using the service over forty times.
With this a complex range of conditions were evidenced with the majority being drug and alcohol dependent, being admitted via ambulance.
Although the burden is not great it does raise the question of why this is happening, and is representative of a failure in the system.
Communication and access to relevant data seems key to making the necessary improvements.
Healthwatch will attend further meetings to monitor and see how improvements are being made to develop the healthcare and social needs of these attenders.
Please refer to the summary report below for further details.
St George's University Hospital’s Foundation Trust Board
Posted on 26/04/2017
The meeting was attended by the Trust's Directors and Senior staff, governors, members of the public and our Healthwatch representative. The meeting was opened with a patient story highlighting her poor experience with communictations regarding the closure of the Uro-gyneacology department at St Georges. Although the St John's therapy centre at A and E was praised it was not enough to ignore the very important concern of the impact that staff demoviation and encouragement is having on patient care.
On the flip side Marie Noelle Orzel has recently been appointed as Improvement Director by NHSI (NHS Improvement) to make staff engagement a priority.
Finances were also highlighted and the decreases or safe budgeting, especially with staffing were seen to have a knock on effect with premium-payment extra-hours staff in operating theatres. This has lead to fewer planned operations being carried out.
Health watch have a very committed involvement to the Quality Improvement Plan and spoke directly to the Chief Nurse and relayed their desire for regular meetings, aand the possibility of conduting future quality inspections.
Please refer to the report below to see other planned improvements.
St George's University Hospital’s Foundation Trust Board Meeting
Posted on 24/04/2017
Directors and Senior staff of the Trust, Governors and Members of the public all attended this meeting and had input in to the issues discussed.
Issues relating to the St George's Quality Review Meeting held last October 2016 which highlighted a number of these key issues are now being addressed, and although progress is slow, inprovements have been made.
Quality inspections have been restarted and improvements made on controlling agency use and overall staff billing. The Quality and Improvement Plan also shows progress with the goods news of an order in place for over 800 new beds which will remove the risks from the current lack of bed rails.
The elective care programme which is following up all patients on waiting lists is now starting with the contract for the first phase signed. This will look at the 20,000 records of most concern to identify any patients whose care has not been completed properly. Current waiting lists are being closely tracked and full data is being entered for all new patients. This is a major step forward in the Trust.
Healthwatch will continue to monitor improvements and areas of concern. Please refer to the link below for further details.
A Healthwatch representative attended the latest presentation of the 5 year Sustainability & Transformation Plan with Wandsworth Clinical Commissioning Group (CCG) staff, Wandsworth councillors, and the general public.
The main point of discussion was the public's engagement on the Sustainability & Transformation Plan (STP). We would encourage you to take a look at the Healthwatch website for more information about the STP. Please click on the following link.
Crisis Recovery Cafe Meeting held at the Vestry Hall in Mitcham
Posted on 19/04/2017
This was a well informed meeting opened by Mark Clenaghan, Head of Service Delivery for the Acute and Urgent Care Pathway at Southwest London St George’s (SWLStG) Mental Health Trust. The meeting comprised mainly of mental health service users and carers from the South west London boroughs. They engaged in a lively Q and A session (Question and Answers) after a presentation led by Gayle Lowery-Jones, Regional Manager for Hestia, one of the providers, and her counterpart Debbie from the other provider, CDARS (Community Drug and Alcohol Recovery Service).
The aim of the recovery cafes is to provide five of the struggling South West London Boroughs with an extra community resource to support those with mental health and additional needs. This will provide a more suitable alternative to A&E and hopefully reduce the number of hospital admissions.
Each cafe will support 25 customers and run 365 days of the year at various times: early morning, afternoon and evening, including bank holidays.
Health watch will keep in touch with this interesting and much needed initiative.
Wandsworth Black Minority Ethnic (BME) Mental Health Forum
Posted on 19/04/2017
The forum was chaired by Malik Gull of WCEN and party to Mark Robertson from the CCG (Clinical Commissioning Group), and Darren Fernandes from the Mental Health Trust and Leon Gooding from Wandsworth Social Services.
There was discussion on the implementation of a mental Health Crisis Cafe in Tooting Broadway from 1st April, with Hestia in the process of recruiting an appropriate amount of support workers to aid the project. The main concern to this project was ease of access to service users in a fragile state of mind.
The meeting then focussed on the Black Mental Health Conference last November. Four key priorities seen were:
working in schools,
diversity awareness training for key staff,
focus on therapies other than medication
and listening to/communicating with patients.
The WCEN proposed smaller strategy groups to meet in between these forums to take the work of Black Minority ethnic mental health forward in a more focussed way.
Healthwatch will continue to follow and support the work of this important community forum on an invited basis. Please read the attached report for more details.
Wandsworth Black Minority Ethnic (BME) Mental Health Forum
Posted on 12/04/2017
The Forum meet every two months and are working actively with the Mental Health Trust to overcome inequality and promote mental health and well being in the Black Minority Ethnic (BME) community. It was hosted by WCEN (Wandsworth Community Empowerment Network) and chaired by Malik Gul.
At this well attended meeting a number of comprehensive issues were discussed, including:
Service Updates for: Wandsworth Carers Centre, Voicing Views and the Wandsworth Lesbian, Gay, Bi-Sexual and Transgender (LGBT) mental health group to name a few.
The Tooting Recovery Cafe
The Co-production with East Wandsworth Community Mental Health Team (CMHT)
Primary Care Plus
The Mental Health Trust's Equality and Diversity Strategy
Follow-up to the Black Mental Health Conference
Healthwatch are committed to supporting the important work of this Forum and following the issues raised. Please find a full details of the meeting attached.
Report from the St George's Hospital Quality Committee
Posted on 05/04/2017
The St George's Quality Committee looks at the hospital Trust's performance, patient outcomes and satisfaction, as well as compliance with corporate standards.
New procedures are in the process of being prepared following reports of serious incidents and complaints at the hospital and the Trust is keen to find ways to involve patients in the shaping of these new standards.
To read our brief report from this meeting, click the icon below.
Discussion around Wandsworth's Suicide Prevention Strategy was complimented with information regarding a new clinical programme for suicide mitigation and reduction that will be funded by the Clinical Commissioning Group.
Healthwatch will be keeping an eye on the performance of other CCG commissioned services, like IAPT (now Talk Wandsworth), Primary Care Plus, Dual Diagnosis and the Urgent Care Pathway. It is hoped that these complimentary services will work alongside other, long established, mental health services.
Please see the attaced report for further details.
St George's Clinical Quality Review Meeting (CQRM)
Posted on 06/03/2017
There is lots going on within the Trust which unfortunately faces financial challeges, staff shortages and a cycle of staff changes. Despite this however, St George's was found to be in the top 25% for providing quality stroke services.
At the meeting some difficult issues were highlighted where the Trust has been encouraged to work on treatment waiting times, transfer of care to other departments and repatriation of patients to other hospitals.
Healthwatch has therefore decided to continue attending these meetings and will be monitoring the situation closely.
Please read the attached feedback form from our Healthwatch representative for more details.
Feedback Report on the Children’s Safeguarding Board
Posted on 06/03/2017
The meeting broached sensitive subjects highlighting where improvements have been made via Ofsted audits and local police. The impact of the Alan Wood report promoting new models of safeguarding was also discussed.
Also discussed was the increase in missing children, particularly in the Croydon area and the need for schools to be aware of the early signs of domestic violence in homes. Please refer to the attached report to see how the introduction of police pilot 'Project Tearose' is helping with this concern.
Healthwatch sees attendance at these meetings as vital to monitor the improvements of a service deemed by Ofsted Inspection as “Inadequate”. We also intend to seek out more actual evidence of young people’s voices being heard and how this is making a difference to service improvement.
Feedback from Wandsworth Safeguarding Adults Partnership Board (WSAPB) meeting
Posted on 06/03/2017
The meeting hightlighted important, key issues around mental health care and the safeguarding of vulnerable adults and the importance of educating all local statutory and voluntary organisations. There is a now a single safeguarding team, but governance arrangements in each Borough remain separate. Key issues included:
Safeguarding Training Report - this focussed on extensive in-house training for staff and voluntary organisations
Report on management of Deprivation of Liberty Safeguards (DoLS) - as a direct result of legislation
Items from the Performance Report - including reports of a signicant increase of sexual abuse cases
Sources of safeguarding, quality concerns and complaints (since Sept 2015)
The safety and quality issues discussed at this meeting are of central importance to Healthwatch. Regular information exchanges are key to our work.
Please click on the attached report for a full explanation of all the crucial issues discussed.
Enter & View Visit to Crocus Ward at Springfield Hospital
Posted on 03/03/2017
A team of five authorised volunteers from Healthwatch Wandsworth was involved in planning and undertaking a visit to Crocus Ward, at Springfield Hospital. With the agreement of senior managers, the team collected information by means of interview and observation. We spoke to a total of eight inpatients, two relatives and one former patient who happened to be there at the time of our visit.
Overall, we formed a favourable opinion of Crocus Ward as a place to receive treatment and care. The environment was stimulating, clean, pleasant and comfortable, with information clearly displayed and caring, personal attention to detail.
Although the Trust was recently inspected by the Care Quality Commission (CQC) back in March 2016, we wanted to complement the findings of that inspection, which rated Crocus Ward as 'Good', but also identified some areas for improvement.